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Article Excerpt
According to 2007 statistics reported by the Substance Abuse and Mental Health Services Administration (SAMHSA, 2008), there were an estimated 22.3 million individuals in the U.S. aged 12 or older (9% of the population) who met the DSM-IV diagnostic criteria for either substance abuse or dependence. Of those 22.3 million, 15.5 million were classified with alcohol abuse or dependence, 3.7 million were classified with drug abuse or dependence, and approximately 3.2 million had abuse or dependence on both alcohol and drugs.
The present study examines employment outcomes and workplace accommodation issues for individuals with substance abuse disorders. Rehabilitation Services Administration (RSA) client service records show the types of employment successfully rehabilitated individuals have attained. Workplace accommodation information, however, is not included in the RSA case-closure record (RSA-911 form). Given the importance of workplace accommodations, data from the Job Accommodation Network (JAN) have been incorporated to provide a more complete picture of the services needed for individuals with substance abuse disorders to retain employment. Thus, the focus of the current article is on approaches to serving individuals with substance abuse disorders, drawn from two databases. Analyses are conducted to examine the rates of successful employment outcomes (case closures) of clients with either alcoholism or drug addictions who were served by the State/Federal Vocational Rehabilitation System across three years (1996, 2000, 2004). A primary reason for selecting 1996 as the first year for the RSA data was that the available JAN database spanned 1996 to 2005.
Counselors in the Rehabilitation Services Administration (RSA) provide counseling and employment-related services to individuals with disabilities to obtain employment and live more independently (Rehabilitation Services Administration, 2006). Analyses are conducted to examine the prevalence of accommodation inquiries made to the Job Accommodation Network (JAN) for clients with substance abuse (alcoholism or drug addiction). JAN is a free resource for information regarding job accommodations and Title I of the ADA. The service is available free of charge to anyone, but the majority of inquiries (68%) are from employers and individuals with disabilities. JAN averages about 32,000 telephone inquiries (cases) per year and provides one-on-one consultation (and follow-up materials and communications, as necessary) to each person about all aspects of job accommodation, including the accommodation process, effective accommodation options, funding sources for accommodations, product information, disability awareness, and legal rights and responsibilities under the employment provisions of the ADA.
The following research questions are investigated:
1. What are the demographic characteristics for individuals with substance abuse disorders (Alcoholism vs Drug Addiction) who received Vocational Rehabilitation services?
2. Are there differences between clients (consumers) with Alcoholism vs Drug Addiction, in terms of Vocational Rehabilitation services received and outcome (rehabilitated vs not rehabilitated)?
3. What occupations were involved for those Vocational Rehabilitation consumers whose outcomes were successful (rehabilitated)?
4. In the JAN case data for substance abuse calls from 1996 to 2005, what are the relative proportions of (a) Causative Factor, (b) Caller Industry, (c) Job Function, and (d) Issue Discussed?
5. What commonalities link the findings from the RSA cases to the findings from the JAN cases on substance abuse disorders?
In the workplace, individuals with substance abuse disorders often exhibit difficulties with attendance, concentration, staying organized, meeting deadlines, handling stress, and maintaining stamina during the workday (Batiste, 2005a; 2005b). The obligation to provide accommodations for people with substance abuse under the ADA can be confusing to employers because the obligation differs somewhat from the obligation to accommodate employees with other types of disabilities. The difference mainly arises from the general rule that employers do not have to provide accommodations to enable an employee to continue abusing substances. For example, the ADA requires employers to consider providing flexible work schedules for employees with disabilities who are experiencing problems related to their disabilities (e.g., an employee with multiple sclerosis who cannot work late because of fatigue, or an employee with Crohn's disease who needs frequent restroom breaks). However, if the current abuse of substances is causing the problems, under the ADA, the employer does not have to provide accommodations to address those problems. In addition, employers are not required under the ADA to accommodate employees with substance abuse by allowing them to violate conduct rules (e.g., working under the influence of illegal drugs). On the other hand, employers may need to consider accommodations related to treatment of the addiction, such as leave time for rehabilitation or a flexible schedule to attend AA meetings.
In a systematic review, Adamson, Sellman, and Frampton (2009) found that, for patients with alcohol use disorders, one of the "key predictors" of drinking-related outcome was previous employment (during the baseline period). There is evidence lending support to vocational services being incorporated into substance-abuse treatment (Deren & Randell, 1990; Durkin, 2002; Leshner, 2001; SAMHSA, 2000). Employment has been shown to be beneficial for retention in treatment programs and moderating relapse occurrence (Platt, 1995; Wolkstein & Spiller, 1998). Wolkstein, Bausch, & Weber, 2000 suggested that relevant topics to be included in treatment for substance abuse are the importance of work (independence, income, respect), pre-treatment factors (employment history, education, social milieu), treatment goals (realistic employment, drugs/alcohol), services (basic employment training, problem-solving skills, job placement), integrated rehabilitation model (vocational, economic, social, psychological, legal, spiritual), and post-employment services (job coaching, ongoing counseling for employment retention and sobriety). Unemployment and vocational instability constitute a theme emphasized by rehabilitation professionals and researchers (e.g., Brown & Saura, 1996; Gorske, Daley, Yenerall, & Morrow, 2006; Magura, 2003; Rehabilitation Research and Training Center on Substance Abuse and Disability, 1996; Renwick & Krywonis, 1992).
In addiction-treatment evaluation research, employment has been viewed as both a desired outcome and an element of treatment (e.g., income, self-esteem, integration into mainstream society). Barriers that may work against the vocational rehabilitation client with substance use disorders include: job-related barriers (e.g., lack of education or training), attitudinal barriers (e.g., employer bias), program-level barriers (e.g., poor vocational services), medical and emotional barriers (e.g., continued alcohol or drug use), and family and societal barriers (e.g., disincentives from public financial support) (Platt, 1995). Misconceptions about the nature of substance abuse as a disability may create additional barriers, not only for the client, but also for the counselors working with these individuals. These misconceptions may be decreased by providing additional training to vocational rehabilitation counselors in the area of substance abuse (Greer & Walls, 1997; West & Miller, 1999). The present research...
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