It's More Common Than Most Employers Realize
Substance use disorders don't discriminate by industry, role, or income level. Around 20% of full-time employees in the U.S. have a substance use disorder, yet most go unidentified and unsupported at work. Employees struggling with alcohol or drug use are rarely absent in obvious ways. They show up, just impaired, distracted, or disengaged.
The scope of the problem continues to grow. According to SAMHSA, the rate of drug use disorder among Americans aged 12 or older increased from 8.7% in 2021 to 9.8% in 2024. Meanwhile, 80% of people who needed treatment for a substance use disorder in 2024 did not receive it. That gap between need and access lands squarely in the workplace.
It's Often a Private Struggle
Stigma remains one of the biggest barriers to employees seeking help. Many workers fear that disclosing a substance use issue will affect their job security, their reputation, or their relationships with coworkers. So they stay quiet, and the struggle continues beneath the surface.
Research shows that confidentiality concerns and fear of negative judgment prevent a significant share of people from accessing care, even when treatment is available. This is compounded by the fact that substance use and mental health are deeply linked: in 2024, one in three adults with a substance use disorder also had a co-occurring mental illness, according to SAMHSA.
Creating a culture where employees feel safe enough to ask for help isn't just the right thing to do. It's a prerequisite for any wellness intervention to actually work.
It Has a Direct Impact on Your Bottom Line
The financial case for addressing substance use is now impossible to ignore. A 2025 CDC study published in the American Journal of Preventive Medicine found that substance use disorders cost the U.S. economy nearly $93 billion in lost productivity in 2023, approximately $3,703 per affected worker.
That total breaks down across four categories employers feel directly: inability to work ($45.25 billion), absenteeism ($25.65 billion), presenteeism ($12.06 billion), and household productivity loss ($9.68 billion). The presenteeism figure is particularly important. Employees who are physically present but cognitively impaired represent a cost that rarely shows up in standard HR reporting.
Substance use disorders also cost employer-sponsored health plans an estimated $35.3 billion annually, according to a JAMA Network Open study, hitting benefits budgets regardless of company size.
It's Not a Lost Cause and Employers Are Uniquely Positioned to Help
The workplace is one of the most powerful intervention points available. Employees spend more waking hours at work than almost anywhere else, which means employers have both the access and the opportunity to make a real difference.
