Transcript Open poster - CTN Dissemination Library


Employment is a potent predictor of positive treatment
outcomes (Kiddorf et al, 2004).

Efforts to improve rates of employment in persons with
substance use disorders (SUDs) have generally been
disappointing.

One third of individuals who exhibit substance
dependence or abuse also experience serious
psychological distress (SAMSHA, 2003).

The presence of co-morbid mental health symptoms has
been found to have a significant impact on substance
abuse treatment outcomes (Compton et al, 2003).
To examine psychiatric and medical
co-morbidities that may influence
employment outcomes in
individuals enrolled in substance
abuse treatment.

Participants were identified through 6
psychosocial (PS) and 5 methadone
maintenance (MM) community treatment
programs.

All sites participated in the randomized
clinical trial of the Job Seekers’ Workshop
(JSW), CTN 0020, through the NIDA
Clinical Trials Network (CTN).
 18 years of age or older;
 Met DSM-IV criteria for 1+ (lifetime)
Substance Use Disorder;
 Reported unemployment or underemployment
(worked <20 hrs/week in 4 weeks prior to
study enrollment);
 Completed at least 30 days of SUD treatment;
and
 Motivated to get a job.
 Patients
meeting study criteria, completed
a standardized baseline assessment prior
to randomization in the clinical trial of
JSW.
 Baseline measures included a
demographic survey and the Addiction
Severity Index-Lite (ASI-Lite), as well as
other assessments not used for the
present study.

MM participants were more likely to be older, female, unemployed,
African American and have a medical disability than PS program
participants (all p<.05; See Demographic Table).

PS participants were more likely to report recent (past 30 days)
depression (p<.04) and anxiety (p<.011) than MM participants.
Rates of lifetime anxiety were also higher in PS as compared to MM
participants (see Results Table 1).

PS participants were nearly twice as likely to report both recent and
lifetime trouble concentrating (p<.001) than MM participants. More
than half of PS participants reported trouble controlling violence
(lifetime) as compared to one-fourth (26.2%) of MM patients
(p<.001) (see Results Table 2).

PS program participants were nearly twice as
likely to report suicidal thoughts/plan (47.1%)
compared to MM program participants (25.9%)
(p<.001) (see Results Table 3).

PS participants were also more likely to report a
suicide attempt (lifetime) than MM participants
(p<.001) (see Results Table 3).

MM and PS participants differed on a variety of
demographic variables.

Overall, PS participants presented with greater
psychiatric symptom severity (current and lifetime)
at time of study enrollment than MM participants.

MM participants, however, were more likely to
present with chronic medical problems and need for
medications to treat such conditions.

Future research will examine the extent to which
these psychiatric and demographic variables relate
to outcomes for the RCT of the JSW intervention.
Methadone
(MM)
N=301
Psychosocial
(PS)
N=327
P-value
Race
Caucasian
26%
55%
.05
Gender
Female
60%
46%
.05
Employment
Unemployed
87%
80%
.05
Disability Status
Disabled
23%
9%
.05
Variable
Methadone
(MM)
N=301
Psychosocial
(PS)
N=327
P-value
Depression
(past 30 days)
36.4%
43.8%
.04
Depression
(lifetime)
65.1%
70.8%
N.S.
Anxiety
(past 30 days)
42.3%
51.7%
.011
Anxiety
(lifetime)
58.4%
69.9%
.002
Variable
Methadone
(MM)
N=301
Psychosocial
(PS)
N=327
P-value
Trouble
Concentrating
(past 30 days)
28.2%
41.0%
.001
Trouble
Concentrating
(lifetime)
37.4%
57.1%
.001
5.6%
9.1%
N.S.
26.2%
53.8%
.001
Variable
Trouble Controlling
Violence
(past 30 days)
Trouble Controlling
Violence
(lifetime)
Methadone
(MM)
N=301
Psychosocial
(PS)
N=327
P-value
Suicidal Thoughts
(past 30 days)
3.0%
4.0%
N.S.
Suicidal Thoughts
(lifetime)
25.9%
47.1%
.001
0.3%
0.6%
N.S.
20.1%
34.7%
.001
Variable
Suicide Attempt
(past 30 days)
Suicide Attempt
(lifetime)
N=11

This research was supported by NIDA
Clinical Trials Network (CTN) grant DA
2U10DA013034 (Mid-Atlantic Node)