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Substance Abuse & the Workplace – Impact on Your Employee Benefits

Contain Cost, So Not All is Lost

Understanding the Issue – Impact of Increased Substance Use Disorders in the Workplace

From alcoholism to marijuana use and prescription drug overuse, substance use disorder (SUD) is alarmingly widespread in the workplace today.  


of all adults with an alcohol or illicit drug use disorder are employed. [1]


Nearly 9% of employed adults have a current alcohol or illicit drug use disorder. [1]

workers have an untreated substance use disorder. [2]


of workers jobs with a large percentage of male employees have higher rates of SUD - ex: in construction, 19% of workers suffer from SUD. [2]

states reported increases in substance misuse and opioid-related overdoses due to stress & mental health issues heightened by the lingering pandemic. [2]


of employers say their workplaces are impacted by opioid misuse. [2]


of American workers were affected by an increase in alcohol and other substances 1 year into the pandemic. [3]


from all-time low of 3.5% just 10 years ago - more U.S. workers are testing positive for marijuana than ever before. [4]


Aside from severely compromising employee health, SUD can impact employers’ financial health. The National Council on Alcoholism and Drug Dependence (NCADD) reports that SUD can cost as much as $81 billion in absenteeism, presenteeism, loss productivity, higher healthcare bills, and workers’ compensation claims.  


The National Institute on Drug Abuse (NIDA) found substance users cost employers twice as much in workers’ compensation and medical expenses. In fact, they’re five times more likely to file workers’ compensation claims.  


And, findings from the NSC shows on average, employers pay about $4,770 in health insurance premiums for employees with SUD versus $2,900 for those without it. 


A greater prevalence of SUD among employees can make the workplace unsafe for everyone. Poor judgement, slower reflexes, and careless errors are some of the byproducts of employee SUD that can be especially costly (and catastrophic) on the job when concentration or the ability to react quickly is absolutely essential (e.g., driving a delivery truck, operating a forklift, climbing a ladder, etc.) 


The U.S. Department of Labor claims that 65% of on-the-job accidents are related to drug and alcohol abuse in the workplace. 



Despite the growing costs and concern, only 17% of employers think they are well prepared to address the impact of growing SUD on their workplace. Fortunately, an experienced benefit advisor can help. With a wide range of expertise and access to resources, they can offer support that helps you better contain the costs of SUD more confidently by helping you: 

1. Focus on prevention and advocating worker well-being.  

2. Review employee assistance programs (EAP) and health offerings to make sure they offer robust services, including:  

  • Specially trained professionals who can manage instances of SUD 
  • Adequate coverage for providing a full range of treatments, from inpatient and outpatient to follow-up care and ongoing support for recovery 


According to the National Safety Council, workers in recovery: 

  • Miss 13.7 fewer days each year than workers with an untreated SUD 
  • Miss 3.6 fewer days than an average employee 
  • Help employers avoid $8,175 in turnover, replacement, and healthcare costs 


3. Consider additional support tools that may be effective for dealing with SUD-afflicted employees.

4. Understand the importance of documenting and communicating a drug-free work environment, a key factor for disputing or denying workers’ comp claims where SUD is suspected.  

5. Be aware of changing laws, particularly around legalizing cannabis and how marijuana use can effect operations and future workers’ comp claims.

6. Comply with state and federal discrimination regulations that protect employees with SUD undergoing treatment.

7. Develop programs that can help you maintain a safe and productive work environment. 


[1] National Survey on Drug Use and Health from the Substance Abuse and Mental Health Services Administration (SAMHSA)
[2] The National Safety Council:
[3] Occupational Health & Safety (OH&S)
[4] 2022 Quest Diagnostic Drug Testing Index (DTI) 

Strategies to Manage the IssueCombat Substance Use Disorder in the Workplace

Today, 75 percent of employers say substance use is prevalent among their employees. But only 17 percent feel extremely well-prepared to address the issue. 

To help more employers address the issue, we polled benefits and loss control experts for their insights. Here’s a list of some steps they suggest to help lower the costs of substance use disorder (SUD) in the workplace.  


Understand the connection between mental health and SUD 
According to the National Institute of Mental Health (NIMH), SUD is indeed a mental disorder. Not only can it affect a person’s brain and behavior, but it can also lead to an inability to control the use of substances, such as: alcohol, marijuana, or prescription meds.  


Make sure that health insurance plans address both physical and mental health 
Today, we know that good physical health is connected to sound mental health. But with so many stressors impacting workers, particularly since the pandemic, mental health and wellbeing benefits have become acutely relevant – and highly valued. Now more than ever, evaluate existing benefits plans to make sure mental health support is included or consider new options that help employees take care of their mental wellness. 


Since 2020:
67 percent of Americans have experienced more stress.
Source: American Psychological Association (APA) study 


Review Employee Assistance Programs (EAP) 
When someone is afflicted with SUD (or has a loved one suffering from it), it can affect their ability to focus on work and keep their job, generate money problems, and increase the chance of exacerbating anxiety, depression, or other medical problems. 

Review current offerings to ensure they offer a robust suite of services that employees need, like easy access to professional, high-quality care, and specific SUD resources for employees and/or their family members.  

Then, on a regular basis, not just during open enrollment, communicate information about SUD services, (e.g., one-on-one counseling, assessment, referrals to treatment programs, personal coaching, and recovery support.) Not only can these services be critical for getting employees the help they need, but they can also help limit the hidden costs of SUD, like presenteeism, absenteeism, and lost productivity.  


Leverage telehealth 
With more employees now working remotely, broader telehealth services can be key for screening, diagnosing, counseling, treatment, and getting support for SUD and other mental health needs. Among the benefits employees can access via telehealth: 

    • faster access to professional care 
    • greater privacy and convenience from at-home treatment and online therapy  
    • virtual consults for medicine 
    • digital tech that can provide instant support to augment treatment 

According to the U.S. Health Resources and Services Administration, “When used in combination with other treatment methods, telebehavioral health interventions can be part of an integrated approach to treating substance use disorders.”



Advocate for a culture around safety and compassion

Focus on:  

    • preventing accidents from occurring in the first place 
    • mitigating damages, if an accident or injury occurs 
    • addressing issues, like SUD, and getting back to normal as soon as possible  



    • communicate and enforce safety policies and procedures, including drug-free and drug-testing policies 
    • report and investigate accidents or injuries on a timely basis  
    • show compassion for injured or addicted workers and make sure they get the treatment they need 
    • establish return-to-work programs that get employees back to meaningful work as soon as medically possible 


Document policies and procedures 
SUD policies should not only be part of safety programs and procedures, but they should also be fair, firm, and consistent for all. Make them easily accessible, for instance, in your employee handbook. This way employees know what is, and is not, appropriate on-the-job-behavior. Work with legal and HR teams to correctly document: 

    • expectations particularly around the use/misuse of drugs, alcohol, and prescription meds 
    • consequences for not adhering to substance-free policies 
    • proof that employees received the policy, understand it, and verify they will follow the rules 


Understand leave laws around SUD treatment and recovery 
As more states legalize marijuana, you’ll want to consult with HR and legal teams to make sure any SUD policies and practices at the workplace fully comply with both new and existing laws that protect employees. For example: 

The Family Medical Leave Act (FMLA) – allow employees who meet certain requirements to take an unpaid, job-protected leave to take care of a health condition, including SUD. 

The Americans with Disabilities Act (ADA) – make it illegal for employers to discriminate against recovering alcoholics and drug users who have a history of SUD or who are in treatment. 


Communicate with employees 
No matter what programs you offer around SUD prevention, support and recovery, make sure all employees know the breadth and depth of services that are available and how to access them. Building greater awareness for the problem and how to stop it is an important step in preventing claims and ensuring a safe working environment for all.



Of course, there are many other factors employers may want to consider as they seek to lower the costs associated with substance use disorder among employees. Working with an experienced and trusted advisor can help you navigate and select the best options for your organization.  

Determining a Path Forward – Contact Your Benefits Broker to Learn More.

Contact us today to find out how we can help you manage costs from SUD.

This material has been prepared for informational purposes only. BRP Group, Inc. and its affiliates, do not provide tax, legal or accounting advice. Please consult with your own tax, legal or accounting professionals before engaging in any transaction.