Interventions for Unemployed Hazardous Drinkers

Despite recent improvements in the US economy, unemployment remains a significant concern,
and estimates indicate that one-third of unemployed persons drink at hazardous levels,
adversely impacting their health and abilities to find jobs. Reinforcement interventions are
highly efficacious in reducing substance use, and they can be applied to increase job-seeking
activities as well. In partnership with CT United Labor Agency, this project is designed to
reduce hazardous drinking and enhance active participation in job-seeking activities among
those with job loss. It will evaluate the independent and combined effects of reinforcing
negative breathalyzer samples and job-seeking activities to ascertain the simplest and most
cost-effective approach to improving outcomes in this population. Unemployed individuals with
hazardous drinking (N = 280) will be randomly assigned to one of four conditions using a 2 x
2 design: standard care, standard care with reinforcement for submitting negative
breathalyzer samples, standard care with reinforcement for job-seeking activities, or
standard care plus reinforcement for both negative breathalyzer samples and job-seeking
activities. Participants in all conditions will receive usual services part of CT United
Labor Agency, along with a novel remote breath alcohol monitoring procedure. The study
interventions will be in effect for three months, and participants will be followed for one
year. Alcohol and other drug use, employment, psychiatric symptoms, and global measures of
health will be assessed throughout treatment and follow-up. Reinforcing negative breathalyzer
samples is expected to significantly reduce drinking, and reinforcing job-seeking activities
is expected to increase re-employment rates and reduce time until job attainment. Reinforcing
both negative breathalyzer samples and job-seeking activities is hypothesized to improve
outcomes along both domains. The reinforcement interventions may also decrease psychiatric
distress and slow progression of physical decline, common among the unemployed. If
efficacious and cost-effective, results from this study may stimulate adoption of
reinforcement interventions in the context of unemployment services. Reducing the adverse
consequences of hazardous drinking and improving job re-entry may have pronounced benefits in
a highly vulnerable segment of the US population.