If you are struggling with Substance Use Disorder (SUD) and wondering how to talk you’re your employer about it, read on. First, know that you are not alone. Somewhere between 5 and 17 percent of your employees suffer from substance abuse disorders (SUDs).

Second, know your rights. Look into your company’s drug and alcohol policies and healthcare benefits. While Title I of the Americans with Disabilities Act permits employers to ensure that the workplace is free from the illegal use of drugs and the use of alcohol, the law states that an employer may not discriminate against a person who has a history of drug addiction but who is not currently using drugs and who has been rehabilitated. Nor can they discriminate against an employee who is currently participating in a rehabilitation program for drugs. With regards to alcohol use, employees who abuse alcohol may be considered disabled under the ADA if they are an alcoholic or a recovering alcoholic and therefore their SUD is a covered disability. A disability is generally defined as an impairment that “substantially limits” a major life activity. The ADA requires that an employer give a “reasonable accommodation” to an employee who can demonstrate that they are substantially limited in a major life activity.  Of course the ADA is a complex law and it also states that an employer can hold employees who use drugs or alcohol to the same standards of performance and conduct that are set for other employees. The law can be found in detail here.

Then there is the Family Medical Leave Act of 1993 (FMLA). This law allows eligible employees, at eligible companies, to take up to 12 work weeks of unpaid leave during any 12-month period to care for a new child, care for a seriously ill family member, or recover from a serious illness. Under FMLA, Substance Use Disorders (SUDs) qualify as a serious illness. Therefore, a person who takes FMLA leave to treat a SUD can’t be fired. More details on FMLA can be found here.

The Affordable Care Act and the Mental Health Parity and Addiction Equity require that health plans treat mental health and substance use disorders the same way they treat other health issues. That means your company’s mental health and substance use disorder coverage must be comparable to coverage for general medical and surgical care. And limitations on mental health and substance use disorder benefits such as copayments, visit limits, and preauthorization requirements, must generally be comparable with those for medical/surgical benefits.

Finally, the U.S. federal government’s HIPAA regulations govern the privacy requirements for Substance Use Disorder treatment, as they do any provision of health care in the U.S. Under HIPAA rules, a patient’s “personal health information” must be private, and there are strict rules concerning how that information may be disclosed. 

Third, ask about treatment options. Effective treatment programs have been proven to be effective in improving worker productivity among employees with SUD. When employees get help, the Journal of Substance Abuse Treatment reports that unplanned absences decrease by 85 percent and discipline problems decrease by 75 percent.  Telehealth is a highly effective way to access treatment because you can seek and receive treatment from the privacy of your home or even a quiet conference room. Receiving treatment from a private, comfortable and familiar setting, reduces a major barrier to seeking help.  And it’s flexible and doesn’t require time commuting to and from treatment.

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