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= Introductory Paragraph =
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When people don't have job opportunities, the likelihood of drug abuse  increases. Therefore, part of a comprehensive strategy should include specific efforts to create job opportunities for people in order to strengthen their support systems and prevent them from abusing  drugs if they do not have a job. By targeting employment opportunities (and connections to those jobs) to people who might otherwise begin to abuse drugs, the health of the community can increase. 
 
The effect that a job has on mental health is what makes it such a important factor in prevention. Cultivating a positive support system and a positive frame of mind is essential.&nbsp; In a population 18 and older it was shown that 10% more people who were unemployed used illegal substances in the past month then those that had a full time job.<ref>https://www.stlouisfed.org/publications/regional-economist/july-2013/exploring-the-link-between-drug-use-and-job-status-in-the-us</ref>&nbsp;&nbsp;&nbsp;This is because of the general financial hardships that those who are unemployed face. This can create a stronger drive to escape which can lead to drug abuse.&nbsp;&nbsp;
 
Sustaining recovery often means rebuilding lives. Many in early recovery need assistance with basic job training skills and making plans to further their education. Others may have lost their professional license and ability to practice their former profession (e.g. nursing, stock broker, commercial truck driver etc.). However, virtually all people in recovery face the additional challenge of stigma which is frequently associated with addiction no matter their efforts to address their health problems, nor stabilize their lives.&nbsp;<ref>http://ifi-wikis.com/IFI-OpioidCrisis/Improve_Education,_Job_Training,_and_Employment_for_People_in_Recovery</ref><br/> <br/> These issues become compounded when the individual has a criminal record. Helping those in recovery access opportunities for education, job training, and employment greatly enhances their ability to support themselves and their dependents, while also building self-worth and a sense of accomplishment. These latter attributes have come to be known as important elements of recovery capital,<ref>Laudet and W. White, “Recovery Capital as Prospective Predictor of Sustained Recovery, Life satisfaction and Stress among former poly-substance users,” Subst Use Misuse. 2008; 43(1): 27–54.</ref> which collectively has been shown to incentivize sustained recovery while reducing the likelihood of relapse, yet for those with criminal histories, there are often systematic barriers and obstacles placed in the way of achieving them.&nbsp;<br/> <br/> Treatment providers, recovery community organizations, and employers, alike, can provide critical assistance in two primary areas: 1) helping individuals with SUD find treatment and long-term recovery supports and 2) by assisting those new to recovery but ready for employment with access to job training, skill development, and identification of employment prospects.&nbsp; Employees in recovery have been shown to be loyal, productive members of the workforce and key assets to any employer. Helping individuals secure the necessary treatment and/or recovery support which helps them sustain recovery, may involve the upfront costs of treatment and recovery support services, but ultimately serves to integrate them into a healthier lifestyle, which often including stable housing, gains in healthcare and social connections, and improvements to their employment and financial situations.
 
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= Key Information =
 
<br/> Opioid misuse and use disorders were more common among people with lower family incomes, without health insurance or without jobs.<br/> In the United States, 18.1% of unemployed adults use illicit drugs – that’s more than double the percentage of users who are employed full-time.<br/> States with higher unemployment rates tend to have higher rates of drug use.<br/> <br/> Many people in recovery have an extremely difficult time getting back into the workforce. A sizable portion of those in early recovery may have criminal histories, spotty or uneven work histories, or are dislocated workers. Because of these barriers, individuals in early recovery often struggle to find gainful employment. This is a major problem as the inability to obtain a steady job, stable housing and transportation are often the necessities required to achieve a quality lifestyle. That said, there are some success strategies gaining traction that are working to help these individuals with their vocational challenges and also some innovations among employers who have attempted to create a recovery-friendly work environment and are more receptive to hiring “second chance” employees. With the help of targeted programs and resources people in recovery can get back on their feet and move more swiftly through this life changing process.&nbsp;
 
One of the more familiar vocational routes for individuals who achieved a year or more of sobriety and who want to help others with addictive disorders is the pursuit of a job as a peer support specialist or recovery coach (hereafter peers.) Peers are individuals who have gained the requisite training and certification in their state to use their “lived experience” of addiction and recovery to help others seeking to secure and sustain their recovery. By working with a peer, an individual can walk through the challenges of recovery with someone who has “been there and done that, “ and perhaps relate more to their own challenges while receiving “hands on” feedback regarding how they might approach rebuilding specific areas of their life. This dynamic helps both the peer and the person being served, perpetuates sound growth for both, and at its best, builds communities of recovery.
 
Some examples of vocational development that SUD treatment programs and Recovery Community Organizations (RCOs), alike, have traditionally employed include: resume development, mock interviews, job searches, and provision of support to the new employee outside their job structure. Having assistance to build resumes, practice job interviewing, and help identifying job opportunities can greatly increase a person’s chance of getting back into the workforce. Although there is a small, but ever growing pool of businesses open to offering “second-chance” opportunities (See, Promising Practices below for examples), they represent an important and critical example of “early adopter,” among employment innovators.&nbsp; In&nbsp; securing local assistance, people in recovery can find “peers” who have lived through similar challenges and circumstances and can offer their guidance and support. Distilling further the “success stories” of these treatment and recovery support organizations, should yield greater returns for those early in sobriety as they seek and secure employment and/or enhanced education/training.&nbsp;&nbsp;
 
= Relevant Research =
 
Peer Support<ref>https://mail.google.com/mail/u/0?ui=2&ik=ba1da77130&attid=0.1&permmsgid=msg-f:1691420259747931150&th=177921c3c42ca40e&view=att&disp=inline&realattid=f_kl12keq30</ref><br/> <br/> SAMHSA Peer Recovery<ref>https://www.samhsa.gov/sites/default/files/programs_campaigns/brss_tacs/peers-supporting-recovery-substance-use-disorders-2017.pdf</ref><br/> <br/> Distinguishing Between Recovery Coach and Peer Support Specialists<ref>https://www.mkrecoverycoaching.com/2015/09/03/what-is-the-difference-between-a-recovery-coach-a-peer-recovery-support-specialist-and-a-professional-recovery-coach/#:~:text=A%20nearly%20universal%20definition%20of,and%2C%20as%20a%20result%2C%20can</ref><br/> <br/> Peer Support and RCOs in underserved communities<ref>https://www.sciencedirect.com/science/article/pii/S0306460319302011?casa_token=SJAHdQwJpmAAAAAA:2IguaCr1U0Op50yboCWsNSTRdiOn0_Z1tmOUWw9jeoSyvpCgrY2J5b29P_ow6eX__dNkw8fV3nQ</ref><br/> <br/> Prisoner Reentry Programs<ref>https://journals.sagepub.com/doi/pdf/10.1177/0011128703049003002</ref><br/> <br/> Current Addiction Treatment Institutions<ref>https://www.sciencedirect.com/science/article/pii/S0740547208001839?casa_token=8XpF9x6GwxgAAAAA:ovwV_-e0V2EOagRtYCehdzLsWUeq7mctm6vwrhUj6uLHzc6qPbaKJPFK8iTlhoMBUckt-h2nmb0</ref><br/> &nbsp;
 
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= Impactful Federal, State, and Local Policies =
 
There are a number of federal, state, and local policies which impact how those with active SUD or who are actively in recovery interface within their workplace.&nbsp; By learning how best to navigate through these programs and policies, employers become better public stewards and those in recovery are better positioned to reenter and succeed at work.&nbsp; &nbsp;
 
There are presently four major federal laws in the U.S. which govern an organization’s reaction to substance misuse or disorder in the workplace. Of the four, the Americans with Disabilities Act (ADA) and the Occupational Safety and Health Act (OSHA) also cover the rights of those with mental health issues. A brief description of each follows below:
 
I.&nbsp; &nbsp; &nbsp; ''The Controlled Substances Act (CSA)'' places all substances which are in some manner regulated under existing federal law into one of five schedules.&nbsp; This placement is based upon the substance’s medical use, potential for abuse, and safety or dependence liability.&nbsp; More information can be found in Title 21 United States Code (USC) Controlled Substances Act. The Act states that marijuana is an illegal substance, notwithstanding the growing number of states that have legalized it for medicinal and recreational use.
 
ii.&nbsp; &nbsp; &nbsp; ''The Occupational Safety and Health Act'' while not offering specific directives to the development of drug-free workplace policies, the Act requires that employers have a responsibility to provide a safe workplace under its general duty clause. If an employer turns a blind eye to drug use in the workplace, it can be found to be in violation of the law. It should be noted that this policy has rarely been enforced. OSHA also administers the Whistleblower Protection program, ensuring that an employer cannot retaliate by taking "adverse action" against workers who report injuries, safety concerns, or other protected activity.
 
&nbsp;iii.&nbsp; &nbsp; ''The Drug-Free Workplace Act ''- The Drug-Free Workplace Act of 1988 (41 U.S.C. 81) is an act of the United States which requires some federal contractors and all federal grantees to agree that they will provide drug-free workplaces as a precondition of receiving a contract or grant from a Federal agency. Although all covered contractors and grantees must maintain a drug-free workplace, the specific components necessary to meet the requirements of the Act vary based on whether the contractor or grantee is an individual or an organization. While the law was written to address federal contractors and grantees, many businesses have developed drug free workplace policies regardless of their affiliation with the federal government.&nbsp; The Act does not require drug testing of candidates or employees, nor does it require employers to fire workers for testing positive for illegal drugs. However, employers must make continuous good-faith efforts to maintain a drug-free workplace, which usually means having a policy and a mechanism for drug testing. Please See SAMHSAs toolkit on developing a Drug Free Workplace.[1]
 
&nbsp;iv.&nbsp; &nbsp; ''The Americans with Disabilities Act (ADA) ''prohibits discrimination based on a current, past or perceived disability. The law also covers association with an individual with a disability.&nbsp; Under the ADA, employers are required to provide reasonable accommodations to qualified employees with disabilities, unless doing so would pose an undue hardship. Qualified employees are those who hold the necessary degrees, skills, and experience for the job; and who can perform its essential functions, with or without an accommodation.
 
'''Prescription Medications with Illicit Substances in the Workforce'''
 
Workplaces across the country, who perform urine screens on their employees are facing increasing complexities with the increasing popularity of&nbsp; Medication Assisted Treatment (MAT) to treat those with Opioid Use Disorders (OUDs). MAT generally includes the following pharmaceuticals: buprenorphine, naltrexone and methadone. These medications contain opioid elements that will turn a drug screen “positive,” openjng th edoor to discrimination among those seeking employment or who in recovery on MAT.&nbsp;&nbsp;
 
Though its recreational use may outpace its medical application, marijuana possession and use has become legalized in more than 35 states. For companies working in these states, or further confounding, for those with operations in multiple states, corporate human resource departments and their attorneys are doing their best to keep pace with these changing laws so that they have personnel policies in place which govern employee behavior in this area.&nbsp; &nbsp;&nbsp;
 
It is critical for those with such prescriptions who are stabilizing in their recovery, that industry is well educated regarding contemporary medical practices to prevent individuals from facing&nbsp; additional hurdles to securing and sustaining employment.&nbsp;&nbsp;
 
'''Medical Marijuana:'''
 
Legalization of Marijuana - which states have&nbsp; legalized recreational use&nbsp;&nbsp;
 
Several states have legalized marijuana.<ref>https://www.nsc.org/membership/training-tools/best-practices/marijuana-at-work</ref>
 
One of the most common questions regarding marijuana usage is the impact it has on employees in the workplace. Studies from the National Institute of Drug Abuse&nbsp; show that “employees who have tested positive for marijuana have 55% more industrial accidents, 85% more injuries, and 75% greater absenteeism compared to those who have tested negative” (NSC 2021). Companies combat this by following SAMHSA drug testing guidelines which administer required employee drug tests whenever the employer chooses to do so after developing a policy plan. SAMHSA states that employers can hire a Medical Review Officer (MRO), which is a licensed physician who has extensive knowledge on a wide variety of illicit substances. The MRO will obtain each laboratory result and examine as well as provide the employers with the concluding&nbsp; results. According to SAMHSA, the most commonly used tests are urinalysis tests. Urinalysis tests are also required for federal regulated programs.&nbsp;<ref>https://www.samhsa.gov/workplace/resources/drug-testing</ref>
 
'''Medication Assisted Treatment (MAT) Opioids'''
 
Medication Assisted Treatments (MATs) are increasingly a popular form of treatment for people in recovery from opioid use disorders (OUDs). MATs are medications constituted&nbsp; with opioid elements and have proven to be highly successful when combined with traditional outpatient treatment.&nbsp; The term MAT generally includes the following pharmaceuticals:&nbsp; &nbsp;buprenorphine (suboxone), methadone (brand name Diskets), and naltrexone (brand name Vivitrol). The most challenging hurdle with the use of MAT is that those compelled on MAT exposed to urine screening will have “positive” test results communicating the presence of an opioid in their system. How should employers address these issues? Employers may not know their employee has been prescribed a drug in the MAT class. This is an evolving area for business leaders and the HR directors frequently tapped for their expertise in writing and enforcing these policies.&nbsp;
 
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Below are some organizational resources that possess a knowledge base in this changing landscape:
 
&nbsp;'''Trucking Laws'''<ref>https://www.truckingtruth.com/wiki/topic-6/cdl-drug-alcohol-test-methods-detection-times#ua</ref>
 
'''American Association for Treatment of Opioid&nbsp; Dependence'''- AATOD Website<ref>http://www.aatod.org/</ref>
 
'''Legal Action Center<ref>https://www.lac.org/work/priorities/fighting-discrimination/addiction-medication-denials</ref>'''
 
The Legal Action Center is an important resource for those in recovery attempting to get back into the workforce. Among other things, LAC provides technical support and resources on the rights and contemporary&nbsp; issues that impact those substance use disorders and those with prior criminal histories. While the Legal Action Center is critical to “second chance” employees and their “would be” employers,&nbsp; it is but one in a handful of resources to help those with nonviolent criminal histories overcome barriers to gainful employment. Each year, former offenders are released back into society, however, this transition is not as simple as it sounds. After being convicted, the offender will have to present their past criminal record to their employers. This makes it extremely difficult to find a stable and suitable job. Few companies offer “second chance” opportunities for former convicts and many are unable to fully reintegrate back into society. Traditionally, substance use treatment programs and now Recovery Community Organizations, have developed community-based strategies to help their&nbsp; client -participants re-enter&nbsp; the workforce.&nbsp;
 
In addition to LAC, there are a number of national organizations that are working in this area, as well (see below). For example, the Council on Recovery, an organization which meets with employers and their&nbsp; HR representatives, to establish Employee Assistance Programs (EAPs), helps smooth the transition back into the workplace for those dislocated or developing new employment relationships in early recovery.&nbsp;&nbsp;
 
'''SAMHSA&nbsp; - US Drug Free Workplace Act<ref>https://www.samhsa.gov/workplace/toolkit</ref>'''
 
= Available Tools and Resources =
 
'''AddictionCenter.com'''<br/> Provides useful tips for those who are fresh out of recovery or struggling with substance abuse issues<ref>AddictionCenter.com</ref>
 
'''Careeronestop.org'''<br/> A service provided by the US department of labor that helps people find jobs based on their location<ref>Careeronestop.org</ref><br/> &nbsp;
 
'''National H.I.R.E. Network.'''<br/> The National H.I.R.E. (Helping Individuals with Criminal Records Re-enter through Employment) Network seeks to help individuals overcome the barrier of their&nbsp; prior criminal histories to secure employment. H.I.R.E. provides a broad range of resources including agencies and organizations that can be of assistance in providing employment-related services as well as assisting with legal issues arising from having a criminal record. Its clearinghouse offers resources, information, and assistance to aid people with criminal records, practitioners, researchers, and policymakers.&nbsp; Listings are by state, government agencies, and community-based organizations.<ref name="Waehrer, G. M., E. Zaloshnja, et al. (2008). “Substance-use problems: are uninsured workers at greater risk?” J Stud Alcohol Drugs 69(6): 915-23.">https://itrusteauth.nih.gov/NIHLibrary/genSAMHSAticket.asp?url=https://www.ncbi.nlm.nih.gov/pubme
</ref>
 
'''RetrofitCareers'''<br/> RetrofitCareers purpose is to provide a direct online portal for those in “successful” drug or alcohol recovery to find meaningful employment in order to sustain one’s own Work/Life balance. In turn, providing willing businesses with a direct online portal can help them proactively seek and find valuable employees who are in “successful” drug or alcohol abuse recovery.<ref>https://www.retrofitcareers.com/</ref>
 
'''The Council On Recovery'''<br/> The Council On Recovery is an organization that strives to help recoverers get back into the workforce. They work closely with Employee Assistance Programs (EAPs) to give support to second chance employees. The Council On Recovery also helps businesses establish an EAP to help maintain a healthy work environment for all employees.<ref> https://www.councilonrecovery.org/community-programs/workplace-solutions/ </ref>
 
'''Vera Institute of Justice&nbsp;'''<br/> The Vera Institute of Justice is an organization which manages a myriad of training, program development and justice-related evaluation services.&nbsp; Their Substance Use and Mental Health Program (SUMH) serves to alter and establish sufficient programs in prison to help offenders with mental health or substance abuse recovery. Some of their main goals include reducing the use of jails, expanding access to Health Care, and supporting kids and young adults.<ref>https://www.vera.org/centers/substance-use-and-mental-health</ref>
 
'''Pew Charitable Trusts'''<br/> Pew Charitable Trusts is a non-profit policy “think tank” which works to develop policies and programs that better serve the public. Their Substance Use Prevention and Treatment Initiative aims to help those in recovery and improve the lives of those with a substance use disorder. One of their main goals is to “expand access to effective treatment for substance use disorders”.<ref> https://www.pewtrusts.org/en/projects/substance-use-prevention-and-treatment-initiative</ref>
 
'''The Bureau of Justice Assistance: Office of Justice Programs'''<br/> The US Department of Justice’s Bureau of Justice Assistance (BJA) has established a pathway for individuals in recovery to make a smoother transition back into society with their Office of Justice Programs (OJP). BJAs Offender Reentry Programs (ORP)&nbsp; provides grants to local communities and community-based nonprofits whose mandate is to facilitate the reintegration of formerly incarcerated individuals, many of whom have been impacted by substance use disorders, back into society.<ref>https://bja.ojp.gov/funding/opportunities/o-bja-2021-41005.</ref>
 
'''SAFER Foundation'''<br/> Based in Chicago, Illinois, the SAFER Foundation is a non-profit organization which supports individuals in recovery from substance use disorders in getting back into society. They work to support their clients by improving their socio-economic status. SAFER also has sub-projects such as helping incarcerated veterans get back on their feet.&nbsp;<ref>https://saferfoundation.org/</ref><br/> <br/> '''Faces and Voices of Recovery'''<br/> Faces and Voices of Recovery<ref>https://facesandvoicesofrecovery.org/</ref> is an organization which aims to fight the social stigma around substance use disorders by providing services and programs to help those in recovery. One of their primary initiatives is the Association of Recovery Community Organizations (ARCO) which assists in developing and improving the work of RCOs and the recovery community, across the nation. RCOs are critical in their ability to establish a supportive recovery network for those in recovery, which enhances the sobriety, housing and employment situations of their participants.<ref>http://wellnessandrecovery.org/what-is-an-rco.html</ref><br/> <br/> '''Technology Transfer Centers (TTCs)<ref>https://techtransfercenters.org/landing</ref>'''
 
= Promising Practices =
 
'''DV8 Kitchen - Soulful Enterprise'''<br/> A restaurant in Kentucky, DV8 Kitchen strives to provide employment within their restaurant cafes for those in recovery. Their training program, Soulful Enterprise, teaches employers how to manage a work environment with people in recovery and how best to hire them. According to their website, business owners can save money and time by taking the right steps.<ref>https://events.dv8kitchen.com/</ref><br/> <br/> '''Hirsch Electric, LLC'''<br/> Hirsch Electric, LLC is an electric company which serves over 30 major buildings in the Baltimore area. Since their development, they have supported the concept of giving people a “second chance” by providing jobs to those in recovery or financial struggle. A few of their main partners include Project JumpStart, Fellowship of Christian Athletes, and Meals on Wheels. Hirsch Electric also provides a recovery house known as Building New Lives.<ref>http://www.hirschelectricllc.com/about/commitment-to-community/</ref><br/> <br/> '''Allied Trades Assistance Program'''<br/> The Allied Trades Assistance Program (ATAP) is a non-profit organization formed by the Philadelphia Trade Union to provide assistance and services to those in addiction recovery. ATAP pairs union members with SUDs to other union members with stable recovery using a peer-based recovery system. ATAP also serves to help businesses establish an employee assistance program (EAP) which can help employees in recovery with a smooth transition into the workforce and fight social stigmas.<ref>https://www.alliedtrades-online.com/</ref><br/> <br/> '''Second Chance Offender Rehabilitation Effort - Eastern District of Virginia'''<br/> The Second Chance Offender Rehabilitation Effort (SCORE) of the Eastern District of Virginia (EDVA) is a program which helps offenders who have served their sentences enter back into society through reentry programs and courts. SCORE provides a 5 phase program where the participant will be supervised over the course of a minimum of 15 months. Graduates of the program will learn how to live a more productive and meaningful life away from substances and have the opportunity to re enter into society. Its goals and objectives are similar to BJAs ORP program though contained to this geographic region. <ref>https://www.justice.gov/usao-edva/reentry-program</ref>&nbsp;
 
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= Sources =

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