We’ve Got To Talk About It

The meeting invite from our HR director was marked “private.” I assumed the purpose was to discuss a sensitive matter with an employee in my branch. I hadn’t expected that employee to be me. 

“This is going to be a difficult conversation,” the director said. “Someone reported smelling alcohol on your breath and we’ve gotta talk about it.”  

Talking about it was the last thing I wanted to do. I’ve come to believe that is part of the problem. Talking more openly at work about problems with alcohol and other drugs could reduce the stigma and encourage people to seek help earlier. 

According to the Centers for Disease Control and Prevention (CDC), 70% of adults in the U.S. (13.6 million) with a substance use disorder (SUD) are employed. That means about 9% of employed adults continue to use alcohol and other drugs despite experiencing related physical, social, financial, and/or legal problems. 

For every employee with an untreated SUD, employers spend an average of $8,800 annually due to increased healthcare costs, absenteeism, lost productivity, injuries, and turnover. 

Stigma and secrecy give a distorted view of substance use problems 

If those numbers seem high to you, you’re probably not alone. Most of us underestimate the prevalence of SUD because people who experience problems with alcohol or other drugs work hard to keep them hidden.  

It was only when I began to talk about my experiences that others shared their stories with me. I learned how widespread and varied substance use problems are. People living with SUD or in recovery are everywhere. Most of us don’t fit the stereotypes. Many of us manage to keep it under the radar, sometimes for years.  

It doesn’t take much guesswork to understand why people experiencing problems with alcohol and drugs don’t want others to know. According to the 2024 Shatterproof Addiction Stigma Index, almost half of respondents surveyed said they’d be unwilling to move next door to, or have a close friend who is, a person with SUD.  

The stigma even sticks to people who no longer use alcohol or other drugs. More than 60% of survey respondents said they’d be unwilling to have a person in recovery from SUD serve as their work supervisor or marry into their family. As a person in recovery who is a supervisor and a spouse, that hits close to home. 

I don’t fault anyone for keeping quiet. Their reticence, however, leaves us with a picture of the SUD spectrum that only highlights the extreme. Our tendency to focus on severe examples involving arrests, homelessness, or job loss can make it easier for people to minimize the less severe consequences they’ve experienced and conclude they don’t have a problem.  

It allows us to think of those experiencing substance use problems as "other,” which can subject them to a degree of judgment and intolerance that wouldn't happen if we recognized them as "us."  

Here's what we need to talk about 

People rarely discuss getting help for problems with alcohol and other drugs. As a result, most of us don’t know much about treatment options. That was certainly the case for me.  

A bit of familiarity with the basics could give employees what they need to help themselves or their coworkers. Here are six simple messages I wish that I had known:

• Withdrawal can be dangerous and potentially deadly, depending on the substance and pattern of use. Anyone who decides to quit using alcohol or drugs after sustained and regular use should consult with a medical professional. 

• Treatment doesn’t always require taking time away from work or family. For many people, outpatient care can be just as effective as residential treatment. This is particularly important for people who are primary earners or caregivers in their households.  

• Medications to treat SUD are available. Research has shown certain types of medication to be highly effective in the treatment of opioid and alcohol use disorders. These medications are considered standards of quality care and something people seeking treatment should ask about. 

• Treatment for SUD is covered by health plans. The Affordable Care Act and other federal and state laws have expanded health plan coverage for SUD treatment in recent years. Shatterproof Treatment Atlas and FindTreatment.gov from SAMHSA are online tools that people can use to find options covered by their health plan and appropriate for their needs.

• Overdose reversal medication is easy to use and carries minimal risks. With the rise of fentanyl in the illicit drug supply, opioid overdose deaths have surpassed car accidents as a leading cause of accidental deaths. The Food and Drug Administration (FDA) recently approved making naloxone nasal spray available without a prescription. Employers should keep naloxone on hand and ensure their employees know where it is and how to use it.   

• People can, and do, recover from SUD (and thrive!). According to a study conducted by the CDC and the National Institute on Drug Abuse (NIDA), 75% of people who experience SUD eventually recover.   

Employers can work with their health plans and employee assistance programs to add information and resources to internal communications and trainings. Shatterproof offers a comprehensive guide of Employer Resources, including information about Just Five, an online video series designed for workplace learning . 

Making the workplace a safe place to talk about SUD 

At a work reception during my early days of sobriety, a board member chided me for choosing a bottle of water from a table stocked with beer and wine.  

“What are you, a Boy Scout?” he asked. “Go ahead. Have an adult beverage.” In workplaces where drinking is accepted, and sometimes expected, maintaining sobriety can be difficult.  

In recent years, there has been growing interest in the “recovery-ready workplace.” According to the U.S. Department of Labor, which published a 2023 Recovery-Ready Workplace Toolkit, recovery-ready workplaces adopt policies and practices that support people in recovery, encourage employees with SUD to seek help, ensure access to treatment and support for substance use problems, and provide SUD education to reduce stigma and misunderstanding.  

While there’s no one-size-fits-all solution, moving toward a recovery-ready workplace requires a focus on the three “P’s”: 

• Policies: Do current policies strike the right balance between protecting the organization and making people with SUD feel comfortable seeking help?

• Practices: At workplace functions where alcohol is served, are there alcohol-free options? Are there rules that prevent alcohol being included in workplace raffles and gift giving? Are hiring practices inclusive enough to allow people in recovery from SUD to compete for positions? 

• People (culture): Has the workplace provided employees with sufficient education and training to mitigate the stigma of substance use problems and to let people know how to seek help? 

There have also been significant strides when it comes to talking about mental health at work. The National Alliance on Mental Illness (NAMI) 2024 Workplace Mental Health Poll found that 74% of full-time employees in the U.S. say it is appropriate to discuss mental health concerns at work. The study found 59% of America’s largest employers (5,000+ employees) offer workplace mental health training. 

If talking about mental health at work reduces the stigma and encourages more people to seek help, the workplace seems like a pretty good place to talk about substance use disorders, too. For many of us, the workplace is the social setting where we spend more than half our waking hours and where we receive health information and benefits.  

Let’s make it a goal, particularly in the workplace, to make recovery from SUD as normal and accepted as drinking itself.  

About Grant Boyken

Grant Boyken works in media relations. Previously, he served as a senior director for Shatterproof, where he worked with a team to successfully launch Treatment Atlas in California. Grant is a former public affairs and government relations executive and is in recovery from an alcohol use disorder. 

Contact: gboyken@gmail.com