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Building Evidence-Based Strategies to Improve Employment Outcomes for Individuals With Substance Use Disorders

Karin Martinson, Doug McDonald, Amy Berninger, and Kyla Wasserman


March 26, 2021

As part of the Building Evidence on Employment Strategies for Low-Income Families project (BEES), led by MDRC and on behalf of the Office of Planning, Research, and Evaluation within the Administration for Children and Families, this paper examines the impetus and existing evidence on programs that integrate employment services with treatment and recovery services for people with opioid and other substance use disorders (SUDs). It reviews the limited but promising evidence on the effectiveness of integrating these services in improving participants’ employment outcomes.

Among the findings:

  • Opioid misuse has increased at an alarming rate and now represents a significant share of SUDs.
  • SUDs are more prevalent among those who are unemployed, have lower earnings and educational levels.
  • Employment can help people with substance use disorders stay on the path to recovery, reflecting both the economic and noneconomic benefits of work. Yet many people with SUDs face challenges in finding and keeping a job, including discrimination based on having a criminal history, mental or physical health problems, and limited education and skills.
  • Employment services have historically not been a primary element in SUDs programs.
  • Studies of programs that combine employment services and SUD treatment services have produced some positive results on employment outcomes. But many of the studies weren’t rigorous and study samples were small. So it’s hard to draw conclusions about the efficacy of any approach.
  • Further research is needed on how to integrate employment and SUD treatment services to improve both economic and treatment outcomes. The BEES project provides an opportunity to examine this approach.