Psychosocial dimensions of work and the risk of drug dependence among adults.

The authors used prospectively gathered data to study whether different psychosocial work environments might signal increased risk of drug dependence syndromes. Adult participants were selected by probability sampling from households in five metropolitan areas of the United States. Subjects were sorted into risk sets defined by age and census tracts. Incident cases were identified using case definitions for drug abuse/dependence syndromes involving controlled substances, assessed by the Diagnostic Interview Schedule (DIS) administered during a baseline interview and at follow-up one year later. When the data were adjusted for baseline sociodemographic risk factors, history of alcoholism, and selected work conditions, increased risk of drug abuse/dependence was observed in subjects characterized by high levels of physical demands and low levels of skill discretion (high strain jobs) (relative odds (RO) = 4.92) and in subjects characterized by high levels of physical demands and decision authority (RO = 5.26). Findings from the present study underscore the importance of previously observed associations linking psychosocial work environments to mental health, and the results extend the range of findings to the drug dependence syndromes.