Affiliations: [a]
Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY, USA
| [b]
Center for Learning and Health, Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
Correspondence:
[*]
Address for correspondence: Mikhail Koffarnus, Department of Family and Community Medicine, University of Kentucky, 2195 Harrodsburg Rd, Suite 125, Lexington, KY, 40504, USA. E-mail: koffarnus@uky.edu.
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.
