Recovery Ready Workplaces: A key strategy for reducing overdoses and sustaining recovery from substance use disorder

Madison Fields; Joseph Longley; Jennifer A. Martinez; Shelly Weizman; Regina LaBelle

doi:10.5055/jom.2023.0798

Authors

Madison Fields, JD
Joseph Longley, JD
Jennifer A. Martinez, PhD
Shelly Weizman, JD
Regina LaBelle, JD https://orcid.org/0000-0003-1475-3217

DOI:

https://doi.org/10.5055/jom.2023.0798

Keywords:

addiction policy, substance use disorder, Recovery Ready Workplaces, Americans with Disabilities Act

Abstract

In 2021, overdose deaths surpassed the 100,000 mark for the first time in the United States’ history, and alcohol-related deaths continue to surpass 140,000 each year. Regulatory and societal barriers to effective treatment and prevention of substance use disorder (SUD) persist. Innovative strategies and approaches to support long-term recovery can help reduce morbidity and mortality associated with SUD. Improving access to quality treatment and the availability of a broad range of policies and programs to support recovery and address social determinants of health, including employment supports, are key to curbing the overdose epidemic and rebuilding stronger communities.

This article outlines the role Recovery Ready Workplaces can play in reducing overdoses and helping individuals sustain recovery from SUD, as well as in strengthening communities. This article describes how congressional and state legislative action, Americans with Disabilities Act (ADA) enforcement and expansion, and other programmatic and fiscal policy changes at the state and federal levels will accelerate the adoption of Recovery Ready Workplaces as an element of a comprehensive response to SUD. The article also identifies existing state models and proposes specific federal- and state-level solutions to address some of the current limitations.

Recovery Ready Workplaces benefit employees, employers, and the nation's economy. Recovery Ready Workplaces are a supportive tool and policy strategy to help those with SUD thrive in recovery and to bolster communities and the economy as a whole.

Author Biographies

Madison Fields, JD

Fellow, O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC

Joseph Longley, JD

Senior Associate, Addiction and Public Policy Initiative, O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC

Jennifer A. Martinez, PhD

Intern, Addiction and Public Policy Initiative, O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC

Shelly Weizman, JD

Project Director, Addiction and Public Policy Initiative, O’Neill Institute for National and Global Health Law; Adjunct Professor of Law, Georgetown University Law Center, Washington, DC

Regina LaBelle, JD

Initiative Director, Addiction and Public Policy Initiative, O’Neill Institute for National and Global Health Law; Director, Master of Science in Addiction Policy and Practice, Georgetown University, Washington, DC

References

Spencer MR, Miniño AM, Warner M: National Center for Health Statistics Data Brief No. 457: Drug overdose deaths in the United States 2001–2021. Available at https://www.cdc.gov/nchs/data/databriefs/db457.pdf. Accessed February 1, 2023. DOI: https://doi.org/10.15620/cdc:122556

Center for Disease Control and Prevention: Alcohol-related disease impact (ARDI) report. Available at https://nccd.cdc.gov/DPH_ARDI/Default/Report.aspx?T=AAM&P=612EF325-9B55-442B-AE0C-789B06E3A8D5&R=C877B524-834A-47D5-964D-158FE519C894&M=DB4DAAC0-C9B3-4F92-91A5-A5781DA85B68&L=&F=AAMCauseAgeGroupAllNew&D=H. Accessed February 1, 2023.

Center for Disease Control and Prevention: Overdose death rates increased significantly for Black, American Indian/Alaska Native people in 2020. Available at https://www.cdc.gov/media/releases/2022/s0719-overdose-rates-vs.html. Accessed February 1, 2023.

Substance Abuse and Mental Health Services Administration: 2020 national survey on drug use and health. Available at https://www.samhsa.gov/data/release/2020-national-survey-drug-useand-health-nsduh-releases. Accessed February 2, 2023.

Florence C, Luo F, Rice K: The economic burden of opioid use disorder and fatal opioid overdose in the United States, 2017. Drug Alcohol Depend. 2021; 218: 108350. DOI: https://doi.org/10.1016/j.drugalcdep.2020.108350

Stringellow EJ, Lim TY, Humphreys K, et al.: Reducing opioid use disorder and overdose deaths in the United States: A dynamic modeling analysis. Sci Adv. 2022; 8(25): eabm8147. DOI: https://doi.org/10.1126/sciadv.abm8147

Substance Abuse and Mental Health Services Administration: SAMHSA's working definition of recovery. Available at http://store.samhsa.gov/sites/default/files/d7/priv/pep12-recdef.pdf. Accessed January 11, 2023.

American Institutes of Research, Center for Addiction Research and Effective Solutions: Employment as a social determinant of addiction. Available at https://www.air.org/sites/default/files/2022-05/Employment-Social-Determinant-of-Addiction-Webinar-summary-April-2022rev.pdf. Accessed January 11, 2023.

Laudet AB, White W: What are your priorities right now? Identifying service needs across recovery stages to inform service development. J Subst Abuse Treat. 2010; 38(1): 51-59. DOI: https://doi.org/10.1016/j.jsat.2009.06.003

US Department of Labor, Employment and Training Administration: Recovery-Ready Workplace. Available at https://www.dol.gov/agencies/eta/RRW-hub/Recovery-ready-workplace. Accessed January 24, 2023.

Krueger AB: Where have all the workers gone? An inquiry into the decline of the U.S. Labor Force participation rate. Available at https://www.brookings.edu/wp-content/uploads/2017/09/1_krueger.pdf. Accessed February 2, 2023. DOI: https://doi.org/10.1353/eca.2017.0012

Gitis B, Soto I: The labor force and output consequences of the opioid crisis. Available at https://www.americanactionforum.org/research/labor-force-output-consequences-opioidcrisis/. Accessed February 2, 2023.

Recovery Centers of America: Economic cost of substance abuse disorder in the United States. 2019. Available at https://help.recoverycentersofamerica.com/rs/956-DDP-611/images/2019-rca-study-economic-cost-of-substance-abuse-disorder.pdf. Accessed February 2, 2023.

Goplerud E, Hodge S, Benham T: A substance use cost calculator for US employers with an emphasis on prescription pain medication misuse. J Occup Environ Med. 2017; 59(11): 1063-1071. DOI: https://doi.org/10.1097/JOM.0000000000001157

Dunigan R, Acevedo A, Campbell K, et al.: Engagement in outpatient substance abuse treatment and employment outcomes. J Behav Health Serv Res. 2014; 41(1): 20-36. DOI: https://doi.org/10.1007/s11414-013-9334-2

Rumrill SP, Bishop ML: The role of employment status, change, and satisfaction for people who have completed substance use disorder treatment. Work. 2023; 74: 355-369. DOI: 10.3233/WOR-236012. DOI: https://doi.org/10.3233/WOR-236012

Substance Abuse and Mental Health Services Administration: 2018 National Survey of Drug Use and Health (NSDUH) Releases. Available at https://www.samhsa.gov/data/release/2018-national-survey-drug-use-and-health-nsduh-releases. Accessed January 24, 2023.

U.S.C. §§ 12101 et seq. 1990.

Becoming a Recovery Friendly Workplace: Available at https://www.recoveryfriendlyworkplace.com/join-us. Accessed January 23, 2023.

Holyoke Career Center: Becoming a recovery ready workplace. Available at https://masshireholyoke.org/the-recovery-ready-workplace/becoming-a-recovery-ready-workplace/. Accessed January 24, 2023.

Boston Medical Center, Grayken Center for Addiction: Developing policies and practices. Available at https://www.bmc.org/addiction/library/developing-policies-practices. Accessed April 13, 2022.

H.B. 1007,120th Gen. Assemb., 2d Reg. Sess. (Ind. 2018): Available at https://iga.in.gov/legislative/2021/bills/house/1007#digest-heading. Accessed January 24, 2023.

Indiana Workforce Recovery: Indiana substance use treatment law. Available at https://www.in.gov/recovery/files/Indiana_workforce_recovery_employer_guidelines.pdf. Accessed January 24, 2023.

US Office of Personnel Management: Federal workforce data. Available at http://www.fedscope.opm.gov/. Accessed February 3, 2023.

Society for Human Resource Management: Are employees undergoing treatment for drug and alcohol addictions covered under the ADA? Available at https://www.shrm.org/resourcesandtools/tools-and-samples/hr-qa/pages/adadrugsandalcohol.aspx. Accessed January 10, 2023.

Adamczyk v. Chief of Police of Baltimore Cnty., 134 F.3d 362, 362 (4th Cir. 1998).

Illegal Use of Drugs and Alcohol, 42 U.S.C. § 12114(a) 1990.

Mararri v. WCI Steel, Inc., 130 F.3d 1180, 1185 (6th Cir. 1997).

Illegal Use of Drugs and Alcohol, 42 U.S.C. § 12114 1990.

Mauerhan v. Wagner Corp., 649 F.3d 1180, 1183 (10th Cir. 2011).

Mauerhan v. Wagner Corp., 649 F.3d 1180, 1184 (10th Cir. 2011).

Mauerhan v. Wagner Corp., 649 F.3d 1180, 1188 (10th Cir. 2011).

Center for Disease Control and Prevention, National Institute for Occupational Safety and Health: Workplace supported recovery program. Available at https://www.cdc.gov/niosh/topics/opioids/wsrp/default.html. Accessed January 24, 2023.

Laudet AB, Savage R, Mahmood D: Pathways to long-term recovery: A preliminary investigation. J Psychoactive Drugs. 2002; 34(3): 305-311. DOI: https://doi.org/10.1080/02791072.2002.10399968

National Institute of Drug Abuse: Drugs, brains, and behavior: The science of addition, treatment and recovery. Available at https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery. Accessed January 23, 2023.

US Department of Labor, Employment and Training Administration: Work opportunity tax credit. Available at https://www.dol.gov/agencies/eta/wotc. Accessed January 24, 2023.

Internal Revenue Service: Work opportunity tax credit. Available at https://www.irs.gov/businesses/small-businesses-self-employed/work-opportunity-tax-credit#targeted. Accessed February 3, 2023.

New York State: Office of addiction services and support: Recovery ready workplace tax credit. Available at https://oasas.ny.gov/recovery-friendly-workplace-tax-credit#:~:text=The%20Recovery%20Friendly%20Workplace%20Tax,a%20maximum%20of%20%242%20million. Accessed February 3, 2023.

Han B, Compton WM, Blanco C, et al.: Prescription opioid use, misuse, and use disorders in US adults: 2015 national survey on drug use and health. Ann Intern Med. 2017; 167(5): 293-301. DOI: https://doi.org/10.7326/M17-0865

Manhica H, Straatmann VS, Lundin A, et al.: Association between poverty exposure during childhood and adolescence, and drug use disorders and drug-related crimes later in life. Addiction. 2021; 116(7): 1747-1756. DOI: https://doi.org/10.1111/add.15336

Center for Disease Control and Prevention, National Center for Injury Prevention and Control: Preventing adverse childhood experiences (ACEs). Available at https://www.cdc.gov/violenceprevention/pdf/preventingACEs.pdf. Accessed January 23, 2023.

US Office of Personnel Management: Policy, data, oversight, Federal Civilian Employment. Available at https://www.opm.gov/policy-data-oversight/data-analysis-documentation/federal-employment-reports/reports-publications/federal-civilianemployment/. Accessed January 24, 2023.

US Department of Health and Human Services: Employee assistance program. Available at https://www.hhs.gov/about/agencies/asa/foh/bhs/employee-assistant-program/index.html. Accessed January 24, 2023.

US Department of Education: Office of special education and rehabilitative services: Rehabilitation services administration. Available at https://www2.ed.gov/about/offices/list/osers/rsa/index.html. Accessed January 23, 2023.

Social Security Administration: Vocational rehabilitation cost reimbursement program. Available at https://www.ssa.gov/work/vocational_rehab.html. Accessed January 23, 2023.

Social Security Administration: Follow-up of former drug addict and alcoholic beneficiaries. Available at https://www.ssa.gov/policy/docs/rsnotes/rsn2001-02.html. Accessed January 23, 2023.