Substance use disorders (SUDs) remain one of the most under-addressed health concerns in the workplace, yet they quietly affect productivity, healthcare costs and employee wellbeing every day. In the U.S. alone, 48 million people have a clinically diagnosed SUD, yet fewer than 10% of those who need treatment actually get substance use care. Employees fear they may lose their job or be judged or looked down upon because of stigma around SUDs. They may also not know where to find help.
“Given how much time individuals spend at work, employers are in a unique position to support their employees’ well-being and safety,” says Justin Yang, MD, MPH, FACP, FACOEM, FASAM, Medical Director at Pelago. “That includes providing access to confidential, evidence-based substance use care that’s grounded in clinical best practices.”
Many employers want to help, and it starts with understanding the scope of the issue. SUDs aren’t always visible, but they show up in absenteeism, reduced productivity, safety risks, and higher healthcare spend.
According to the CDC, SUDs cost employer-sponsored insurance plans an estimated $35.3 billion a year. And yet, despite the high costs, substance use is rarely addressed with the same urgency as other health concerns. That gap hurts employees and it costs companies more than they realize.
Given how much time individuals spend at work, employers are in a unique position to support their employees’ well-being and safety. That includes providing access to confidential, evidence-based substance use care that’s grounded in clinical best practices.
Why Aren’t Employees Seeking Help for Substance Use?
The stigma around substance use still remains incredibly strong. Employees worry about being judged, labeled, or sidelined for promotions if they admit they need help.
Many employees also question whether their health information will truly remain confidential or if seeking support could somehow put their job security at risk. It’s a vulnerable position, and trust is paramount, yet often lacking.
Even if an employee musters the courage to overcome these fears, they often face a confusing maze of treatment options. The available choices might feel too extreme for their specific needs, or conversely, too difficult to access logistically. “Navigating treatment options, whether inpatient, outpatient, or ongoing support, can be overwhelming,” Dr. Yang says. “That lack of clarity often becomes a barrier, and without clear guidance, many individuals delay care until their situation worsens.”
Understanding these real-world barriers is the first step toward building bridges over that accessibility gap.
Ways to Help Employees Get Substance Use Care
Supporting employees with substance use challenges doesn’t require a total overhaul. Small changes can create a meaningful impact, especially when they reduce stigma, build trust, and simplify access. Here’s where to start:
Start with culture
Normalize conversations around substance use just like you would with other health issues. Train managers to respond with empathy, create safe spaces for dialogue, and make sure employees know they won’t be penalized for seeking help.
Internal campaigns, anonymous stories, employee resource groups, or offering non-alcohol options at company-sponsored events can help reinforce the message.
Protect privacy and reduce fear
Reinforce that treatment is confidential and protected under HIPAA. Employees need to trust that asking for help won’t put their job or reputation at risk. Consider adopting explicit anti-stigma policies to ensure no disciplinary action will be taken against employees who come forward to seek treatment.
Support recovery on the job
Flexibility is key. Whether it’s adjusted hours, remote options, or time off for treatment, accommodations show that you value your employees’ health and long-term recovery. Plan for reintegration after treatment and offer continued support.
Think beyond the program
Recovery doesn’t end when a program does. Continued access to counseling, cognitive behavioral therapy (CBT), medication-assisted treatment (MAT), or peer support can help employees stay on track. Creating a recovery-ready culture also means paying attention to everyday signals—like making sure social events provide non-alcoholic options.
What to Look for in a Substance Use Management Partner
If you’re offering support for substance use, the quality of care matters just as much as access. Employees are more likely to engage when the solution is built around their needs.
Lantern recently partnered with Pelago, so that its members have the ability to access comprehensive and personalized SUD treatment. “We’re connecting workforces to the best specialty care, and substance use treatment is an area too many people lack access to effective and affordable treatment,” says Dickon Waterfield, President of Lantern. “Pelago’s tailored programs are comprehensive, easily accessible with in-person and telehealth options, and ultimately improve health outcomes.”
Substance use isn’t a one-size-fits-all diagnosis, so treatment shouldn’t be either. When you’re looking for a program for your workforce, make sure it supports the full spectrum of needs, whether someone wants to cut back or fully quit. That includes CBT, MAT, coaching and counseling, and family support. “People are more likely to engage in care when it’s flexible and fits into their day-to-day life,” says Suzette Glasner, Ph.D. Chief Scientific Officer at Pelago. “Virtual or hybrid programs, flexible scheduling and easy onboarding can mitigate common access barriers.”
When choosing a SUD program, ask about its clinical approach and how they define success. Do they track engagement, change in use, improvements in quality of life? “It’s important to understand how a program measures success.,” Dr. Glasner says. “Look for partners who are committed to demonstrating impact both in terms of clinical outcomes and cost savings to your organization. The strongest programs are grounded in science and designed to deliver meaningful business results.”
Recovery doesn’t happen in a single step. Also look for partners that offer ongoing support after treatment, like relapse prevention, maintenance therapy or peer support.
People are more likely to engage in care when it’s flexible and fits into their day-to-day life. Virtual or hybrid programs, flexible scheduling and easy onboarding can mitigate common access barriers.
How to Increase Substance Use Program Engagement
Engagement with substance use support depends on more than just availability—it comes down to trust, awareness, and consistency. Your employees can’t take advantage of the support you offer unless they know it’s there and believe it’s safe to use. Substance use benefits shouldn’t be buried in the fine print. Use onboarding, manager training, and internal campaigns to make sure employees know what’s available.
It’s also important to normalize substance use as a health issue, not a moral failing. The more employees understand their options, the more likely they are to seek help.
Understand that most people with an SUD don’t take action right away. That’s why consistent, empathetic communication is so important. The right partner can support you with best practices and nurture employees at every stage, not just those in crisis.
Substance use is a complex challenge, but supporting employees through it doesn’t have to be. When employers create a culture of trust, remove barriers to care and invest in high-quality treatment solutions, the results are measurable: better health outcomes, stronger teams and a workplace where people feel genuinely supported. Too often, substance use care is reactive and only introduced after a crisis. But with the right approach, employers can make it easier for people to take that first step earlier, when care is most effective and less costly.
