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Substance Abuse Treatment Participation and Employment Outcomes for Public Disability Beneficiaries with Substance Use Disorders


Quantitative research methods are used to examine the interaction among public disability benefit receipt, substance abuse, participation in substance abuse treatment, and employment among US adults. Using cross-sectional data from the 2002 and 2003 Survey on Drug Abuse and Health, the results demonstrate that disability beneficiaries who have substance use disorders are more likely to access treatment than persons with substance use disorders who are not beneficiaries. Results could not confirm, however, that those beneficiaries who access treatment are more likely to return to employment than those who do not access treatment.

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  1. 1.

    “Positive constructions include images such as ‘deserving,’ ‘intelligent,’ ‘honest,’ ‘public spirited,’ and so forth. Negative constructions include images such as ‘undeserving’, ‘stupid’, ‘dishonest’, and ‘selfish’” (Schneider and Ingram,1 p. 335).

  2. 2.

    In keeping with the focus on personal responsibility and employment, for example, SSA implemented the Ticket to Work program in 1999, providing every disability beneficiary with an opportunity to select an employment service provider of their choice to pursue employment. While there is no specific requirement that beneficiaries must participate in this program, the program is designed to provide monetary incentives to both beneficiaries and employment service providers in an attempt to encourage participation. The program is currently being evaluated. As with other SSA employment demonstrations, participation from beneficiaries has thus far been low.9

  3. 3.

    Treatment receipt was significant in all five models for non-beneficiaries, although in a negative direction, suggesting that those who participated in treatment during the past year were less likely to be employed during the past week. The odds ratio for treatment in the final model was 0.627, indicating that the odds of working for persons who participated in treatment were 37% lower than the odds of substance abusing persons who did not participate in treatment, holding all other variables equal. Type of abuse or dependence was significant for non-beneficiaries, with persons with illicit drug abuse or dependence less likely to be employed than persons who did not have illicit drug abuse or dependence. Age, gender, race, education, and marital status were significant for the non-beneficiary models, with older, white, educated, married males more likely to be employed. Survey year was significant at the 0.05 level, with persons completing the 2002 survey more likely to be employed than those that completed the 2003 survey.

  4. 4.

    Results available from author.

  5. 5.

    Brucker, D. Comparative analysis: Substance abuse, disability and public disability programs. Working paper, 2007.


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The author would like to thank Radha Jagannathan, Joel Cantor, Joceyln Crowley, Carol Harvey, and two anonymous reviewers for their recommendations, challenges, insight, and assistance.

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Correspondence to Debra L. Brucker PhD.

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Brucker, D.L. Substance Abuse Treatment Participation and Employment Outcomes for Public Disability Beneficiaries with Substance Use Disorders. J Behav Health Serv Res 34, 290–308 (2007).

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  • substance abuse
  • disability
  • treatment
  • employment