The current flood of drug abuse among Americans is at such a high level that the federal government has launched a national effort reaching out to employers to join in securing successful recovery outcomes for its victims. The unspoken question, however, is how many abusers will choose to seize the lifeline they are being thrown.
There is no arguing that the drug abuse situation in this country is as dire as it has ever been and requires better means and an active commitment to addressing it. In November the federal government issued a new resource for employers called the Recovery-Ready Workplace Toolkit: Guidance and Resources for Private and Public Sector Employers.
The multi-agency effort is described as enlisting the help of employers to stem the tide of drug abuse while expanding employment opportunities for people in recovery from substance use disorder and to promote Recovery-Ready Workplace (RRW) policies. The program is being made available made available through the Recovery-Ready Workplace Resource Hub. The Web-based toolkit is hosted by the Labor Department’s Employment and Training Administration and is designed to be useful across various economic sectors and different industries.
“Untreated substance use disorder is extremely costly to employers, resulting in missed workdays, reduced productivity, unnecessary employee turnover, and increased healthcare costs. Substance use disorder can also make hiring qualified candidates challenging and can increase the risk of work-related accidents and associated liabilities,” the toolkit states. “Because of this, adopting RRW policies is not simply the right thing to do—it makes good business sense.”
The 129-page publication appears to be a compilation of different positions and practices recommended by government offices and private agencies over the years for employers who have been confronting this problem. It covers such topics as how and why employers can create an RRW employment program, various recommended policies and techniques employers can adopt, and provides lists of resources available to them.
“The intent is to reduce the stigma around substance use disorders, provide employment opportunities, maintain safe workplaces, and demonstrate to employees that their employer supports individuals in recovery,” explains attorney Kathryn J. Russo of the Jackson Lewis law firm.
Topics covered by the toolkit address how to hire people in recovery, including those with a history of criminal justice system (CJS) involvement related to their substance use; identify work-related risk factors for substance use and take steps to address them; and make sure employees have access to treatment, recovery supports and other services and supports they need.
It also sets out how to delineate clear return-to-work polices to facilitate a successful transition back to the workplace following treatment or to manage work during treatment when an absence is not required, as well as offering appropriate medical or disability leave to receive treatment for injuries and other conditions leading to pain and to receive SUD treatment when needed.
At the same time it released the toolkit, the administration announced that New Hampshire Gov. Chris Sununu (R) was named to oversee the creation of a national institute—built on a model he created in his home state—to provide training and resources for companies willing to hire and help people in recovery for substance use disorder.
Sununu will serve as honorary chairman of the Recovery Friendly Workplace National Institute and lead its advisory board, along with leading other efforts to help states and businesses expand employment opportunities for those in recovery. Termed a nonprofit, nonpartisan effort, the institute will be supported by the Global Recovery Initiatives Foundation.
In addition to distribution of the toolkit for businesses, other efforts will include the development of model legislation for state legislatures interested in establishing tax credits, grants and other incentives for employers to become certified as recovery-ready workplaces.
In 2018, Sununu launched New Hampshire’s Recovery Friendly Workplace Initiative, created to encourage employers in that state to support individuals with substance use disorders and develop their own recovery-ready workplaces. Rhode Island later followed New Hampshire’s example in creating a similar program.
Sununu said during the White House announcement that he came up with the idea for the program because of his experience as a private businessman at a time when he was managing a ski resort, where he saw firsthand the difficulties some of his employees had in grappling with recovery from drug abuse and returning to normal life, including rejoining the workforce.
“For so long, people were working and couldn’t go to treatment because they were afraid to be seen walking into a treatment center by their employer,” he said. But as soon as his state’s program got off the ground all that changed. “Now all of a sudden, people weren’t afraid to go seek treatment. They were talking to their employers about it.”
A Stubborn Crisis
The most recent comprehensive snapshot of how serious the situation in the U.S. has become is the statistical report released mid-November by the Substance Abuse and Mental Health Services Administration (SAMHSA) of the Department of Health and Human Services (HHS). It found that 70.3 million people aged 12 or older (or 24.9%) used illicit drugs in 2022.
Although alcohol follows its historical pattern of being the most abused psychoactive drug, marijuana was the most used illicit drug, with 22% of people aged 12 or older (or 61.9 million people) having used it in 2022.
Those numbers are even scarier when you realize that 48.7 million people over the age of 12 (or 17.3%) were found to have suffered from a substance use disorder (SUD) in 2022, including 29.5 million who had an alcohol use disorder (AUD), 27.2 million who had a drug use disorder (DUD), and 8 million people who had both an AUD and a DUD.
When it comes to the nation’s workforce, the numbers are no less daunting. This has been especially true in recent years with the widespread legalization of marijuana and the flood of fentanyl originating in China entering through our southern border with Mexico, which has killed upwards of 100,000 Americans each year from overdoses.
In March Quest Diagnostics reported that the percentage of employees in the general U.S. workforce testing positive for marijuana following an on-the-job accident increased to its highest level in 25 years in 2022. That year, post-accident marijuana positivity of urine drug tests in the general U.S. workforce was 7.3%, an increase of 9% compared to 6.7% in 2021.
In 2022, the combined U.S. workforce urine drug positivity for all drugs persisted at 4.6%—the highest level in two decades, according to the numbers reported by Quest, which also found that the rising overall drug positivity rate for general workforce urine testing was observed across industries.
“This historic rise seems to correspond with sharp increases in positivity for marijuana in both pre-employment and post-accident drug tests, suggesting that changing societal attitudes about marijuana may be impacting workplace behaviors and putting colleagues at risk,” said Keith Ward, general manager and vice president for employer solutions at Quest Diagnostics.
The rise in drug abuse both on and off the job can be seen in the frequent headlines about the latest overdose cases and the all-too-common sight of hordes of homeless drug abusers crowding the public spaces and government-sanctioned shooting galleries in major American cities.
While the legalization movement has widened its efforts to include hallucinogens and hard drugs, some social service organizations and local and federal government agencies also have chosen to promote “safe” sites for drug abusers to ingest their preferred drug of choice, going so far as to supply pipes and needles to abusers.
Pew research also has shown public support for legalizing marijuana grew significantly over the past 20 years. It reported in November 2022 that 88% of Americans supported marijuana legalization, with 59% believing that marijuana should be legal for medical and recreational use by adults and another 30% believing that it should be legal for medical use only.
But a backlash to current drug policies appears to be developing and may be driving the public to reconsider at least some of its attitudes. Earlier this year voters in Kentucky rejected a referendum that would have legalized marijuana in that state.
Public and Private Initiatives
Advocates of taking a more active approach to recovery are being heard and making some headway as the public grows more unhappy with the more indulgent approach taken in some areas. However, there is increasing evidence that recovery services will remain a hard sell given that so many people have embraced the incentives offered by the more indulgent approach already taken by policymakers.
When it comes to marijuana, for example, state legislatures in states where it is already legal are continuing to adopt stringent measures that limit employers’ ability to maintain drug-free workplaces, and 15 states so far have adopted new laws prohibiting employment discrimination against cannabis users. This includes punishing employers for disciplining employees for getting high when they are officially off the job.
Certain safety-sensitive jobs are excluded, including professional truck drivers and other transportation workers. No one wants to be put in the position of having to share the road with a truck or bus driver who is high (not to mention being a passenger on public transit or a plane or train with operators who are stoned).
Earlier this year the Department of Transportation (DOT) approved the authorization of employers for the first time to use oral fluid testing in addition to urine testing for truck drivers. (The problem with urine testing is that it detects the presence of marijuana in the body that could be up to 30 days old, while saliva testing shows use in the previous five to 72 hours).
But the new rule has a catch: Employers are not allowed to begin testing under the new rule until the federal government has approved at least two laboratories and one kind of testing device for employers to use, which it has yet to do. In October, the American Public Transportation Association sent a letter to Health and Human Services Secretary Xavier Becerra urging his department to certify oral testing labs.
The Albuquerque, N.M., city Transit Advisory Board also wrote to Becerra asking that he speed up the approval of testing labs. “We must continue to ensure that operators are not impaired while they are in charge of a bus or train, while accommodating this legal and cultural shift,” they stated.
The trucking industry is very concerned about the persistent upward trend of drivers who are testing positive but choosing not to go through rehab and return to their jobs behind the wheel. Nonetheless, the industry continues to push for measures that will allow it to gain better control over the current situation.
John Hausladen, president of the Minnesota Trucking Association, commented in an industry report earlier this year, “As an industry committed to workplace and roadway safety, we owe it to ourselves and our families to make sure we can screen to maintain a clean and sober workforce.”
More than half of all positive trucking industry drug tests are for marijuana metabolite according to the Federal Motor Carrier Safety Administration (FMCSA) Drug and Alcohol Clearinghouse (DACH) data. According to the DACH data, by the end of December 2022, it turned out that 27.6% of drivers taken out of service because of positive tests for marijuana later were able to return to safety-sensitive positions and only 4.5% completed a follow-up testing plan.
“This is an indication that as of January 2023, positive drivers or driver candidates are far more likely to leave the industry (and, in theory, enter another industry) instead of completing the RTD process,” pointed out the American Transportation Research Institute (ATRI) in its June report about the impact of marijuana legalization on truck drivers.
American Trucking Associations also advocates the use of hair testing to keep drivers who are high from behind the wheel. “We cannot have anyone impaired using marijuana or any other narcotic operating this equipment,” Chris Spear, ATA’s president, told Congress earlier this year. “Somebody’s got to step up to the plate and put safety first. Want to smoke weed at home? Smoke weed at home. If it’s legal, fine,” he added. “Do not get behind the wheel of an 80,000-pound vehicle. We need to have strong standards, and we need to enforce the law.”
Due to controversy over testing methods, FMCSA in earlier years had rejected proposals to allow the use of hair testing for commercial drivers, although research has found that method to be far more accurate than urine testing. However, this year the agency announced that it had approved proposed guidelines for hair testing by employers, which are still waiting for final approval by the White House.