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Stigma-Free Workplaces: Are We Doing Enough to Support the Right to Work?

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It is said that you can pass all of the laws in the world to correct societal wrongs, but if no one uses or actively enforces them, nothing will change. Knowing what we know about the impact of stigma on the lives of people in recovery, I have to wonder, why are we not more active when it comes to workplace discrimination perpetrated against people in recovery and why is there is so little movement to establish “recovery friendly” also known as Recovery Ready” workplaces?

Congress enacted the ADA in 1990 to provide protections to persons with a physical or mental disability, including those with substance use disorder.[1] The law classifies substance use disorder as a disability, meaning disfavoring someone for being in recovery or based on their past drug use is illegal. In the first decade following the passage of the law, only a handful of cases were litigated. But, this is changing, in part due to the introduction of medication-assisted recovery. In fact, the Department of Justice released guidance in April 2022 on the use of the ADA with regard to substance use disorders. The Justice Department Guidance on Protections for People with Opioid Use Disorder Under the Americans with Disabilities Act gives specific case examples and rationale for determining when an action by an employer is violating the law.[2]

In many respects, people in recovery are unaware of their rights and in some cases believe they just don’t deserve them (internal stigmatization). It is difficult for clients to understand that they can substitute commonly referenced discrimination complaints with the words “person with addiction” to obtain the same meaning. For instance, “It is illegal for an employer to deny employment based upon sexual orientation” has the same meaning as, “It is illegal for an employer to deny employment based upon a person’s recovery from addiction.” Likewise, passing up a person for promotion, limiting career training or opportunity, applying punitive measures to make people “prove their worthiness as an employee,” or any other differential treatment based on a person’s status as being in recovery is also prohibited by the Americans with Disabilities Act (ADA).

Addiction being accepted as a chronic relapsing brain disease within medicine has benefited those in recovery because they are included in ADA protections, however, for many people in recovery, their addiction included involvement with the justice system as a direct result of their disease. Often, people in recovery are discriminated against by employers in ways that do not violate ADA directly because employers use criminal history to legally bar people in recovery from employment opportunities or advancement instead of recovery status alone. In CA, strides are being made to help people in this situation. SB731, with goes into effect in 2023, essentially seals arrest and conviction records (with the exception or sex offenses) after four years of a person being off supervision if no other crimes are committed in that time frame. It’s a step in the right direction, but criminal records still are allowed to affect people in recovery who were justice-involved for four years, a period in which people in early recovery are vulnerable.  As we know, employment is integral to recovery for many. Positive associations between improved employment and improved functioning in other areas (e.g., those measured by the ASI) have been reported, including lower rates of relapse, less criminal activity, and fewer parole violations among employed compared to unemployed persons.[3] Thus, spreading awareness about the rights enshrined under the ADA, and continued advocacy for justice involved people in recovery should be a priority. Afterall, how can one exercise one’s rights if they are not aware they exist, and how can we keep people who were justice involve due to their addiction from being discriminated against unless changes are codified into law. Regarding ADA specifically, empowerment in the workforce is an area we all can contribute to. From peers, to licensed therapists, we all should be on the front lines of providing vital information about the ADA.

The next layer of stigma that needs to be broken is the lack of support at workplaces in general. This was brought to my attention by the Service Employees International Union (SEIU). SEIU representatives reported that their locals had indicated that workforce supports for people with addiction and their families was a primary concern of their members. Workers, on their own, have pinpointed a need for recovery friendly workplaces. We are vital to meeting this need.

Creating recovery friendly workplaces starts with making the following goals a priority:

  1. Develop a short presentation to deliver to employers about recovery friendly workplaces
  2. Host a training at your facility on ADA law and application as it pertains to people in recovery

Clinicians/case managers can prepare their clients under their care by doing the following:

  1. Develop a list of referrals for clients who may need legal assistance returning to work
  2. Provide clients with ADA information upon discharge
  3. Discuss impressions about workplace perceptions with clients

Most importantly, we need to evaluate our own internal bias when it comes to workplace discrimination. Do we perpetuate stigma in the workplace? Do we respond to discrimination against people with addiction in the same way that we would if the discrimination was based upon race or sexual orientation? Is there some part of our own experience that resonates, “Of course you will struggle with employment… look at what you did to deserve it?”

Until we truly believe that workplace discrimination against people with addiction is real and morally and legally wrong, we will continue to perpetuate stigma in the workplace that so dramatically impacts long-term recovery. Change starts with us; devoting one hour this week to update yourself on the ADA and to have resources ready would be time well spent.

References

[1] Ten Years After the ADA Amendment Act (2008): The Relationship Between ADA Employment Discrimination and Substance Use Disorders, Elie G. Aoun and Paul S. Appelbaum Psychiatric Services 2019 70:7, 596-603

[2] 42 U.S.C. §§ 12111-12117. The Equal Employment Opportunity Commission (EEOC) and the Department of Justice jointly enforce the ADA’s ban on employment discrimination. For more information or to file a complaint of employment discrimination, visit eeoc.gov.

[3] Arria AM. Drug treatment completion and post-discharge employment in the TOPPS-II Interstate Cooperative Study. J Subst Abuse Treat. 2003;25:9–18. [PubMed] [Google Scholar]

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Pete Nielsen is the President and Chief Executive Officer for the California Consortium of Addiction Programs and Professionals (CCAPP), CCAPP Credentialing, CCAPP Education Institute and the Behavioral Health Association of Providers (BHAP), and Publisher of Counselor Magazine

CCAPP is the largest statewide consortium of addiction programs and professionals, and the only one representing all modalities of substance use disorder treatment programs. BHAP is the leading and unifying voice of addiction-focused treatment programs nationally.

Mr. Nielsen has worked in the substance use disorders field for 20 years. In addition to association management, he brings to the table experience as an interventionist, family recovery specialist, counselor, administrator, and educator, with positions including campus director, academic dean, and instructor.

Mr. Nielsen is the secretary of the International Certification and Reciprocity Consortium, and the publisher for Counselor magazine. He is a nationally known speaker and writer published in numerous industry-specific magazines. Mr. Nielsen holds a Master of Arts in counseling psychology and a Bachelor of Science in business management.

Pete Nielsen LAADC, CADC II, CAI, SAP

Pete Nielsen is the President and Chief Executive Officer for the California Consortium of Addiction Programs and Professionals (CCAPP), CCAPP Credentialing, CCAPP Education Institute and the Behavioral Health Association of Providers (BHAP), and Publisher of Counselor Magazine CCAPP is the largest statewide consortium of addiction programs and professionals, and the only one representing all modalities of substance use disorder treatment programs. BHAP is the leading and unifying voice of addiction-focused treatment programs nationally. Mr. Nielsen has worked in the substance use disorders field for 20 years. In addition to association management, he brings to the table experience as an interventionist, family recovery specialist, counselor, administrator, and educator, with positions including campus director, academic dean, and instructor. Mr. Nielsen is the secretary of the International Certification and Reciprocity Consortium, and the publisher for Counselor magazine. He is a nationally known speaker and writer published in numerous industry-specific magazines. Mr. Nielsen holds a Master of Arts in counseling psychology and a Bachelor of Science in business management.

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