Substance Use
Risk factors for experiencing substance use-related employment stigma among emergency department patients at high risk of opioid overdose Ralph Welwean* Ralph Welwean Laura C. Chambers Brandon D. L. Marshall Francesca Beaudoin
Abstract
Background: People who use drugs report hesitance to seek employment because of stigma around drug use, which may be compounded by other forms of stigma (e.g., related to race/ethnicity). We evaluated risk factors for substance use-related employment stigma among emergency department (ED) patients who use drugs.
Methods: This was a cross-sectional study among ED patients at high risk of opioid overdose in Rhode Island. The outcomes were three self-reported measures of substance use-related employment stigma. Multivariable log-binomial regression was used to estimate the association between participant characteristics and each outcome.
Results: Among 648 participants, 25.8% reported they had been turned down for a job due to current/past drug use, 40.8% disagreed that most employers will hire someone treated for drug use if qualified, and 77.7% agreed that most employers will pass over applicants treated for drug use in favor of others. Females reported they had been turned down for a job due to drug use less often than males (adjusted prevalence ratio [PR]=0.72, 95% confidence interval [CI]=0.53-0.98). Persons with a history of homelessness (aPR=1.82, 95%CI=1.24-2.66) and addiction treatment (aPR=1.95, 95%CI=1.22-3.12) more often reported having ever been turned down for a job due to drug use. Race/ethnicity was not associated with substance use-related employment stigma.
Discussion: Perceived substance use-related employment stigma was common among ED patients who use drugs, and men, and those with a history of homelessness or addiction treatment may be particularly affected. Employers can help improve employee attitudes and change hiring practices to reduce such stigma.