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Keane, Martin (2008) Drug treatment and employment. Drugnet Ireland , Issue 27, Autumn 2008 , p. 12.

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McIntosh et al. report on an analysis of follow-up data collected in the course of the Drug Outcome Research in Scotland (DORIS).1 The data were collected at the DORIS 4 stage, 33 months from baseline data collection. The study found that recovering drug users who had received assistance that was specifically employment-related were three times more likely to have found paid employment than those who had received no such assistance.

 Of a total study population of 695 at 33-month follow-up, 140 respondents (20%) said that they had had paid employment since their interview at 16-month follow-up (DORIS 3 stage).
 
The analysis identified, through logistic regression modelling, which aspects of the treatment process facilitated or promoted the achievement of paid employment by recovering drug users. The co-variable that had the strongest independent association with the achievement of paid employment was the individual’s receipt of focused assistance from their treatment agency to obtain a job, employment skills or education. The analysis also showed there was a non-significant relationship between the different treatment modalities and the achievement of paid employment.
 
These are useful findings in the context of the recommendations of the Working Group on Drugs Rehabilitation2 which endorses the role of employment-focused training for recovering drug users in treatment. Currently, the main vehicle for such training is the FÁS Special Community Employment Scheme (CES); however, reviews by Bruce3 and Lawless4 highlight the limitations of this intervention. Both reviews concluded that, rather than focusing on the original, vocational objectives of the scheme, the intervention was mainly fulfilling a supportive therapeutic function.
 
One intervention that has shown effectiveness in improving employment prospects for recovering drug users is the customised employment supports (CES) model. This model involves a skilled vocational counsellor working intensively with a small caseload of clients to overcome the vocational and non-vocational barriers that hinder employment.
 
Consideration should be given to piloting the CES model in local drugs task forces areas, or adapting the FÁS model to include CES elements, to provide viable option for individuals who want to work with a more intensive model.
 
Service providers should not be disheartened that the objective of progressing recovering drug users into paid employment may not be achieved at the first attempt, even when education and skills are improved and employability has been enhanced. Some recovering drug users may wish to take a more gradual approach to entering the labour market and can be supported in a phased but structured way. This report discusses the option of using intermediate employment models that reintroduce individuals to the discipline and routines of the workplace in a gradual way, and provide them with evidence of their competence and reliability to present to prospective employers.
 
Improving the employability of recovering drug users should become a key component of drug policy and practice. Research has identified a number of ways in which being in paid employment can contribute to an individual’s ability to create and sustain a drug-free life. According to this report, being in paid employment
• enables the recovering drug user to fill his or her time constructively
• promotes economic independence
• helps reintegration to wider society by removing the individual from the drug-using network and towards drug-free social relationships
• enhances self-esteem and helps build new sense of self, which protects against relapse
• conveys status, which acts as an important symbol to the individual of their ability to return successfully to a conventional life.
 
It is encouraging for policy makers and service providers that the evidence base for effective interventions to improve employability for recovering drug users is increasing. Ultimately, this evidence can contribute to the development of effective care plans for recovering drug users and form an important element in the future of drug rehabilitation and drug-related social reintegration in Ireland.
 
1. McIntosh J, Bloor M and Robertson M (2008) Drug treatment and the achievement of paid employment. Addiction Research and Theory, 16(1): 37–45.
2. Working Group on Drugs Rehabilitation (2007) National Drugs Strategy 2001–2008: Rehabilitation. Report of the Working Group on Drugs Rehabilitation. Dublin: Department of Community, Rural and Gaeltacht Affairs.
3. Bruce A (2004) Drugs task force project activity for FÁS Community Employment and Job Initiative participants. Dublin: FÁS.
4. Lawless K (2006) Listening and learning: evaluation of Special Community Employment programmes in Dublin North East. Dublin: Dublin North East Drugs Task Force.
5. For a description of the model and its evaluation see Keane M (2007) Innovative job placement model for methadone maintained clients. Drugnet Ireland, 24: 7–8.
Item Type:Article
Issue Title:Issue 27, Autumn 2008
Date:2008
Page Range:p. 12
Publisher:Health Research Board
Volume:Issue 27, Autumn 2008
EndNote:View
Accession Number:HRB (Available)
Subjects:HJ Treatment method > Treatment outcome
VA Geographic area > Europe > United Kingdom > Scotland
MP-MR Policy, planning, economics, work and social services > Labour and work > Employment and unemployment

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