Heroin use, opiate substitution treatment and employment: A qualitative study

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

Aims: To assess the impact of OST and heroin dependency upon employment and to identify the positive and negative effects paid work can impart on recovery and treatment outcomes.

Methods: A qualitative study involving 10×20-60-minute-long, semi-structured interviews at a substance misuse service centre. The ten participants were all in full-time employment and receiving OST. Iterative Categorisation and elements of Framework were used to analyse the data by the interviewer.

Results: Employment influences recovery by giving purpose, structure, a sense of normality, reduces contact with other drug users and increases contact with non-drug users. OST affects employment by reducing reliance on heroin, improves workability and reliability but can act as a barrier to gaining employment. Participants overcame the typical drug use related barriers to employment.

Conclusions: OST enables employment maintenance. Stable employment improves recovery and makes treatment less challenging. Participants saw themselves becoming integrated into society which has benefits in terms of improving treatment outcomes and decreasing heroin use. There is a ceiling to these benefits due to treatment-related limitations such as being unable to progress professionally. The barriers to employment faced by many heroin users can be overcome, understanding how this was done has critical future use.


Dr Edward Day – Birmingham and Solihull Mental Health NHS Foundation Trust; University of Birmingham Dr Thomas Parkman – National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience (IOPPN), King ‘s College London

Conflicts of interest:

No conflict of interest

Mr Oliver Emmerson