Keeping Your Job While Going to Inpatient Rehab: Long-Term or Short-Term

Going to Rehab With a Job: Can I Get Fired for Going to Rehab?

A national survey that investigated substance abuse in the workplace found that 15.3% of U.S. workers reported drinking alcohol before or during work hours, while 3.1% of the workforce reported using illicit drugs in the same situation.1 Although these figures indeed sound alarming, they do not come as a total surprise as over 70% of substance users in the U.S. are employed. This makes substance abuse in the workplace a major concern, especially keeping in mind the following facts:2

  • Substance users have 3.5 times more chance to be involved in a workplace accident than other workers.
  • People who abuse drugs or alcohol are less productive in the workplace as a result of absenteeism, negligence, poor performance, or bad relationships with their coworkers.
  • Substance users tend to change jobs more often, even more than three times in one year.
  • Healthcare costs for workers with alcohol problems are two times higher than for other workers.

Even despite knowing these risks, many people avoid entering rehab. According to the results of the National Survey on Drug Use and Health carried out in 2017, about 1 in 5 people in the U.S. who perceive a need for treatment for substance abuse do not seek treatment at specialized treatment facilities because they believe that deciding to go to rehab would have a negative effect on their job. This is actually the third strongest reason why people in the U.S. do not undergo treatment, the leading two being the lack of motivation to quit using substances and inability to afford treatment.3

These barriers often result from the lack of awareness that US substance abuse treatment laws make it possible to keep the job while in treatment, either by taking a leave from work to go to rehab or by taking advantage of treatment opportunities such as work rehab programs, which are designed in such a way that the user can undergo substance abuse treatment without completely quitting their job.

Inpatient drug rehab rules & substance abuse treatment laws

Legal Rights of Employees Struggling With Substance Abuse

There are several laws and regulations that make it possible for US workers to keep their jobs during and after substance abuse treatment. This may apply to individuals undergoing treatment, as well as their immediate family members.

Americans With Disabilities Act (ADA)

This act has been in force since 1990 and it was amended in 2008. According to ADA, employers cannot fire, refuse to promote, or refuse to hire an employee because of their substance abuse history. The same applies to situations when employees who are struggling with substance use issues are enrolled in a substance abuse treatment program.4

However, this does not mean that the employer is obliged to hire or keep an employee who is actively using substances and not seeking treatment.4 In other words, entering rehab means that a substance user is more likely to keep the job than lose it.

Family and Medical Leave Act (FMLA)

FMLA makes it possible for employees that have worked for the employer for at least 1,250 hours in the past year to take up to 3 months of unpaid job-protected leave if they are suffering from a serious health condition. The same applies to situations when they are asking for a leave to care for their child, spouse, or parent with a serious health condition.5

This category of conditions covered under FMLA includes substance use disorders or physical illnesses related to substance use, as well as caring for a family member who is undergoing treatment for these conditions.5

In addition, FMLA for rehab protects workers from being demoted, fired, or refused promotion because of taking 12 weeks off for treatment. This for example means that a person who has undergone FMLA alcoholism treatment and is able to meet all professional requirements after returning from their leave will not lose their job.5

This act was adopted in 1993 and applies to all public and private companies with more than 50 employees.5

In addition to this federal regulation, nine US states and Washington D.C. have laws that ensure partially or fully paid medical leave.6

How to Talk to Your Employer About Addiction Treatment?

In addition to knowing your rights in the workplace, you also need to get familiar with the policies and resources that your company has regarding substance abuse issues and treatment. Some organizations have Employee Assistance Programs (EAPs), the purpose of which is to help resolve the productivity issues of employees who are struggling with personal concerns. This service can have many forms (in-house or external) and may include consultation related to substance abuse screening, treatment referral, and follow-up care.7

When it comes to talking to your employer, the focus should be placed on the proactive approach toward recovery. The conversation should be confidential but at the same time very honest.

This conversation should take place after looking into treatment options so that you can propose a clear plan of action to your employer. If inpatient treatment is advised, in cases where inpatient drug rehab rules do not allow for you to carry on working while in treatment, you will typically need to take a leave. In such situations, you may need to consider FMLA alcohol treatment or drug rehabilitation. On the other hand, you may also find work rehab programs that are organized in such a way that they allow you to carry on working.

Types of Addiction Treatment

There are many different inpatient and outpatient treatment programs. The choice of the best option will depend on several factors:8

  • Level of medical care that the patient needs, depending on their general health condition
  • Type of addiction and severity of withdrawal symptoms
  • Support that the patient has in their immediate environment
  • Personal preferences regarding whether the patient prefers a spiritual or a secular atmosphere, a gender-sensitive environment, etc.
  • Whether the patient would like to carry on working or taking care of their family members while in treatment

Alcohol or drug rehab work programs are designed to help people who would like to receive treatment without leaving their workplace.

Length and Cost of Rehab

According to the Principles of Effective Treatment of the National Institute on Drug Abuse, most individuals need at least 3 months of substance abuse treatment for successful recovery. This time includes not only detox or the period when the patient may need intensive medical supervision, but also outpatient services such as counselling or peer support groups.8

The cost of detox may range from $250 to $800 per day. Outpatient care may range from $1,400 to $10,000, while residential treatment may cost $5,000 to $80,000 depending on the length of stay.9

When it comes to the cost of medication, the average cost for 1 full year of methadone maintenance treatment is approximately $4,700 per patient.10

What to Do After Treatment?

Substance abuse treatment programs typically include a relapse prevention component. In other words, the person who undergoes treatment learns how to handle triggers that have resulted in drug or alcohol abuse and organize their life in order to maintain abstinence in the long run.11 This refers to all spheres of life, but it is indeed vital that the relapse prevention plan is followed in the workplace.

Sometimes when the employer notices work issues related to the employee’s substance abuse, rather than terminating their employment, they may require the employee to sign Return-to-Work Agreement, which may also be referred to as “last chance agreement”.

By signing this document, the worker may need to acknowledge that there is a substance use issue that harms their work performance and may need to commit to going to rehab as an alternative to losing their position. In addition, the worker may be required to agree that upon completing the treatment program they will return to work and comply with all professional standards. However, it is important to mention that this depends on the employer and that they are not obligated to give such an agreement to their employees.12

Unsure where to start? Take Our Substance Abuse Self-Assessment

Take our free, 5-minute substance abuse self-assessment below if you think you or someone you love might be struggling with substance abuse. This evaluation consists of 11 yes or no questions that are designed to be used as an informational tool to assess the severity and probability of a substance use disorder. The test is free, confidential, and no personal information is needed to receive the result. Please be aware that this evaluation is not a substitute for advice from a medical doctor.

How to Get Treatment?

The first step is looking into treatment options and getting more specific information about treatment. This can be done by contacting American Addiction Centers. There is a toll-free helpline with admission navigators who can guide you through the process of entering rehab and immediately check your insurance coverage.