title: A therapeutic workplace for the long-term treatment of drug addiction and unemployment: eight-year outcomes of a social business intervention.
abstract: This study evaluated the long-term effects of a therapeutic workplace social business on drug abstinence and employment. Pregnant and postpartum women (N = 40) enrolled in methadone treatment were randomly assigned to a therapeutic workplace or usual care control group. Therapeutic workplace participants could work weekdays in training and then as employees of a social business, but were required to provide drug-free urine samples to work and maintain maximum pay. Three-year outcomes were reported previously. This paper reports 4- to 8-year outcomes. During year 4 when the business was open, therapeutic workplace participants provided significantly more cocaine- and opiate-negative urine samples than controls; reported more days employed, higher employment income, and less money spent on drugs. During the 3 years after the business closed, therapeutic workplace participants only reported higher income than controls. A therapeutic workplace social business can maintain long-term abstinence and employment, but additional intervention may be required to sustain effects.
authors.affiliation: Johns Hopkins University School of Medicine.
authors.forename: Will M
authors.initials: WM
authors.lastname: Aklin
authors.affiliation: Johns Hopkins University School of Medicine.
authors.forename: Conrad J
authors.initials: CJ
authors.lastname: Wong
authors.affiliation: Johns Hopkins University School of Medicine.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Hampton
authors.affiliation: Johns Hopkins University School of Medicine.
authors.forename: Dace S
authors.initials: DS
authors.lastname: Svikis
authors.affiliation: Johns Hopkins University School of Medicine.
authors.forename: Maxine L
authors.initials: ML
authors.lastname: Stitzer
authors.affiliation: Johns Hopkins University School of Medicine.
authors.forename: George E
authors.initials: GE
authors.lastname: Bigelow
authors.affiliation: Johns Hopkins University School of Medicine. Electronic address: ksilverm@jhmi.edu.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Silverman
mesh_terms: D000328:Adult; D004651:Employment; D005260:Female; D006801:Humans; D008691:Methadone / Q000627:therapeutic use*; D009294:Narcotics / Q000627:therapeutic use*; D049590:Postpartum Period; D011247:Pregnancy; D012054:Reinforcement, Psychology; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D016896:Treatment Outcome; D014478:Unemployment; D017132:Workplace
chemical_list: D009294:Narcotics; D008691:Methadone
keywords: Cocaine; Contingency management; Employment; Heroin; Incentive; Methadone; Social business