FAQs for Employees
Frequently asked questions that employees may have regarding substance use disorder
I think I may have a substance use disorder. What’s my next step?
You’re not alone! Almost 15% of persons under age 25 have an SUD and up to 25% of the American population is sometimes on the job under the influence of alcohol or some illicit drug.(1) SUD not only impacts work performance but it can be deadly.
Fortunately, the stigma surrounding SUD is beginning to lift. SUD is finally being recognized as a treatable, chronic medical condition. Medication assisted treatment (MAT) is dramatically changing the prognosis for the disease.
The first step when you suspect you may have a SUD is to seek evaluation. In addition to substance abuse, it’s important to identify other problems such as depression or anxiety which commonly occur with SUD and may impact recommended treatment. Options for evaluation include:
Your personal primary care physician (PCP). If you have a PCP you’re ahead of the game. A trusted caregiver knows your medical history well and can point you in the right direction. Unfortunately, in today’s fragmented health care system, many adults don’t have a PCP.
Your employer may offer an Employee Assistance Program or EAP. This is an entirely confidential service which typically involves a professional counselor who assesses the problem and offers next step evaluation and treatment recommendations.
Operation Lighthouse offers a link to the Shatterproof website where you can confidentially complete a self assessment and be directed to validated treatment resources.
If you do have a problem, there’s hope! Treatment options range from outpatient care to inpatient detox and rehabilitation. MAT is saving lives.
Shatterproof and Operation Lighthouse are working with employers to create a stigma-free, healthy workplace where employees can confidentially get the best science-based assessment and treatment guidance they need.
References
EASNA (2017) Special Report: Selecting and Strengthening EAPs: A Purchaser’s Guide. Alexandria, VA. Employee Assistance Society of America.
Should I tell my employer I have a substance use disorder?
If you’ve recognized you have a substance use disorder and have sought appropriate medical treatment, you’ve already taken the most important first step. Substance use disorders of alcohol or illegal use of opioids and other prescription drugs are chronic medical conditions which are treatable. It’s important to get into medically supervised treatment as soon as possible.
Unfortunately, because of perceived stigma attached to these disorders and fear of termination, you may be hesitant to tell your employer about your condition. However, your treatment may require some period of time away from work. Disclosing your need for treatment is usually the best course of action you can take to help yourself during recovery. Having your employer’s support has been shown to increase your chance for successful treatment and recovery (1).
As you consider disclosure, you should be aware of 2 federal laws as well as your own company’s policy for substance use disorder:
Employers have a responsibility to ensure a safe workplace (Occupational Safety and Health Act- OSHA) and cannot turn a blind eye to illegal drug use in the workplace. Employers are permitted by OSHA to develop and implement a drug or alcohol testing program for workplace substance abuse (2).
The Americans with Disability Act (ADA) prohibits employers with more than 15 employees from discriminating against employees with a physical disability. This includes persons who have completed drug rehabilitation or are currently in treatment, but no longer using illegal drugs (“in recovery”). You are not protected if you are currently using illegal drugs. If you have a current alcohol dependency issue you are protected as long as you are in treatment. Protection for drug and alcohol use disability under the ADA means your employer cannot terminate you or deny promotion on the basis of a history of SUD or current enrollment in a treatment program. You must also be offered “reasonable accommodation” to facilitate successful performance of your work (3). This might include scheduling to allow attendance at outpatient treatment visits or Alcoholics Anonymous meetings for example
The Family Medical Leave Act (FMLA) requires employers with more than 50 employees to allow an employee with at least one year’s service (1250 hours) to take up to 12 weeks of unpaid, job protected leave for treatment of substance use disorder. An employer may require a medical provider’s statement documenting the reason for treatment. This information must be held in confidence by the employer (3,4).
In summary,
If you have a SUD, get proper medical evaluation and treatment as soon as possible. Depending on your situation, you may be offered inpatient or outpatient treatment, or some combination of both. Once you’re no longer using drugs illegally and in treatment, you’re protected by the ADA at your job.
Disclosing your condition to your employer may improve your chances of recovery. Under the ADA, your employer is required to engage in an interactive process with you to develop accommodations which allow you to continue successfully performing your essential work duties while in treatment. Your employer may be able to guide you to confidential resources within an Employee Assistance Program (EAP).
If you continue to use illegal drugs and haven’t sought treatment, you are not protected by the ADA. If your employer suspects you are using drugs, based on observed work behaviors or changed performance, you may be required to take a drug test. You risk termination. Though not required, an employer may choose to offer a “last chance” agreement. The employer agrees not to fire you in exchange for your agreement to receive SUD treatment and refrain from further use of alcohol or drugs. Regular drug testing is usually required and work performance typically is monitored. Violating the agreement typically results in immediate termination.
References
Jordan, D. (2017). Should you tell your employer you have a substance use problem? US News Health(January 20, 2017). Accessed February 21, 2021 at: https://health.usnews.com/health-care/for-better/articles/2017-01-20/should-you-tell-your-employer-you-have-a-substance-abuse-problem.
Occupational Safety and Health. Chapter 4: Substance Abuse under the ADA. Accessed February 21, 2021 at: https://www.usccr.gov/pub/ada/chr.htm
Americans with Disabilities Act (ADA). The ADA, Addiction & Recovery. Accessed February 18, 2021 at: https://adata.org/factsheet/ada-addiction-and-recovery
Job Accommodation Network.Last chance agreements for employees with drug and alcohol addictions. Accessed February 19, 2021 at: https://askjan.org/publications/consultants-corner/Last-Chance-Agreements-for-Employees-with-Drug-and-Alcohol-Addictions.cfm