Some Obstacles to Employment for Persons with Chronic Substance Use Disorders

Abstract

In the U.S., persons with severe and chronic substance use disorders (SUDs) manifest crippling impairments in fulfilling ordinary adult roles, pose serious threats to public health and safety, and constitute one of the costliest populations served by health care systems. Published peerreviewed studies of SUDs and their treatments report problems nearly equal in magnitude to those of persons with severe mental illness (SMI: schizophrenia, manic-depression, major depression), especially extremely poor labor force participation (>80% unemployment), low educational attainment, lack of health care insurance, and earned income below U.S. federal poverty levels. Persons with chronic SUDs rarely receive comprehensive services (especially vocational services) (McLellan et al., 2000) and civil rights protections that promote recovery from illness and facilitate reintegration into their communities (Parikh, 2004). Below, I describe some of the many obstacles to illness recovery and to obtaining and retaining meaningful employment.