Substance Use Disorders and the Work Place

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Substance use disorders (SUDs) for nearly every drug have increased since the pandemic. The number of overdoses has increased as well, with the Centers for Disease Control and Prevention estimating that 107,655 people died of an overdose in 2021. The increase of SUDs may have a profound impact on workplaces, affecting the productivity and safety of employees as well as the viability of businesses themselves.

Workers with SUDs miss, on average, 14.8 days of work per year, while those using opioid pain medications miss 29 days. This contrasts with people without a SUD, who miss 10.5 days on average. People in recovery miss an average of 9.5 days. However, most businesses do not feel adequately prepared to address the reality that employers and employees may be struggling with SUDs.

Human resources departments can play an important role in addressing SUDs in the workplace. HR departments can set the tone or ethos of a business through its policies and implementation. Some suggestions include:

• There should be clear and easy access to employer-based health insurance coverage. An SUD is both a physical and mental health condition, so policies should ensure there is parity in coverage of physical and mental health.
• All policies should be in accordance with the Americans with Disabilities Act since a severe SUD may be categorized as a disability.
• Human resource departments must have clear and specific policies about reviews, leaves of absence, reasons for dismissal, and procedures for adjudicating and perhaps appealing decisions.
• Workers need to know their rights, so all employment protections should be clearly identified and easily accessible.

Employers and supervisors can be allies in addressing these challenges, perhaps because they have witnessed behaviors or identified patterns of missed work. A few concrete suggestions include:

• Never hold work meetings in a bar.
• Don’t organize outside-of-work activities around alcohol.
• If organizing a work event, ensure there are many non-alcoholic beverages that are just as festive and appealing as the alcoholic ones.
• Be flexible in work shifts or tasks if someone has appointments aimed at addressing the problem.
• If you are in recovery yourself, be willing to share your story. Listen without judgment. Ask if they want help or support.
• Be an ally and run interference if another starts cross-examining a person about their use. Deflect or redirect others who are engaging in gossip and speculation.

Coworkers are often on the frontline of SUDs in the workplace. They may see behaviors a supervisor might not and may bear the burden of lost productivity and absenteeism. However, they, too, may be allies. Some recommendations include:

• Help a coworker get ahead of the situation with a supervisor if there have been missed work days, lower productivity, etc. Convince a coworker that it is better to be proactive than reactive. Role-play what to say to the boss or supervisor.
• Validate fears about work and other possible consequences of their problem and the additional consequence of not proactively addressing it.
• Help untangle the complicated language in employment policies and help to locate helpful information. Know employment protections.
• Be willing to cover or be flexible on work shifts or tasks if a person has appointments related to addressing a drug or alcohol problem.

The decriminalization of marijuana or cannabis in many states, though not on the federal level, presents additional, though not insurmountable, complications to workplaces. So, too, does the legalization of medical marijuana in some states where recreational use remains illegal.

Businesses may find themselves navigating between different and inconsistent laws, not certain which ones take precedence. They may also find themselves imposing workplace restrictions that may seemingly conflict with a person’s right to consume cannabis. Some suggestions related to cannabis use:

• Educate all employees about what sort of accommodations must be made for the use of medical cannabis.
• Have clear policies about drug testing and what counts as a “clean result.”
• Identify which, if any, jobs no amount of cannabis use is permissible.
• In states where recreational cannabis is legal, be able to definitively state whether it is permissible to consume products at the workplace during the day.

The best workplace policies are proactive, consistent, and clear. No policies will ever keep people from struggling with SUDs in the workplace, but good policies can both be helpful to the individuals suffering and the companies employing them.