Supporting Employees With Substance Use Disorder

More than 30 million U.S. adults with substance use disorders are employed, but alcohol and drug use doesn’t even crack the top five reasons members contact our program.

While progress has been made in reducing the stigma around mental health, there is still a long way to go in addressing the persistent stigma surrounding addiction. That’s why fostering open discussions on the topic, dispelling common myths, and breaking down barriers to care are so important.

Employers have a unique opportunity to help employees face these challenges by creating an environment that facilitates open discussions about mental health and provides seamless navigation to appropriate care and resources.   

Common myths about substance use disorders  

Many of the beliefs people hold about substance use disorders trace back to stereotypes and misinformation. These myths aren't just inaccurate; they actively discourage employees from seeking help.

Myth: Overusing drugs or alcohol is a choice. 
Fact: Substance use disorder is a mental health condition, not a choice. 

Myth: Only men struggle with substance use disorders.   
Fact: While men have historically had higher rates of substance use or dependence, women are just as likely as men to develop a substance use disorder, according to the National Institute of Drug Abuse. In the 1980s, men were five times more likely than women to meet criteria for alcohol use disorder; by 2023, that ratio had narrowed to 1.4 to 1.

Myth: People who have an addiction don’t have stable jobs or family life. 
Fact: According to the National Institute for Occupational Safety and Health, an estimated 46 million Americans aged 18 or older experienced a substance use disorder in 2022. Nearly two-thirds of those people, just over 30 million, were employed.

When you take time to learn the facts, it becomes clear that substance use disorders can impact anyone.  

That said, there are common risk factors that everyone should be aware of. These risk factors include mental health concerns, family history, exposure to trauma, and various environmental and social characteristics.  

Common barriers employees face in accessing care  

Even when employees recognize they may have a problem, a range of barriers can prevent them from seeking support. Understanding these barriers is the first step toward addressing them.

Stigma 

Substance use disorders are some of the most stigmatized mental health disorders globally, making it challenging for people to admit they’re struggling and ask for support. People living with a substance use disorder may be perceived as untrustworthy, dangerous, or incapable of change. That stigma causes many people to experience feelings of shame and hopelessness, which causes them to delay care or avoid it altogether. It's hard to break that cycle without the right support.

Fear  

Fear can make stigma even worse. For example, employees may worry that disclosing a substance use problem could put their job at risk. Many individuals express concerns about the financial implications of admitting a problem and seeking appropriate care. Will the right support be affordable? Will their job be impacted if they need time off work to participate in treatment? How will friends and family respond? These fears are not irrational; they reflect real uncertainties that well-designed employee substance use policies can help address.

Lack of resources 

The lack of resources, or even awareness that resources exist, is itself a major obstacle preventing many individuals from seeking support. Financial constraints, such as inadequate insurance coverage, can deter people from taking that first step. Poor treatment availability, marked by provider shortages and transportation challenges, can further limit access to necessary care. And the complexity of admission procedures, often involving many steps, can discourage those in need from pursuing treatment altogether.

When stigma, fear, and a lack of information converge, employees often feel both hopeless and helpless, preventing them from taking the steps they need to get the right care.

How does substance use affect the workplace?  

Substance use can significantly affect the workplace, impacting everything from productivity and performance to absenteeism and safety. Fully understanding the organizational impact can help you make a strong business case for an EAP that offers specialized care for those struggling with a substance use disorder.

Productivity and performance 

A 2025 study published in the American Journal of Preventive Medicine found that substance use disorders resulted in an estimated $92.65 billion in lost productivity in the U.S., primarily due to the inability to work ($45.25 billion).

Absenteeism  

Absenteeism was the second largest driver ($25.65 billion) of lost productivity, according to the same study. While the typical worker misses 15 days annually for illness, injury, and other reasons besides vacations and holidays, workers with a substance use disorder often miss an additional 10 days, according to the National Safety Council.

Safety  

Of the additional 10 days missed, most are associated with illness and injury. Furthermore, employees with addictive disorders are five times more likely to file workers' compensation claims than their peers. Mental health and substance use challenges can't be overlooked when considering safety.

Substance use disorders don’t just impact the individuals who are struggling. They can affect colleagues, customers, and your company's reputation. That’s why you must be committed to providing an environment that openly and actively supports individuals struggling with a substance use disorder.

How can employers support employees struggling with a substance use disorder?  

Employers can build environments where employees feel safe asking for help and sustaining recovery. The following strategies support both those who suspect they may have a problem and those already on the path to treatment.

Eliminate the stigma surrounding substance use disorder 

Open, consistent communication is one of the most effective tools you have as an employer. This can take the form of employee education, myth-busting communications, and more regular promotion of available benefits. Take the opportunity to share information about your mental health and wellbeing benefits throughout the year, including at orientation, open enrollment, and wellness events. This helps normalize conversations about mental health and support, and make them a core part of your culture.

Train managers to recognize signs of substance use disorder

When managers are trained to recognize signs of substance use disorder and understand how to address them appropriately, it sets a cultural standard for mental health and wellbeing. Training managers also gives them the language and confidence to approach employees with care and share more about available resources. Your workplace mental health provider can also help navigate more complicated situations. For example, formal management referrals help managers address policy violations or productivity issues related to substance use concerns.

Establish clear employee substance use policies 

A clearly stated and actively promoted substance use policy signals that the organization takes the issue seriously and has thought carefully about how to handle it. Some organizations prefer a zero-tolerance approach; others find that second-chance policies align better with their culture and values. Whichever direction you choose, the policy should be paired with education, resources, and support structures for both employees and managers. A policy without a support pathway is incomplete.

Clinical support, advocacy and navigation  

Deciding to take the first step in seeking care can be overwhelming for employees and their families. A workforce mental health program that functions as an accessible, low-barrier entry point for substance use concerns can be an effective way to reduce risk and severity while improving productivity and reducing missed work. In fact, a recent study from CuraLinc demonstrated the success of EAP intervention for alcohol use, showing 74% of participants who were at risk for alcohol misuse were no longer at risk post-treatment. And those with a productivity problem recovered an average of 40 hours per month of productive time after EAP treatment.

These outcomes reflect what's possible when substance use support is built into the employee experience in a structured, clinically grounded way.

Key components of an effective EAP for substance use

An EAP optimized for substance use concerns goes beyond a referral line. Effective programs offer clinical depth, navigational support, and ongoing accountability at every stage of the employee's journey.

Immediate access 

Immediate access to a licensed clinician is essential, as phone trees, lists of resources, and long wait times can often create more barriers to care. When someone makes the decision to reach out for support, they deserve 24/7/365 access to licensed clinicians who can listen and provide a clinically validated assessment to determine their risk level and appropriate next steps.

Navigation to appropriate treatment options

In addition, look for an EAP that can help guide participants to the right treatment programs. For example, CuraLinc's Care Advocates help confirm program availability and in-network status, reducing confusion and additional steps for the employee who needs support. Specialty-focused clinicians help support complex care navigation.

Family can be a significant source of support for employees with a substance use disorder, but they also need to be taken care of. Look for an EAP that is committed to ensuring family members are well-equipped to provide support throughout recovery. That often means connecting them with counseling, support groups, and resources themselves.

Building a workplace that supports recovery

Supporting employees with substance use disorder is an ongoing commitment that touches every part of the workplace. When you reduce stigma, remove the barriers that keep people from seeking help, and understand the real organizational costs of inaction, you create the conditions for employees to step forward and stay well. By treating substance use disorders with the same care and seriousness as any other health condition, you give your people a clear path forward, and you protect the wellbeing of your entire workforce along the way.

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