Examining Employment and Employment Barriers Among a Sample of Patients in Medication-Assisted Treatment in the United States

Abstract

Background: Barriers to employment are a considerable problem for individuals recovering from an opioid use disorder (OUD). Being unemployed while receiving OUD treatment is associated with poorer treatment outcomes. Objectives: Apply the biopsychosocial model to examine employment status and the association of barriers to employment among a sample of adults receiving Methadone for OUD. Materials and Methods: Administrative data from an east coast midsized urban medication-assisted treatment provider in the United States were obtained from a state database. Univariate analyses were used to describe the sample, and bivariate analyses were used to examine the relationship between employment status and select variables. A logistic regression model was used to predict employment status. Results: Sample characteristics include 80.8% unemployed, 63.1% male, 49.6% White, and 65.3% never married. Employment status was significantly associated with past 30-day depression/sadness (χ2 (1)=11.361, P<0.01), past 30-day anxiety/tension (χ2 (1)=8.799, P<0.01), receiving financial support (χ2 (1)=6.550, P<0.05), having a driver’s license (χ2 (1)=12.984, P<0.001) and having a vehicle (χ2 (1)=43.208, P<0.001). The logistic regression model found those with a vehicle were less likely to be unemployed (odds ratio=0.248, P<0.01), while those awaiting a trial/charge were more likely to be unemployed (odds ratio=9.253, P<0.001). Conclusions: This study identified potential barriers (ie, psychological, transportation, criminal justice system involvement) from a biopsychosocial framework, associated with employment status among a sample of individuals in Methadone treatment. Identifying employment barriers in this population will help with treatment based clinical interventions.