Center for Health Systems Effectiveness (CHSE), Oregon Health & Science University, 3030 SW Moody Ave, Portland, OR 97201, United States; OHSU-PSU School of Public Health, 1805 SW Fourth Ave, Portland, OR 97201, United States.
Department of Social Work, Umeå University, Samhällsvetarhuset, 901 87 Umeå, Sweden.
J Subst Use Addict Treat. 2024 Jan;156:209178. doi: 10.1016/j.josat.2023.209178. Epub 2023 Oct 18.
The Addiction Severity Index (ASI) assesses respondents' biopsychosocial problems in seven addiction-related domains (mental health, family and social relations, employment, alcohol use, drug use, physical health, and legal problems). This study examined the association between the seven ASI composite scores and re-employment in a sample of Swedish adults screened for risky alcohol and drug use who were without employment at assessment.
We conducted a retrospective cohort analysis of employment outcomes among 6502 unemployed adults living in Sweden who completed an ASI assessment for risky alcohol and drug use. The study linked ASI scores to annual tax register data. The primary outcome was employment, defined as having earnings above an administrative threshold. We used Cox proportional hazard models to estimate the association between time to re-employment and ASI composite scores, controlling for demographic characteristics, RESULTS: Approximately three in ten individuals in the sample regained employment within five years. ASI composite scores suggested widespread biopsychosocial problems. Re-employment was associated with lower ASI composite scores for mental health (estimate: 0.775, 95 % confidence interval: 0.629-0.956), employment (estimate: 0.669, confidence interval: 0.532-0.841), drug use (estimate: 0.628, confidence interval: 0.428-0.924), and health (estimate: 0.798, confidence interval: 0.699-0.912).
This study suggests that several ASI domains may provide information on the complex factors (i.e., mental health, health, drug use) associated with long-term unemployment for people with risky substance use.
成瘾严重程度指数（ASI）评估了受访者在七个与成瘾相关的领域（心理健康、家庭和社会关系、就业、酒精使用、药物使用、身体健康和法律问题）中的生物心理社会问题。本研究在对有风险的酒精和药物使用的瑞典成年人进行筛查的样本中，检验了七个 ASI 综合评分与重新就业之间的关系，这些成年人在评估时没有就业。
我们对瑞典的 6502 名失业成年人进行了一项就业结果的回顾性队列分析，这些成年人完成了对有风险的酒精和药物使用的 ASI 评估。研究将 ASI 评分与年度税务登记数据相联系。主要结局是就业，定义为收入超过行政门槛。我们使用 Cox 比例风险模型估计了重新就业与 ASI 综合评分之间的关系，同时控制了人口统计学特征。
在样本中，大约三分之一的人在五年内重新就业。ASI 综合评分表明存在广泛的生物心理社会问题。重新就业与心理健康（估计值：0.775，95%置信区间：0.629-0.956）、就业（估计值：0.669，置信区间：0.532-0.841）、药物使用（估计值：0.628，置信区间：0.428-0.924）和健康（估计值：0.798，置信区间：0.699-0.912）的 ASI 综合评分较低相关。
本研究表明，ASI 的几个领域可能提供与有风险的物质使用人群长期失业相关的复杂因素（即心理健康、健康、药物使用）的信息。
