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APHA Scientific Session and Event Listing

Rebecca S. Spicer, PhD, MPH¹, Deborah Galvin, PhD², Geetha Waehrer, PhD¹, and Ted Miller, PhD¹. (1) Pacific Institute for Research and Evaluation, 11710 Beltsville Drive, Suite 300, Calverton, MD 20705, 301-755-2732, spicer@pire.org, (2) Division of Workplace Programs, Substance Abuse and Mental Health Administration, Center for Substance Abuse Prevention, 1 Choke Cherry Road, Room 2-1043, Rockville, MD 20857

With 19% of all American workers lacking health insurance it is important to understand more about the relationship of insurance coverage with substance abuse and access to workplace treatment services. Our analysis of the 2003 National Survey on Drug Use and Health found that a lack of health insurance is correlated with substance abuse: 40% of uninsured workers report some combination of past-month heavy (including binge) drinking or illicit drug use compared with 29% of insured workers. Compared to the insured, uninsured full-time workers are more likely to be heavy alcohol users (14% versus 8%) and twice as likely to report past month illicit drug use (14% versus 7%). Only 24% of uninsured workers (disproportionately in smaller firms which are less likely to offer health insurance) report access to Employee Assistance Programs (EAPs) compared to over half of insured workers. We conclude that uninsured workers have greater than average substance abuse but fewer protections against this problem and its consequences in the workplace. Workplace programs and policies (e.g. EAPs, drug and alcohol testing) were designed to address substance abuse in worker populations covered by private employer-sponsored insurance. It is not well understood how effective these programs are in companies (in particular large U.S. retailers) with high numbers of employees on pubic insurance (e.g. Medicaid) or with an uninsured employee base that has poor access to behavioral health care. Further study should examine the impact of uninsured workers on the level of substance abuse and its consequences in the workplace.

Learning Objectives: At the end of this session the participant will be able to

• Describe the relationship of insurance coverage with substance abuse and with access to workplace treatment services.
• Discuss teh implications of the study's findings for workplace substance abuse prevention, early intervention and treatment policy.
• Indentify possible ways for workplaces to address substance abuse and its consequences in the uninsured population.

Keywords: Health Insurance, Worksite

Presenting author's disclosure statement:

Not Answered