By Ruth Bowdish, Managing Director, On Demand Occupational Medicine
Eric had always been a reliable worker—the kind of employee every company values. He showed up early, stayed late, and never complained. But one day, a seemingly minor workplace injury changed everything.
It wasn’t a dramatic accident—no sirens, no emergency response teams. Just a bad fall that left his back aching in a way that didn’t go away. His doctor prescribed pain medication, assuring him that with time, he would heal.
But time wasn’t a luxury Eric could afford.
The bills kept coming, and taking time off simply wasn’t an option. So he did what so many hardworking employees do—he pushed through the pain. And when the medication no longer provided the same relief, he adjusted. At first, he took it exactly as prescribed. Then, as his body built a tolerance, he needed just a little more to make it through the day.
Eric never saw himself as someone with a substance use problem. He wasn’t misusing drugs—he was following a treatment plan.
Over the years, he made several attempts to stop, but withdrawal was debilitating. Each effort ended the same: unbearable symptoms that forced him back to the very medication he was trying to leave behind. Eventually, he stopped trying. As long as he continued to work, kept his struggles hidden, and met expectations, he believed no one had to know.
Until the day he was selected for a random drug test.
The moment of reckoning
“Eric, I need you to come with me,” his supervisor said, his tone neutral but firm. “You’ve been selected for a random drug test.”
Eric’s stomach twisted. He forced a chuckle, trying to downplay the knot of anxiety tightening in his chest. “Man, do we really have to do this? I’ve been here for years—never had an issue.”
His supervisor didn’t waver. “Company policy. You know the drill.”
Eric hesitated, lowering his voice. “Look, I—I took something a couple of days ago for my back. It’s prescribed, but it might still be in my system. Maybe we can… you know, reschedule?”
His supervisor sighed, the weight of the situation settling between them. “Eric, I don’t want to be having this conversation any more than you do. But we have policies for a reason.”
Eric swallowed hard. He wasn’t a bad guy. He wasn’t dangerous. He just needed to work.
But in that moment, none of that mattered.
When the system fails
Eric sat in the testing room, staring at the cup in front of him.
The collector explained the process—he needed to provide a specimen. If he couldn’t, he could drink some water and try again. But the clock was ticking.
“I’m fine,” Eric said, shaking his head.
The technician gave him a knowing look, the kind that suggested they’d seen this before. “You should drink some water. It might help.”
He didn’t touch the cup.
Eric wasn’t naïve—he knew what was coming. The moment he handed over a sample, his secret would be out. So he sat there, refusing to drink, refusing to try, hoping that if he waited long enough, the situation might somehow resolve itself.
But it didn’t.
The collector explained the next steps. It would be recorded as a shy bladder situation, and he had options—he could provide medical documentation or discuss the issue with his employer.
Eric knew there was no medical explanation. And there was no way he was going to his boss with this.
So he stood up, walked out the door, and never looked back.
That night, he went home numb. The next morning, he didn’t show up for work. Or the next day. Or the one after that. Maybe they assumed he quit. Maybe no one wanted to deal with it. Either way, no one called.
And Eric sank deeper.
No job. No options. No hope. Just the one thing that had been holding him together all along—the pills.
What if we changed the story?
What if, instead of walking out, Eric had a way forward?
What if his company had a clear, employer-established voluntary self-identification policy, allowing him to step forward and seek help before a test forced his hand?
What if his employer offered an Employee Assistance Program (EAP)—a confidential, judgment-free resource where he could talk to a professional, understand his options, and take steps toward recovery?
What if Eric’s supervisor had been trained in recovery-ready workplace protocols, recognized the warning signs, and responded with support instead of just following procedure?
What if, instead of believing his career was over, Eric knew his company had a one-chance program—a structured pathway to treatment that allowed him to get help while keeping his job?
How different could his life have turned out?
How different could his family’s life have been?
A different approach to workplace substance use
Eric’s story is just one example of how substance use can quietly take hold of employees in workplaces across the country.
Effective leadership is essential in addressing substance use risks while maintaining a safe, productive, and supportive workplace. Leaders play a crucial role in recognizing early warning signs, responding with empathy, and fostering a culture that balances accountability with support. By leveraging emotional intelligence, leaders can navigate sensitive situations, encourage open communication, and reduce stigma surrounding substance use disorders.
A proactive approach is key. Instead of waiting until it’s too late, workplaces can take strategic steps to protect their teams, enhance safety, and support employees on their path to recovery. These include:
- Recognizing early warning signs – Identifying subtle indicators of substance use risks and understanding their impact on workplace safety, productivity, and morale.
- Leveraging emotional intelligence – Using empathetic leadership and effective communication to foster trust and reduce stigma.
- Creating a culture of support and accountability – Balancing workplace policies with resources for employees facing substance use challenges.
Most workplace substance use policies focus on deterrence—zero tolerance, immediate termination, no room for conversation. But here’s the hard truth: deterrence doesn’t stop addiction. It just forces it into the shadows.
With 75% of people with a substance use disorder actively employed, workplaces are more than just places of enforcement.
They are places of opportunity.
The companies that understand this—those that create both safety and support—are the ones that change lives.
What leaders can do
A recovery-ready workplace isn’t just about policies—it’s about creating an environment where employees feel safe seeking help. Here’s where to start:
- Implement voluntary self-identification policies – Give employees a structured way to ask for help before they’re in crisis.
- Provide EAPs and confidential support – Ensure access to professional resources when employees need them most.
- Train supervisors in recovery-ready workplace protocols – Equip leadership with the tools to recognize warning signs and intervene with empathy.
- Offer one-chance or second-chance agreements – Establish structured pathways for employees to seek treatment and return to work when possible.
Eric’s story is just one of many. But it doesn’t have to be.
The real question is: How many more Erics are out there? And what are we willing to do about it?
With employee turnover at an all-time high and engagement at record lows, organizations must rethink how they support their teams. A workforce that feels valued, supported, and empowered is one that thrives.
By prioritizing employee well-being, fostering trust and accountability, and investing in proactive leadership, organizations can shift from merely surviving to truly excelling.
The companies that lead with compassion and action don’t just retain employees—they change lives.