Integrating Employment Services with Substance Use Disorder Treatment and Recovery: The Experiences of Five Programs

Recently, in large part due to the opioid crisis, the federal government has increased its focus on and funding for programs that address both treatment and employment outcomes for people with SUD. Programs that combine employment services with SUD treatment or recovery efforts aim to achieve the dual goals of sustaining recovery and improving economic well-being. This report documents five programs that combine SUD treatment and recovery services with employment services. The report also offers recommendations for those already implementing similar programs or interested in developing them.

• Programs made different decisions regarding the nature and content of employment services and when in the treatment and recovery process those services were offered. Some programs in this study began employment services early in the recovery process, while others began them after participants had been in recovery longer. Moreover, some programs offered participants more leeway in deciding which types of employment services to use and when, while others required participants to follow a specific timeline, participate in specific services, or both. Finally, for some programs, participation in employment services was a condition of program enrollment, while for others it was optional.
• Organizational partnerships are important for providing the range of employment and treatment and recovery services participants need. People in recovery from SUD navigate complex barriers to employment that often require services from multiple systems. Organizations can offer these services (treatment, occupational training, and support services) in different ways. Several types of organizations led the programs in this study, and those organizations had varying abilities to provide the array of services needed. All the programs relied to some extent on organizational partners for some program services.
• Programs offering employment services—including job-placement services—must adapt them to accommodate people in recovery from SUD. While the study found variation in the types of adaptations programs made to employment services, the programs did consistently design those services to reflect the needs of people in recovery from SUD: They adjusted the timing and intensity of employment services to align with treatment and recovery service needs, provided job-readiness services (to prepare people for workplace expectations of behavior and communication) to ease the transition to employment, identified occupational training programs of interest to and appropriate for this population, found appropriate work environments and provided continuing support once participants had jobs, and cultivated relationships with employers to support the hiring of people in recovery.

The report is based on interviews with managers and direct service staff members at five programs integrating SUD treatment and recovery services with employment services, conducted virtually during the summer of 2020.

Betesh, Hannah, Deena Schwartz, Shelley Rappaport, and Karin Martinson. 2022. Integrating Employment Services with Substance Use Disorder Treatment and Recovery: The Experiences of Five Programs. OPRE Report 2022-154. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.