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). \u201cHFAs may use their external academic or vocational successes as justification for their drinking,\u201d says Sarah\u00a0Allen\u00a0Benton,\u00a0MS,\u00a0LMHC,\u00a0LPC, author of Understanding the High-Functioning Alcoholic. \u201cThey 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.\u201d It wasn\u2019t 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\u2019t get help until they face dire legal or financial consequences. \u201cHFAs often wait for an external event to motivate them to stop drinking or to see reason to stop drinking,\u201d notes Benton. Even though Nicole knew she needed help, she didn\u2019t 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? \u201cI couldn\u2019t miss work because I had to pay rent. I didn\u2019t know how to manage it,\u201d 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. \u201cThere are various levels of care that HFAs can engage in that could allow them to continue working simultaneously,\u201d says Benton. Some examples include outpatient treatment, individual and group therapy, and support groups (12-step or SMART Recovery, for example).\u00a0\u201cIf they are unable to stay sober after attending those levels of care, then residential treatment would be recommended,\u201d 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 \u201cHFAs are more likely to lose their job if they have an untreated addiction while working.\u201d 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: \tThe Americans with Disabilities Act (ADA) \u2013 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\u2019t 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. \tThe Family and Medical Leave Act (FMLA) \u2013 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, \u201cIt\u2019s important, but it\u2019s a job. Am I willing to literally die to avoid telling the truth?\u201d The bottom line, says Benton, is \u201cthere is no job that is worth sacrificing your wellness and recovery for.\u201d How Do I Ask for Time Off? Check your company handbook to find out your employer\u2019s process. In most cases, you\u2019ll 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. \u201cIt is important to be discreet about who is told at their place of work so that their privacy rights are protected,\u201d says Benton.\u00a0\u201cThey can also state that they need to address behavioral health issues and not specify the condition.\u201d 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\u2019re 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. \u201cIt was so easy, I wish I would\u2019ve done it sooner,\u201d 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. \u201cI was able to stay in contact with my boss and keep her updated,\u201d 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. \u201cIf 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,\u201d says Benton.\u00a0\u201cIt 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.\u201d Benton points to several factors to consider in making the decision, including: \tDo you like your job? \tDoes the job have any flexibility so you can take a lighter workload for a period of time? \tIs drinking or drug use part of work culture? \tIs it a high-pressure, high-stress work environment? \tDo 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\u2019s boss made accommodations so she could attend outpatient treatment and get follow-up care. Nicole was able to work out a \u201cwaterfall\u201d 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\u2019t 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 \u201chealth issues.\u201d Only her boss and regional manager knew the details, and both were supportive. \u201cAt first, I was worried my boss might treat me differently,\u201d 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\u2019s 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. \u201cBalance and take it easy,\u201d advises Benton. \u201cEarly sobriety is a challenging time because many HFAs are unable to handle as much stress as they were when they were drinking.\u201d 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.