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There is a difficult truth that every HR professional needs to sit with: addiction is already present in your workforce. Not potentially. Not theoretically. Right now, among the people you manage, hire, support, and retain, some are quietly struggling with a substance use disorder (SUD). The vast majority of them will never ask for help, not because they do not want it, but because they do not believe it is safe to.

This is the defining challenge at the intersection of human resources and public health. The team at Master Center for Addiction Medicine has spent years helping organizations navigate it. Their message to HR professionals is clear and urgent: the cost of doing nothing is far greater than the cost of doing something.

Addiction is already in your workforce.

Understanding Substance Use Disorder: It Starts with the Science

Before HR professionals can respond effectively to workplace addiction, they need to understand what they are dealing with. Substance Use Disorder is not a character flaw, a moral failing, or a matter of willpower. It is a medically recognized chronic condition, one that fundamentally alters how the brain manages reward, decision-making, and self-regulation.

Think of it the way we think about diabetes or hypertension. These are chronic, relapsing conditions that require ongoing medical management. SUD is no different. Over time, substance use rewires brain chemistry, particularly the dopamine system, which governs motivation and impulse control.

What begins as a choice gradually becomes compulsion. Even when a person desperately wants to stop, the neurological changes in their brain may make that nearly impossible without professional intervention.

The common signs are worth knowing:

• An inability to cut down despite trying,
• Continued use even when it harms relationships, health, or job performance,
• Escalating tolerance,
• Withdrawal symptoms,
• Cravings, and
• A pattern of neglecting responsibilities.

These are not personality quirks. They are clinical symptoms of a disease. Learn more about the warning signs of alcohol use disorder and when to seek help.

SUD Does Not Discriminate, and Neither Should Your Response

One of the most important things HR professionals can internalize is this: substance use disorder affects employees at every level of the org chart, across every industry, and in organizations of every size. The executive and the entry-level worker, the high performer and the struggling one, SUD does not select based on title, tenure, or apparent competence.

According to SAMHSA’s 2024 National Survey on Drug Use and Health, approximately 48.4 million people, nearly 17% of the U.S. population aged 12 and older, had a substance use disorder in 2024. When you factor in not just employees but their adult dependents on your health plan, the numbers inside your organization become striking.

Master Center’s analysis illustrates this vividly: in a workforce of 10,000 employees with dependents, you are likely looking at around 1,660 individuals with alcohol use disorder, 1,870 with tobacco dependence, and 210 with opioid use disorder, just within your plan population.

1 in 12 workers has an untreated SUD.

Some workplaces face elevated risk. High-stress environments with poor work-life balance, industries where drinking is culturally normalized (think hospitality, legal, and finance), and professions like healthcare, where burnout is endemic, all see higher rates of SUD.

According to NORC at the University of Chicago and the National Safety Council, 70% of adults with a substance use disorder are employed, and one in 12 workers has an untreated SUD.

The question is not whether your workforce includes people with SUD. It is what you are going to do about it.

The Hidden Cost of Alcohol in Your Workplace

Alcohol use disorder is the most prevalent substance issue within the working population, and it is precisely the one most likely to go unaddressed. It is legal, widely available, and socially normalized at happy hours, client dinners, and team celebrations. Dependence develops gradually, slowly enough that neither the individual nor those around them recognize a problem is forming.

The health consequences of alcohol misuse are severe and well-documented. They span virtually every major system of the body:

• Cancer (breast, liver, colorectal, throat, esophageal),
• Cardiovascular disease,
• Liver disease,
• Mental health disorders including depression and cognitive decline,
• Metabolic conditions like diabetes,
• Immune suppression, and
• Reproductive health issues including Fetal Alcohol Spectrum Disorders in dependents.

Each of these conditions carries a corresponding workplace impact. Cancer claims mean high costs and extended disability leaves. Cardiovascular disease drives chronic care costs and absenteeism. Mental health issues fuel rising behavioral health claims and presenteeism.

A peer-reviewed study published in the American Journal of Preventive Medicine found that commercially insured employees with alcohol-attributable diagnoses incur an average of $14,918 in additional healthcare costs annually, driven primarily by heart disease, stroke, liver conditions, and certain cancers. Alcohol is not just a personal health issue. It is a public health issue hiding in plain sight inside your organization.

Alcohol is not just a personal issue. It is a public health issue hiding in your workforce.

The Business Case: Why HR Cannot Afford to Look Away

The financial case for addressing workplace addiction is compelling. Here is what the data shows.

According to SAMHSA’s 2024 National Survey on Drug Use and Health, only about 19% of people who needed substance use treatment actually received it in 2024, leaving more than 80% of affected individuals without professional help. The overwhelming majority of employees with SUD are managing their condition without support, while on your health plan, on your payroll, and in your workplace.

The additional annual healthcare expenditure for a commercially insured employee with an alcohol-related diagnosis averages $14,918. A NORC and National Safety Council analysis found that employers spend an average of $8,817 annually on each employee with an untreated SUD, and that supporting recovery saves employers over $8,500 per employee through reduced healthcare costs, fewer missed days, and lower turnover.

Employers spend an average of $8,817 annually on each employee with an untreated SUD

Beyond direct health costs, alcohol misuse drains U.S. workplace productivity by an estimated $44 to $68 billion annually through absenteeism and presenteeism. Add workplace safety incidents, legal and liability exposure, and the cultural toll on morale and team trust, and the cost of inaction becomes undeniable. Untreated addiction does not quietly maintain a status quo. It escalates.

Five Things HR Can Do Right Now

HR is extraordinarily well-positioned to make a meaningful difference. Master Center outlines five practical areas where organizations can take action:

1. Build Awareness and Reduce Stigma

The single greatest barrier to treatment is stigma. Employees who fear judgment from managers, colleagues, or HR will not ask for help until a crisis forces their hand.

HR can shift that dynamic by normalizing conversations about substance use and recovery. Invest in ongoing awareness campaigns. Share expert insights and real recovery stories. Train managers on the facts of SUD so they lead with understanding rather than assumption.

2. Establish Clear, Compassionate Policies

Your employee handbook should include substance use policies that are both firm and humane.

Clarity matters, because employees need to know where the boundaries are, but compassion matters just as much. Policies that are purely punitive signal to employees that disclosure is dangerous, effectively silencing the people who most need help.

Build recovery-friendly language into your policies and make sure your EAP and benefits offerings explicitly include substance use support and treatment access.

3. Make Help Accessible

Even when people want help, they often do not know how to find it or cannot navigate the barriers. HR can change that by making recovery resources easy to locate, clearly communicated, and genuinely available to all employees.

4. Act Early and Effectively

People with SUD are often highly functional, right up until they are not. Train managers to recognize early behavioral signals: changes in performance, attendance patterns, mood volatility, or interpersonal friction.

Equip them to intervene with empathy and professionalism, and to refer employees for evaluation before the situation becomes a termination, a safety incident, or a medical emergency.

5. Track Progress and Improve

What gets measured gets managed. Establish metrics to assess the impact of your programs, including reductions in absenteeism, EAP utilization rates, disability claims, and employee feedback. Workers in recovery take an average of 13.7 fewer sick days annually than employees with untreated SUD. They are also less likely to be hospitalized and more likely to stay in their jobs longer. These outcomes are measurable and worth measuring.

Key Takeaways for HR Leaders

Master Center’s clinical and HR team distills their experience into four principles that should shape every organization’s approach:

• Functionality is not immunity. Many employees with SUD appear to be performing well, right up until a crisis reveals what has been hidden. Early support, not crisis response, is the goal.
• Punishment suppresses help-seeking. Purely punitive approaches do not solve addiction. They drive it underground. Employees who fear consequences will not ask for help, and the problem grows.
• Employment is a recovery asset. Research consistently shows that employees who maintain stable employment and health coverage during treatment have significantly better outcomes. Your organization is not just a cost-center in this equation. It is part of the solution.
• Early intervention saves money and saves lives. Alcohol-related claims are costly but preventable. Supportive, early intervention reduces cost, reduces suffering, and produces better outcomes for everyone.

About Master Center for Addiction Medicine

Founded in 2016 and headquartered in Glen Allen, Virginia, Master Center for Addiction Medicine is Virginia’s premier evidence-based, fully outpatient addiction treatment provider. Physician-led and rooted in clinical science, Master Center has treated more than 10,000 individuals, bringing together every method proven to work, all in one place, all at the same time.

With locations throughout Virginia, Master Center serves as a critical point of entry into the treatment ecosystem. This integrated model means employees can access medical care, psychiatry, group therapy, and coaching within a single, coordinated program, while continuing to work.

With Master Center’s fully outpatient program, employees get the help they need while working.

For HR professionals looking to take action, Master Center is a resource, a partner, and a guide. Reach out directly to learn how Master Center can support your workforce wellbeing strategy.