Led by Isaac D. Montoya, clinical professor at the UH College of Pharmacy, this National Institutes of Health (NIH) study found that employment reduces the chronic drug use of female welfare recipients.
"Our research yielded such significant results that we feel these findings ultimately can and should be extrapolated to additional populations," Montoya said. "In the U.S., alone, nearly 20 million Americans abuse drugs, with women being less likely to seek treatment than men. And the fact that risk factors and predictors vary across demographics underscores the need to target various sub-populations."
Awarded $4.3 million by the NIH's National Institute on Drug Abuse (NIDA) for a five-year study, Montoya received the funds through the Houston "think tank" Affiliated Systems, where he is a senior research scientist. Assisted by Victoria L. Brown, an adjunct assistant professor at the UH College of Pharmacy and research scientist with Affiliated Systems, and Micah A. Riley, a research assistant with Affiliated Systems, Montoya found that welfare reform - primarily designed to transition women from welfare to work - also may be a significant factor in drug abuse prevention and education. A positive correlation was found between employment and the reduction of chronic drug use within welfare populations, providing definitive data that supports "work therapy" as a tertiary prevention model for drug addiction as an alternative or in addition to traditional therapy options like programs and meetings.
"The study demonstrates that welfare reform policy has an unintended benefit," Montoya said. "Employment promotes a healthy lifestyle by providing structure, income and benefits that increase self esteem and a sense of purpose. These elements may not be provided when recipients simply attend 12-step meetings."
The study also showed that top predictors of drug abuse are linked to risk and protective factors and that prevention programs should be designed to enhance protective factors while reducing risks. According to NIDA, protective factors are those that may reduce the potential for drug use, such as strong bonds within a family network, school, work or religious organization, as well as adoption of conventional norms about drug use. Risk factors make the potential for drug use more likely and include poor academic and career achievement, shy, aggressive and impulsive personality traits, exposure to substance abuse by family members, lack of positive recreational programming and exposure to weak law enforcement for the use of illicit substances.
To establish a preventative model in populations with high risk and low protective factors, the researchers selected female Temporary Assistance to Needy Family (TANF) recipients to participate in the study. Since a lack of time and caring for their children are two of the most cited reasons among female drug users for not seeking treatment programs, the researchers selected employment as the primary prevention strategy for women, an activity achievable and common in an average person's day. These individuals were not participating in any drug treatment programs during the study.
Of the 534 TANF study participants analyzed in the first year, one-third reported being chronic drug users of cocaine, heroin and methamphetamines, using an average of 14 times a week. At intake, five percent of these individuals reported being employed. Employment rates and hours during this first year were measured by interviewing participants quarterly, with employment among drug-users rising to approximately 39 percent.
"We attribute this sharp increase in employment to the outreach and training of the local workforce board," Montoya said. "We have one of the best workforce boards in the country that has been recognized by the Department of Labor and the State of Texas for its leadership in helping people secure employment."
During the second year of the study, the researchers' focus shifted to the effect of employment on drug usage, finding that drug use fell 79 percent during this second year among users who remained employed. With average usage dropping from 14 times a week to three, the findings showed that drug use frequency decreased as employment hours increased.
"This is a significant discovery with unexpected results," Montoya said. "The opportunity to efficiently use tax payers' money by addressing two major problems at once is exciting and affords policy makers the opportunity to be creative in maximizing the use of limited resources."
Montoya's next steps are to design drug prevention efforts for drug using welfare recipients that rely upon this "work therapy" model as its key component to prevent continued drug use. Future drug prevention research efforts also may benefit from observing how individuals spend their time. These findings, he says, may further indicate that lack of opportunity for meaningful and rewarding work leads to an increased likelihood of negative behaviors. Filling that time with employment also would serve to reduce economic barriers.
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