Though more than half of workers believe employer support for substance and alcohol issues is important, only 14% have access to such a benefit, a new survey finds.
The 2024 annual substance use management survey, conducted by virtual substance use disorder clinic Pelago, reached a representative sample of more than 1,200 working adults this past spring. It found that about a third of the workforce—or 60 million Americans—experience personal or family issues related to substance or alcohol use.
Overall, only a third of those reporting problems with drugs or alcohol have received treatment for them, the survey found. Of those who receive assistance from their employer for substance use issues, 4 in 5 reported it was helpful and 41% said it was “very helpful,” the survey found. And the vast majority of workers who received assistance for binge drinking or excessive alcohol use thought it was helpful.
“Substance use is a pervasive issue that affects a significant portion of the workforce, yet the stigma and lack of support prevent many from seeking the help they need,” Yusuf Sherwani, M.D., CEO and co-founder of Pelago, said in a press release. “Employers have a unique opportunity to create and foster recovery-ready workplaces that reduce stigma and provide essential support and recovery resources.”
Substance use issues can affect employees across all job types and work arrangements, contributing to absenteeism, productivity loss, safety concerns and healthcare costs. More than 4 in 10 employees reported missing work due to personal or family substance use issues. And more than a third of those with substance concerns reported having mental-health-related absences.
At the same time, it is not only employees that are affected. More than a fifth of workers reported personal or family problems with substance use, excessive alcohol use or binge drinking. Many also reported having problems with two or more of these behaviors. Nearly a quarter reported issues with adult members, and 7% report these issues with teenagers.
The survey also suggests that women, younger workers, those less educated, LGBTQ+ and Black workers are all at higher risk of substance use and mental health challenges. This underscores the need for comprehensive support programs, a report summarizing the survey findings said.
Emotional barriers like shame and fear prevent many workers from seeking substance use help. More than half reported feeling uncomfortable asking for assistance. More than 70% also reported they are unwilling to discuss personal or family health struggles with their employers. The U.S. Department of Labor advocates for a recovery-ready workplace to lower barriers to seeking help. Employers can implement educational programs to reduce the stigma around these issues and provide confidential access to evidence-based substance use management programs.
While the cost of treatment is also a barrier, if one can’t overcome the initial psychological barrier of seeking help, the other barriers are less important, Sherwani told Fierce Healthcare. It is also important for employers to partner with healthcare providers that are not sharing patient data with employers. To move the needle on the stigma issue, Sherwani explained, employers must guarantee that their program is not punitive.
Employers that proactively address substance use issues in their workforce will see fewer healthcare costs, via rehab and the emergency room, as well as improvements in general productivity.
“What these organizations are seeing as a result of this is very tangible business savings,” Sherwani said.
They would be best served by offering a substance use management benefit not only for employees, but also their families. “What we see in the survey results is that it’s a big distraction, it’s a reason people take time off work—it affects productivity,” Sherwani said.
It is also often the case that an employer does not recognize that co-occurring conditions like substance use disorder exist, Sherwani added, and will offer a mental health treatment program without also offering a program to address substance use. The survey found 62% of those who report personal problems with substances or alcohol also report having depression, anxiety or other mental health concerns. In Pelago's 2023 survey on substance use, 54% of those with substance or alcohol issues had reported mental health issues.
“Substance use disorder is not just another mental health condition,” Sherwani said. It requires specialized support and is often a driver of other conditions. Pelago providers coordinate care with other providers and find that they want to work with a specialist trained in substance use disorder. “The coordinated care model tends to yield the best results,” Sherwani noted.