'An epidemic that keeps growing': Supporting employees through substance use

• Key Insight: Learn how targeted benefits and culture shifts convert mental‑health investments into substance‑use outcomes.
• What's at Stake: Rising workplace substance use threatens productivity, safety, legal exposure and benefits costs.
• Supporting Data: CDC: nearly two‑thirds have substance use disorder; 94% of employers now invest in care.
• Source: Bullets generated by AI with editorial review

A substance use disorder isn't just a personal struggle — it's a workplace crisis that requires leaders' immediate attention and intervention. 

In today's workplace, nearly two-thirds of people suffer from a substance use disorder, according to data from the Center for Diseases Control and Prevention. For organizations, this means that using benefits and policies to address these disorders has become a critical issue for both their business and the health and safety of their employees.

"Substance use disorder is an epidemic that keeps growing," says Zakia Natour, the director of people and talent at addiction and recovery platform Eleanor Health. "Access to treatment and reducing the stigma around getting support has come so far, but there's a huge opportunity to continue."

Read more: These resources can help workers recover from substance use disorders

In the last few years, employers have been more progressive with their efforts to support employees dealing with substance use. A 2023 survey by the U.S. Chamber of Commerce found that 94% of employers are investing in care for mental health and substance use disorders, which are often related. Twenty-eight percent of large employers have expanded their existing health plans, 72% added virtual or telehealth options and 68% have rolled out enhanced supports like employee assistance programs or classes — all with the aim to address substance use by tackling mental health more holistically.  

Making substance use support a core part of business

However, taking those initiatives a step further so that they are more targeted and overt in their approach to substance use support is imperative for making meaningful change. That means tailoring benefits, creating a more empathetic  culture and being open about advocacy both internally and externally. 

"These are topics that are taboo and they are not always talked about openly because they're not a visible or physical disability," Natour says. "But if you don't give these employees a safe space to navigate what they're going through personally, they're unlikely to get treatment or the support they need."

At Eleanor Health, everything from their internal policies to their hiring practices revolves around creating a safe and transparent workplace culture for employees struggling through substance use disorders, Natour says. For example, during their onboarding process, they've dedicated an entire portion to using the right language around substance use, like avoiding the word "clean" because it insinuates that employees still using are dirty. In addition, all of Eleanor's EAP programs offer counseling specific to substance use disorders, and they offer leave separate from regular PTO so that employees can take time to navigate their circumstances and seek treatment without the pressure of performing at work. 

Read more: The peril of ignoring substance abuse in burned-out workplaces

The company even has a Slack channel devoted to discussing substance use resources and strategies where employees can communicate freely with leadership and each other. 

"We've created a space where it's okay to talk about those things and to seek help without the fear of getting punished," Natour says. "If somebody approaches our people team with this type of concern, we meet them where they're at and help them navigate what their next steps are, as well as what their future at Eleanor looks like after their needs have been addressed." 

Education is the key to progress

While Eleanor Health does work closely with substance use as an organization, that doesn't mean that their internal practices can't be replicated in any organization, regardless of its industry. But in order to do so, leaders need to be willing to educate themselves and their workforce first.  

Read more: How this virtual clinic helps employees manage their substance addictions

"Many people in leadership positions aren't even aware of how many people are impacted by a substance use disorder, or the impact that could have on the business and productivity," Natour says. "These conversations should be happening at all levels of the organization, not just from or for the people that are directly or indirectly impacted." 

The most important part, Natour stresses, is for leaders to lead all of these efforts with empathy. She urges HR and benefit leaders to start by taking up an open-door policy so they can best understand where their workforce is with substance use and what employees need from them. 

"Organizations should want to wrap around all of their employees all the time and give them the most support possible," Natour says."[This allows people] to be the best version of themselves and the most successful they can be."