Prevalence and Correlates of Pre-Employment Drug Screens and Job Denial among Veterans with Co-Occurring Conditions

Subst Use Addctn J. 2026 Mar 17:29767342261426114. doi: 10.1177/29767342261426114. Online ahead of print.

ABSTRACT

BACKGROUND: Unemployment is associated with a range of negative consequences and is common among individuals with co-occurring mental health and substance use disorders. Pre-employment drug screens are a potential barrier to attaining employment among individuals who use substances, but little is known about the prevalence and correlates of encountering a pre-employment drug screen and subsequent job denial due to positive drug screen results.

METHODS: Altogether, 500 veterans with a comorbid mental health and substance use disorder completed surveys via a national Qualtrics panel. We examined prevalence rates as well as social, clinical, and demographic correlates of encountering a pre-employment drug screen and being denied a job as a result of a pre-employment drug screen.

RESULTS: Of the 500 participants, 88.2% had encountered a pre-employment drug screen, and 39.9% of this group had been denied a job due to the results of a pre-employment drug screen. In multivariate analyses, older age and higher scores on a questionnaire about drug use were significant predictors of encountering a pre-employment drug screen, while higher scores on separate questionnaires about drug use and alcohol use were significant predictors of job denial.

CONCLUSIONS: Findings from this study suggest that encountering pre-employment drug screens and being denied a job due to pre-employment drug screens are common among Veterans with mental health and substance use conditions. Individuals with high drug use and/or alcohol use may be at greatest risk. Continued research on this common experience is needed to support employment recovery among people who use substances.

PMID:41841558 | DOI:10.1177/29767342261426114