Nicole drank until she blacked out every night, but managed to drag herself out of bed each morning and go to work. Because she continued to work and pay her bills, she spent years denying that she had a drinking problem. Denial and other defense mechanisms are particularly strong among high-functioning alcoholics (HFAs). “HFAs may use their external academic or vocational successes as justification for their drinking,” says Sarah Allen Benton, MS, LMHC, LPC, author of Understanding the High-Functioning Alcoholic. “They may live a more compartmentalized life that allows only certain people or no one at all to see their drinking, while lower functioning alcoholics have less of an ability to hide their drinking or the consequences of it.” It wasn’t until Nicole started noticing worrisome health changes that she realized she needed to quit drinking. In some ways, she was lucky. Many high-functioning alcoholics don’t get help until they face dire legal or financial consequences. “HFAs often wait for an external event to motivate them to stop drinking or to see reason to stop drinking,” notes Benton. Even though Nicole knew she needed help, she didn’t know where to start. As a manager with a great deal of responsibility and a team that depended on her, how could she leave work for more than a few days? “I couldn’t miss work because I had to pay rent. I didn’t know how to manage it,” Nicole recalls. Job concerns are a major barrier to addiction treatment. Three-quarters of people with substance abuse issues are employed, according to the Substance Abuse and Mental Health Services Administration, and many wonder how to keep their job during rehab. Here are a few commonly asked questions about taking time off work for drug rehab, along with answers from those who have been there.
Do I Need to Take a Leave of Absence?
High-functioning alcoholics often avoid seeking treatment until their disease is fairly advanced. In these situations, a leave of absence to spend several weeks in the safety and structure of residential drug rehab is often needed. However, residential treatment is not the only option. “There are various levels of care that HFAs can engage in that could allow them to continue working simultaneously,” says Benton. Some examples include outpatient treatment, individual and group therapy, and support groups (12-step or SMART Recovery, for example). “If they are unable to stay sober after attending those levels of care, then residential treatment would be recommended,” she advises.
How Do I Keep My Job During Rehab?
Many HFAs worry that admitting a problem with alcohol or other drugs or taking a leave of absence for drug rehab could jeopardize their job. But the reality, says Benton, is “HFAs are more likely to lose their job if they have an untreated addiction while working.” Research backs this up. Studies show getting treatment for a drug problem increases the likelihood people will keep their jobs and get even better ones. There are laws that protect people with addiction from workplace discrimination, breaches of confidentiality and job loss. For example:
- The Americans with Disabilities Act (ADA) – The ADA, which applies to employers with 15 or more employees, protects addicted employees from discrimination in the workplace. Although there are exceptions, as a general rule your employer can’t fire you because you decide to attend drug rehab. If you are fired, you may be able to file a claim against your employer with the Equal Employment Opportunity Commission.
- The Family and Medical Leave Act (FMLA) – The FMLA, which applies to employers with 50 or more employees, allows qualified employees to take up to 12 weeks off per year as unpaid leave for addiction treatment, with their jobs protected. This means that when employees return to work, they are entitled to the same or an equivalent position. Talk to your employer and/or medical care provider to see if you qualify for state disability benefits.
Although Nicole loved her job and was terrified to lose it, she reached a point where she said, “It’s important, but it’s a job. Am I willing to literally die to avoid telling the truth?” The bottom line, says Benton, is “there is no job that is worth sacrificing your wellness and recovery for.”
How Do I Ask for Time Off?
Check your company handbook to find out your employer’s process. In most cases, you’ll need to speak with your supervisor or a human resources representative. Be honest, without going into great detail, and let them know you need treatment for addiction. “It is important to be discreet about who is told at their place of work so that their privacy rights are protected,” says Benton. “They can also state that they need to address behavioral health issues and not specify the condition.” If possible, have a plan ready for where you plan to go, how long you need to be on leave, and who can help with your projects while you’re out. Ask if your employer has recommendations or resources available, such as an employee assistance program which can provide referrals for therapy and drug rehab. Once you contact a drug rehab program, they will likely call your health insurance provider to help you understand your coverage and the cost of addiction treatment. Nicole started by talking to her manager at work. She asked for a leave of absence and contacted her employee assistance program. Once she took that first step, there were people along the way who helped with each next step. “It was so easy, I wish I would’ve done it sooner,” she says. Nicole chose Promises Treatment Center in Southern California, which allowed her to have supervised phone and computer access for work and paying bills. “I was able to stay in contact with my boss and keep her updated,” she says. She was also able to take care of disability paperwork and other documentation during her stay so that her transition back to work was smooth.
Should I Go Back to the Same Job?
In drug rehab, your treatment team will help you decide if you should go back to the same job or if a new path would be more conducive to recovery. “If the job was a major stressor that led them to drink, then they may need to reduce their schedule to part time, take a leave of absence for a period of time or quit,” says Benton. “It is also crucial that HFAs are honest with themselves about what they want to do professionally and if their job is the right fit for them in early recovery.” Benton points to several factors to consider in making the decision, including:
- Do you like your job?
- Does the job have any flexibility so you can take a lighter workload for a period of time?
- Is drinking or drug use part of work culture?
- Is it a high-pressure, high-stress work environment?
- Do you have to travel a lot for work, or will you be able to have a regular schedule with some accountability?
After drug rehab, Nicole’s boss made accommodations so she could attend outpatient treatment and get follow-up care. Nicole was able to work out a “waterfall” schedule in which she would start later in the day early in the week, and then start earlier as the week went on. She wasn’t expected to stay in the office past 5pm so she could attend meetings, exercise and get enough sleep.
What Do I Tell People When I Go Back to Work?
When Nicole returned to work after drug rehab, she told anyone who asked about her absence that she was having “health issues.” Only her boss and regional manager knew the details, and both were supportive. “At first, I was worried my boss might treat me differently,” she says, but as it turned out one confided that she had been sober for over 30 years and the other faced her own addiction issues months after Nicole’s return. With 23 million people affected by addiction in the U.S., just about everyone has either faced their own drug or alcohol problem or helped someone else. Whether you go back to the same job or a new one, start off slowly and build as you get more firmly grounded in recovery. “Balance and take it easy,” advises Benton. “Early sobriety is a challenging time because many HFAs are unable to handle as much stress as they were when they were drinking.” She recommends setting limits so you can make time for social support groups, therapy, self-care and stress management activities to help you adjust to your new sober lifestyle.