Discounting of employment opportunities with urine drug testing requirements in opioid users enrolled in the Therapeutic Workplace

Haily K. Traxler, Kenneth Silverman, Mikhail Koffarnus

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: The evidence-based Therapeutic Workplace (TWP) is a promising employment-based treatment where access to work is contingent on objective evidence of abstinence from drugs. TWP is sometimes criticized for requiring individuals who use drugs to voluntarily enroll in a program requiring urine drug testing. OBJECTIVE: This experiment was conducted to assess whether urine drug testing as a condition of employment decreases the value of employment opportunities and to what degree. METHODS: Participants were unemployed, DSM-IV opioid-dependent, and enrolled in TWP. Participants completed discounting tasks assessing preference for a hypothetical job paying a constant wage that did not require urine drug testing and a job that paid a variable wage but required drug testing. The primary outcome was 'job value' operationalized as percentage wage difference to accept a job requiring urine drug testing. RESULTS: Percent wage difference to accept a job that required urine testing was analyzed using GEE. Results revealed a significant main effect of recent drug use (χ2(1) = 10.07, p < 0.01). CONCLUSION: Most participants were willing to accept a urine drug-testing job across wages similar non-drug testing jobs. Participants reporting recent cocaine or heroin use were less likely to choose urine drug-testing employment.

Original languageEnglish
Pages (from-to)183-190
Number of pages8
JournalJournal of Vocational Rehabilitation
Volume59
Issue number2
DOIs
StatePublished - 2023

Bibliographical note

Publisher Copyright:
© 2023 - IOS Press. All rights reserved.

Keywords

  • Contingency management
  • cocaine
  • discounting
  • heroin
  • opioid use disorder
  • therapeutic workplace

ASJC Scopus subject areas

  • Rehabilitation
  • Occupational Therapy

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