Lost opportunities: Gaps in employer support for substance use disorders - Part 3 

Over the past two weeks, we’ve written about Randell, a logistics manager at a manufacturing firm who used alcohol to cope with depression and stress while working remotely during the pandemic. Treatment in an out-of-network facility accomplished little, but after a second stay in a quality facility, where he was treated for undiagnosed depression as well as for alcohol use, he feels better than he has in years. He has learned healthy coping mechanisms for when he feels stressed and is looking forward to getting back to work – especially since, while he was in treatment, his colleagues returned to the workplace.

Randell got to the plant early, eager to see everyone and get back to the job he loved. But his first day back was not what he had anticipated – far from it. When he checked in with his supervisor, expecting her to be as excited as he was, she was quiet and reserved. She did not ask about his experience in treatment, or even ask how he was doing. Rather, the conversation jumped right to what he had missed and what he needed to do to catch up. Randell also noticed that co-workers were avoiding him. At one point he walked into the break room where some colleagues were chatting, and rather than invite him into the conversation, they stopped talking and left. Randell remembered that when a co-worker took leave for cancer treatment, she was welcomed back with cake and balloons. He did not necessarily expect a party, but he certainly thought his colleagues would be happy to see him again. Instead, he felt excluded, and that hurt.

Fortunately, Randell had other sources of support – his family, his therapist, and AA – that helped him rise above the chilly reception he received at his company and stick with sobriety until his work relationships began to normalize. But it would be a long time before he could recapture his former enthusiasm for his job and his feelings of connection with his manager and colleagues.

Research shows that people who return to work after addiction treatment are less likely to relapse and more likely to achieve positive treatment outcomes than those who are unemployed. Employment can aid in one’s recovery by improving quality of life (Petry), and increasing self-esteem and positive affect. However, a return-to-work experience like Randell’s can be very threatening to a person’s sobriety. Feeling “less than,” judged and excluded can be triggering for a person with a substance use disorder. An employer can influence this experience for the better by treating an employee returning after substance use disorder treatment the same way they would treat an employee returning after medical treatment. Additional training for managers around supports that the organization provides (e.g., policies and programs) can help navigate the conversations around return to work from substance use disorder treatment.

Return to work is often overlooked in the substance use disorder continuum. It is not likely that the employee’s problems will have been completely resolved following treatment, and employers should be proactive in providing support in this phase of recovery. This might include allowing time away during work hours to attend appointments, linking the member to peer supports within the organization, or looking at vendor solutions that offer ongoing support through virtual programs. Further, policies around alcohol use at work-related events should be considered and potentially revised. Office happy hours and other employer-sponsored events often involve alcohol. Recognizing that this may be triggering to employees who are recovering from alcohol use disorder, alternatives should be offered.

Randell’s experience has been less than ideal – from his early difficulty in accessing a therapist, to the challenge of navigating a complex network of in- and out-of-network facilities, to a disappointing return to the work place. In the next and final post, we will look at the ideal member experience and explore how Randell’s journey could have been different.

Lost Opportunities: Gaps in Employer Support for Substance Use Disorders Part 2 | Part 3 | Part 4