Extra payments motivate sobriety and employment among people recovering from addiction

https://www.eurekalert.org/pub_releases/2020-04/jhm-epm041820.php

News Release 20-Apr-2020
Johns Hopkins Medicine


After a yearlong study of people with opioid dependence, Johns Hopkins Medicine researchers report evidence that adding $8 an hour to their paychecks may help those in recovery stay drug free longer, as well as encourage them to get and hold regular jobs.

The researchers say poverty is an independent risk factor for drug abuse that treatment plans largely ignore.

In a report on the study, described in the Journal of Epidemiology & Community Health online Feb. 21, the investigators say their intervention could be used widely in low-income neighborhoods as a way to promote employment, reduce drug use and help those ravaged by the opioid crisis better integrate back into their communities.

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All participants underwent regular urine screens three times each week that became more intermittent if the person remained drug-free. If a participant receiving the wage supplement tested positive for cocaine or opioids, the wage supplement was reduced to $1 and more frequent testing resumed. For each day participants were drug free, the wage supplement rose $1 per hour until reaching the maximum of $8 per hour.

During the yearlong intervention, 65% of people with wage supplements provided urine samples free of opioids and cocaine, compared to 45% of those without wage supplements.

People with wage supplements were also 2.9 times more likely to get a job and 2.7 times more likely to rise out of poverty by the end of the year than those without wage supplements.

"Following this study, the vast majority of unemployed people that participated entered into the workforce with minimum wage positions, so we think the wage supplement is helpful in providing motivation to keep jobs that at times can be stressful and difficult," says Holtyn. She says participants worked in construction, grocery stores, the food service industry, house cleaning and delivery.

The researchers caution that because the wage supplements and drug testing stopped after the study period, they will continue to follow participants for another year to see if the reduced drug use and consistent employment effects persist. They are also testing their wage supplement intervention with homeless adults who have alcohol use disorder.

tags: drug use, drug abuse