Almost 50 million people in the U.S. have a substance use disorder, and most of them are in the workforce, according to federal data. Untreated addiction at work can cause big problems: turnover, absenteeism, increased health care costs and injuries, not to mention the devastating personal toll on individuals and their communities.

So in recent years, some employers have taken a larger role in supporting the recovery of their employees, now with a boost from the White House. 

Last November, the Biden administration launched a resource hub and a national institute providing best practices to employers and local governments to promote Recovery Ready Workplaces. 

The national push builds on a New Hampshire state initiative created by Governor Chris Sununu in 2018, which offers training, certification and ongoing dedicated advisers to help businesses in the state, which has been ravaged by the opioid crisis, to become recovery friendly.

“We know that recovery often requires internal and external sources of motivation. And so the workplace is a really strong source of that external,” said Samantha Lewandowski, program director with New Hampshire’s Recovery Friendly Workplace, which is administered by the non-profit United Way Granite State.

“We’re trying to get people to realize that this is happening at your workplace. And so when you don’t talk about it, or it’s stigmatized, you’re really just kind of bearing the brunt of it, you’re just not talking about it,” she said.

More than 350 companies in New Hampshire are participating, including the shoe manufacturer Genfoot in Littleton, New Hampshire, where Shawn Cannizzaro began to turn his life around.

“This is my check stub. I keep it in my office. And I look at it every day,” said Cannizzaro, pulling his first paper paystub from Genfoot in the amount of $336 off his wall where he keeps it pinned.

A few months before he started at Genfoot, Cannizzaro had nearly died.

“They found me floating in a pool from [an] overdose on fentanyl,” he said.

Cannizzaro had a long rap sheet; he’d been in and out of prison for decades and had tried many times to get clean, ending up at a sober living recovery home in Littleton. They hooked him up with the job at Genfoot, loading and unloading raw materials and finished boots.

“They saw something in me. And here’s where I get, like, choked up,” he said. “You know, they saw something in me that I didn’t necessarily see in myself at the time.”

Mark Bonta, the plant manager at Genfoot, said Cannizzaro’s infectious positivity on the job helped convince the company it had made the right move in becoming a recovery friendly workplace.

“Everybody loved him,” said Bonta of Cannizzaro. “People could see that this was a great guy, you know, and he just has a medical problem that needs to be addressed. And he needs support with it.”

Genfoot was able provide that support thanks to the state initiative. It began recruiting workers, like Cannizzaro, from local recovery homes and giving them time on the clock to attend court appointments or counseling sessions.

“They would let me do my 12-step meetings on my headphones, like on my phone,” said Cannizzaro.

Bonta said sometimes staff members drive people to appointments, and the company keeps track of their drug tests and treatment progress, “and it makes it a part of their job responsibilities to stay in recovery.”

The experience hasn’t been without some stumbles, though, like the time Bonta said the company found temporary housing for an employee who had been kicked out of their recovery home, only to see them relapse into addiction for several weeks.

“You do start developing compassion, because you’re getting to know these people on a more personal level and you want to help, right?” said Bonta. “But the lesson I learned was, I didn’t talk to the experts.”

Now, the company discusses any change with an employee in recovery with their recovery home and care team first. Bonta said the costs to the company while participating in the initiative have been nominal and there have been benefits — like a stable workforce that kept the factory open through the pandemic. 

Workplaces are uniquely positioned to support the recovery of their employees because it’s where they spend most of their time, said Dr. Rahul Gupta, the director of Drug Control Policy at the White House. But he noted there’s also a strong business case for companies to be more open and supportive of recovery.

“It allows them to retain those hardworking employees, which is, of course, better for the bottom line of the businesses as well,” said Gupta, pointing to research that recovery-supportive workplace policies can reduce turnover costs, injuries, accidents and health care costs.

Just because substance use disorders aren’t always discussed openly in a workplace doesn’t mean they don’t occur he said: “In the past, not recognizing that substance use disorder is a disease no different than diabetes or hypertension, has led us to create punitive policies in business that have been ineffective.”

Some large employers have moved to adopt more recovery-friendly policies in recent years, including Google and Amazon.

Amazon offers multiple resources for both virtual and in person substance use disorder treatment said Lian Neeman, the director of global benefits, “but the biggest challenge is reducing the stigma, and getting people to a place where they feel comfortable searching and finding and accessing these benefits.”

The most important thing a company can do to destigmatize recovery is to talk about it, said Josh Palacios, a senior program manager with Amazon’s Global Engineering Services.

“Allowing people to be their most genuine self at work, especially in vulnerable situations — like that is really how you can make an impact on people’s lives,” said Palacios, whose own struggle with opioid addiction began after a teenage injury.

While juggling medical appointments during recovery, he told his Amazon supervisor, and her support encouraged him to start a recovery employee resource group in 2022, which now meets once a month.

“I want people to know that they’re not alone, that there’s like minded people at work at all levels, from the warehouse to the C suite,” he said.

Shawn Cannizzaro in New Hampshire worked his way up at Genfoot over several years. Now he owns three sober living recovery homes and has been clean for more than five years.

“And it all started from $10.50 an hour, from someone saying, ‘Alright kid, we’re gonna give you a shot,'” he said.

He’s now getting his own company state-certified as Recovery Friendly so he can do the same for somebody else.