Prior to prescribing, clinicians should be aware of a patient’s employment status as it may be a risk factor for possible nonmedical drug use, according to one of the first studies to assess the relationship between employment status and nonmedical prescription drug use.

Researchers at Columbia University’s Mailman School of Public Health sampled 58,486 adults ≥25 years based on combined data from 2011 to 2013 from the National Survey on Drug Use and Health. 

They found that people who were unemployed reported the highest odds of misusing prescription opioids (7%). This group also reported the highest odds of misusing prescription stimulants (2%). Overall, there were more users of nonmedical prescription opioids (3.5%) compared with nonmedical users of prescription stimulants (0.72%). 

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The odds of nonmedical prescription opioid use were higher in the 26–34 age group of unemployed adults. “Our results confirm the need for adult prevention and deterrence programs that target nonmedical prescription drug use, especially among those unemployed or not in the workforce,” said Silvia Martins, MD, PhD, and lead author of the study. 

Another group also noted for sensitivity was non-full-time employees, as this population “may suffer disproportionately from the indirect harms of nonmedical use of prescription opioids and stimulants insomuch that they have less family-neighborhood, and community-level social ties that would help mitigate harms related to misuse.” In the study, part-time employees showed higher odds of prescription stimulant misuse compared to full-time employees.

“With substance use disorders increasingly recognized as a public health issue – and not one of criminal justice – withholding social support, including treatment, from those with the highest need will contribute to increasing social inequalities,” said Dr. Martins.

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