From Reticence to Recovery: Insights and Resources for Workplace Conversations About Addiction and Treatment
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Several years ago, the HR director called me to her office for a private meeting. I assumed the conversation was going to be about a sensitive personnel matter involving an employee in my branch. I was right but was surprised to learn the employee was me. “This is going to be a really difficult and awkward conversation for both of us, particularly because you outrank me,” the director began after I closed the door behind me and took a seat across from her desk. “Someone reported smelling alcohol on your breath yesterday and we need to talk about it.”
I could feel the heat in my cheeks as my face flushed with embarrassment and shame. After years of hiding my addiction from friends and family, colleagues and clients, my worst fear had been realized. My problem had been discovered. I still can’t explain why, but I suppressed my impulse to dodge and dismiss the issue. For the first time ever, I said the words, “I’m an alcoholic” (i.e., in today’s less stigmatizing parlance, “a person experiencing an alcohol use disorder”). I admitted I had a problem and said I was ready to find help.
According to the Society for Human Resource Management, employers are becoming more interested in providing resources and guidance to employees experiencing addiction. As an HR professional, would you know how to respond to an employee who admits to a problem with alcohol or other drugs and says they are ready to make a change? Do you and your colleagues know as much as you’d like to know about addiction?
Drawing on my personal experience with addiction and my professional experience with substance use disorder (SUD) programs and policy, here are 5 things I believe HR professionals should know about addiction.
One. Addiction in the workplace may be more prevalent than you realize.
If you think addiction isn’t something you have to worry much about at your organization, you may want to think again:
17.3 percent (nearly 1 in 5) of people in the U.S. aged 12 or older had a substance use disorder (SUD) in the past year in 2022 according to data from the Substance Abuse and Mental Health Administration’s (SAMHSA) National Survey on Drug Use and Health (NSDUH).
More than 60% of people experiencing addiction are employed according to SAMHSA’s National Survey on Drug Use and Health (reported in a Fortune Magazine story in July 2023).
According to the nonprofit organization, Shatterproof, addiction costs employers $442 annually due to factors such as decreased productivity, increased turnover and higher healthcare costs. To estimate the financial impact of addiction on your organization, use the National Safety Council’s Employer Cost Calculator.
Two. Addiction doesn’t always fit the stereotypes.
When a person with an SUD continues to function reasonably well at work, we tend to ignore or downplay signs that there is a problem. I certainly managed to convince myself that the steady growth of my salary, responsibilities and other markers of success were proof I didn’t have a problem.
“I can’t have much of a problem if I rarely miss a day of work and have never had a negative performance review,” I’d tell myself to downplay the fact that I had reached the point where I began each day with an early morning drink to ward off the shakes and other symptoms of withdrawal. Even as my drinking problem progressed, no one ever mentioned it to me until that conversation with the HR director.
Experts define substance use disorders as compulsive use of a substance that persists despite negative consequences. This definition allows for considerable variation. Compulsive use can mean daily use, but it can also describe the person who binges regularly, but only on the weekends. Negative consequences can range from arrests for driving under the influence to the subtle psychic and emotional pain of the person who wants to stop using but cannot.
It’s important to understand that people experiencing addiction often learn to hide it well and may not show obvious signs such as absenteeism or lowered job performance. Just because someone doesn’t exhibit the behaviors we expect to see in someone with an SUD doesn’t mean they don’t have a problem that could be helped with treatment.
Three. If you take just a little time to search for resources and learn about treatment options, you could be a big help to an employee in need.
Aside from the occasional online search for “am I an alcoholic?,” I had never done much research on addiction or treatment options. I knew my employer had an Employee Assistance Program (EAP) but was reluctant to use it. I was concerned about confidentiality and the stigma of using a workplace benefit generally associated with mental health and addiction.
Most of what I knew about addiction treatment came from television shows and movies that depict Alcoholics Anonymous meetings in church basements or multi-week stays in well-appointed rehab facilities with yoga and ropes courses (“28 Days” with Sandra Bullock comes to mind). Part of the reason I didn’t seek help sooner is because I thought residential treatment was the only option. I couldn’t fathom time away from family and work obligations or the shame I would feel if others discovered the reason for my absence. I had no idea there were other options.
I’m not suggesting you become an expert, only that you educate yourself enough to be able to point someone toward free and confidential guidance offered by trusted resources. The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA)’s www.findtreatment.gov and Shatterproof’s Treatment Atlas (see video), for example, are two websites designed to help people find treatment for addiction based on location and insurance/payment options. Treatment Atlas, which currently includes treatment providers in 14 states (with more on the way), has a 10-question screening tool developed in collaboration with the American Society of Addiction Medicine to help people determine the type of care they might need.
Here’s some additional information your employees might not know about treatment for addiction:
Withdrawal from alcohol and other drugs can be dangerous, and potentially deadly. It’s important to seek medical care when quitting addictive substances. Depending on a variety of factors such as the particular drug the employee uses, length and frequency of use, and underlying physical conditions, withdrawal symptoms can vary from moderate to severe. Fortunately, withdrawal symptoms can be managed effectively by medical professionals who provide monitoring and medications.
Treatment doesn’t necessarily require time off from work. Before I sought help, I hadn’t realized outpatient treatment was available and that it can be just as effective. Employees who are aware treatment does not require an extended absence from work and family might be more willing to seek help.
Effective medications are available. Certain medications have been found to be effective for treating opioid and alcohol use disorders. For opioids in particular, medication has been shown to increase the likelihood of recovery and prevent overdose deaths. People seeking treatment for addiction should ask their caregivers about medication options.
Most treatment for addiction is covered by employer health insurance plans. When I was ready for treatment, I was pleasantly surprised to learn my health plan covered outpatient treatment without even requiring a copayment from me. In recent years, state and federal mental health parity laws and the Affordable Care Act have expanded treatment coverage for SUDs. Any employee considering treatment for addiction should be advised to check the Evidence of Coverage document for their health plan to learn what treatment services are covered.
Four. Learn what it means to create a “recovery friendly” workplace.
It’s really hard to be a non-drinker in a world where drinking is such an integral part of our social lives and where drinking is not only accepted but expected. In the early days of my recovery, I attended a post-board meeting reception in the cafe of the building where I worked. “You must be a Mormon or a boy scout,” a board member said to me after noticing the glass of water in my hand. “Go ahead and have an ‘adult’ drink,” he said motioning to a table with a large selection of beer and wine.
I’m sure the board member intended no harm, but his comment bothered me. It wasn’t just that the joke wasn’t funny (doesn’t everyone know “Mormon” and “boy scout” are not mutually exclusive categories?!). What really bothered me about the comment was that it put me in the awkward position of having to explain the reason for my abstinence at a time when I was not ready to “out” myself as a person in recovery from a substance use disorder.
In 2023, the U.S. Department of Labor published a Recovery-Ready Workplace Toolkit “designed to help businesses and other employers prevent and respond more effectively to substance misuse among employees, build their workforces through hiring of people in recovery, and develop a recovery-supportive culture.” The toolkit is worth a read, and a good starting point for any organization considering adopting new policies and practices to address SUD in the workplace. We should make it a goal to make recovery from addiction every bit as normal and accepted as drinking itself.
Five. People can and do recover from addiction!
It’s important to remember that recovery from addiction is possible. A 2020 study b the National Institute on Drug Abuse found three out of four people who experience addiction eventually recover. The odds of success are even better for people fortunate enough to have the necessary support and resources. My story is evidence that people can recover from addiction.
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About the author: Grant Boyken used to be a public affairs and governmental relations executive for a financial services organization. He currently serves as a member of the California Health and Human Services’ statewide Behavioral Health Task Force and as a senior director for a national nonprofit organization whose mission is to reduce the stigma of substance use disorders and make it easier for people to find and access appropriate treatment. He is working on a memoir titled “Off the Hook: Addiction, Job Loss, Recovery and My Search for Identity, Purpose and Redemption.”
References:
“Companies are slowly addressing employees’ substance use disorders,” by Theresa Agovino, Society for Human Resources Management (SHRM)August 26, 2021.
“HHS, SAMHSA Release 2022 National Survey on Drug Use and Health Data,” U.S. Department of Health and Human Services, Nov. 13, 2023.
“60% of Americans battling drug or alcohol addictions also have jobs. Here are the professions with the highest rates of substance-use disorder,” by Erika Fry, Fortune Magazine
“Since losing his son to opioids, Gary Mendell has been on a mission to shake up the system,” by Megan O’Neil, Chronicle of Philanthropy, June 5, 2018
“Medications for Substance Use Disorders,” U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). Viewed on the SAMHSA website Feb. 26, 2024.
“Prevalence and correlates of ever having a substance use problem and substance use recovery status among adults in the United States.” By Christopher M. Jones a, Rita K. Noonan a, Wilson M. Compton. 2018. Drug and Alcohol Dependence Volume 214, 1 September 2020, 108169