Alcohol disorders and re-employment in a 5-year follow-up of long-term unemployed

Aims. To establish whether the high prevalence of alcohol abuse among unemp loyed people is explained by alcohol abuse causing unemployment, or vice ve rsa. Design. A 5-year postal follow-up survey of a community sample of unem ployed from Grenland, southern Norway. Participants. Two hundred and twenty -eight unemployed people, registered for more than 12 weeks, aged 16 to 63 years. Response rate 74%. Measurements. The Alcohol Use Disorder Identifica tion Test (AUDIT) and DSM-III diagnoses of alcohol disorders in medical exa minations. Findings. At the 5-year follow up, 23% of those still unemployed and 12% of those re-employed scored higher than the AUDIT cut-point of 10. Re-employment reduced the chance of scoring positive on the AUDIT to 34% o f the chance for those still unemployed. Significant selection to long-term unemployment according to AUDIT score was not demonstrated. None of the 7% who had a DSM-III diagnosis of an alcohol disorder had a job 5 years later , however, suggesting that alcohol-related selection to unemployment does o ccur. Conclusion. The high prevalence of harmful drinking among Norwegian u nemployed is explained mainly by unemployment causing alcohol abuse rather than vice versa. Reducing unemployment should contribute to reduced alcohol problems in Norway.