Demographic Covariates and Vocational Rehabilitation Services as Predictors of Competitive Integrated Employment Among Prime Working-Age Adults Recovering from Addiction: A Hierarchical Logistic Regression Analysis

According to the 2023 National Survey on Drug Use and Health (NSDUH), approximately 48.7 million U.S. adults ages 18 and older (18.85%) experienced a substance use disorder in the past year. Employment is increasingly recognized as a critical public health intervention for individuals recovering from addiction. This study aimed to examine the extent to which demographic factors and vocational rehabilitation (VR) services predict competitive integrated employment (CIE) among prime working-age adults in addiction recovery. Using secondary data from the Rehabilitation Services Administration Case Service Report (RSA-911), the authors employed hierarchical logistic regression analysis to examine associations between demographic covariates, VR services, and CIE. Results indicated that low income and limited education were negatively associated with CIE, while men had higher odds of achieving CIE than women. Several VR services, including short-term support, maintenance service, other services, supported employment, job placement, job readiness, and VR counseling, were positively associated with CIE. These findings highlight empirically supported VR services that rehabilitation counselors can leverage to develop data-driven Individualized Plans for Employment and deliver evidence-based interventions aimed at improving employment outcomes for people recovering from addiction.