One of the steepest barriers to overcome when in need of treatment for a substance use disorder is the fear of losing one’s job. Securing our livelihood is always a top priority, so anything that might threaten it is avoided at all costs. Unfortunately, that might include the cost of life itself.
No matter how risky it might seem to confide in a manager or boss that you need to head to rehab for a while, the fear of losing your job is not grounded in facts. Fortunately, there are job protections in place in the event that addiction treatment is needed. No one should have to trade off their health for a paycheck, which is why the federal legislation was enacted.
Knowing that an employer cannot fire you for going to rehab offers much consolation, but now the question centers on timing. When should you actually sit down with the boss to ask for a leave of absence? Is there a strategy for ensuring this process goes as smoothly as possible? Let’s look at the whole picture and get a feel for how best to inform the boss about your need for treatment with the least possible damage to reputation and career.
You are Not Alone
First of all, it is important to realize that a substantial number of American workers struggle with a substance use disorder. According to the Substance Abuse and Mental Health Services Administration, more than 14 million employed adults have a problem with alcohol or drugs, out of 20.2 million with a substance use disorder. This data indicates that most people who misuse alcohol, prescription drugs, or illegal drugs are employed.
It helps to keep perspective and understand that many people struggle with a substance problem, and being one of them is not a reflection on who you are as a person. Addiction shows no favorites, impacting people of all socioeconomic strata. The earlier you become aware that you need help to overcome a substance use disorder and take steps to obtain it, the better your recovery outlook is.
Your Job is Protected
Having an understanding of the breadth of the job and privacy protections in place is essential. Knowledge is power, as it will give you the confidence needed to ask your boss for a medical leave of absence for a residential rehab, or for an adjusted work schedule for outpatient treatment. These federal laws include:
Americans with Disabilities Act (ADA)
The Americans with Disabilities Act (ADA) offers limited protections against discriminatory practices against employees with substance use disorders. If an employee has a history of addiction, or is currently participating in addiction treatment, and is no longer using, that individual is protected under the ADA and cannot be discriminated against.
Alcoholism is considered a disability, so alcoholics are protected under the ADA. Regardless, employers have a right to enforce policies the prohibit drinking alcohol in the workplace. Also, an employee who is an alcoholic will be held to the same work-related standards as other employees. The ADA does not consider an individual who is active in their addiction while employed to be an “individual with a disability.” Employers have the right to prohibit the use of illegal drugs or alcohol in the workplace, and can legally test employees and terminate them if there is a positive test result.
Family and Medical Leave Act (FMLA)
Under the FMLA, individuals with a medical need, which includes addiction treatment, for an extended leave of absence, including a serious health condition of the employee which prohibits them from working, can be granted up to 12 weeks of paid or unpaid leave without the risk of losing their job. This means that after the 12-week leave, the former position, or a comparable one, with the same benefits and pay will be guaranteed.
There are some restrictions to note. The employee must have worked for the employer for a minimum of one year, and the employer must have a minimum of 50 employees to be held to FMLA requirements. Also, take note that if there is an established policy in place that has been clearly communicated to all the employees which states reasons why an employee may be terminated for drug or alcohol abuse, then the employer can exercise that policy and terminate the employee.
Health Insurance Portability and Accountability Act (HIPPA)
When it comes to protecting one’s privacy before, during, and following an addiction treatment program, there are strict laws on the books. Dating back to the 1970s, the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act and the Drug Abuse Prevention, Treatment, and Rehabilitation Act were issued, and then revised in 1987. These laws ensure that the medical records kept at an addiction treatment center are prohibited from being released without the patient’s consent. The Health Insurance Portability and Accountability Act (HIPPA) further protects patient privacy.
When Should You Tell the Boss?
Chances are the fact that you are dealing with an addiction issue is not a secret. People who work alongside you day in and day out have probably picked up on the signs that something is up. Maybe you have been calling in sick more often, or arriving late to work. Maybe you are not completing work projects on time, or your job performance has been slipping. Maybe coworkers have noticed that you are not attending to your personal grooming lately. There are many signs that coworkers and management might have detected before you do approach your boss. The takeaway is not to wait too long before meeting with the boss to discuss a need for treatment. The sooner the treatment is completed and you are in recovery, the less disruption there will be in your workplace.
The way you handle your request for an extended leave for rehab is critical. Mishandle the process and you could face termination. For example, impulsively entering rehab without giving the employer notice or requesting a medical leave of absence can result in termination. The best way to proceed is to sit down with an HR representative or your boss and explain the need for addiction treatment. Handling this matter in a constructive, professional manner is imperative for things to go smoothly, thereby reducing the risk to employment.
Even though you may feel uncomfortable discussing the need for rehab, most employers have dealt with this problem many times before. There is usually a specific process for requesting a medical leave of absence and they will guide you through the paperwork. Employers want to feel assured that you intend to return to the job following treatment, and that you have made plans with coworkers to help with the workload in your absence. Employers often view the employee initiating the treatment process as a positive, as they see it as a temporary disruption that will result in a more productive, healthier employee in the near future.
Residential or Outpatient Rehab: Which is Best for You?
The level of care needed will depend on the severity of the alcohol or drug problem. However there are other considerations that factor into this decision, such as how much your insurance plan covers, whether you are able to take an extended leave from work and family duties, and which setting is the best one for your unique needs.
Outpatient programming is best suited for those with emerging to moderate substance use disorders. Generally, outpatient programs come in three levels of intensity, each having unique requirements as well as services offered. These types of outpatient rehab include:
- Basic outpatient treatment. This is the least intensive outpatient rehab, offering evaluation, psychotherapy sessions, and addiction education for individuals with a mild or recent substance use disorder.
- Intensive outpatient program (IOP). The IOP provides a more robust program that requires about 9 hours of participation each week.
- Partial hospitalization program (PHP). The PHP offers the highest level of care for an outpatient program, with about 30 hours per week, or more, of programming.
All outpatient programs provide flexibility for living arrangements. The individual can remain at home outside of treatment hours and working, or they may want to stay in sober living housing if a supportive home environment is not available.
For individuals with a more severe addiction, the residential rehab setting is appropriate. The residential option offers round the clock support and monitoring, so it is a more controlled environment. This deters the individual from accessing substances while in treatment, a protection that outpatient rehab does not really provide. Some of the benefits of a residential program include:
- Offers a structured environment, which reduces stress and provides a regular daily schedule
- Offers more individualized treatment
- Offers a more intensive level of care
- Extended stay increases recovery success
- Offers a wide range of treatment elements over the course of the day
- Some residential rehabs also treat co-occurring mental health issues
- Offers continuing care services and alumni services
What you can Expect in Rehab
Whether you opt for outpatient or residential treatment, there are some basic treatment elements that are universal. However, the residential programs will have more depth and breadth in their services. Following the detox and withdrawal step, the primary treatment elements include:
Evidence-based therapies: These are scientifically studied therapies that resulted in statistically significant results. Clients will engage in the therapy best suited to their own specific needs and underlying factors. All of these therapies assist the individual in changing their thoughts and behaviors around the substance use. Some examples of evidence-based therapies include cognitive behavioral therapy (CBT), motivational enhancement therapy, dialectical behavior therapy (DBT), and contingency management.
Group sessions. Peer interaction in group therapy sessions is essential while in treatment. These sessions offer the participants a supportive space where they can share their stories and practice new skills.
Medication-assisted treatment (MAT). Ongoing medical support can benefit some individuals in recovery from alcohol or opiate dependence. The drugs, such as naltrexone or buprenorphine, are closely monitored.
Recovery classes. Recovery tools are taught, equipping clients with new coping skills and better communication techniques, and relapse prevention strategies that will benefit them when encountering challenges in recovery.
If you have come to that important crossroads and have decided it is time to sit down with the boss and make a plan to go to rehab, have confidence that you cannot lose your for time off to get treatment.