Why open access to vocational services in substance use treatment matters: Commentary on Cosottile and Defulio (2020)

This article presents the argument that all veterans engaged in substance use treatment, regardless of current or recent use, should be allowed access to vocational services through Veterans Affairs (VA). This argument is presented as a commentary to Cosottile and DeFulio (2020), who argue for the VA to restrict veteran's access to work and Compensated Work Therapy (CWT) transitional work (TW) services to those who have demonstrated abstinence from substances.

Our commentary provides an overview of relevant literature and programmatic considerations.

The VA previously had common practice of restricting access to CWT TW services based on demonstrated sobriety and now has explicit policies and guidance against this practice. Research demonstrates that employment is an important recovery goal, that employment and substance use influence one another (both positively and negatively), and that substance use does not detract from employment outcomes of individuals participating in vocational rehabilitation services.

Work activity is not simply a means or incentive for achieving sobriety. Employment is a critical component of recovery that supports a healthy sober lifestyle. Vocational services can be successfully integrated into substance use treatment without restricting access to those who have demonstrated sobriety. (PsycInfo Database Record (c) 2022 APA, all rights reserved).