Factors associated with employment in a sample of heroin dependent individuals receiving opiate substitution treatment (OST): a cross-sectional study.

First published: 10 May 2019 | Last updated: 20 May 2019

Aims: To identify factors associated with the ability to maintain successful employment in clients receiving OST. To be able to describe the employment patterns of an employed group of individuals receiving OST.

Methods: A cross-sectional study based at Solihull Integrated Addiction Services was conducted between January and April 2017. Three questionnaires were administered, during a 20 minute interview, to 55 employed and 55 unemployed clients receiving OST. The questionnaires explored physical health, employment, drug use, mental health, recovery capital, and dependence severity. Statistical analysis was used to compare the employed and unemployed groups.

Results: The employed group had a greater recovery capital, better physical and mental health, fewer drug problems, and a less severe dependence however, they were using heroin as frequently as the unemployed group. In a logistic regression analysis three variables were significantly associated with employment: months of longest period of employment (OR=1.01, p=0.003); number of chronic medical conditions (OR=0.44, p=0.011); and number of days of psychological problems in the last 30 days (OR=0.95, p=0.031). The majority of employed participants were working in either skilled trades or unskilled labour occupations, with an average of 20 days worked in the previous month.

Conclusions: Individuals receiving OST can successfully maintain employment. Various factors associated with the ability to maintain successful employment were identified, further research is required to understand how these individual factors influence employment and to understand the relationship between employment and recovery. These recommendations will be disseminated through publication and conference presentations.


Dr Ed Day, Birmingham and Solihull Mental Health NHS Foundation Trust, Kings College London. Ms. Shabana Akhtar, Birmingham and Solihull Mental Health NHS Foundation Trust.

Conflicts of interest:

No conflict of interest

Miss Elizabeth Lowe