This project addresses the impact of problem drug use (defined as frequency of use, misuse, and dependence) on labor force participation and job-related problems in a nationally representative longitudinal sample of United States adults. A key objective is to investigate racial/ethnic disparities in these associations. Both the US Substance Abuse and Mental Health Services Administration (SAMHSA) National Outcomes Measure and the NIDA Clinical Trials Network have identified employment as an area in need of improved research and intervention. Yet, important gaps remain in our understanding of the population-level impact of problem drug use on labor force participation and the extent to which this impact is disproportionately shouldered by race/ethnic minorities. Also, it remains to be shown if and how much recovery from problem drug use improves employment outcomes for all workers. Research evidence shows that racial/ethnic minorities are more likely to have higher unemployment rates and unfair labor market experiences. Also, they suffer more social consequences, such as greater likelihood of involvement with the child welfare or criminal justice systems when they misuse, abuse or are dependent on drugs. However, it is unclear whether these disproportionate consequences of problem drug use extend to, or contribute to, the observed racial/ethnic disparities in employment outcomes. The proposed study answers these questions using the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative household survey with an oversample of racial/ethnic minority adults (n=43,093 wave 1 and n=34,653 followed up in wave 2). NESARC collects detailed consumption information on timing and quantities of alcohol, marijuana, stimulants, opioids and depressants.
The Specific Aims are: 1: To investigate the impact of problem drug use on labor force participation, to determine whether this impact differs among racial/ethnic minorities, and to evaluate whether recovery from problem drug use can mitigate this impact. We hypothesize that problem drug use will be negatively associated with labor force participation and that Black, Native American/Alaskan Native and Hispanic individuals will be disproportionately affected by these adverse effects. We also hypothesize that recovery from problem drug use will be associated with improved labor force participation at wave 2, but racial/ethnic minorities will benefit less from the positive effects of recovery. 2: To investigat, among labor force participants, the impact of problem drug use on employment outcomes and to investigate racial/ethnic disparities. Our hypotheses are that problem drug use will be associated with job loss and job-related conflict, and racial/ethnic minorities will be disproportionately affected by these effects. Impact: Determining the extent of racial/ethnic disparities in the job consequences of problem drug use is necessary to guide future work to uncover and address mechanisms underlying these disparities.
The project will identify which drug use phenotypes across the spectrum of problem use are most strongly associated with adverse job outcomes. This will enable more refined targeting of drug abuse programs and workplace interventions to mitigate these outcomes. Also, determining the extent of racial/ethnic disparities in the job-related consequences of problem drug use and whether or not recovery can improve job outcomes among drug users is necessary to guide researchers, program planners and policy makers.
