This page is optimized for a taller screen. Please rotate your device or increase the size of your browser window.

Integrating Employment Services with Substance Use Treatment and Recovery: The Experiences of Five Programs

Hannah Betesh, Deena Schwartz, and Karin Martinson, Abt Global; Shelley Rappaport, MDRC


October 17, 2022

Largely due to the opioid crisis, the federal government increased its focus on and funding for programs that address treatment and employment outcomes for people with substance use disorders (SUD). Programs that combine employment services with SUD treatment or recovery efforts aim to sustain recovery while improving economic well-being.

This report, led by Abt Global researchers, documents five programs that combine SUD treatment and recovery services with employment services. The report, part of the MDRC-led Building Evidence on Employment Strategies for Low-Income Families (BEES) project, also offers recommendations for those already implementing similar programs or interested in developing them. The report is based on interviews with managers and direct service staff members conducted virtually during the summer of 2020. The report’s focus on how these programs operate is of particular importance given the extent to which the COVID-19 pandemic has affected substance use disorder rates, overdose rates, and the labor market. This report does not address the effects of program services on participants’ outcomes.

The report describes the experiences of programs in three critical aspects of program design and implementation: (1) structuring programs to integrate employment services with treatment and recovery services; (2); designing employment services to address the needs of people with SUD; and (3) providing support services and connecting people with SUD with jobs appropriate for them.

The study revealed that: (1) Programs made different decisions regarding the nature and content of employment services and when to offer those services in the treatment and recovery process. Some programs began employment services early in the recovery process, while others began them after participants had been in recovery longer. (2) Organizational partnerships are important for providing the range of employment and treatment and recovery services participants need. People in recovery from SUD navigate complex barriers to employment that often require services from multiple systems. (3) Programs offering employment services—including job-placement services—must adapt them to accommodate people in recovery from SUD.

The report contained four suggestions for practitioners:

  • Determine the sequence in which the program will offer treatment and recovery and employment services and the nature and content of employment services
  • Build organizational partnerships to provide the range of employment services and treatment and recovery services participants require
  • Adapt employment services to accommodate people in recovery from SUD
  • identify the funding sources needed to address the full range of participants’ needs.

The Office of Planning, Research, and Evaluation in the Administration for Children and Families at the U.S. Department of Health and Human Services funded the report.