Abuse and dependence on alcohol or other substances is closely linked to problems with finding and keeping a job. Researchers estimate that one in five families on welfare have an adult with an alcohol or drug problem. Employment options are limited for those who cannot pass a drug-screening test as a condition of employment; past drug- or alcohol-related convictions may also restrict opportunities. Moreover, the symptoms associated with chemical addiction can frequently interfere with maintaining employment. Studies have shown that people with such addictions are far less productive at work, are more likely to injure themselves or someone else, and have higher-than-average health care claims, compared to those with no addiction. These problems often result in cycling in and out of jobs and welfare. Most individuals with a drug or alcohol addiction require intervention before they can maintain steady employment. Chemical addictions sometimes mask psychiatric disorders; while mental health conditions such as depression, mania, and attention deficit disorder often coexist with alcoholism or drug dependency.
The DSM-IV makes a clinical-diagnostic distinction between alcohol or substance abuse and alcohol or substance dependence. Dependence is a diagnosis involving a maladaptive pattern of substance use, leading to clinically significant impairment or distress. It is considered to be a long-term condition (though responsive to treatment) and is characterized by having at least three symptoms from a list of criteria that includes, among other symptoms, tolerance, withdrawal, taking a substance in larger amounts or over a longer period than was intended. Alcohol or substance abuse, on the other hand, is characterized by having only one or more symptoms, which include problems in performance at work, school, or home; recurrent use when it is physically hazardous; and recurrent substance-related legal problems. If a person meets the criteria for substance dependence, a substance abuse diagnosis is not applicable. Although dependence is the more serious and long-term condition, both dependence and abuse of alcohol or other substances is likely to interfere with the ability to obtain and maintain employment.