NIEHS and NIOSH Explore the Expansion of Recovery Friendly Workplace Programs

Recovery friendly workplaces (RFWs) have emerged around the United States as an important intervention to both prevent and address substance use disorders (SUD) and the opioid overdose crisis among workers. A RFW program strives to prevent SUD and overdose by creating a safe, hazard-free and healthy workplace by reducing the chance of injury and the subsequent use of opioids, providing support for workers who are struggling, and facilitating opportunities for employment for people in treatment and recovery. According to the American Action Forum, an estimated 2 million people are out of the workforce due to the opioid crisis.

The National Institute for Occupational Safety and Health (NIOSH) encourages employers to create Workplace Supported Recovery programs to prevent substance use, reduce stigma, and support recovery. Workplace Supported Recovery programs are similar to RFW programs and utilize Total Worker Health^® strategies to collectively address worker safety, health, and well-being.

To learn more about recovery-supportive workplace programs, NIOSH recently collaborated with the National Institute of Environmental Health Sciences (NIEHS) Worker Training Program to support a national analysis that captured the achievements and gaps of 25 established RFW programs and 19 programs in the informal or contemplative stage from 31 states. The report was funded by the National Institutes of Health Office of Disease Prevention. Access the full report here.

A broad range of program activities were reported, including outreach, education and training; RFW certification programs, improving access to treatment and recovery resources and benefits; and reforms of punitive workplace drug policies. Nearly two-thirds of survey respondents reported diversity, equity, and inclusion in their RFW programs, and half reported the inclusion of people with lived experiences with recovery in key decision making.

The report also documents substantial gaps in the national effort to establish RFWs. The top three responses to challenges in establishing and maintaining an RFW were employer buy-in, funding, and stigma. Stigma often flows from the misunderstanding that people with a substance use disorder are not worthy of support, access to treatment, or recovery resources. Other findings include:

• About two thirds of states do not have an established RFW program.
• Resources for outreach, training of employers, unions, and communities are lacking.
• Most RFW programs do not engage in job placement activity or provide recovery support for job placements.
• Only 17% of programs addressed prevention of workplace injuries as part of their services.

The report describes the urgent need for increased investments in RFW programs, including federal, state, and private funding to bolster existing programs and initiate new ones where they do not exist. Funding for intervention effectiveness research can ensure that the movement to develop RFWs is evidence-based. Collaboration among funders, researchers, and RFW program administrators can help ensure that evidence-based strategies are shared. To this end, a new Recovery Research Interagency Workgroup, led by the Office of National Drug Control Policy and the National Institute on Drug Abuse, is working to develop, prioritize, and coordinate the implementation of a federal recovery research agenda. Both NIOSH and NIEHS are members. This workgroup will assess the current scientific knowledge of recovery from SUD; review federally funded research, evaluation, and data collection portfolios and strategies; and identify areas where additional research, evaluation, and resources are needed. In addition to identifying priority recommendations, the workgroup will determine where existing authorities and resources permit the allocation or reallocation of research and evaluation funding to identified priority research priorities and where additional funding may be required to increase an existing effort or to establish a new one.

RFWs are a key priority in the National Drug Control Strategy. In contrast to previous workplace approaches, RFWs address the work-related causes of SUD (such as work-related injuries and illnesses or difficult working conditions that lead to daily or frequent pain) and encourage workers to come forward to access treatment and support without the fear of discipline and disgrace.

According to the Substance Abuse and Mental Health Services Administration 2021 National Survey on Drug Use and Health, an estimated nearly 21 million people in the U.S. are currently in recovery. RFWs are key to realizing the potential economic benefits of hiring people in recovery and retaining current workers. When implemented, according to the findings from NORC at the University of Chicago and the National Safety Council, RFWs have benefits for both workers and employers. People in recovery use less sick leave and health benefits and experience fewer workplace injuries.

The economic impact of the opioid crisis on employment is severe. The Joint Economic Committee estimates the opioid epidemic cost the United States nearly $1.5 trillion in 2020 alone—up 37% from 2017, when the CDC last measured the cost. Retaining current workers and employing people in recovery are good for business and the economy.

NIOSH and NIEHS also contributed to the development of the new Recovery-Ready Workplace Resource Hub. The hub provides information, guidance, tools, best practices, and a range of other resources to help public and private sector employers effectively address substance use disorder in the workforce, hire people who are in or seeking recovery, and support recovery in the workplace.

Read more about NIOSH and NIEHS efforts to prevent substance use and support recovery in workplaces:

Workplace Supported Recovery: New NIOSH Research Addresses an Evolving Crisis 

New NIEHS Resources to Prevent and Address Opioid Misuse and Promote Recovery Friendly Workplace Programs 

Jamie C. Osborne, MPH, CHES® is a Public Health Analyst with the NIOSH Office of the Director.

L. Casey Chosewood, MD, MPH, is Director of the NIOSH Office for Total Worker Health.

Allison Weingarten, LMSW, is a Communication and Outreach Consultant with the National Clearinghouse for Worker Safety & Health Training.

Jonathan Rosen, MS, CIH, FAIHA®, is an Industrial Hygiene Consultant with the National Clearinghouse for Worker Safety & Health Training.

Sharon Beard, MS, CIH, is Director of the NIEHS Worker Training Program.