Supporting employees in recovery

Supporting an employee who’s in recovery from substance use can feel intimidating—even when you genuinely want to help. You’re worried about saying or doing the wrong thing, or being perceived as insensitive or out of touch.

That hesitation is normal, but it shouldn’t translate to inaction. A generic brochure or hotline might seem like enough, but they’re not built for what recovery really requires. Hotlines exist for crisis triage and referrals—not the months or years of recovery that follow.

Real support means going further than a phone number. But fortunately, it doesn’t take a large budget or a major overhaul either. This guide covers what you need to know.

What real support actually looks like

It isn’t necessarily a shiny, new program. Even a few specific, low-cost commitments can add up to something way more meaningful than a phone number.

You might hear this called “recovery capital.” It’s the social, financial, and structural resources that help someone stick with their recovery over time—not just complete a single treatment stint.

As an employer, you have more influence over this capital than you might think. Here’s how you can build it for your employees.

Coordinating care that continues after initial treatment ends

Recovery is an ongoing journey, not a single destination. So, completing treatment is closer to the starting line than the finish line.

With that in mind, research shows that extending support into early recovery leads to fewer relapses and re-admissions. People also stay more engaged and feel more supported as they work to make lasting changes.

Employers aren’t the ones delivering continuing care, but they can control whether it’s required through steps like:

• Build confirmation of a step-down or aftercare plan into standard return-to-work paperwork (the same way many leave policies already require medical clearance before someone returns).
• Ask the substance use treatment benefit or care navigation vendor whether continuing care planning is required as part of the benefit or something the employee has to arrange on their own. (Hint: If it’s up to the employee alone, you might want to consider a different vendor.)

Neither of these involves completely reworking your benefits package. They just make continuing care part of the process, instead of something an employee has to figure out after treatment ends.

Making sure coverage doesn’t stop when treatment does

Having an aftercare plan is one thing, but being able to afford it is another. Inpatient care and detox are usually the most visible parts of substance use treatment, so benefits design tends to stop there.

But other efforts like outpatient therapy, medication-assisted treatment, and step-down care are what actually keep recovery going.

Yet coverage for these is often lackluster, if they’re covered at all. Many of these resources have tighter visit limits, higher copays, or fewer in-network providers than what somebody with a physical condition would face for comparable follow-up care.

This isn’t just anecdotal. The Department of Labor, HHS, and Treasury’s own 2024 report to Congress found that health plans are still falling short of covering mental health and substance use benefits on par with medical and surgical care—despite being legally required to.

It’s worth checking your plan’s details for outpatient and step-down substance use disorder care and then comparing them to a chronic condition. If the substance use care hits a cap or a steeper copay first, you’re just undercutting the importance of an aftercare plan.

Planning their return to work in advance

Most employers don’t have a standard return-to-work process for someone coming back from substance use treatment. They just figure it out one conversation at a time—and usually on the employee’s first day back.

It’s a flawed approach, but a common one. In fact, it’s so common that the White House Office of National Drug Control Policy built the Recovery-Ready Workplace Toolkit to help employers stop winging it when trying to support their workers.

If one of your employees is returning to work after treatment, aim to figure out three things beforehand:

1. How their workload will ramp up
2. What accommodations are available (e.g., flexible scheduling, temporary adjustments to hours or duties)
3. Who they can go to if things start to feel shaky or overwhelming.

Put simply, the employee shouldn’t have to figure everything out on their first day back. Having a plan in place shows them that you’re welcoming their return—not just allowing them to come back.

Prioritizing check-ins beyond the first 90 days

For employees who do get support from their employer, nearly all of it happens around the return date itself. But then it quickly tapers off as they get back into their day-to-day—which is arguably when they need even more support and resources.

That’s why it’s helpful to check in with employees regularly. This could mean:

• Putting recurring, low-key check-ins on the calendar past their initial return window, instead of stopping at 30, 60, or 90 days
• Giving the employee a way to flag if something feels off without waiting for the next scheduled check-in, so support doesn’t always have to be initiated by the manager

Ninety days is an arbitrary line. Recovery doesn’t stop there, and support shouldn’t either.

Protecting their confidentiality

Employees shouldn’t have to explain the nitty-gritty of their diagnosis or worry about what will be shared with their coworkers just to benefit from the support and resources you offer.

Getting this right is just as much about compliance as it is about compassion. Substance use treatment records actually carry stronger privacy protections than most health information. A federal law known as 42 CFR Part 2 requires stricter consent before those records can be used or shared—and it’s even tighter than standard HIPAA rules.

It’s your responsibility to uphold these protections in your workplace. For example, you could:

• Build appointment flexibility and leave options into policies from the start (as a standard option available to everyone), so nobody has to disclose a diagnosis just to access them.
• Keep the details of why someone’s on leave or working modified hours between the employee and HR.

Privacy shouldn’t be something your employees need to ask for. It should be built in from the start.

Building peer connection into your workplace

Recovery can get lonely, especially once the structure of active treatment is gone and someone is back to their “normal” life and job.

The CDC’s own guidance on workplace-supported recovery specifically recommends that employers provide peer support and peer coaching to help workers in recovery feel more connected.

Keep in mind that none of this works if it means outing someone. Peer connection always has to be something an employee opts into themselves. Here are a few starting points that offer connection without sacrificing confidentiality:

• If you have employee resource groups focused on mental health, disability, or wellbeing, make sure recovery is a welcome topic there—not just something that’s tiptoed around.
• Consider offering access to a peer recovery coach or mentor as a resource employees can seek out on their own. This should never be someone assigned to them because HR or a manager knows their history.
• Rethink how central alcohol is to work events. Happy hours and open bars aren’t the only way to celebrate or unwind as a team.
• Fold recovery into communications you’re already sending (like Mental Health Awareness Month content, EAP promotion, or benefits orientation) rather than treating it as a topic that needs its own separate campaign.

Seemingly small moves like these send the message that people are seen, valued, and never alone in recovery—whether they choose to speak up about it or not.

Why it’s worth getting recovery support right

Taking recovery support seriously is good for your workers—and it’s good for business too. Here are some of the potential benefits of adequate support:

• Lower turnover:The Department of Labor (DOL) found that workers with an untreated substance use disorder have a turnover rate 44% higher than the workforce overall, while employees in recovery see turnover 12% lower than average. Investing in someone’s recovery makes them more likely to stick around.
• Reduced absenteeism: According to the same DOL research, workers with an untreated SUD take nearly 50% more unscheduled leave than their peers, while workers in recovery average nearly 10% fewer unscheduled absences than the typical employee.
• Higher productivity: Over 42% of employees who use substances say they experience a noticeable drop in their productivity as a direct result of their substance use. Ongoing support is what keeps that dip from becoming permanent.
• Lower relapse risk: A sense of disconnection can increase the risk of relapse, so continued support is crucial for helping people through recovery. Skip it, and you risk sending your company (and your employee) back through the same disruption, stress, and costs.

None of these efforts are complicated, but they do require treating recovery as an ongoing part of someone’s personal and professional life—not a one-time box to check.

Carrum Health can help by connecting employees with vetted substance use treatment providers and coordinating care beyond initial treatment.

Ultimately, real support is more than a brochure or hotline. It means continuing to show up for your employees in meaningful ways—even long after their formal treatment ends.