Abstract
Background
Substance use disorders (SUDs) pose significant challenges for workforce participation, with stigma identified as a major barrier affecting employment outcomes and recovery processes.
Objective
This scoping review examines (1) barriers faced by individuals with SUDs in workforce participation, (2) social and psychological effects of workplace stigma, (3) potential benefits of employment for these individuals, and (4) recommendations for improving workplace environments.
Methods
A scoping review was conducted across CINAHL, Science Direct, Web of Science, and ULAKBIM databases (2015–2025). Fifteen studies meeting eligibility criteria were analyzed using MAXQDA, and methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT).
Results
Four themes emerged, namely barriers (stigma, poor working conditions, wage inequality, job search difficulties, discriminatory labor market attitudes), benefits of workforce participation (personal, social, and interactional), facilitators (previous work experience, social support), and workplace improvement recommendations (anti-stigma training, work-life-treatment balance, employment policies).
Conclusions
Workforce participation plays a pivotal role in breaking the addiction cycle. Addressing stigma through anti-discrimination policies, work-life balance regulations, and targeted employment support is essential for successful integration of individuals with SUDs into the workforce.
Keywords
Introduction
One major effect of substance misuse involves its burden on public well-being and financial systems, affecting personal relationships at home, work, and among peers - alongside broader community consequences.1–4 When people struggle with drugs or alcohol, they often pull away from loved ones, classrooms, and close connections; over time, disengagement grows, reshaping daily routines into something more solitary.5–9 Left unchecked, this separation harms both body and mind, 10 increasing risks such as job loss, unstable housing, and involvement with crime.11–13 These barriers make reconnection harder, limiting chances for full participation in everyday life,14,15 while judgment from others adds further strain through exclusion and bias.16,75 Stigma's harmful effects go well beyond individual well-being, reaching into how people engage socially and economically. Employment becomes harder to access or sustain when someone has a substance use disorder. This lack of work deepens isolation while weakening financial security. Seeing these challenges clearly helps shape better support systems. Policies gain strength when built on real experiences of those affected. Recovery pathways change when workplaces become more open. Economic outcomes shift once inclusion moves from idea to practice.
Worldwide, around 11.3 million people struggle with substance abuse; meanwhile, findings from a major Canadian investigation show stronger negative attitudes toward those with drug dependence compared to others.17,18 Rejection due to bias may affect multiple areas - jobs, personal connections, medical care included.19,20 Despite progress elsewhere, barriers still block many who use substances from joining the labor market. Earning potential often depends heavily on whether someone can secure steady work. One way to ease economic strain involves removing obstacles that people with substance use disorders face. When these hurdles stay in place, joblessness tends to rise - costing more over time while limiting output. Trouble staying sober often complicates reentry into work life. Feeling cut off from coworkers or bosses adds another layer of difficulty. Sometimes, even when capable, workers are seen as less reliable because of past addiction21,57,73, 76 Addressing these barriers and reducing unemployment among substance users is vital for preventing economic losses and promoting their successful integration into society.22,23 However, preventing unemployment related explicitly to substance addiction helps avoid economic losses and provides a significant advantage in the individual's social integration.23,24 Additionally, supporting an individual's participation in the workforce can be a crucial motivational factor in breaking the cycle of addiction and achieving societal acceptance. Moreover, supporting individuals with substance use disorders in their participation in the workforce and their acceptance within society are considered key motivators in breaking the cycle of addiction. This review addresses four specific objectives as (1) to identify barriers faced by individuals with SUDs in workforce participation; (2) to examine the social and psychological effects of stigma towards these individuals in the workplace; (3) to explore the potential benefits of workforce participation for individuals with SUDs; and (4) to synthesize recommendations for improving workplace environments to support their integration. Beyond focusing solely on challenges, this analysis pulls together past research to explore how stigma blocks job engagement among people dealing with substance use disorders. Because workplace inclusion remains uneven, attention shifts toward how better working environments might support recovery and stability. Although earlier studies have touched on employment hurdles tied to SUDs, what sets this overview apart is its structured look at both social judgment and labor market outcomes. Instead of stopping at obstacles, it unfolds the positive effects that jobs can bring - ranging from income to renewed self-worth. Rather than presenting one-sided conclusions, the examination weaves together opposing elements: exclusion versus opportunity, difficulty versus progress. Through this lens, integration into work settings appears less like an exception and more like a realistic path forward.
This research connects to the global targets set in 2015, especially Goal Three: promoting health and well-being. Progress that lasts requires harmony among society, nature, and financial systems to lift living standards across time. Tackling misuse of substances supports this aim directly. When people recovering from addiction work, they add value - through labor and taxes - which strengthens communities slowly but steadily. Feeling useful on the job may also reshape how those with past dependencies view themselves, quietly lowering chances of falling back. Though unseen at times, these shifts matter deeply. Working alongside people who have faced substance use challenges brings communities closer to fairness. Previous research25–29 backs this idea. Although some recent efforts touch on recovery programs29–32 - few papers examine up-to-date shifts. Even fewer explore new directions (see33–35). Because of this gap, the present overview turns attention toward an overlooked topic in both public health and employment research. Through structured methods, it examines how stigma shapes mental well-being, weighs obstacles against advantages, then suggests realistic steps forward. In doing so, it adds value while pointing out why deeper inquiry remains essential.
Materials and methods
Beginning with a wide lens, scoping reviews pull together available evidence on a given subject. They map what is already known by sorting through studies across journals, books, policy papers, and similar materials. 72 Rather than focusing narrowly, these reviews cast a broad net to capture the scope of work done so far. One key aim stands out - spotting where information is missing. Through systematic searching, researchers gather relevant material, then examine it to trace patterns or absences. The outcome often shapes how scholars approach unanswered questions later. Such efforts help clarify which areas need deeper study. What emerges is a clearer picture of present understanding, built piece by piece.
This study chooses the scoping review approach for distinct purposes. First, because it allows exploration beyond clinical aspects - extending into social, economic, and emotional consequences tied to substance misuse. Examining diverse literature reveals how prejudice affects job opportunities for people dealing with addiction. Different studies, built on varied methods and ways of gathering information, help uncover common patterns in workplace exclusion. Evidence drawn from multiple sources sheds light on obstacles within hiring systems. Some reports highlight positive outcomes when those recovering find stable jobs. Factors that support successful entry into work environments begin to emerge through wide-ranging analysis. Insights gathered lead to specific suggestions - not vague ideas - for helping integrate affected individuals into labor markets.
Search strategy and study selection
In order to select the articles to be included in the review, the databases and the references of the articles were examined, and expert opinion was obtained. The study was carried out by retrospectively reviewing the publications related to the topic in databases. The studies were accessed by three researchers from CINAHL, Science Direct, Web of Science and ULAKBİM databases. A preliminary literature review was conducted for the keywords to be used in the search, and some experts in the field were interviewed (a manager and a psychologist in the Directorate of Probation; a social worker and a psychologist working at YEDAM). A keyword list containing synonyms, abbreviations, and spelling variants was prepared based on the literature review and expert opinion (Stigma OR Stigmatization OR social stigma OR stereotyping AND among drug users OR substance users OR in drug addiction OR drug abuse OR substance use OR drug misuse OR substance-related disorders AND in workplace OR at work OR under employment OR work conditions of substance abuse related stigma OR experiencing stigma in work). Before starting the search, Turkish Science Terms, Medical Subject Headings (MeSH) and similar studies were scanned and the English and Turkish equivalents of the appropriate keywords were determined. Each database was reviewed between February and May 2025 in line with this keyword list. When searching databases, the search strategy was being able to access the full text free of charge and having the keywords in the title and abstract. The references of the articles reached as a result of the search were also reviewed. Finally, an independent researcher was consulted regarding the suitability of the articles. The PRISMA checklist including the criteria to be considered in the reporting of systematic review or meta-analysis studies was taken into account in the selection and summing up of the articles (Figure 1). PRISMA, a 27-item checklist developed in 2009 and revised in 2020, facilitates transparent reporting of systematic reviews, particularly in the health field. 36
PRISMA statement.
Utilizing PICOS components
The research employed the PICOS framework (participants, intervention/exposure, comparator, outcome, and study design) as a guiding structure, thereby facilitating the identification of clear indicators within the scoping review process.37,38 In light of the PICOS components, the following criteria were established for the articles:
Participants: Given that the age range of 18–64 is considered to be the working-age population, studies conducted with individuals in this age range and with a history of substance use were included.
Intervention/Exposure: No intervention criteria were required.
Comparison: Due to the inclusion of studies with descriptive, exploratory, and correlational designs, the need for a specific comparison group was not considered a critical factor.
Outcomes: The studies were expected to evaluate the stigma and social and psychological impacts of substance use in the workplace, as well as working conditions.
Study Design: The study excluded systematic review, meta-analysis, thesis and case analysis/reporting studies, including those following quantitative, qualitative, and mixed research procedures.
Eligibility criteria
This review includes the research studies conducted between 2015–2025 on the subject. Quantitative, qualitative and mixed method articles published in Turkish or English whose full text can be accessed free of charge were included in the study. The inclusion of Turkish-language articles was based on the research team's language competencies, allowing for comprehensive coverage of regional literature that may not be indexed in English-language databases. The open-access restriction was applied due to institutional access limitations; however, this may represent a potential source of selection bias, as some relevant paywalled studies may have been excluded. This limitation is acknowledged and discussed in the limitations section. Systematic review and meta-analysis studies were not included to avoid secondary citation and repetition. Theses, papers and reviews were also excluded from the study. In the first stage, the inclusion criteria are discussed in the titles and brief abstracts of the articles:
Focusing on the stigmatization of substance use in the workplace. Presenting findings on the social and psychological problems that are associated with stigmatization in the workplace. Conducted with individuals who were of working age (18–64 years old) and had a substance use disorder. Conducted in the context of the Sustainable Development Goals (SDGs) released by the United Nations in 2015.
Procedure for selecting publications
Search results were combined using Endnote, and duplicate articles were removed. The title, abstract and keywords of the articles obtained from the databases were examined based on the inclusion criteria. Articles that did not meet the inclusion criteria were excluded. Then, the full texts of the articles were reviewed by an independent researcher in terms of inclusion criteria. Disagreements during the process were resolved by consulting a third researcher.
Data extraction
During data extraction, the researchers first independently reviewed selected articles. Information on the author(s), date, sources, country, purpose of the study, sample characteristics, study design, data collection methods, data analysis, and results was collected for each article (Table 1). Two researchers conducted the article review, and the third researcher checked for accuracy to reduce the margin of error and potential bias. Each article was assessed using the following research questions as a guide 39 :
Characteristics of the evaluated articles.
(1) What are the barriers that substance-dependent individuals face in participating in the workforce? (2) What are the social and psychological consequences of stigma towards substance-dependent individuals in the workplace? (3) What are the potential benefits of substance-dependent individuals participating in the workforce? (4) What are the recommendations for improving the workplace environment to support substance-dependent individuals participating in the workforce?
Methodological quality assessment
The methodological quality of the articles included in the review was evaluated using the Mixed Methods Appraisal Tool (MMAT). 52 Even though critical appraisal often does not form part of scoping reviews, the MMAT was included here to support consistency and openness in how evidence was handled - especially since newer guidelines suggest such steps when reviews are meant to guide real-world decisions.53,54 Rather than treating results as definitive, using this tool gives readers a clearer sense of where conclusions come from, along with clues about how solid the underlying research might be. What matters most is that the MMAT has been tested before: earlier work verified it measures what it should, plus studies showed different reviewers tend to score similarly. 55 This tool enables simultaneous evaluation of qualitative, quantitative, or mixed methods studies. The MMAT includes two screening questions applicable to all research methods and four additional criteria specific to qualitative and quantitative research. Mixed-methods studies, however, comprise three components: the qualitative component, the quantitative component, and the mixed-methods component. The presence of each criterion is assigned a score of “1,” while its absence or obscurity is assigned a score of “0.” The evaluation assigns a score of 25% for each criterion met, resulting in a maximum score of 100% if all criteria are met. In mixed-methods studies, the component with the lowest score is considered the overall quality score (Table 1).
Data analysis and synthesis
The analysis was carried out with MAXQDA 2022 (version 22.4.1), and a total of 93 codes were obtained. The problem of stigma was the most coded concept with 24 codes related to the effect of stigmatization and the stigmatizing environment, followed by problems arising from the working environment (such as wage inequality, discrimination, and the attitude of the labor market) with 13 codes. As in the code example, the lack of understanding of the needs, some codes were coded only in one study. Such codes were presented by integrating them with other codes with similar content. MAXMaps was built using the hierarchical code-subcode model.
Ethical approach
Ethical permission was not required as the research articles included in the study were obtained from open search engines and electronic databases.
Results
Following PRISMA guidelines (Figure 1), a total of 1927 articles came from database searches and hand-checking references. Duplicates removed, the pool narrowed to 832 entries. Screening then ruled out 801 studies - reasons included conference abstracts, books sections, review formats, opinion pieces, government documents, synthesis analyses, or mismatched populations. Full texts pulled for the leftover 31 publications. Among those, another 16 got left aside due to themes like risk minimization strategies, reproductive wellness topics, tool creation efforts, or unlawful behavior patterns. One article got left out after a quality check done with the MMAT method. Starting off, fifteen papers made it into the scoping phase. Seven were based on qualitative analysis. A pair used random assignment in trials. Five relied on numerical data methods. One combined both numbers and narratives within its design.
Barriers to participation in working life (MAXMaps).
Benefits of participation in working life (MAXMaps).
Facilitators in working life (MAXMaps).
Suggestions for improving the working environment (MAXMaps).
Theme 1. Barriers to participation in working life
The analysis revealed five interconnected categories of barriers that individuals with SUDs encounter in workforce participation, including stigma, poor working conditions, wage inequality, difficulties in finding a job, and discriminatory labor market attitudes (Figure 2).
Stigma problem: Substance users face significant stigma in the workplace, labeled as dangerous, criminal, and unreliable.43,45 This stigma manifests as negative emotions (fear, anger) and avoidance, hindering their employment opportunities. 43 They are subjected to constant scrutiny, expected to fail, and face difficulties finding housing due to drug testing and distrust. 45 This widespread stigma significantly affects their employment and recovery processes 56 . 47 Distrust and stigma prevent them from working in specific professions (e.g., teaching) and finding permanent jobs, 47 creating substantial barriers to reintegration into society.
Working conditions: It is observed that people with an addiction experience difficulties in terms of working conditions due to the discrimination and stigma they are exposed to at work. Barriers such as lack of health insurance, inadequacy and inconvenience in accommodation, transportation, which directly hinder regular attendance, and assistance for child care,29,48,50 irregular and temporary work, 47 low wages, heavy working conditions, and constant night shifts 49 are the examples of poor working conditions.
Wage inequality: There are noticeable inequalities between addicted employees and other employees regarding wages and personal rights. 48 The insurance fees of addicted employees are not paid or underpaid compared to other employees. 56 Their working hours are reduced depending on the season, 47 and thus they experience financial losses. All these problems prevent the regular participation of people with an addiction in working life.
The problem of finding a job: The criminal record of addicted individuals40,47,58 inadequate past work experience, and not having a profession make it difficult for them to find a job.29,48 Addicted individuals who experience anxiety due to stigmatization from society experience reluctance and difficulty in participating in working life because they have difficulty establishing social relationships due to self-stigmatization.42, 49
Attitude of the labor market: Since the labor market is not willing to hire individuals who have not been in business for a long time or who have taken a long break, it is essential to be in employment and to have the skills that the labor market requires for addicted individuals. 44 The stigmatizing and biased attitude of the job market towards these individuals 48 is also visible. Employers still perceive those who undergo addiction treatment or who have completed the process as individuals who are at risk of not coming to work on time, disrupting work, disrupting the harmony between other employees, and going into the process of relapse; thus, employers believe that they should be constantly monitored.29,45,46 Addiction is considered to be an individual's preference rather than a disease. 46 Individuals who do not want to be exposed to these prejudices and be accused of behaviors such as theft have to carry the burden of hiding their addiction history or treatment processes from their workplace as a solution. 51
Theme 2. Benefits of participating in working life
Three main categories of benefits emerged from participation in working life for individuals with SUDs -- personal, social, and interactional (Figure 3).
Personal benefit: Since participation in working life is considered an opportunity for the individual, it positively affects the recovery process and provides financial support to meet their needs. 48 Working addicts can better cope with self-stigmatization processes,56,57 and they have higher perceptions of social support, 58 which contributes to the development of their skills and improves their self-confidence.56,57 Taking part in working life has positive reflections on the recovery process 47 as it contributes to the development of an awareness of skill development, encourages them to turn to new business areas, 44 and increases their satisfaction with working life. The satisfaction brought by participating in the working life is related to the income provided and the social relations established in the working environment. 56 It is a fact that the social relations established at the workplace may also lead to experiencing prejudiced attitudes. At this point, addicted individuals develop their resilience and evaluate the work environment as an area to show themselves and prove that they can do good things; therefore, their recovery process is affected positively. 51
Social benefit: Being in the same work environment with individuals who have received addiction treatment or whose treatment process continues helps non-addicted individuals to understand the addiction pattern and its results better. It is clear that it is essential to value addicted individuals as human beings, to protect their right to life under all circumstances, and to understand their needs and the difficulties they experience. 56 When addicted individuals think that they do not have the right to live with dignity because society does not have enough information about them, 45 stigmatization attitudes are more intense, and these attitudes may be felt more severely by addicted individuals.56,57 When individuals who are in the same working environment as addicted individuals understand all these social variables and begin to accept that addicted individuals can participate in the production life in society,40,56 prejudices in the society are avoided, and social benefit is created.
Interaction environment: A relationship of trust is established between individuals who come together with addicted individuals in their working lives, and they can share their life experiences. 56 Thanks to this interaction environment, addicted individuals can express themselves directly; their self-esteem improves, 48 and they become emotionally stronger. 42
Theme 3. Facilitators in working life
Two main facilitators supporting workforce participation were identified: previous work experience and social support (Figure 4).
Previous work experiences: Individuals with work experience before substance use feel closer to returning to work after treatment, and their previous experience helps them adapt to work. 44 Having insurance from the previous or current job and having retirement benefits are favorable working opportunities for addicted individuals, which improve their adaptation and commitment to their job and workplace. 47
Social support: Addicted individuals state that they protect themselves from stigmatization attitudes and self-stigmatization processes with the emotional and social support they receive from their colleagues and families. 43 When they have relatives with whom they can share their problems, addicted individuals perceive stigma less, and thus, their quality of life improves in terms of social relations, and this improvement is also reflected in business life42,43,58 Factors such as meetings in the workplace, the job itself, and the establishment of an interaction network increase the social interaction of addicted individuals and improve the treatment and recovery process. 48
Theme 4. Suggestions for improving the working environment
Three main suggestions emerged for improving the working environment: anti-stigma awareness-based education, ensuring a work-life-treatment balance, and improving employment-related anti-addiction and harm reduction policies (Figure 5).
Anti-stigma awareness-based education/meeting the education needs: Job assistance programs, employment services emphasizing career goals, employment services compatible with the treatment process, job preparation programs, access to employment services, training about job applications,44,50 vocational training targeting the needs of the labor market, 56 and interview skills training 29 can be counted as suggestions that can raise awareness about preventing stigma in working life.
Work-life-treatment process balance: Addicted individuals need to participate in business life and continue treatment and rehabilitation processes simultaneously without a break29, 47 Health professionals and employers must know this situation and the functional relationship between substance use and work outcomes46,57 and make the necessary arrangements. It is stated that adapting individuals to working life from the early stages of the treatment process (taking into account areas of interest and treatment appointments) positively affects the working environment. 50
Improving the employment perspective of anti-addiction policies - developing harm reduction policies: It is suggested that policies against addiction should be supported by egalitarian, anti-oppression, and transparent implementation processes and principles, and these policies should be encouraging enough to strengthen capacity building. 56 By raising awareness that employment is a functional tool in the fight against addiction,44,47,50 agreements or protocols should be developed with employers for the employment of these individuals to combat addiction. 29 In addition, holding awareness campaigns to improve public awareness about anti-stigmatization 43 and supporting policies and laws to enable addicted individuals to return to their productive lives apart from punitive methods 40 may prevent addicted individuals from being excluded from working life.
Discussion
This scoping review examined 15 studies to address four objectives related to workforce participation among individuals with substance use disorders (SUDs). The findings are summarized according to the four themes that emerged from the analysis. What stood out first was how people dealing with substance use disorders often run into roadblocks - judgment from others, unstable jobs, uneven pay, trouble finding work, plus hiring biases that shut doors. Moving forward, being part of the workforce brought more than just income; it helped build resilience, grow abilities, and gave structure, along with broader effects like less bias from coworkers and deeper connections through shared effort. Behind these gains, two elements kept appearing: having worked before, even briefly, made reentry easier, alongside steady encouragement from family or peers. Suggestions coming through included teaching teams about stigma, shaping workplace rules that allow room for treatment, and backing services that guide every step toward stable roles. Altogether, this adds clarity to what makes working life hard for this group - not only emotionally taxing environments but persistent stereotypes - while showing how meaningful involvement in jobs can serve as quiet therapy.
Though engaging in work supports recovery by improving personal well-being, social ties, and relationships, those struggling with addiction often meet barriers such as prejudice, low wages, tough employment environments, challenges finding jobs, and bias within hiring systems. From both private and public viewpoints, drug dependence creates heavy financial strain - driving demand for better prevention, treatment, and reintegration methods, lowering efficiency at work, while also disrupting long-term job planning and advancement.59–61 Studies43,45,47 highlight the difficulty of finding permanent employment due to these inequalities, putting individuals at risk of re-entering the addiction cycle. Substance abuse is mainly associated with employment issues among young people, making measures and policies to support individuals’ retention in the workplace even more valuable.22,62 A bidirectional relationship is indicated between substance use and workforce participation, such as job loss due to substance use or substance use due to job loss 74 . 63 While some studies47,48 focus on irregular work and unequal pay, others29,50 discuss the impact of a lack of support programs (e.g., childcare) on both individuals and families.
One study 64 highlights the need for economic support, employment opportunities, and positive attitudes to integrate individuals with addiction into society. Stigma plays a significant role, with negative employer attitudes complicating job search.45,46 Though working, people with past addictions often remain under scrutiny, marked by persistent stigma. 29 A shift in joblessness appears tied to drug treatment demand - one study 65 finds that each percentage point bump in unemployment brings about a 9% uptick in care requests. Economic strain might feed into substance reliance, one study hints. This highlights the importance of facilitating work participation for individuals struggling with addiction, as unemployment can trigger relapse and exacerbate stigma internalization.
Working life offers a secondary benefit of providing an interaction environment for the addicted individual, which supports the recovery process of the addicted individual, decreases internalized stigma, and changes the perception of social support positively42,48,56–58 Participation in working life prevents the addicted person from thinking about the addictive substance, and it is a motivating factor to receive treatment. Having a job and the social support felt at the workplace improves the individual's self-confidence and social support perception. 66 Therefore, it can be stated that working life has a therapeutic effect on addicted individuals.
This study emphasizes two essential elements of the existence of individuals with substance use experience in working life. One of them is previous work experience. It can be assumed that individuals with work experience and a profession before substance use can more easily adapt to processes such as work discipline, working hours, holidays, or teamwork required by the work environment. The continuation of social security, which they had in their previous workplace, in their new jobs creates a double-sided effect that increases their motivation to work and makes them feel secure about their future. Notably, the economic and social contributions of the addicted individual's previous work experience have only been investigated in a limited number of studies.44,47 The second key element, social support, has been addressed by relatively more studies. One study 43 states that with social support, the addicted individual can avoid the stigma processes, while some researchers42,58 argue that sharing the stigma problem through interpersonal relationships contributes to the relaxation and healing of addicted individuals. Substance abusers may also self-stigmatize with the effect of stigmatization from society, and they see themselves outside of social life. It is known that exclusion from society causes individuals to blame themselves for unsuccessful job applications. 67 This internalization of stigma is consistent with recent evidence showing that stronger beliefs emphasizing individual responsibility and free will are associated with higher levels of substance use stigma. 68 One study 48 points out that working life and coworkers expand the area of social support beyond family and relatives, and social interaction is a critical component in coping with stigma.
Finally, our study highlights that, in addition to addressing an individual's own dynamics and treatment process, there is also a need for workplace adjustments to prevent stigma faced by individuals with substance use disorders in the workforce. Previous studies44,50 offer various suggestions to help individuals with substance use experience in their working life. Other studies29,56 approach the subject with more customized suggestions. The common point in all of these studies is the elimination of the inadequacies that individuals with substance use experience in adapting to work dynamics. In this respect, it can be stated that there is a need for employment policies that can develop addicted individuals in areas needed by the sectors and orientation programs that will prepare individuals for business life. Although shaping employment policies requires long-term planning, this study can summarize the three steps required for policies. The preliminary step is to evaluate how the labor market will evaluate working with individuals with substance use experience and whether each sector is suitable at the same level. While employment policies are developed for individuals with substance use experience, considering the treatment processes as a dynamic of these individuals and including them in business life is the second step, as pointed out by some researchers.29,46,47,50,57 Since substance abuse causes social problems as well as individual problems, holistic treatment requires the cooperation of all social actors. Strengthening non-governmental organizations and local administrations is necessary for developing community education, recovery, and harm reduction practices. 69 As highlighted in this review, previous studies40,56 summarize the principles and objectives of employment policies, pointing to the third important step for policy studies. However, although not included in the final theme identified in the review, one study 48 considers negative cultural capital, a notable concept in the study, a dimension that should be considered in employment policies. Cultural capital, a part of social welfare, 70 experiences a negative transformation with stigma and discrimination in working life and destroys the potential of individuals to be a part of social and cultural development. One of the most critical factors of this transformation process, its relationship with education, is discussed in previous research. 71 In addition, the importance of agreements with the labor market is also emphasized. 29
Conclusion
The reviewed articles demonstrate that both personal and societal reasons hinder the participation of individuals with substance use disorders (SUDs) in the workforce. However, when participation is supported, these individuals’ personal development and societal benefits are undeniable. Our study emphasizes four key points and provides summary application recommendations for sociology, social work, psychology, health, and law.
Figure 6 illustrates how key themes, such as stigmatization, social relationships, working conditions, wage inequality, and their interrelations, are connected. Stigmatization, which plays a central role, appears to be heavily intertwined with feelings of worthlessness, difficulties in forming relationships, personal benefits, and wage inequality. The feeling of worthlessness associated with stigma appears to be linked to difficulties in interpersonal relationships stemming from a lack of understanding of the individual's needs. Understanding the relationship between stigma and personal benefit in conjunction with other codes is critical. Looking at it differently, links among individual gains, unequal or low pay, poor views on employment, and tough job settings allow two conclusions. One insight lies in workplace difficulties revealing how social, financial, and mental healing overlap. These elements do not act alone - they shift together. Another point emerges when unfair treatment, such as shame or unbalanced earnings, erodes private advantages. Such pressures stretch beyond single people, deepening gaps across communities. Fixing imbalances becomes less about isolated fixes, more about seeing patterns. Outcomes depend not just on income but on respect, access, and stability woven into daily work life. What ties together those patterns most clearly is how they connect to access to resources. Facing judgment along with its negative effects, people rely on learning programs that challenge bias, backing from relatives, or systems designed to minimize damage. Although being judged stands out, another repeated idea - exclusion from opportunities - shows a problem nearly as widespread. Missing fair pay at jobs highlights this exclusion, linking it tightly to how society distributes advantages.
Conceptual model of findings.
Looking at it one way, this research highlights four main ideas while suggesting real-world steps useful in areas like sociology, social work, psychology, healthcare, and legal studies. Work settings often create serious hurdles - people dealing with substance use commonly confront unfair treatment, missing health coverage, unstable living situations, poor access to transit, unequal pay, and scarce job-related perks. On top of that, landing steady jobs becomes harder due to prior convictions, gaps in professional background, plus skeptical views held by employers about hiring them. Yet another angle: being part of the labor force brings gains - not just personal ones like stronger confidence, clearer sense of belonging, money autonomy, improved interaction abilities - but also wider community effects. Others who share workplaces with these individuals begin seeing addiction differently, challenging old assumptions simply through daily contact. Sometimes prior job history helps. Trust within teams often makes adjustment easier afterward. Support networks matter more than many realize. When colleagues show understanding, confidence grows slowly. Employment itself becomes part of healing for some. Positive settings reduce stress significantly over time. Training that challenges bias changes attitudes quietly. Mixing therapy schedules with shifts works better when planned well. Offices with clear recovery guidelines see fewer setbacks. Belief in capability affects hiring choices behind the scenes. Inclusion tends to lift broader community results too. People contribute differently when given space to stabilize.
Limitations and implications for future research
This review study has certain limitations. In light of these limitations, recommendations for future research have been developed. Firstly, the review should have included reports of national and international organizations, unpublished articles, theses, and studies in languages other than English. The restriction to open-access articles may have excluded relevant paywalled studies, potentially introducing selection bias. Additionally, the inclusion of only English and Turkish languages, while based on the research team's competencies, may have limited the scope of findings from other linguistic contexts. Expanding the searches to include different languages and broader scopes will deepen the findings obtained. Second, due to the scarcity of articles focusing directly on the subject, themes allowing regional comparisons could not be reached. Therefore, it is recommended that a comprehensive examination of the cultural impacts on employment and substance use treatment policies be conducted. The third limitation is the scarcity of studies focusing on the stigma that individuals with a history of addiction are directly exposed to in working life. Although subject-specific studies have been reviewed in this study, it is seen that the studies include different factors such as social life, migration, and harm reduction policies. Thus, the authors tried to filter the findings of the studies with a focus on working life. In this regard, future research should conduct reviews categorizing different factors and present findings focused on developing practice models for the field of addiction.
Footnotes
Acknowledgements
Not applicable.
Ethical approval
Ethical approval was not required for this study, as it is a scoping review based exclusively on previously published literature and did not involve human participants or the collection of primary data.
Informed consent
Informed consent was not required for this study, as it is a scoping review based exclusively on previously published literature and did not involve human participants.
Authors’ contributions
All authors have read and approved the final version of the manuscript. Conceptualization: DAU; Data Curation: ZY, DAU; Formal Analysis: ZY, DAU; Investigation: ZY; Methodology: DAU; Project Administration: ZY; Resources: ZY, DAU; Visualization: DAU; Writing–original draft: ZY, DAU; Writing–review & editing: ZY, DAU.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the Scientific Research Projects Coordination Unit of Selçuk University under the Social Contribution Project program (Project No: 2245001).
Declaration of conflicting interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data availability statement
This study is a scoping review based exclusively on previously published studies. No new data were generated or collected. Data related to the coding and categorization processes used during the review are available from the corresponding author upon reasonable request.
