Substance Use Disorder (SUD) in the Workplace

Prevalence of SUD in America

An estimated 46 million U.S. adults age 18 or older experience substance use disorder (SUD). Nearly two-thirds of this population, 30.1 million, are employed. According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2023 National Survey on Drug Use and Health Annual National Report:

What is SUD?

SUD is a health condition that occurs when the recurrent use of alcohol or drugs “causes clinically significant impairment,” including other health conditions and failure to meet responsibilities at work, home, or school. SUD is a “treatable [condition] that affects a person’s brain and behavior, leading to their inability to control their use of substances like legal or illegal drugs, alcohol, or medications.” When SUD progresses to addiction, it is defined (PDF) as a “chronic condition that can be treated but generally not cured, like diabetes or heart disease.” Commonly known types of SUD are opioid use disorder and alcohol use disorder.

Who is Impacted by SUD?

Although SUD exists across all sectors of society, certain groups may be disproportionately affected. Data show that SUD significantly impacts all populations, particularly those from historically underserved communities:

• American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander, and Black people age 12 or older are significantly impacted by SUD (SAMHSA, 2023, Slide 24) (PDF).
• Female adults age 18 or older account for 11.1 million people who have co-occurring SUD and mental health conditions (SAMHSA, 2024, Slide 44).
• Of all LGBTQIA+ adults age 18 or older, 8.1 million have SUD (SAMHSA, 2024, Slide 23).
• Many justice-involved youth have SUD, which is a strong predictor of re-offending, with about 60% of youth in juvenile facilities meeting the criteria for SUD.

Creating Recovery-Ready Workplaces

Employers who effectively respond to substance use in the workplace and work to hire, onboard, retain, and advance people in recovery from SUD benefit from an expanded labor pool, increased worker well-being, decreased turnover, improved productivity, and reduced health care costs. Because employers are uniquely positioned to address SUD in a way that benefits the nation’s economy, the National Drug Control Strategy (PDF) was created to promote and support recovery-ready workplace (RRW) policies across the public, private, and federal sectors. The RRW Toolkit supports employers in developing RRW policies and provides information to help them address substance use in their workforce. Employers can find further information on the Recovery-Ready Workplace Resource Hub.

SUD and the Law

Workers with SUD may be protected from discrimination on the basis of disability under federal civil rights law. Employees may be protected by the Americans with Disabilities Act (ADA) of 1990 or the Rehabilitation Act of 1973 (Rehab Act), depending on the employer they work for:

• ADA
  • Title I applies to private employers with 15 or more employees, state and local governments, employment agencies, and labor unions.
  • Title II applies to public entities, regardless of workforce size.
• Rehab Act
  • Section 501 applies to federal agencies.
  • Section 503 applies to federal contractors and subcontractors.

Workplace SUD Guides

Supporting Employees with SUD: A Guide for Employers

This guide helps employers develop policies and procedures to respond effectively to substance use in the workplace. It also helps employers effectively hire, onboard, retain, and advance people in recovery from SUD.

A Guide for Workers with SUD: What You Should Know

This guide helps workers with SUD navigate employment situations as a person with a disability.