Sociodemographic and economic characteristics mark potential barriers to recovery, and can help inform the development of treatment plans, healthcare system models, and policies. This study used Norwegian public health data to identify some of these factors that help uncover disadvantages for people with substance use disorder.
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Demographic, social, and economic factors associated with substance use disorders are important for developing individualized treatment plans and offering services that meet the needs of specific sub-populations. Characterizing sociodemographic factors in drug-specific populations can also inform new policies to help address inequalities in healthcare systems that hinder recovery among individuals with certain substance use disorders and sociodemographic backgrounds.
Though previous studies have evaluated the sociodemographics associated with substance use disorders in treatment settings or in the broader population, there are several limitations to this research. Data that concern the entire population are often restricted to the evaluation of the most prevalent types of substance use disorders (e.g., alcohol, cannabis), which limit important comparisons between less prevalent drug use disorders with significant societal impact (e.g., opioids, sedatives). Moreover, few largescale (e.g., national) investigations of treatment-seeking populations have compared sociodemographic factors across multiple different drug classes, restricting our ability to make drug-specific conclusions and recommendations.
Additional large-scale population level research looking at the sociodemographic and economic characteristics associated with specific substance use disorders among individuals in addiction treatment is needed to further inform our understanding of addiction and enhance individualized treatment approaches. International research is also needed to speak to cultural (e.g., drug trends) and healthcare differences (e.g., publicly vs. privately funded addiction healthcare systems) that might influence different findings in different countries. In this study, the researchers used national Norwegian public health data to evaluate sociodemographic differences between individuals receiving publicly funded substance use disorder treatment and the general population, and between individuals with different types of substance use disorders.
The research team conducted a national retrospective case-control study of 31,245 individuals with substance use disorders who were enrolled in treatment in Norway, and 31,275 individuals from the general population in Norway (i.e., control group).
Two primary datasets were used to extract sociodemographic data, including the Norwegian Patient Registry and the Norwegian National Population Register. The Norwegian Patient Registry, consisting of the entire population of patients in Norway’s public specialized healthcare system, was used to extract a sample of individuals with a primary diagnosis of substance use disorder who were admitted to specialized substance use disorder treatment or a psychiatric hospital between 2009 and 2010. The Norwegian National Population Register was used to obtain a random sample of age and gender matched individuals from the general population who were surveyed in 2010.
Substance use disorders assessed in this study included a primary diagnosis of: 1) alcohol use disorder (40%), 2) opioid use disorder (19%), 3) cannabis use disorder (11%), 4) sedative/hypnotic use disorder (5%; e.g., benzodiazepines), 5) cocaine use disorder (1%), 6) other stimulants (7%; e.g., amphetamines), and 7) other substance use disorders or several substance use disorders (17%), which may have included alcohol and/or sedatives/hypnotics. These disorders were also grouped into licit and illicit substance use disorders. Licit substance use disorder (45%) included alcohol use disorder and sedative/hypnotic use disorder. Illicit substance use disorder (55%) included all other categories.
Sociodemographic variables of interest included:
Sociodemographic factors (percentages and averages) were compared between patient vs. control populations and between patients with illicit vs. licit substance use disorders. Means and percentages among specific substance groups were also compared by examining differences between patients with different types of substance use disorder.
Individuals with substance use disorders were more disadvantaged in all sociodemographic and economic categories.
Compared to the general population, individuals admitted to substance use disorder treatment were more likely to have a low level of education, to have a father with a low level of education, to live alone in an urban dwelling, and to receive disability pensions and government financial assistance.
The general population had a greater percentage of people who lived with young children and were employed, with a higher average annual income and higher annual wealth.
Individuals with an illicit substance use disorder were more disadvantaged in all sociodemographic and economic categories.
Compared to individuals with licit substance use disorders and controlling for age and gender, those with illicit substance use disorders were more likely to have a low level of education, to have a father with a low level of education, to live alone in an urban dwelling, and to receive disability pensions and government financial assistance.
A greater percentage of people with a licit substance use disorder lived with young children and were employed, with a higher average annual income and higher average annual wealth.
Figure 1. This figure shows sociodemographic differences between the general Norwegian population and individuals in Norway who were admitted to treatment for a substance use disorder, as well as differences between those with a primary diagnosis of a licit versus illicit substance use disorder. Those with any substance use disorder had disadvantaged sociodemographic and economic characteristics across all categories, relative to the general population. Compared to individuals with licit substance use disorders, those with illicit disorders had disadvantaged sociodemographic and economic characteristics across all categories. In this study, licit substance use disorders included 1) alcohol use disorder and 2) sedative/hypnotic use disorder, whereas illicit substance use disorders included 1) opioid use disorder, 2) cannabis use disorder, 3) cocaine use disorder, 4) other stimulant use disorders, and 5) ‘other substance use disorders or multiple primary substance use disorders.
The opioid group was particularly disadvantaged.
Individuals with opioid use disorder had the highest percentage of individuals with low educational achievement, who were living alone, receiving government financial assistance and disability pensions. They also had the lowest likelihood of being employed, the lowest average annual income, and the lowest average annual wealth.
Individuals with alcohol use disorder and those with cocaine use disorder were most likely to be employed, had the highest average annual income, and were the least likely to have low educational attainment, to receive disability pensions and government financial assistance. In addition, individuals with cocaine use disorder less commonly lived alone and were most likely to live in an urban dwelling.
Figures 2 and 3. The highest and lowest percentages within each sociodemographic category that differed from all other substance use disorders are shown in bold red ink. Individuals with opioid use disorder were more likely than those with all other substance use disorders to have a low level of education and to receive government financial assistance and were the least likely to be employed. Individuals with cocaine use disorder were significantly less likely to be living alone relative to those with all other substance use disorders.
Figure 4. The highest and lowest values within each sociodemographic category that differed from all other substance use disorders are shown in bold red ink. Individuals with opioid use disorder had significantly lower average annual income and lower average annual wealth compared to all other substance use disorders. Individuals with cocaine use disorder had a significantly higher average annual income relative to all other substance use disorder groups.
This study helps us better understand the characteristics of individuals who have substance use disorders, and how these characteristics differ by substance type. Studies like this can ultimately help us better understand the barriers to long-term recovery that patients might be facing which can inform individualized treatment plans and programs geared toward addressing disparities in certain substance use disorder populations.
The outcomes of this study are consistent with prior research conducted in other countries (e.g., United States, Finland, etc.), showing that individuals with substance use disorders have demographic and socioeconomic characteristics that put them at a disadvantage relative to the general population, including financial and educational disadvantages. Prior studies have found that living with a partner or being married may be a protective factor against developing a substance use disorder, and this study further suggests that living with young children may also be a protective factor. Whether these sociodemographic factors came before or after the substance use disorder developed is unclear, but these disadvantages have important implications for how healthcare systems can help support individuals in treatment and recovery. Understanding the differences between various types of substance use disorders can further inform individualized treatment approaches that help create an equal playing field for successful recovery outcomes.
In this study, individuals with opioid use disorders were most likely to have disadvantages, a finding demonstrated in previous research. For example, individuals with a history of opioid use disorder in the United States are shown to have lower employment rates and quality of life relative to individuals without a history of opioid problems. Even among people in recovery, those recovering from opioid problems show larger disadvantages, including lower recovery capital (resources that are needed to support recovery, such as basic needs, employment, social support, etc.) compared to individuals recovering from other substance use problems like alcohol and cannabis. These disadvantages may place individuals with opioid use disorder at increased risk for recurrence of substance use and disorder symptoms after treatment and work against their long-term recovery. Indeed studies show that being employed is associated with higher quality of life, self-esteem, and happiness. Therefore, it appears that healthcare and government systems might benefit from implementing employment training and access programs that help individuals who are seeking recovery from opioid use disorder. Doing so could help individuals acquire the skills and resources they need to build a stronger foundation from which they can launch a successful recovery journey, including adequate education and job skills/opportunities that can promote financial stability and long-term wellbeing to support recovery. Though licit substance use disorders like alcohol use disorder are associated with fewer disadvantages than the other substances, this group was still less well-off than the general population and, therefore, also require assistance to improve their social and economic wellbeing.
It is worth noting that addiction treatment is a public health service that is offered virtually free of charge in Norway, limiting the influence of financial barriers to treatment entry and completion on this study’s outcomes. Though treatment is more financially accessible in Norway, economic-related disparities nonetheless emerged for individuals with substance use disorders which could hinder successful recovery after treatment completion. For example, reduced income and wealth relative to the general population might limit one’s ability to flourish beyond treatment if opportunities do not arise to grow financial resources that help one afford basic needs and build recovery capital. Individuals with illicit substance use disorders, opioid use disorder in particular, appear to be more greatly disadvantaged financially and might require enhanced support to boost their economic status during/after treatment. Programs that help one obtain vocational skills and employment, or that help individuals plan for investment and retirement, might help promote financial stability in addition to long-term well-being.
Individuals with substance use disorder were more socially and economically disadvantaged relative to the general population, such that they had a lower average annual income and lower annual wealth, were more likely to have a low level of education, to be unemployed, and to receive disability pensions and government financial assistance. Those who had illicit substance use disorders faced more pronounced socioeconomic obstacles than individuals with licit substance use disorders. Specifically, those with opioid use disorder faced the greatest degree of disadvantage relative to the other substance groups, whereas those with alcohol use disorder and cocaine use disorder fared somewhat better.
Amundsen, E. J., Bretteville-Jensen, A. L., & Rossow, I. (2022). Patients admitted to treatment for substance use disorder in Norway: a population-based case–control study of socio-demographic correlates and comparative analyses across substance use disorders. BMC public health, 22(1), 1-12. doi: 10.1186/s12889-022-13199-5
l
Demographic, social, and economic factors associated with substance use disorders are important for developing individualized treatment plans and offering services that meet the needs of specific sub-populations. Characterizing sociodemographic factors in drug-specific populations can also inform new policies to help address inequalities in healthcare systems that hinder recovery among individuals with certain substance use disorders and sociodemographic backgrounds.
Though previous studies have evaluated the sociodemographics associated with substance use disorders in treatment settings or in the broader population, there are several limitations to this research. Data that concern the entire population are often restricted to the evaluation of the most prevalent types of substance use disorders (e.g., alcohol, cannabis), which limit important comparisons between less prevalent drug use disorders with significant societal impact (e.g., opioids, sedatives). Moreover, few largescale (e.g., national) investigations of treatment-seeking populations have compared sociodemographic factors across multiple different drug classes, restricting our ability to make drug-specific conclusions and recommendations.
Additional large-scale population level research looking at the sociodemographic and economic characteristics associated with specific substance use disorders among individuals in addiction treatment is needed to further inform our understanding of addiction and enhance individualized treatment approaches. International research is also needed to speak to cultural (e.g., drug trends) and healthcare differences (e.g., publicly vs. privately funded addiction healthcare systems) that might influence different findings in different countries. In this study, the researchers used national Norwegian public health data to evaluate sociodemographic differences between individuals receiving publicly funded substance use disorder treatment and the general population, and between individuals with different types of substance use disorders.
The research team conducted a national retrospective case-control study of 31,245 individuals with substance use disorders who were enrolled in treatment in Norway, and 31,275 individuals from the general population in Norway (i.e., control group).
Two primary datasets were used to extract sociodemographic data, including the Norwegian Patient Registry and the Norwegian National Population Register. The Norwegian Patient Registry, consisting of the entire population of patients in Norway’s public specialized healthcare system, was used to extract a sample of individuals with a primary diagnosis of substance use disorder who were admitted to specialized substance use disorder treatment or a psychiatric hospital between 2009 and 2010. The Norwegian National Population Register was used to obtain a random sample of age and gender matched individuals from the general population who were surveyed in 2010.
Substance use disorders assessed in this study included a primary diagnosis of: 1) alcohol use disorder (40%), 2) opioid use disorder (19%), 3) cannabis use disorder (11%), 4) sedative/hypnotic use disorder (5%; e.g., benzodiazepines), 5) cocaine use disorder (1%), 6) other stimulants (7%; e.g., amphetamines), and 7) other substance use disorders or several substance use disorders (17%), which may have included alcohol and/or sedatives/hypnotics. These disorders were also grouped into licit and illicit substance use disorders. Licit substance use disorder (45%) included alcohol use disorder and sedative/hypnotic use disorder. Illicit substance use disorder (55%) included all other categories.
Sociodemographic variables of interest included:
Sociodemographic factors (percentages and averages) were compared between patient vs. control populations and between patients with illicit vs. licit substance use disorders. Means and percentages among specific substance groups were also compared by examining differences between patients with different types of substance use disorder.
Individuals with substance use disorders were more disadvantaged in all sociodemographic and economic categories.
Compared to the general population, individuals admitted to substance use disorder treatment were more likely to have a low level of education, to have a father with a low level of education, to live alone in an urban dwelling, and to receive disability pensions and government financial assistance.
The general population had a greater percentage of people who lived with young children and were employed, with a higher average annual income and higher annual wealth.
Individuals with an illicit substance use disorder were more disadvantaged in all sociodemographic and economic categories.
Compared to individuals with licit substance use disorders and controlling for age and gender, those with illicit substance use disorders were more likely to have a low level of education, to have a father with a low level of education, to live alone in an urban dwelling, and to receive disability pensions and government financial assistance.
A greater percentage of people with a licit substance use disorder lived with young children and were employed, with a higher average annual income and higher average annual wealth.
Figure 1. This figure shows sociodemographic differences between the general Norwegian population and individuals in Norway who were admitted to treatment for a substance use disorder, as well as differences between those with a primary diagnosis of a licit versus illicit substance use disorder. Those with any substance use disorder had disadvantaged sociodemographic and economic characteristics across all categories, relative to the general population. Compared to individuals with licit substance use disorders, those with illicit disorders had disadvantaged sociodemographic and economic characteristics across all categories. In this study, licit substance use disorders included 1) alcohol use disorder and 2) sedative/hypnotic use disorder, whereas illicit substance use disorders included 1) opioid use disorder, 2) cannabis use disorder, 3) cocaine use disorder, 4) other stimulant use disorders, and 5) ‘other substance use disorders or multiple primary substance use disorders.
The opioid group was particularly disadvantaged.
Individuals with opioid use disorder had the highest percentage of individuals with low educational achievement, who were living alone, receiving government financial assistance and disability pensions. They also had the lowest likelihood of being employed, the lowest average annual income, and the lowest average annual wealth.
Individuals with alcohol use disorder and those with cocaine use disorder were most likely to be employed, had the highest average annual income, and were the least likely to have low educational attainment, to receive disability pensions and government financial assistance. In addition, individuals with cocaine use disorder less commonly lived alone and were most likely to live in an urban dwelling.
Figures 2 and 3. The highest and lowest percentages within each sociodemographic category that differed from all other substance use disorders are shown in bold red ink. Individuals with opioid use disorder were more likely than those with all other substance use disorders to have a low level of education and to receive government financial assistance and were the least likely to be employed. Individuals with cocaine use disorder were significantly less likely to be living alone relative to those with all other substance use disorders.
Figure 4. The highest and lowest values within each sociodemographic category that differed from all other substance use disorders are shown in bold red ink. Individuals with opioid use disorder had significantly lower average annual income and lower average annual wealth compared to all other substance use disorders. Individuals with cocaine use disorder had a significantly higher average annual income relative to all other substance use disorder groups.
This study helps us better understand the characteristics of individuals who have substance use disorders, and how these characteristics differ by substance type. Studies like this can ultimately help us better understand the barriers to long-term recovery that patients might be facing which can inform individualized treatment plans and programs geared toward addressing disparities in certain substance use disorder populations.
The outcomes of this study are consistent with prior research conducted in other countries (e.g., United States, Finland, etc.), showing that individuals with substance use disorders have demographic and socioeconomic characteristics that put them at a disadvantage relative to the general population, including financial and educational disadvantages. Prior studies have found that living with a partner or being married may be a protective factor against developing a substance use disorder, and this study further suggests that living with young children may also be a protective factor. Whether these sociodemographic factors came before or after the substance use disorder developed is unclear, but these disadvantages have important implications for how healthcare systems can help support individuals in treatment and recovery. Understanding the differences between various types of substance use disorders can further inform individualized treatment approaches that help create an equal playing field for successful recovery outcomes.
In this study, individuals with opioid use disorders were most likely to have disadvantages, a finding demonstrated in previous research. For example, individuals with a history of opioid use disorder in the United States are shown to have lower employment rates and quality of life relative to individuals without a history of opioid problems. Even among people in recovery, those recovering from opioid problems show larger disadvantages, including lower recovery capital (resources that are needed to support recovery, such as basic needs, employment, social support, etc.) compared to individuals recovering from other substance use problems like alcohol and cannabis. These disadvantages may place individuals with opioid use disorder at increased risk for recurrence of substance use and disorder symptoms after treatment and work against their long-term recovery. Indeed studies show that being employed is associated with higher quality of life, self-esteem, and happiness. Therefore, it appears that healthcare and government systems might benefit from implementing employment training and access programs that help individuals who are seeking recovery from opioid use disorder. Doing so could help individuals acquire the skills and resources they need to build a stronger foundation from which they can launch a successful recovery journey, including adequate education and job skills/opportunities that can promote financial stability and long-term wellbeing to support recovery. Though licit substance use disorders like alcohol use disorder are associated with fewer disadvantages than the other substances, this group was still less well-off than the general population and, therefore, also require assistance to improve their social and economic wellbeing.
It is worth noting that addiction treatment is a public health service that is offered virtually free of charge in Norway, limiting the influence of financial barriers to treatment entry and completion on this study’s outcomes. Though treatment is more financially accessible in Norway, economic-related disparities nonetheless emerged for individuals with substance use disorders which could hinder successful recovery after treatment completion. For example, reduced income and wealth relative to the general population might limit one’s ability to flourish beyond treatment if opportunities do not arise to grow financial resources that help one afford basic needs and build recovery capital. Individuals with illicit substance use disorders, opioid use disorder in particular, appear to be more greatly disadvantaged financially and might require enhanced support to boost their economic status during/after treatment. Programs that help one obtain vocational skills and employment, or that help individuals plan for investment and retirement, might help promote financial stability in addition to long-term well-being.
Individuals with substance use disorder were more socially and economically disadvantaged relative to the general population, such that they had a lower average annual income and lower annual wealth, were more likely to have a low level of education, to be unemployed, and to receive disability pensions and government financial assistance. Those who had illicit substance use disorders faced more pronounced socioeconomic obstacles than individuals with licit substance use disorders. Specifically, those with opioid use disorder faced the greatest degree of disadvantage relative to the other substance groups, whereas those with alcohol use disorder and cocaine use disorder fared somewhat better.
Amundsen, E. J., Bretteville-Jensen, A. L., & Rossow, I. (2022). Patients admitted to treatment for substance use disorder in Norway: a population-based case–control study of socio-demographic correlates and comparative analyses across substance use disorders. BMC public health, 22(1), 1-12. doi: 10.1186/s12889-022-13199-5
l
Demographic, social, and economic factors associated with substance use disorders are important for developing individualized treatment plans and offering services that meet the needs of specific sub-populations. Characterizing sociodemographic factors in drug-specific populations can also inform new policies to help address inequalities in healthcare systems that hinder recovery among individuals with certain substance use disorders and sociodemographic backgrounds.
Though previous studies have evaluated the sociodemographics associated with substance use disorders in treatment settings or in the broader population, there are several limitations to this research. Data that concern the entire population are often restricted to the evaluation of the most prevalent types of substance use disorders (e.g., alcohol, cannabis), which limit important comparisons between less prevalent drug use disorders with significant societal impact (e.g., opioids, sedatives). Moreover, few largescale (e.g., national) investigations of treatment-seeking populations have compared sociodemographic factors across multiple different drug classes, restricting our ability to make drug-specific conclusions and recommendations.
Additional large-scale population level research looking at the sociodemographic and economic characteristics associated with specific substance use disorders among individuals in addiction treatment is needed to further inform our understanding of addiction and enhance individualized treatment approaches. International research is also needed to speak to cultural (e.g., drug trends) and healthcare differences (e.g., publicly vs. privately funded addiction healthcare systems) that might influence different findings in different countries. In this study, the researchers used national Norwegian public health data to evaluate sociodemographic differences between individuals receiving publicly funded substance use disorder treatment and the general population, and between individuals with different types of substance use disorders.
The research team conducted a national retrospective case-control study of 31,245 individuals with substance use disorders who were enrolled in treatment in Norway, and 31,275 individuals from the general population in Norway (i.e., control group).
Two primary datasets were used to extract sociodemographic data, including the Norwegian Patient Registry and the Norwegian National Population Register. The Norwegian Patient Registry, consisting of the entire population of patients in Norway’s public specialized healthcare system, was used to extract a sample of individuals with a primary diagnosis of substance use disorder who were admitted to specialized substance use disorder treatment or a psychiatric hospital between 2009 and 2010. The Norwegian National Population Register was used to obtain a random sample of age and gender matched individuals from the general population who were surveyed in 2010.
Substance use disorders assessed in this study included a primary diagnosis of: 1) alcohol use disorder (40%), 2) opioid use disorder (19%), 3) cannabis use disorder (11%), 4) sedative/hypnotic use disorder (5%; e.g., benzodiazepines), 5) cocaine use disorder (1%), 6) other stimulants (7%; e.g., amphetamines), and 7) other substance use disorders or several substance use disorders (17%), which may have included alcohol and/or sedatives/hypnotics. These disorders were also grouped into licit and illicit substance use disorders. Licit substance use disorder (45%) included alcohol use disorder and sedative/hypnotic use disorder. Illicit substance use disorder (55%) included all other categories.
Sociodemographic variables of interest included:
Sociodemographic factors (percentages and averages) were compared between patient vs. control populations and between patients with illicit vs. licit substance use disorders. Means and percentages among specific substance groups were also compared by examining differences between patients with different types of substance use disorder.
Individuals with substance use disorders were more disadvantaged in all sociodemographic and economic categories.
Compared to the general population, individuals admitted to substance use disorder treatment were more likely to have a low level of education, to have a father with a low level of education, to live alone in an urban dwelling, and to receive disability pensions and government financial assistance.
The general population had a greater percentage of people who lived with young children and were employed, with a higher average annual income and higher annual wealth.
Individuals with an illicit substance use disorder were more disadvantaged in all sociodemographic and economic categories.
Compared to individuals with licit substance use disorders and controlling for age and gender, those with illicit substance use disorders were more likely to have a low level of education, to have a father with a low level of education, to live alone in an urban dwelling, and to receive disability pensions and government financial assistance.
A greater percentage of people with a licit substance use disorder lived with young children and were employed, with a higher average annual income and higher average annual wealth.
Figure 1. This figure shows sociodemographic differences between the general Norwegian population and individuals in Norway who were admitted to treatment for a substance use disorder, as well as differences between those with a primary diagnosis of a licit versus illicit substance use disorder. Those with any substance use disorder had disadvantaged sociodemographic and economic characteristics across all categories, relative to the general population. Compared to individuals with licit substance use disorders, those with illicit disorders had disadvantaged sociodemographic and economic characteristics across all categories. In this study, licit substance use disorders included 1) alcohol use disorder and 2) sedative/hypnotic use disorder, whereas illicit substance use disorders included 1) opioid use disorder, 2) cannabis use disorder, 3) cocaine use disorder, 4) other stimulant use disorders, and 5) ‘other substance use disorders or multiple primary substance use disorders.
The opioid group was particularly disadvantaged.
Individuals with opioid use disorder had the highest percentage of individuals with low educational achievement, who were living alone, receiving government financial assistance and disability pensions. They also had the lowest likelihood of being employed, the lowest average annual income, and the lowest average annual wealth.
Individuals with alcohol use disorder and those with cocaine use disorder were most likely to be employed, had the highest average annual income, and were the least likely to have low educational attainment, to receive disability pensions and government financial assistance. In addition, individuals with cocaine use disorder less commonly lived alone and were most likely to live in an urban dwelling.
Figures 2 and 3. The highest and lowest percentages within each sociodemographic category that differed from all other substance use disorders are shown in bold red ink. Individuals with opioid use disorder were more likely than those with all other substance use disorders to have a low level of education and to receive government financial assistance and were the least likely to be employed. Individuals with cocaine use disorder were significantly less likely to be living alone relative to those with all other substance use disorders.
Figure 4. The highest and lowest values within each sociodemographic category that differed from all other substance use disorders are shown in bold red ink. Individuals with opioid use disorder had significantly lower average annual income and lower average annual wealth compared to all other substance use disorders. Individuals with cocaine use disorder had a significantly higher average annual income relative to all other substance use disorder groups.
This study helps us better understand the characteristics of individuals who have substance use disorders, and how these characteristics differ by substance type. Studies like this can ultimately help us better understand the barriers to long-term recovery that patients might be facing which can inform individualized treatment plans and programs geared toward addressing disparities in certain substance use disorder populations.
The outcomes of this study are consistent with prior research conducted in other countries (e.g., United States, Finland, etc.), showing that individuals with substance use disorders have demographic and socioeconomic characteristics that put them at a disadvantage relative to the general population, including financial and educational disadvantages. Prior studies have found that living with a partner or being married may be a protective factor against developing a substance use disorder, and this study further suggests that living with young children may also be a protective factor. Whether these sociodemographic factors came before or after the substance use disorder developed is unclear, but these disadvantages have important implications for how healthcare systems can help support individuals in treatment and recovery. Understanding the differences between various types of substance use disorders can further inform individualized treatment approaches that help create an equal playing field for successful recovery outcomes.
In this study, individuals with opioid use disorders were most likely to have disadvantages, a finding demonstrated in previous research. For example, individuals with a history of opioid use disorder in the United States are shown to have lower employment rates and quality of life relative to individuals without a history of opioid problems. Even among people in recovery, those recovering from opioid problems show larger disadvantages, including lower recovery capital (resources that are needed to support recovery, such as basic needs, employment, social support, etc.) compared to individuals recovering from other substance use problems like alcohol and cannabis. These disadvantages may place individuals with opioid use disorder at increased risk for recurrence of substance use and disorder symptoms after treatment and work against their long-term recovery. Indeed studies show that being employed is associated with higher quality of life, self-esteem, and happiness. Therefore, it appears that healthcare and government systems might benefit from implementing employment training and access programs that help individuals who are seeking recovery from opioid use disorder. Doing so could help individuals acquire the skills and resources they need to build a stronger foundation from which they can launch a successful recovery journey, including adequate education and job skills/opportunities that can promote financial stability and long-term wellbeing to support recovery. Though licit substance use disorders like alcohol use disorder are associated with fewer disadvantages than the other substances, this group was still less well-off than the general population and, therefore, also require assistance to improve their social and economic wellbeing.
It is worth noting that addiction treatment is a public health service that is offered virtually free of charge in Norway, limiting the influence of financial barriers to treatment entry and completion on this study’s outcomes. Though treatment is more financially accessible in Norway, economic-related disparities nonetheless emerged for individuals with substance use disorders which could hinder successful recovery after treatment completion. For example, reduced income and wealth relative to the general population might limit one’s ability to flourish beyond treatment if opportunities do not arise to grow financial resources that help one afford basic needs and build recovery capital. Individuals with illicit substance use disorders, opioid use disorder in particular, appear to be more greatly disadvantaged financially and might require enhanced support to boost their economic status during/after treatment. Programs that help one obtain vocational skills and employment, or that help individuals plan for investment and retirement, might help promote financial stability in addition to long-term well-being.
Individuals with substance use disorder were more socially and economically disadvantaged relative to the general population, such that they had a lower average annual income and lower annual wealth, were more likely to have a low level of education, to be unemployed, and to receive disability pensions and government financial assistance. Those who had illicit substance use disorders faced more pronounced socioeconomic obstacles than individuals with licit substance use disorders. Specifically, those with opioid use disorder faced the greatest degree of disadvantage relative to the other substance groups, whereas those with alcohol use disorder and cocaine use disorder fared somewhat better.
Amundsen, E. J., Bretteville-Jensen, A. L., & Rossow, I. (2022). Patients admitted to treatment for substance use disorder in Norway: a population-based case–control study of socio-demographic correlates and comparative analyses across substance use disorders. BMC public health, 22(1), 1-12. doi: 10.1186/s12889-022-13199-5
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