Working to help recovering drug users30 January 2017
Our evidence review of Drug Treatment Outcomes and Employment was published as part of Public Health England’s wider evidence review for their forthcoming Drugs Strategy. Drawing on a large body of research, the review explored the relationship between employment, employment support and drug treatment outcomes.
Drug treatment and employment – helping each other out
Our research found evidence of a strong two-way relationship between drug treatment and employment:
- The provision of employment support as part of, or alongside, drug treatment contributes to the increased likelihood of post-treatment employment;
- Being in employment was correlated with higher drug treatment success rates, including encouraging greater engagement with drug treatment, increased periods of drug-abstinence and reductions in rate of relapse.
Along with our appraisal of the existing evidence, PHE’s own research also highlighted this positive ‘two-way’ relationship. Indeed, they recognised employment, and the wide range of benefits it brings, as a key component of recovery. Further, analysis of National Drug Treatment Monitoring System (NDTMS) found that the employment rates for individuals that successfully complete drug treatment was double that of individuals who had dropped out of treatment prematurely.
This relationship seems obvious; successful drug treatment, which addresses an individual’s addiction, is likely to lead to the stabilisation of the recovering individual’s lifestyle, and hence gaining or sustaining employment. Likewise, employment and the resulting sense of structure, achievement and identity, is likely to contribute to reduced drug use and sustained rehabilitation.
Many people affected by drug related problems often face additional barriers to employment, particularly mental health issues. It is estimated that individuals with mental health conditions are twice as likely to suffer from substance abuse than the general population. Similarly, chronic drug use, can lead to the development or exacerbate a range of mental illnesses. Other common factors identified amongst drug users included poor self-confidence, experience of the care or judicial system, low levels of education and skills, and housing needs.
Integration and innovation
The United Kingdom has one of the highest performing and accessible drug treatment systems in the world. Despite this the current system fails many service users. The available evidence is clear; for individuals to sustain recovery, the provision of a wider net of integrated services is needed. Jobcentres and employment support programmes can play an important role in the delivery of complex of support. Unfortunately, research conducted by PHE suggests interactions with JobCentre Plus or the Work Programme, were largely negative, with services having little understanding about drug use and recovery, and provision unable to cater for individuals facing multiple disadvantage.
The recently published review led by Prof. Dame Carol Black echoed these findings and called in the Government to “promote more integrated collaboration across the benefits and health systems”. Providing an intensive, multidisciplinary package of support makes it more likely that drug users can make a successful and sustained recovery.
The Government’s commitment to reform, recently set out in the ‘Work, Health and Disability Green Paper’, provides an opportunity to test, and learn about developing appropriated support for this group. It is essential that the government tests the evidence in a UK setting, utilising the Work and Health trials as an opportunity to move away from the Work Programme’s limitations. Central to this should be the use of a coordinated approach between health and employment support, using innovative approaches like the co-location of JCP staff within health and treatment facilities and Individual Placement Support alongside other forms of interventions.