Year of Publication



Martin School of Public Policy and Administration

Executive Summary

Public funding of substance abuse treatment (SAT) in Kentucky dates back to the 1950s when legislators sought to curb the problem of alcoholism through legislative acts. The definition of substance abuse expanded through the years to include other substances such as cocaine, marijuana and opiates.

Employment after SAT is a critically important outcome for policymakers to consider when allocating funds because it assists in social re-integration, helps to prevent relapse and promotes economic self-sufficiency. Because of this, employment is an important factor to consider when assessing the impact SAT has on its clients (participants).

The Kentucky Alcohol and Other Drug Abuse Prevention, Intervention and Treatment Law was enacted in summer 1994, includes language requiring any substance abuse treatment center receiving state or federal funding to participate in an outcome study designed to measure the intervention‘s impact, if any, on a client. The statute mandates the study measure a client‘s length of participation in a treatment modality and change in behavior one year after discharge from the treatment program.

To meet the requirements set forth in the legislation, the University of Kentucky Center on Drug and Alcohol Research conducts the Kentucky Treatment Outcome Study (KTOS), a report prepared annually for the Department of Behavioral Health within the Cabinet for Health and Family Services. According to the KTOS website, "the study compares client self-report information from the two data collection times and produces reports on changes in substance use, criminal justice involvement, supports for recovery, living situation, and employment one year after treatment."

The evaluation is required to include information regarding change in alcohol and/or drug use patterns, employment status and involvement with the criminal justice system from admission to discharge from treatment. Regarding employment, data analysis was limited to examining changes in employment status, number of days paid for work and income during the previous month and year.

This analysis seeks to determine if factors such as setting (rural vs. urban), employment history, type of criminal history, type of drug use and existence of psychological problems impact employability after substance abuse treatment. Results show those living in a metro setting more likely to be employed after SAT than those living in the non-metro and very rural settings. Clients also show a greater likelihood of being employed after SAT if marijuana and/or opiate usage in the previous 12 months were not reported at intake. Finally, logistic regression modeling shows age and employment pattern at intake to be the most powerful predictors of employment pattern at follow-up. This confirms previous research showing that younger clients as more likely to enter employment after SAT.