Saturday, July 03, 2010

Substance abuse and unemployment - literature review

Apologies ahead of time for the odd citation scheme...

This is a result of a brief survey designed to determine the percentage of unemployed individuals who are substance abusers. The survey was conducted over a three day period and is in no way an exhaustive or thorough treatment of the subject. The survey included a phone interview with a representative of the Chilliwack office of the Human Resources and Skills Development Canada (HRSDC) and a literature review.

The HRDC representative indicated that he could not locate any data that identified those with substance abuse disorders who were accessing assistance under the Persons with Disabilities (PWD) or the Persons with Persistent Multiple Barriers (PPMB) programs. He did acknowledge that there were probably many unemployed persons who would be considered “substance abusers” currently accessing these programs. The lack of easily accessible data around this does not necessarily mean that the HRDC data base could not yield this type of data, only that is was not accessible through that office at that time.

In reviewing the literature I found that there is substantial research that supports the theory that there is a positive correlation between substance abuse and unemployment. However quantitative data that would provide statistical information about individual’s concurrently experiencing unemployment and substance abuse was scant with only one major research study found that focused on Canadian data.

The Canadian Center on Substance Abuse published The Costs of Substance Abuse in Canada 2002 as an aid to understanding and interpreting the original report of the same name, written under contract by Rehm et al., (2002, 2006). This document and the original report focused on the costs of substance abuse with one of the costs being the indirect costs associated with loss of productivity. “By comparing average income levels reported by those with a substance abuse problem and those without a substance abuse problem, it is possible to calculate the difference, which becomes an economic cost attached to illness and injury linked to substance abuse” (Rehm et al., 2006). Productivity loss was further defined as short and long term disability attributed to substance abuse.

In 2003 the productivity loss due to substance abuse overall was calculated to be $24 billion or 61% of the total social costs. The cost of loss of productivity, due to long-term disability was calculated to be approx. $6 billion due to alcohol abuse and 4.4 billion due to illegal drug use. (Rehm et al., 2006).

Following are excerpts that pertain to the question of - What percentage of unemployed individuals also abuse substances?

According to a 2002 United Nations report … there is a correlation between unemployment and prevalence of substance use in many countries; and prevalence of illicit drug use is higher among younger age groups (18-25 years of age) in practically all countries.1

Goodman and Hankin presented their research findings that examined “both direct and indirect impacts of alcohol consumption on labor force participation and income, with controls for drug abuse and smoking (2006).

… study uses the recently collected National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), designed to be the primary source for information and data on the U.S. population for alcohol and drug use. The NESARC provides multi-dimensional information on alcoholism, drug abuse, and cigarette smoking, as well as excellent individual and labor market information.

Separate analyses by gender show that alcohol use significantly impacts the choice between part-time and full-time employment. Heavy drinkers are more likely to be unemployed or part-time workers compared to lighter drinkers or abstainers. In contrast, alcohol use has an insignificant impact on income conditional on employment.

Conclusions: The labor force impacts of alcohol and substance abuse are complex. The alcohol impacts are most pronounced with respect to labor force participation, and full- v. part-time employment. Drug use has its major impact on men with respect to labor force participation (less likely to be full-time) and health (worse health). Women who use drugs are also less likely to work full-time and will have worse health. 2

Renwick and Krywonis (1992) suggest that unemployment for substance abusing individuals is “much higher” than the averages for unemployment rates in North America citing statistics by the Addiction Research Foundation which produced a mean annual rate of 36.9%. However these statistics were from data collected from 1986-89.

It is a recurrent and well-documented theme in the addiction literature that unemployment and vocational instability are serious problems among persons who abuse substances (Gardiner, 1978; Peachey, & Franklin, 1985; Waldo, & Gardiner, 1984).

Annual intake records between 1985 and 1989 for the Addiction Research Foundation (Clinical Institute) in Toronto, Ontario indicate that unemployment for this population is much higher than the current average rates for North America (Addiction Research Foundation [ARF], 1986, 1987, 1988, 1989). For the 14,659 substance abuse clients reporting their employment status during this period, the mean annual rate of unemployment was 36.9% (ARF, 1986, 1987, 1988, 1989).

Employment difficulties for individuals who abuse substances are related to both obtaining and maintaining work (Renwick & Krywonis, 1988; Yates et al., 1988).

A retrospective interview study of clients admitted to a treatment facility for substance abuse intervention demonstrates drastic declines in vocational productivity over the year prior to their treatment (Gardiner, 1978). This research also indicates that vocational stability, measured in terms of the number of jobs held, is generally poor during this period.

Another study focused on maintaining employment following residential treatment for addiction suggests that employment stability deteriorates markedly from one month post-discharge and onwards (Waldo & Gardiner, 1984). This research underscores the need for particular attention to "job survival" (Gardiner, 1978, p. 502) skills.3

Dooley and Prause measured the impact of unemployment and underemployment on alcohol misuse in the National Longitudinal Survey of Youth concluding that job loss increased risk of alcohol misuse.

… these results confirm previous findings that job loss can increase the risk of alcohol misuse, provide new evidence that two types of underemployment (involuntary part-time and poverty-level wage) can also increase this risk and suggest that these effects vary over time.4

In the Journal of Health Economics, MacDonald and Pudney published results of their research on Illicit drug use, unemployment and occupational attainment (2000).

… we find compelling evidence to suggest that drug use, particularly the use of opiates, cocaine, and crack cocaine, is associated with an increased risk of unemployment, regardless of age or gender.5

In a study titled, Barriers to Employability Among Women on TANF With a Substance Abuse Problem researchers found that women who abused substances spent more time on welfare that non-substance abusing women.

In a comparison of cumulative total years receiving welfare benefits for the substance abuse and non-affected samples. The substance abuse sample spent significantly more total time on welfare than the non-affected sample.
On average the substance abuse sample spent 12 years (SD=8.5) versus 5.8 years (SD=5.5) for the non-affected sample. Research also indicates that groups differed for long and short stays on welfare. About 36% of substance abusers received welfare benefits for more than 15 years versus only 7% of the comparison sample. Conversely, 66% of the non-affected sample received welfare benefits less than six years versus 28% of the substance abuse sample. (see here for full report)

In the 2002 National Survey on Drug Use and Health, Substance Abuse and Mental Health Services Administration (SAMHSA) reported the following:

• Current employment status was highly correlated with rates of illicit drug use in 2002.
o An estimated 17.4 percent of unemployed adults aged 18 or older were current illicit drug users compared with 8.2 percent of those employed full time and 10.5 percent of those employed part time.
o Of the 16.6 million illicit drug users aged 18 or older in 2002, 12.4 million (74.6 percent) were employed either full or part time.
o Most binge and heavy alcohol users were employed. Among the 51.1 million adult binge drinkers in 2002, 40.8 million (80 percent) were employed either full or part time.
o 12 million (79 percent) of the 15.2 million adult heavy drinkers were employed.

• Among Unemployed Adults the rate of drug use was higher among unemployed persons compared with those from other employment groups.
o 17.4 percent of unemployed adults (18 and over) reported current drug use.
o Binge and heavy alcohol use rates were higher for unemployed persons (34.7 and 13.3 percent, respectively, for binge and heavy use) than for full-time employed persons (29.0 and 8.4 percent, respectively).6


J. Rehm, D. Baliunas, S. Brochu, B. Fischer, W. Gnam, J. Patra, S. Popova, A. Sarnocinska-Hart, B. Taylor. In collaboration with E. Adlaf, M. Recel, E. Single
The Costs of Substance Abuse in Canada 2002 March 2006

Single, E., Robson, L., Xie, X., and Rehm, J. (1996). The Costs of Substance Abuse in Canada. Canadian Center on Substance Abuse, 75 Albert Street, Suite 300, Ottawa, Ontario, Canada K1P 5E7.

1. United Nations Office for Drug Control and Crime Prevention, Global Illicit Drug Trends 2002, New York, 2002, p. 213-14. As cited in The Policy for the New Millennium: Working together to redefine Canada’s drug strategy interim report of the special committee on non-medical use of drugs. Paddy Torsney, M.P. Chair December 2002

2. Goodman, A. C. and Hankin, J. R. , 2006-06-04 "Employment and Income Effects Related to Drinking with Controls for Drug Abuse and Smoking: Analysis Using the NESARC Database" Paper presented at the annual meeting of the Economics of Population Health: Inaugural Conference of the American Society of Health Economists, TBA, Madison, WI, USA . 2009-05-25 from

3. Renwick, R M., Krywonis M., 1992. Personal and Environmental Factors Related to Employment: Implications for Substance Abuse Intervention. The Journal of Rehabilitation, Vol. 58

4. Dooley D, Prause J. (1998) Underemployment and alcohol misuse in the National Longitudinal Survey of Youth. J Stud Alcohol. 1998 Nov;59(6):669-80.
Department of Psychology and Social Behavior, University of California, Irvine 92697, USA

5. MacDonald, Z, Pudney, S., Illicit drug use, unemployment, and occupational attainment, Journal of Health Economics, Volume 19, Issue 6, November 2000, Pp.1089-1115, ISSN 0167-6296, DOI: 10.1016/S0167-6296(00)00056-4. (

6. Substance Abuse and Mental Health Services Administration, Results from the 2002 National Survey on Drug Use and Health: National Findings, September 2003.


DT said...

I think youth empowerment programs will also do considerably well to prevent Drug Abuse

Diversified Topics said...

No matter who is addict, drug abuse should be dealt with empowerment programs.