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journal article May 30, 2025

Positive changes in employment status are associated with reduced alcohol use frequency at discharge from outpatient specialty treatment

Nicholas L. Bormann ORCID Tyler S. Oesterle ORCID Andrea N. Weber ORCID Doo‐Sup Choi ORCID Victor Karpyak ORCID Stephan Arndt ORCID
Alcohol: Clinical and Experimental Research Vol. 49 No. 6 pp. 1286-1296 · Wiley
View at Publisher Save 10.1111/acer.70044
Abstract
AbstractBackgroundWorkforce engagement can provide structure, income, feelings of accomplishment, and personal contacts, growing an individual's recovery capital (RC). Employed individuals are also more likely to complete addiction treatment. We sought to investigate whether changes in employment status from alcohol treatment admission to discharge correlated with changes in alcohol use frequency over those time points.MethodsThe Treatment Episode Dataset—Discharges (2017–2021) provided the data. Employment status (full‐time, part‐time, unemployed, and not in labor force) and alcohol use frequency (daily use, some use, and no use in past month) were assessed at treatment admission and discharge. Changes in alcohol use frequency during treatment were recorded as Reduction or No reduction. Logistic regression using reduced alcohol use frequency as the dependent variable included employment status at admission and discharge separately. A second analysis included employment status at both admission and discharge and their interaction term. An adjusted model included all covariates (race, ethnicity, age, education, and referral source), with its results being used to derive the marginal probabilities of reduced alcohol use frequency.ResultsThere were 856,085 alcohol treatment admissions over the 5 years, with 221,724 (25.9%) first admissions. Transitioning from not in the labor force or unemployed to full‐time saw the largest percentage of encounters decreasing alcohol use frequency: 71.9% (95% CI: 70.0–73.7) and 69.3% (95% CI: 68.1–70.5), respectively. Those remaining unemployed had the lowest reduction at 26.7% (95% CI: 26.3–27.1), with a sample reduction of 42.7% (95% CI: 42.5–42.9) overall. Far more people (60.4%) completed treatment within the Reduction group than in the No reduction group (30.2%).ConclusionsFindings suggest that improving employment status may be relevant for reducing alcohol use frequency. This aligns with past work showing overall improved health outcomes with lower unemployment levels. Incorporating vocational training and workforce engagement activities into outpatient treatment may help augment traditional approaches to improve an individual's RC.
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References
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[3]
How to Interpret Statistical Models Using marginaleffects for R and Python

Vincent Arel-Bundock, Noah Greifer, Andrew Heiss

Journal of Statistical Software 10.18637/jss.v111.i09
[45]
Substance Abuse and Mental Health Services Administration. (2021)Treatment Episode Data Set: Discharges (TEDS‐D) 2021. Available from:https://www.samhsa.gov/data/data‐we‐collect/teds‐treatment‐episode‐data‐set/datafiles/teds‐d‐2021
Metrics
3
Citations
50
References
Details
Published
May 30, 2025
Vol/Issue
49(6)
Pages
1286-1296
License
View
Authors
N
Nicholas L. Bormann

Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USA

T
Tyler S. Oesterle

Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USA

A
Andrea N. Weber

Department of Psychiatry University of Iowa Iowa City Iowa USA; Department of Internal Medicine University of Iowa Iowa City Iowa USA

D
Doo‐Sup Choi

Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USA; Department of Molecular Pharmacology and Experimental Therapeutics Mayo Clinic Rochester Minnesota USA

V
Victor Karpyak

Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USA

S
Stephan Arndt

Department of Psychiatry University of Iowa Iowa City Iowa USA; Department of Biostatistics University of Iowa Iowa City Iowa USA

Cite This Article
Nicholas L. Bormann, Tyler S. Oesterle, Andrea N. Weber, et al. (2025). Positive changes in employment status are associated with reduced alcohol use frequency at discharge from outpatient specialty treatment. Alcohol: Clinical and Experimental Research, 49(6), 1286-1296. https://doi.org/10.1111/acer.70044
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