Unemployment appears to play a role in the risk for nonmedical use of prescription opioids and stimulants, according to a new study at Columbia University’s Mailman School of Public Health. The findings show that unemployed workers are at the highest risk for misusing prescription opioids, and those out of the workforce entirely are most at risk for misusing prescription stimulants.
The study, published in the journal Social Psychiatry and Psychiatric Epidemiology, is among the first to investigate the link between employment status and nonmedical prescription drug-users over the age of 25 and show how social characteristics influence nonmedical prescription drug use.
For the study, the researchers sampled 58,486 adults 25 years and older based on combined data from 2011 to 2013 from the National Survey on Drug Use and Health.
People who were currently unemployed reported the highest risk of prescription opioid misuse at seven percent. Those out of the workforce reported the highest odds of misusing prescription stimulants at two percent. Overall, there were more users of nonmedical prescription opioids (3.5 percent) compared with nonmedical users of prescription stimulants (.72 percent).
Nonmedical prescription opioid use is defined as any self-reported use of prescription pain relievers that were not prescribed or are taken for the experience or sensation they impart.
“Our results confirm the need for adult prevention and deterrence programs that target nonmedical prescription drug use, especially among those unemployed or not in the workforce,” said senior author Silvia Martins, M.D., Ph.D., associate professor at the Mailman School and epidemiologist.
Of greatest concern are unemployed adults between the ages of 26-34, since the risk for nonmedical prescription opioid use is higher in this age group compared to older adults. The findings also showed higher odds of prescription stimulant misuse among those only employed part-time compared with persons employed full time.
“Our findings on these associations between employment status and nonmedical prescription drug use parallel other research about emerging adulthood and taking on new social roles, such as marriage and parenthood,” said Martins.
The observation that unemployment is linked to a variety of diseases, including mental disorders, is of utmost importance to those instituting policies regulating control of nonmedical prescription drugs.
“Physicians, in particular, should be aware of patients’ employment status and the elevated risk between unemployment and non-medical drug use and drug and mental disorders prior to prescribing,” said Martins.
The connection between employment status and the misuse of opioids and stimulants also has important public health implications. Furthermore, having sensitivity to non-full-time employed people — a population that the data suggests experiences greater social disadvantage — is vital, according to Martins.
“By improving our understanding of these associations and the role of employment in drug use behaviors and modes of access, drug prevention, and deterrence programs can target users more effectively, especially when combined with regulation,” said Martins.
“Non-full-time employed people may suffer disproportionately from the indirect harms of nonmedical use of prescription opioids and stimulants insomuch that they have less family-, neighborhood-, and community-level social ties that would help mitigate harms related to misuse.”
“With substance use disorders increasingly recognized as a public health issue — and not one of criminal justice — withholding social support, including treatment, from those with the highest need will contribute to increasing social inequalities.”