When a colleague on the warehouse floor of Hypertherm Associates, a New Hampshire–based manufacturer of industrial cutting tools and software, made a comment about “junkies” and complained about the public expense involved in saving them, Jamie Green knew it was her moment to speak up.
“I’m in recovery,” she told him, then asked a pointed question: “Do you think my life is worth saving?”
It was an awkward moment, to be sure. But after 19 years of moving to new locations and new jobs in hopes of leaving her addiction to alcohol, heroin, opiates, and cocaine behind, Green was finally thriving. She was ready to live her recovery “out loud,” she told Fortune. Her colleague, to his credit, heard her clearly. “That really changed his perspective,” she recalls. The two became close friends.
Crucially, Green had no reason to worry about disclosing that history at work; Hypertherm is a global company with 2,000 employees and a pioneer in the “recovery-friendly workplace” movement—a nascent nationwide effort to revolutionize the way American businesses approach issues of substance-use disorder in the workforce.
When Green interviewed for the job, there was a “Recovery-Friendly Workplace” sticker on the front door and cards with a list of resources in the company’s restrooms. When she acknowledged that she was in recovery herself, and that she might need certain accommodations, “they didn’t bat an eye.”
In the four years since, Green has risen through the ranks, becoming an environmental stewardship specialist for the company and chair of Hypertherm’s substance-use disorder task force. She’s now a homeowner with an associate’s degree and is on track to graduate with a bachelor of science in 2024.
The workforce is full of Jamie Greens—and some enlightened employers are looking for more of them, realizing that the old ways of addressing substance-use disorder among employees simply don’t work. And they’ve got the federal government on their side: The Biden administration has put its weight behind the notion that businesses can and should help address the nation’s opioid and overdose epidemics. It is encouraging employers to provide “recovery-ready” workplaces and states to join the effort.
Employers who are taking part say they’re motivated by human decency, but also by self-interest: It’s a bet that supportive workplaces will help them build loyal, stable workforces at a time when labor is distressingly scarce.
For all these reasons, it’s a rare example of a movement that already has bipartisan support: States red and blue, from Alaska and Kentucky to Rhode Island and Nevada, have organized initiatives in recent years encouraging businesses to support people in recovery or impacted by substance-use disorders, in hopes that many more will seek out treatment.
It’s easy to see why: 106,699 Americans died of an overdose in 2021, and 46 million people, or one in six (16.5%) of Americans above the age of 12 suffer from at least one substance-use disorder. Those figures include 29.5 million with an alcohol-use disorder and 24 million with a drug-use disorder (7.3 million struggle with both) according to the 2021 National Survey on Drug Use and Health.
And despite long-held stereotypes of “addicts” as derelict and nonfunctioning, the majority of the adult population with an addiction—more than 60%, according to the NSDUH—are employed. An analysis of NSDUH data from 2012-2018 estimated that approximately 1 in 11 American workers had a substance use disorder in the previous year (see chart for rates by occupation). Statistically it’s clear that all Americans know many people struggling with addiction—family, friends, and colleagues—and yet it remains unthinkable in most American workplaces for an employee or job-seeker to admit to substance-use disorder, past or present.
View this interactive chart on Fortune.com
Today’s medical and scientific communities define addiction as a disease, a health condition like cancer or diabetes. The Americans With Disabilities Act protects people with substance-use disorder: The A.D.A. prohibits employers from discriminating against a person with a S.U.D., or a history of one (so long as they are not currently engaged in the illegal use of drugs). But studies have shown that employees’ fear of being fired or harshly judged has meant most hide their struggle, some going so far as to seek treatment outside of their employer-provided health plans.
“Addiction is such a stigmatized problem, and people generally hide in the shadows, especially at work,” says Dr. Anna Lembke, a psychiatrist and professor and director of addiction medicine at Stanford University School of Medicine.
American workplaces have become more diverse and welcoming spaces in recent decades, the product of years of hard-fought battles over gender, race, disability, neurodiversity, and other identities. Overcoming discrimination against those who have struggled with substance-use disorder may be an even taller order, says Richard Frank, director of the Brookings Schaeffer Initiative on Health Policy: “Let’s face it, there aren’t too many things in our society as stigmatized as opioid addiction.”
Dana Lariviere’s office in a white-shingled building in Dover, N.H., with its family photos and enormous candy jar, wouldn’t strike you as the birthplace of a workplace revolution.
But seven years ago, in a turn that surprises Lariviere as much as anyone, the self-professed conservative embarked on a radical experiment in hiring at his telemarketing company, Chameleon Group: actively recruiting workers in recovery from drug addiction.
Since then Lariviere has become a kind of poster boss for the recovery-friendly workplace movement.
This wasn’t a role that came naturally to him. Previously, he had considered addiction a scourge that people brought upon themselves, a social ill that had little to do with his business. But all that changed in 2016, when he got an out-of-the-blue phone call from an employee he had fired five years before. The conversation left him “gobsmacked,” he told Fortune: The woman, who he remembered letting go after too many unheeded warnings about showing up late for work and being generally unreliable, told him she’d been addicted to heroin when she worked for him.
Since then, she had gotten sober and, as part of her recovery, had begun the process of making amends. Impressed by the woman’s gesture and honesty, Lariviere offered her a job interview, and then a job. His managers objected, unsettled at the idea of bringing “druggies” into the workplace, but on the job “she knocked it out of the park,” he recalled as if still marveling at the outcome. He soon promoted her to management.
She no longer works at the company, but Lariviere now sees that hire as a turning point for Chameleon Group. At the time, New Hampshire had one of the lowest unemployment rates in the country, and Lariviere was struggling to find good, loyal workers. It was also one of the states most hard-hit by the opioid crisis, and there was no shortage of local people trying to overcome addiction.
So began a hiring spree of people in recovery that, seven years later, numbers in the dozens—at times, half of Chameleon Group’s staff of 40 has been in that category. And though there have been a few bumps along the way, Lariviere calls this one of the best business decisions he’s ever made.
“We can choose to stick our heads in the sand about this, and pretend that it’s not happening, but it’s happening,” Lariviere told Fortune, pointing out that there are people who struggle with addiction in most workplaces—they just don’t usually feel comfortable admitting it to colleagues and bosses. “The difference between my business and your business is I know the people who are suffering from substance-use disorder, and you don’t. The difference is we have programs in place to be able to deal with this.”
Indeed, decades and more than a million deaths into the nation’s devastating overdose epidemic, America’s employers mostly live in a state of awkward denial: The reality of it is right there—in their workforces. They just don’t see it.
“If you think that you do not have anyone in recovery or with substance-use [issues] in your business, you’re either too small, or you’re mistaken,” said Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy, addressing an audience at the Brookings Institution in April. His own office, he tells Fortune, has hired people in recovery, and he has found that they are among some of his hardest-working and most dedicated staffers.
Gupta views businesses as part of a key strategy to address the nation’s addiction crisis: increasing the number of people who seek out treatment and stay in recovery. Currently just 8% of those who need treatment get it, according to the NSDUH.
A “recovery-ready workplace,” by Gupta’s definition, is one where those who are struggling with a substance-use disorder have people to talk to, where “they don’t have to hide their disease … they can seek out help whenever they want to.” In such an environment, he says, an individual will be bolstered by employment and its rewards—a sense of purpose and community, the pay and health benefits.
"There aren't too many things as stigmatized as opioid addiction."
Richard Frank, director, Brookings Schaeffer Initiative on Health Policy
The problems with the status quo don’t just affect employees with addiction issues and their families; businesses that fail to address substance-use disorder in employee ranks lose enormous sums every year in the form of higher health care costs, absenteeism, and presenteeism (when employees are at work, but not fully productive).
To understand just how much, Gupta recommends employers seek out the National Safety Council’s Substance-Use Employer Cost Calculator, which provides estimates based on a workplace’s location, size, and industry. Fortune did some rough calculations and found that at a company with the size and profile of Amazon, for example, the annual costs could be as high as $1.1 billion; for Walmart, the NSC calculator estimates a loss of $1.3 billion, and for Apple, $128 million. A 2016 surgeon general report put the total cost of substance-misuse and substance-use disorders to society at $442 billion.
Another way to look at it: Each employee who recovers from a substance-use disorder saves their company more than $8,500 on average.
Recovery-friendly workplaces are a natural extension of a landscape in which the ever-pressing need for talent has led employers to drop college degree requirements and adopt fair-chance hiring initiatives, which prevent employers from asking job candidates about their criminal history.
$442 billion
Estimated annual U.S. cost of substance misuse and substance-use disorders to society. Source: U.S. Surgeon General, 2016
But making a company recovery-friendly is no simple task. It demands a level of trust between employers and employees that takes work to achieve. It may also require a reckoning with long-standing policies that treat a positive drug test as cause for disciplinary action.
To the extent that there’s a playbook for such efforts, it comes from New Hampshire, where Republican Gov. Chris Sununu launched the nation’s first formal Recovery Friendly Workplace (RFW) initiative in 2018.
Sununu, as a former CEO himself, had come to understand the importance of such an approach at his ski resort, where he’d had various employees impacted by substance-use disorder. In announcing the effort, he framed the idea as a win for employers: “This initiative will help businesses attain greater safety, productivity, and profitability by addressing addiction ‘head-on’ in the workplace,” he said, predicting that it had the “wings to go national.”
There are more than 350 organizations, representing over 95,000 employees, participating in the New Hampshire RFW program, which by design is relatively simple and not overly prescriptive. Businesses receive expert assistance and training and declare their commitment to RFW principles, but implementation—whether a company uses drug testing or bans happy hours, for example—is up to them.
It’s important to note that recovery-friendly workplaces still do not allow workers to get high on the job. Preventing substance misuse is the focus. But the rules are enforced differently. For example, instead of being fired, an employee with a positive drug test may be connected to resources and given a second chance. A relapse may be viewed as a medical setback, rather than grounds for dismissal.
“This is not about destigmatizing people who use drugs,” Lembke, of the Stanford University School of Medicine, explains. “This is about helping people who have a form of psychopathology that we conceptualize as addiction, so that they can be healthier people and, ultimately, potentially more productive workers.”
Too often businesses have been part of the problem, Gupta says, with policies and attitudes rooted in an era when addiction was considered a behavioral problem or moral failure. Years of research have shown that addiction is in fact a brain disease that rewires neurological pathways and makes dependence increasingly difficult to overcome.
Dana Lariviere, founder and CEO, Chameleon Group
“The difference between my business and your business is I know the people who are suffering from substance-use disorder, and you don’t.”
Creating a recovery-friendly workplace can be a learning process, as Lariviere can attest. At first he made the mistake of hiring people who were still addicted to drugs, an issue that led to some hair-raising episodes, as when an employee, on a visit to the company’s largest customer, used drugs in the bathroom and nodded off during the meeting.
Even well-meaning efforts can backfire: After Lariviere hired a quorum of individuals in recovery, for example, he started organizing regular meetings with them to check in. He was eager to be supportive, but as one person in the group eventually pointed out to him, the meetings had, in effect, singled them out.
And making accommodations or changing cherished perks such as office happy hours can be unpopular among other employees and require education for the whole workforce.
At Hypertherm, Green says that openness has been key to her own recovery and building a sense of personal accountability and safety; her colleagues check in on her at tough times, for example. But a recovery-friendly workplace doesn’t demand people be public about substance-abuse issues—it’s personal health information, after all—only that the workplace offers support for people struggling with them.
Relapse, a common experience for people with substance-use disorder, is perhaps the trickiest aspect for employers, and it requires anticipating such events and preparing for them.
Some recovery-friendly workplaces require employees who have relapsed to submit to more scrutiny than other employees—for example, requiring they sign an agreement recommitting to recovery, undergo random drug screenings, or allow their employers to check in with their treating provider to confirm how they’re doing.
Honesty is the key, Lariviere says. He has had employees approach him in dire crisis, afraid to leave the office for fear they’ll use again. In those cases, he says, he’s happy to do whatever it takes to find a person help or get them a spot in treatment. “But,” he adds, “if you lie to me, you’re done.”
Success stories are more common, he says, but he has learned the hard lesson that you can’t save everyone. Lariviere’s team has lost former employees to overdoses or suspected ones, as well as one beloved colleague who had still worked at the company and openly battled addiction.
“That was devastating,” says Lariviere.
Like all forms of workplace diversity, recovery-friendly approaches can improve workplaces in intangible ways that go beyond the individual employee’s experience. Moments of workplace connection like Green’s on the factory floor at Hypertherm can breed broader empathy for people with different life experiences.
Before instituting recovery-friendly policies under New Hampshire’s program, Mark Bonta, plant director for boot manufacturer Genfoot America in Littleton, N.H., was under no illusions about addiction among the ranks of his 100-strong workforce. For years, he struggled with how to handle employees who showed up to work drunk or who, under the influence of opioids, fell asleep on the factory floor. His facility was full of dangerous machinery, and company policy was to deal with such incidents as disciplinary events, sending anyone who wasn’t sober home for the day, and terminating employment if it happened too often.
But that didn’t strike him as a good solution, a feeling that particularly haunted him after an incident in 2011 when he fired a young woman who came to work smelling of alcohol several days in a row. On the final day, after she failed a Breathalyzer test, Bonta drove her home. He watched her climb the stairs to her apartment in tears. She died less than six months later of liver failure, he recalls, the catastrophic outcome of her untreated substance-use disorder.
Now Bonta has different stories to tell. Take Catherine Forbes, a 36-year-old who arrived at Genfoot scared and only weeks into recovery in January 2019. Her previous years had been marked by a series of unspeakable lows: Hooked on heroin, she had been arrested, had an abusive partner, and had a stint living in her car. She had lost her driver’s license and her children to the state. Getting sober and getting a job were conditions for regaining custody of her kids.
At Genfoot, Forbes started as a stitcher, a job that required operating a machine to sew together winter boots, fastening a chunky rubber sole to a fabric sleeve with two elegant threads of nylon. She was “a handful” at first, she recalls.
On break during her first day, she called her mom to say she couldn’t do it—her focus was too poor, her patience too short, and her hands too shaky for such precise work.
She felt doomed by her previous work experiences, she told me when I visited the factory in early July: “Nobody wanted to work with me because they knew that I was an addict or that I had a history of quitting, and then going back and quitting and going back.”
Genfoot was different. “Genfoot doesn’t just give up on you,” Forbes told me. “They help teach you that work ethic and to apply it.” Over time, she grew to like the people and the work—the repetition and meticulousness of it, as well as the sense of accomplishment she felt at the end of each day. She has twice been named Genfoot employee of the month and is studying to become a shift supervisor.
“My ambition has skyrocketed,” she told me. “I went from not wanting to be at work and not knowing what to do being at work, to wanting to be there—and wanting to be there more, and wanting to be more involved and give back to them like they’ve given to me.”
16.5%
The percentage of Americans above the age of 12 who suffer from at least one substance-use disorder. Source: The National Safety Council's substance-use employer cost calculator
That positive trajectory at work dovetails with an increasingly settled life outside it. Forbes is now four years sober, with her own apartment, a brand-new truck, a supportive fiancé, and shared custody of her children.
“If it wasn’t for Genfoot,” she told me, “I don’t think I’d have made it this far.”
Of course, employment alone is not enough to cure entrenched addiction. Part of the education for Lariviere and his team was seeing, up close, the complexity and degree of difficulty embedded in his employees’ recovery efforts.
In some ways, coming to work and staying off drugs seemed the least of it: A number of his hires had to attend hours of court-mandated treatment and report for spontaneous drug tests; others lived in rule-intensive recovery homes that demanded attendance at midafternoon meetings, or received addiction treatment, like methadone, which requires showing up for daily medication appointments. Few had driver’s licenses, and fewer had cars.
Granting employees time (and sometimes providing transportation) for these obligations is a common recovery-friendly practice.
Some hires struggled to afford food and basic needs because of the expense of their sober-living facilities, so Lariviere started providing them with meals and business clothing. Witnessing recovery-committed employees struggle because of such obstacles frustrates him, he said, but it also has instilled in him a deep respect for those who succeed.
Bonta agrees: “The people that I’ve seen overcome their addiction—it can really speak to me and any employer about how much resolve and how much strength and character they must have to be able to overcome something so difficult,” he tells Fortune. “You want that person working for you.”
So far the recovery-friendly workplace movement has mostly been led by small businesses, while many of America’s largest corporations have been slow to openly acknowledge addiction as a workforce issue.
But some larger companies have begun to step up, even if they haven’t been officially designated as “recovery-friendly workplaces.”
Leidos, a government contractor with 45,000 employees (No. 288 on the Fortune 500), has been working on the issue since 2017, after an employee wrote to then-CEO Roger Krone about the loss of his son to opioids. And the cloud-based software company Salesforce has Soberforce, an internal Slack group launched by an employee during the pandemic for individuals in recovery or those trying to get there: 400 of the company’s roughly 79,000 employees participate in the network.
At Amazon, Josh Palacios, a 35-year-old senior program manager with the company’s global engineering and security services division, thought long and hard before speaking out about his recovery, he told Fortune. Palacios started his career at the e-commerce giant in 2013 as a temp, joining Amazon’s army of warehouse workers while still in a deep, all-consuming battle against his addiction to prescription opiates.
In the midst of America’s worsening epidemic, he knew he couldn’t be the only one. As he moved up the ranks, from time to time he mused about starting a company wiki page or an internal resource guide that might help his fellow Amazon colleagues confront their substance-use disorder.
Last year, four years into his own recovery, Palacios finally worked up the nerve to pitch his massive employer on the idea. Today he leads an employee affinity group, Recovery@Amazon, which has become a component of the company’s strategy to support employees and their family members with substance-use disorder. Amazon also covers several treatment options for substance-use disorder, and travel to access them.
Palacios has shared his story in presentations to leaders and peers across the organization and at an Amazon-sponsored rally in downtown Seattle. Still, he says, being open about own substance-use disorder at one of the world’s largest companies isn’t exactly comfortable.
“Every time, I’m nervous,” he says.
Given his success, fellow employees are often surprised to learn his history, he says. “They’re like, ‘That doesn’t seem like you.’ And I think that that is equally as important—making sure that people are aware that statistically there are addicts everywhere, in our family and our work. And I don’t think enough people are aware of that.”
A version of this article appears in the August/September 2023 issue of Fortune.
