Helping employees overcome substance use disorder

70 million Americans deal with alcohol or opioid use disorder each year. According to estimates, 70 to 80% of those struggling with substance use disorder (SUD) are also employed.

While it’s easy to dismiss substance use disorder as a “personal” problem, it directly impacts an employee’s focus, motivation, accuracy, safety, and morale at work. Put simply, it hinders their ability to do their job well—which means it’s a prevalent and significant workplace challenge that employers should be aware of.

(And, honestly, most if not all “personal” problems are likely affecting a person’s work life—this one just tends to have a larger impact.)

Unfortunately, substance use disorder is still very stigmatized, making it a challenging subject for employers to address. If and when you recognize an employee is struggling with substance use, here’s how you can help them feel seen and supported, rather than called out and condemned.

5 ways to support employees struggling with substance use

1. Create a supportive culture

Many people feel ashamed of their substance use. And, unfortunately, shame is a driver for addiction—which only perpetuates a toxic cycle. So, one of the best ways you can help your employees is by creating a workplace culture where they feel seen, supported, and safe.

This does not mean enabling or encouraging substance use, but rather fostering an environment that emphasizes inclusion and support over punishment and judgement.

You can do this by:

• Avoiding using stigmatizing language (e.g., “drug addict” or “clean”) when talking about substance use disorder
• Including substance use with other medical issues in your benefits, resources, and documentation
• Providing training to managers about how to handle sensitive and difficult conversations with their direct reports
• Normalizing talking about mental and behavioral health by having managers lead by example

While all of the above are positive steps, remember that employees will do most of their learning by watching how you handle other situations—even if they aren’t directly related to substance use.

Whether an employee needs parental leave or time off for cancer treatment, how you manage and respond to those circumstances will clue the employee in on how sensitive and understanding you’ll be if and when they need support.

2. Understand the legal and ethical implications

How you interact with an employee who has a substance use disorder isn’t just about feelings—there are real legal requirements and ethical guidelines to take into account. Two of the biggest to be aware of are The Americans with Disabilities Act (ADA) and the Family Medical Leave Act (FMLA).

The ADA applies to companies with 15 or more employees, while FMLA applies to those that have at least 50 employees.

Under the ADA, employers cannot discriminate against employees with disabilities at any stage of employment. Does substance use disorder count as a disability? It depends. Any employee who is currently engaging in the illegal use of drugs is not a qualified individual with a disability under the ADA. However, those who are actively participating in a rehabilitation program or those who have been successfully rehabilitated are covered—provided they’re not currently using any illegal substances.

If you don’t offer paid time off for substance use treatment and recovery services, employees might opt to use FMLA leave to get unpaid, job-secured time away to pursue treatment. They are within their right to do so, as long as their treatment is provided by a healthcare provider or someone who works on referral from a healthcare provider. The FMLA documentation explicitly states that “absence because of the employee’s use of the substance, rather than for treatment, does not qualify for FMLA leave.”

These regulations can have a lot of complexities and nuances, so it’s best to consult with a human resources or legal professional to get your questions answered.

3. Provide and promote resources and support

Fostering an environment where people feel safe to acknowledge their disorder and pursue treatment is an important foundation, but employers also need to take extra steps to provide the tangible resources and opportunities employees need.

You can start by revisiting your health insurance plans to confirm they include coverage for high-quality addiction treatment centers. Think that means a hefty price tag? Partnering with Carrum Health means you can connect your employees with high-quality substance use care and treatment while also reducing your employer costs (and the costs for the member getting treatment).

Providing access to an employee assistance program (EAP) can also help your employees get the support they need for a variety of sensitive topics (including substance use disorder). Referrals from EAPs to substance use treatment are admittedly low, but much of that comes back to awareness and access. 34% of workers admit they don’t know what their EAPs cover, while 20% are unsure how to access the service at all.

So, regardless of the resources you offer—whether it’s improved insurance plans, EAPs, hotlines, counseling, or something else—make sure that they’re all actively promoted and easy for employees to find and understand.

4. Engage in compassionate conversations

If you notice an employee is struggling at work and suspect substance use, you don’t necessarily need to keep quiet. Workers are increasingly willing to talk about mental health and related topics with their supervisors, particularly when you’re mindful about choosing the time and place. You’ll want plenty of focused time (this shouldn’t be a rushed conversation) and a neutral, private setting.

However, this is important: You should not accuse an employee of having an issue with substances, even if you’ve seen numerous signs signaling the employee is struggling.

Instead, open the conversation with something more general like, “I’ve noticed a change in your performance. Is everything okay?” This gives the employee the agency to decide how much they’re comfortable discussing. The only exception is if you specifically see an employee using alcohol or drugs during their work hours. That’s a safety issue that requires more direct communication.

If the employee does open up about their struggles with substance use, continue the conversation with empathy and concern, while avoiding blame and judgment. Provide information about the options and resources you offer, and reaffirm that you’re there to support them on their journey to recovery.

5. Build a recovery-supportive environment

Supporting an employee who is struggling with substance use disorder doesn’t stop if and when they decide to pursue treatment—that’s only the beginning. You also need to fully support their recovery journey and their return to work.

Maintaining strict confidentiality is a key piece of this. Have candid conversations with the employee to determine what they’re comfortable with their colleagues knowing and how you should explain their absence, if applicable.

For employees who want more connection and community at work, employee resource groups (ERGs) give your workers an opportunity to feel less alone and benefit from peer support. Additionally, for employees who seek treatment through Carrum Health, Carrum will provide the employee with ongoing support and resources throughout the entire treatment journey, along with a dedicated clinical care navigator to help them through the process.

When it comes to supporting recovery, even seemingly small changes can make a big difference.

For example, don’t center your work celebrations, events, and gifts around alcohol. Try a team cooking class rather than a wine tasting. Or opt for a game night instead of a happy hour. At events where there’s alcohol, provide plenty of non-alcoholic options as well (outside of just water and soda).

As time goes on, make an effort to continue to check in with the employee, but resist the urge to micromanage or helicopter. Let your employee set the tone for how much they want to communicate about their recovery journey. Ultimately, their substance use disorder doesn’t define them—so it shouldn’t dominate all of your conversations at work.

Wanting to support an employee struggling with substance use is a noble mission, as long as you remember that your role is to support and not scrutinize or stigmatize. Putting the above strategies into play won’t just make a positive difference for employees who are dealing with SUD—it’ll positively impact your entire organization.

Learn more about Carrum’s valued-based substance use treatment program.

The information contained on this page is for informational purposes only. No material is intended to be a substitute for professional legal or medical advice, diagnosis, or treatment.