April 18, 2025

Coordinate with EAPs, health plans and other partners to conduct anti-stigma campaigns and peer support training programs to encourage the use of behavioral health resources.

Stigma is a barrier to connecting employees with SUD treatment, especially for people of color, low-wage earners, LGBTQ people and others. EAP providers and other organizations conduct peer support and manager trainings to help employees and managers better understand the importance of mental health and how to support their coworkers, as well as get a refresh on resources available to them. According to Business Group on Health’s 2025 Employer Health Care Strategy Survey, in 2024, 74% of employers conducted manager training to help recognize mental health issues and to direct employees to services._¹ These trainings can be done in concert with company campaigns to create awareness about specific mental health challenges, including SUD. For more information on addressing stigma in the workplace, see the Business Group’s Reducing Mental Health Stigma: Employers FAQs.

Consider first-offense forgiveness policies that, in the case of an SUD-related workplace incident, trigger treatment interventions rather than immediate termination.

The fear of losing one’s job leaves some employees hesitant to seek SUD treatment. Some employers have instituted policies that forgive an employee’s poor performance or a safety event if it is related to a SUD as long as they sign a contract to receive treatment, adhere to EAP recommendations and avoid a second offense. This policy can create an environment that is supportive of struggling employees and may encourage people with SUD who have not experienced an adverse event to seek treatment before one occurs.

Steer employees to high-quality, evidence-based care in inpatient, outpatient, and community facilities.

There are several approaches employers can take to help employees get connected to high-quality, evidence-based care:

• Ensure that your vendors, including navigation services, health plans, EAP and others, are educated on company resources for SUD and incentivize cross-referrals.
• Consider virtual care options using similar quality metrics as for in-person care. Ask vendors about what other outcomes metrics they may use to track success that isn’t claims-based.
• Consider reducing or eliminating cost-sharing for COE facilities. Based on findings in Business Group on Health’s 2025 Employer Health Care Strategy Survey, 29% of employers implemented COEs devoted to substance use disorders.¹ COE networks can be directly-contracted, implemented through health plans, or delivered through third-party COE network curators. For more information, see the Business Group’s Centers of Excellence Considerations for Employers.
• Consider offering travel reimbursements for patients and a family member when they go to COE facilities.
• Eliminate out-of-network coverage for non-accredited residential and outpatient facilities. There are several accrediting organizations to consider, but all of them will ensure a minimum level of safety for their patients.² Some employers looking to simply eliminate coverage for “spa-like” facilities that encourage people to travel have put geographic limits on how far a patient may travel from their home to get coverage (e.g., mile limits or state restrictions). Coverage elimination must be balanced with patient disruption.
• Ask health plans and EAPs for data on the performance of their in-network providers. The Shatterproof ATLAS for identifying high-quality providers for SUD includes several quality metrics to consider.

Cover evidence-based treatments such as MAT.

MAT drug treatments such as naltrexone, buprenorphine, methadone, acamprosate and others should be covered. With patients for whom they are medically appropriate, these treatments have a strong evidence base of effectiveness; coverage should not be a barrier. COE networks for residential care generally require in-network facilities to offer MAT, but self-insured employers do not universally cover them.

Work with health plans to promote integrated behavioral and mental health treatment into primary care, acute care and surgical support programs, or directly contract with health systems that have done so.

As many health systems take on financial risk for the total cost of care for attributed patients, they must implement comprehensive strategies for increasing access to evidence-based SUD treatment. When considering whether to provide some form of steerage to an accountable care organization (ACO) or to a high-performance network, employers should ask providers and health plans about their behavioral health integration into primary care, primary care provider training to treat and triage SUD patients and overall timely access to behavioral health services. Surgeries are often associated with significantly debilitating events (e.g., a heart attack or accident) and/or require long periods of recovery; this can lead to depression and anxiety. Having behavioral and mental health services incorporated within surgical support programs can help patients find healthy ways to address depression and anxiety, rather than self-medicating with alcohol or other drugs.

Support and provide resources for caregivers with dependents that are coping with a substance use disorder.

Caregivers experience significant challenges when caring for someone with SUD. It often leads to mental health challenges that stem from stress, guilt and secondary trauma of caring for someone with SUD. More than 80% of employees with caregiving responsibilities said this additional work affected their productivity, showing the toll of caretaking; strategies to support employees who are caregivers can be found in the Business Group on Health’s Family Benefits Bundle on caregiving.

Take steps to prevent SUD from happening in the first place.

Much of what leads to SUD happens outside of an employer’s ability to make a difference, but there are still steps employers can take to reduce its likelihood among their employee population:

• Limit exposure to potentially addictive medications to treat pain, like opioids. This can be done through coverage limitations, plan design preference for tamper-resistant formulations and steerage to COEs for other medical services that normally require pain management (e.g., musculoskeletal procedures). Similarly, consider implementing virtual physical therapy programs that can manage pain while limiting opioids.
• Reconsider the extent to which alcohol is included when creating healthy office event policies. In the same way that your cafeteria may feature healthy foods, create gatherings that encourage social interaction without centering around an addictive substance that some employees may struggle with.
• Support the health and well-being of employees holistically. Sometimes circumstances such as mental health issues, financial insecurity or past trauma can lead to heavy substance use. Providing benefits like bereavement leave to cope with loss and financial wellness courses can help mitigate challenging employee circumstances and possibly curb a substance use disorder from arising.

Create opportunities for employees to find support from their employee peers through their journey to sobriety and/or for caregivers of dependents with SUD.

Some employers have taken the step to create sober-focused employee resource groups (ERGs) or affinity groups to give employees who are sober, working toward sobriety or taking care of people with SUD a place to find peer support.² This is not a replacement for group therapy, but a place where people can build camaraderie, share thoughts with employer leadership about supporting healthy use of alcohol and other drugs, and learn about company resources to support them. This will require company leadership support, as many employees will be reluctant to admit they have challenges with alcohol or drug use in the workplace.

Promote services that connect employees and dependents to community resources that support people with SUD.

Several public and private organizations exist to help connect people with SUD to community resources that can augment the benefits that employers provide. This can include mutual support groups like Alcoholics Anonymous that meet in community facilities such as the YMCA, community centers or churches. Some of these organizations are public, such as findhelp.org (formerly called “Aunt Bertha”), and others are offered by third-party vendors that work with health plans and providers to make connections between plan members, patients and social services in their communities. Concierge and navigator programs have begun to add capabilities to connect members to community resources. Employers should ask their vendor partners how they are leveraging social services to support employees and their families and include public resources in communication campaigns.

Conclusion

SUD can have a profound impact on an employee’s ability to safely and productively work, making the condition of health and workforce imperative for employers. Fortunately, SUD can be treated with evidence-based care, and the appropriate resources, including medication and mental health supports, if available. Employers can support employees and their families in several ways; combatting stigma, supporting caregivers, and helping employees find high-quality treatment for themselves and loved ones all make a big difference for individuals and the company.

Related Resources

• Health Care Costs, Vendor Accountability, Impact of 2024 Election Among Trends To Watch in 2025, Says Business Group on Health
• Growing Mental Health Needs Drive Costs Globally, Requiring Employers to Push for Value
• Innovation Showcase Recap: Substance Use Disorder

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