Should employers help addicted workers get drug and alcohol treatment? It’s a question that may not have merited much consideration for you in the past, but know this: If you own, manage, run or serve as administrator for a business, there’s a good chance you have an alcoholic or an addict working for you.
Most employers have employees who struggle with a drug and alcohol problem, and determining the best course of action when these situations come to light can be difficult. There are many different points of view when it comes to addressing such problems, and while you’re wrestling with the question of should employers help addicted workers get drug and alcohol treatment, it’s important to keep in mind that time is of the essence — because while you are trying to figure out how to proceed, someone’s livelihood, and life, is hanging in the balance.
You’re not the first business owner or manager to wrestle with such questions, however, and you certainly won’t be the last — but you can develop a strategy that approaches the problem from both a fiscally sound point of view as well as a humane one, because despite the conundrum you may feel like you’re in, there are some principles that you can use to develop your own response to these situations.
In this piece, we’ll help you address:
- The Human Element: How to help your employees when they need it most.
- The Financial Consideration: Does it make more fiscal sense to terminate and rehire to fill the position, or offer rehabilitation?
- Employment Law: Can you legally fire someone for a drug addiction if you don’t have any previously documented performance issues?
- The Loyalty Program: When you choose to support an employee in need, they become the most loyal employee you’ll have, and their “comeback” story will inspire others.
- The Recovered Employee: What having a recovered alcoholic or drug addict can do for your workforce.
We may not answer all of your questions, but hopefully we’ll help you consider a number of different possibilities — including some you may have never thought about before now. So, should employers help addicted workers get drug and alcohol treatment? Let’s break it down.
The Human Element: Beyond Just the Bottom Line
Should employers help addicted workers get drug and alcohol treatment? Let’s dissect that question first to determine whether certain words and phrases in it might elicit negative feelings in you, as an employer, manager or business owner, toward the individual who needs help.
The word “addict” has long been the subject of stereotypes, and for some people, thinking of addiction in a negative light, and by association those who suffer from it, is a natural reaction. After all, while there seems to be more conversation about addiction and alcoholism as legitimate illnesses, public opinion has been somewhat biased for years. Consider:
- More than 35 years ago, a study in the International Journal of the Addictions  polled “two hundred and fifty-six respondents from a small, upper-mid-western college town (who) answered a questionnaire designed to assess their first impression images of the term ‘drug addict.’ The results indicated that the overwhelming image was of a disoriented, unhealthy, thin, low-class, male ‘hippie’ with behavioral and skin problems who suffered from a disease.”
- Fast-forward 30 years, to a study published in the journal Psychiatric Services of 709 people about addiction : “Respondents held significantly more negative views toward persons with drug addiction. More respondents were unwilling to have a person with drug addiction marry into their family or work closely with them. Respondents were more willing to accept discriminatory practices against persons with drug addiction, more skeptical about the effectiveness of treatments, and more likely to oppose policies aimed at helping them.”
It goes without saying, then, that addicts and alcoholics still face a great deal of scorn because of the specific nature of their problem, even though the “problem” is defined as a disease by most medical associations, including the American Medical Association and the American Society of Addiction Medicine.  How it qualifies as a disease is a complex answer about which dozens of journal articles, research papers and books have been written, but a 2016 article by Harvard Health Publishing, a division of Harvard Medical School, describes it this way :
“An addicted person’s impaired ability to stop using drugs or alcohol has to do with deficits in the function of the prefrontal cortex — the part of the brain involved in executive function. The prefrontal cortex has several important jobs: self-monitoring, delaying reward, and integrating whatever the intellect tells you is important with what the libido is telling you. The difficulty also has to do with how the brain, when deprived of the drugs to which it is accustomed, reacts to stress. The response is usually exaggerated negative emotion, and even despair. In this setting, the strong association of learned environmental cues (for instance, smelling beer at a ball game or seeing the corner where the dealer can be found) exacerbates the craving for the substance. And the flood of intoxicating brain chemicals called neurotransmitters (chiefly dopamine) during drug use makes the brain relatively insensitive to ‘normal’ sources of pleasure — say, a good conversation with a friend or a beautiful sunset.”
So what, exactly, does that mean? Dr. Michael Bierer, the author of that Harvard Health Publishing post, puts it bluntly: Just saying “no” is not enough. “The person needs to develop alternative sources of joy and reward, and people who have been isolating themselves in order to drink or use drugs without inhibition may need to work in a purposeful way to re-acquire habitual ‘joy’ — social interactions, physical pleasures like a swim or a bike ride, and other healthy, enjoyable rewards,” he writes. Sometimes, he points out, individuals who suffer from addiction — known in the medical field as a substance use disorder — can mature out of it without treatment, but it’s important to point out, he adds, that the further along the spectrum of mild to moderate to severe substance use disorder that someone gets, the more difficult it is for a person, if not impossible, to stop on his or her own.
So what does all this mean for you, as an employer? Obviously, your employees are people — flesh-and-blood human beings who work for your company or at your facility but who also have lives, families, loved ones and communities outside of their jobs that consider them valuable members. Dismissing a drug and alcohol problem by one of your employees as a nasty habit instead of the illness that science tells us it is runs counter to everything a company that cares for its employees wants to provide. That doesn’t mean issues, problems and broken rules — or even broken laws — are to be swept aside and forgiven, but it does beg the question: If an addict is a sick person who needs to get well and not a “bad” person who needs to be good, how should they be treated? Chances are, you wouldn’t dismiss an employee battling diabetes, or hypertension, or asthma — similar chronic, progressive and (if left untreated) possibly fatal illnesses. Should addicts, then, be burdened with the stigma of failure because they suffer from a disease of a different nature?
Should Employers Help Addicted Workers Get Drug and Alcohol Treatment? Dollars and Sense
To understand the financial ramifications of addiction, let’s start broad and bring it into a narrower focus, in terms of lives, dollars and business:
- According to the Centers for Disease Control (CDC), provisional overdose deaths for calendar year 2019 totaled 71,148 people . To put that into perspective: According to the National Archives , that’s almost 13,000 more deaths than the 58,220 American casualties in the entirety of the Vietnam War.
- Also from the CDC : “Excessive alcohol use is responsible for more than 95,000 deaths in the United States each year, or 261 deaths per day.” That would make alcohol-related fatalities the seventh leading cause of death annually , between Alzheimer’s and diabetes.
- Abuse of alcohol and illicit drugs combined costs this country more than $442 billion annually “in costs related to crime, lost work productivity and health care,” according to the National Institute on Drug Abuse (NIDA) . By comparison, the 2020-21 annual budget for California, the most populous state in the country, is $202 billion .
- According to the occupational safety and health magazine EHS Today , “drug abuse costs employers $81 billion annually,” and “some 70 percent of the estimated 14.8 million Americans who use illegal drugs are employed.”
The EHS Today piece, using information from the National Council on Alcoholism and Drug Dependence, goes on to detail how a drug and alcohol problem can affect an addicted employee:
- “After-effects of substance use (withdrawal) affecting job performance.”
- “Preoccupation with obtaining and using substances while at work, interfering with attention and concentration.”
- “Illegal activities at work, including selling illegal drugs to other employees.”
- “Psychological or stress-related effects due to drug use by a family member, friend or co-worker that affects another person’s job performance.”
Clearly, drugs and alcohol take a toll — not just on the health of affected individuals in your employ, but on the work they do for your company. And it may seem like the simplest solution to these problems is to terminate individuals with a problem so that they’re no longer affecting your productivity, your brand or your bottom line. But is that the ideal solution? That depends on a number of factors — the most obvious being the value of the job a specific employee does, but more importantly on the costs the company will incur for replacing that employee, should you choose to terminate him or her instead of offering drug and alcohol treatment. Dr. Jeffrey Stuckert, writing for the website Psych Central, breaks some of those costs down :
- “Separation Costs … paid for exit interviews, administrative duties, separation/severance pay and unemployment compensation.”
- “Vacancy Costs,” which “may include the costs paid to employees who work overtime to take over additional duties, or to find and hire a temporary employee to take over that specific employee’s tasks.”
- “Replacement Costs,” which “may include the cost of attracting applicants, entrance interviews, testing, medical exams and acquiring and disseminating information.” And
- “Training Costs,” which “may include formal or informal training costs, literature costs, technology costs, and time spent learning additional tasks.”
“Oftentimes,” Stuckert continues, “financing these costs can be more expensive than the cost it takes to send an employee to drug and alcohol treatment.” Those costs vary widely across various fields and industries, and it’s impossible for us to put a price tag on the value of an employee and how much companies would spend in order to replace that employee. What we do know, however, is that drug and alcohol treatment provided at a facility like Cornerstone of Recovery can be viewed as an investment — one that goes far beyond simply ensuring that employees with a drug problem returns to full functionality so that they can accomplish their assigned tasks.
In fact, according to a 2018 report in The Washington Post , “employers, researchers and government officials suggested that successfully helping an employee with a substance abuse problem breeds allegiance to the company.” The report goes on to detail how the New Hampshire-based company Hypertherm bills itself as a “recovery friendly” workplace that is “willing to overlook employment gaps and some brushes with police that accompany drug use. They encourage open discussion of addiction in the workplace to reduce stigma. Perhaps most significantly, they treat substance abuse and relapse as medical issues like surgery or maternity — a time for the company to support, not abandon, the employee.”
The results, Hypertherm Vice President Jenny Levy told The Post, have made hers a better company, because employees “who are supported through their recovery are incredibly loyal,” she said. “They make great workers.”
Should Employers Help Addicted Workers Get Drug and Alcohol Treatment? What the Law Says
Should employers help addicted workers get drug and alcohol treatment, or should such offenses lead to an automatic dismissal? For businesses and companies who have employees struggling with a drug and alcohol problem, such a predicament is problematic, to say the least.
On one hand, most employers have a zero tolerance policy modeled after the Drug-Free Workplace Act of 1988, which states  that "the unlawful manufacture, distribution, dispensation, possession, or use of a controlled substance is prohibited." While the act applies primarily to federal contractors and federal grant recipients, many companies have followed suit by crafting their own policies, because it just makes for good business practices, as the National Drug-Free Workplace Alliance points out : “Most employers strive to provide a safe work environment and encourage personal health. They consider the abuse of drugs and alcohol on the job to be an unsafe, counterproductive work practice. Furthermore, they see substance abuse as a serious threat to other staff and their customers.”
It's understandable, then, that company leaders, executives, employers and human resource workers may be initially inclined to enforce a zero tolerance policy with a draconian hand. But there are a number of considerations to take into account that have as much to do with company policy as they do employment law.
Let’s start with alcohol consumption. Is there a policy that addresses alcohol and drug use in your employee handbook? If so, according to the legal reference site Nolo.com , and “you catch an employee actually using alcohol at work, you can deal with it through your company's standard disciplinary procedures. Depending on the circumstances and on your company's policies, the punishment can range from an oral reminder to immediate termination.”
However, the website goes on to point out, “the consequences should depend in part on whether the employee has endangered the health and safety of others. For example, an employee who has a few beers at lunch before returning to work operating a forklift might warrant more severe discipline that a waitress who has a glass of wine at lunch.”
But what about after-hours alcohol consumption? Safety-sensitive careers in which individuals are on-call after hours aside, most employers have no desire to police when or how much an employee drinks when he or she is off the clock. But if their drinking begins to take a toll on job performance, that’s another matter entirely: “The federal Americans with Disabilities Act (ADA) and many state disability rights laws protect alcoholics from workplace discrimination. The ADA doesn't allow employers to make an employment decision based solely on the fact that an employee is an alcoholic. An employer can, however, make a decision (including a decision to discipline or terminate an employee) based on the employee's inability to meet the same performance and productivity standards that it imposes on all employees.” 
Your employee handbook, according to the financial website The Balance , should explicitly detail regulations concerning drug use as well, but again, the ADA, along with the Rehabilitation Act of 1973, “affect drug and alcohol policies.” The Balance goes on to highlight certain regulations covered by both of those statutes:
- Employers can “prohibit the illegal use of drugs and the use of alcohol in the workplace,” and “testing for illegal use of drugs does not violate the ADA (but must meet state requirements).”
- In addition, pre-employment drug testing is standard procedure, but “all candidates need to be treated equally and no individual can be singled out for testing. “
- When it comes to random drug testing among employees, The Balance notes that “many states require employers to verify a cause for testing currently employed workers for substances. Employers in those states must have a reasonable suspicion that the employee in question is abusing drugs and that safety or performance has been compromised.”
- While “employers may discharge or deny employment to those who currently engage in the illegal use of drugs,” it’s important to note that “employers cannot discriminate against drug addicts who have a history of drug addiction or who are not currently using drugs and have been rehabilitated (or who are currently in a rehabilitation program).”
- In addition, “reasonable accommodation efforts, such as permitting time off for medical care, self-help programs, etc., must be extended to drug addicts who have been rehabilitated or who are undergoing rehabilitation.”
- Alcoholism is often held to different standards: While “employers may discharge, discipline, or deny employment to alcoholics whose use of alcohol hinders job performance or behavior to the same extent that such actions would result in similar disciplinary action for other employees” … “an alcoholic may be determined as an ‘individual with a disability’ under the ADA.”
- The ADA, The Balance goes on to point out, “does not protect casual drug users,” although “those with a record of addiction … are covered by the Act.”
When it comes to addressing addiction and alcoholism in the workplace, it’s always wise to proceed with caution, even if you’ve decided that termination is preferable to providing or encouraging an addicted employee to seek treatment. Many companies have Employee Assistance Programs set up for situations like this, or have trained human resources staff members well-versed in the necessary protocol. In some cases, managers, owners and employers may want to consult with a company’s legal representative to ensure full compliance with the law.
Ultimately, as the trade publication IndustryWeek  points out, “employers should generally address substance abuse by addressing the effects it has upon an employee’s performance and behavior (e.g., absenteeism, disappearance from worksite, failure to satisfy production standards). In contrast, employers should generally avoid drawing conclusions or taking action based upon an employee’s perceived or self-claimed status as an ‘addict’ or a person with a problem.”
Should Employers Help Addicted Workers Get Drug and Alcohol Treatment? The Loyalty Program
In December 2018, NPR detailed the plight of recovering addicts seeking employment and running into numerous closed doors because of their histories. One Philadelphia-based company, the piece pointed out , took a different tact: Delta, a lighting company, went out of its way to recruit those in recovery as part of its workforce, according to Vice President Joe Arndt.
"They're tremendously loyal to us, and they just work harder because they realize that they don't necessarily have a lot of other options which is kind of sad," he told NPR.
An important factor about addiction that every employer should know: No one thinks less of an addict or an alcoholic than the individual who wears that label. At Cornerstone of Recovery, we’re intimately familiar with the guilt, shame, self-loathing and self-hatred that addicts and alcoholics feel, because the majority of our staff members are in recovery themselves. We know what it’s like to be driven to do things completely out of character for us, things that go completely against previously established norms, morals and values. We know full well the agony of wanting to stop but being unable to do so. And because we’re unable to do so, we find ourselves caught in a vicious repetitive cycle: The more things we do to perpetuate our addiction, the greater our guilt becomes, and in turn so too does the desire to assuage that guilt with — you guessed it — more alcohol and drugs.
By the time we admit that we need help, or that we’re confronted and forced to acknowledge that our lives are out of control, we feel worthless, unworthy and fully deserving of any scorn, punishment and retribution that might be handed down by friends, family members and employers. In fact, we often fully expect it … which makes grace, forgiveness, kindness and understanding so much more powerful, because those are reactions we feel as if we don’t deserve.
To have them offered by someone like an employer, whose small act of encouragement and reassurance that if we get help, our jobs will be waiting — that can make all the difference. That engenders a loyalty that’s fierce and a dedication that’s unwavering, because while those may seem like small acts to you, as an employer, they’re great gifts to us, as addicted employees who have languished for so long in physical, mental and emotional misery. It’s something we don’t forget.
Fortunately, other forward-minded business and civic leaders have recognized that for several years now. In 2013, British Work and Pensions Secretary Iain Duncan Smith launched a program to give cash incentives to businesses that offered recovering addicts “lasting employment.”
"They can be highly-motivated, loyal and committed workers and all the more grateful for the opportunity because of their history,” Smith said at the time . Earlier this year, The Wall Street Journal  profiled Cincinnati’s Nehemiah Manufacturing Company, a “second chance” organization that seeks to hire recovering addicts and individuals with criminal records because “hiring people with a criminal past can pay big dividends for companies, such as closer community ties and a loyal workforce. The result? “Today, Nehemiah’s annual turnover stands at roughly 15%, well below the 38.5% average for consumer-products companies, as reported by Mercer’s 2019 U.S. Turnover Survey. Nehemiah says it had operating income of $5.7 million on sales of $59.4 million in 2018.”
Should employers help addicted employees get drug and alcohol treatment? It makes sense from a business standpoint, but is it also possible for a company to do more? Absolutely, and by doing so, the loyalty felt by employees who receive a second chance through treatment adds value to the company’s brand. Members of an employee’s family and community see what his or her employer is doing, not just in facilitating treatment but in the encouragement of recovery — and that word-of-mouth good will often does far more for a company than professional marketing efforts.
As the National Safety Council points out , “employers play a very important role in helping employees in recovery. Employees who are in recovery have equal or lower healthcare costs, absenteeism and job turnover compared to employees who never report (a substance use disorder). Employers who help employees complete treatment are likely to see a high return on investment when working with employees throughout treatment to achieve recovery. Supporting employees in recovery creates clear reasons and culture for job satisfaction and loyalty in the workforce.”
Giving Back: The Recovered Employee
Should employers help addicted workers get drug and alcohol treatment? What’s in it for them? What is there to gain from an economic and vocational perspective, they may be wondering? Plenty, according to the available data. For example, according to Harvard Health Publishing , “treatment for addiction, facilitated within or by the workplace, has been shown to be successful in increasing employees’ legal, mental, and social functioning, as well as decreasing absenteeism rates, workplace conflict, and productivity problems upon return from treatment. Investing in employee treatment yields high returns, with an estimated gain of 23% among employees with an income of $45,000 per year or an estimated gain of 64% for employees earning $60,000 per year.”
Dr. Stuckert  gets even more specific. In addition to offsetting the costs of rehiring and retraining to fill a position vacated by an employee terminated for a drug and alcohol problem, there are a number of strengths that an employee in recovery can bring to an organization, including:
- Productivity, because after treatment, “he or she will be more responsive to their superiors, and in general, he or she will be a healthier employee physically and emotionally.”
- Job satisfaction, for the employee and those whose jobs and attitudes might have been impacted by that employee’s alcohol or drug problem: “After treatment, the employee will be able to perform better at work, managing their workload and others more efficiently.”
- Company loyalty, including the elimination of risks to a company’s reputation because of accident, workplace injury or inferior job performance: Employees who receive treatment “may experience feelings of greater loyalty toward a company willing to provide them with assistance and help while they are dealing with their disease, and will ‘pay’ the employer back with increased productivity, a boost in work performance, and company loyalty.”
And treatment, research shows, works: A study published in the Journal of Substance Abuse Treatment  revealed upon 6 and 12 month follow-ups with employees who received drug and alcohol treatment, 65 percent were retained by their original employers, and “Significant improvements were seen in absenteeism, number of employment problem days, and whether their job was in jeopardy 12 months later.”
And that’s not all: Dr. David Sack, also writing for Psych Central , notes that employees in recovery from addiction and alcoholism often emerge as advocates for the recovery process in their various treatment and recovery communities. The foundation of most 12 Step self-help programs involves those who have achieved recovery helping others still struggling, and that can carry over to their places of employment, Sack said: “They have firsthand knowledge of the disease and a great deal of passion for helping others. When combined with professional training and education, these individuals develop the skills to understand the complexities of addiction and co-occurring disorders and meet the demands of working with addicted clients.”
That’s doesn’t mean an employee with an alcohol and drug problem will emerge from treatment and be ready for a role in human resources — but it does mean that given an opportunity to return to work and to earn the trust and respect back of colleagues and supervisors, recovering employees can be an asset to companies in ways that aren’t immediately clear when the problem first reveals itself. At the very least, the answer to the question, “Should employers help addicted workers get drug and alcohol treatment?” should be considered through the lens of long-term dividends, which means understanding that addiction and alcoholism recovery aren’t the same things as abstinence: They involve addressing internal issues, traumas, pain and life traps that keep afflicted individuals trapped in a cycle of self-destruction.
In other words, it’s not just about alcohol and drugs, and dismissing employees because they struggle with a substance confuses the forest for the trees: Individuals who come out of a comprehensive drug and alcohol treatment program are often stronger in all areas of their lives, and the traits with which they return to work may make them not just better employees, but better leaders, coworkers, friends and community members who add so much more value to a business than just those defined by their job requirements.
As Dr. John F. Kelly, writing for Psychology Today, puts it: “Research has shown programs addressing alcohol and other drug use in the workplace to be cost effective, contributing to the health and well-being of the employee and organization. In a time of high national rates of alcohol and other drug use disorders, it is important that organizations address this growing public health crisis by supporting employees seeking treatment and recovery.”
Addiction has plagued mankind throughout our history, but because of advances in science and medicine, we now understand it for what it is: a disease with a biological component that requires complex treatment — which is all the more effective when employers take a proactive, compassionate approach. That doesn't mean your business, your bottom line or your other employees should be sacrificed or penalized because you offer a hand up to those who suffer from addiction or alcoholism — but it does mean that success in your industry has to come at the exclusion of those who suffer from a very real illness.
Should employers help addicted workers get drug and alcohol treatment? The evidence speaks for itself: Doing so positions an organization as a caring, committed company that looks out for its employees ... is stepping up as a business dedicated to doing everything within its power to push back against the public health scourges of addiction and alcoholism ... and earns a return on its investment in the employees afflicted by these diseases.