Talking to Your Boss About Rehab

You can already hear yourself saying rehab to a supervisor, and you keep putting the call off. Tonight, ask which office handles time off and what the request has to say. You do not have to narrate a diagnosis to find that out.

If you are in immediate danger at work, including a seizure or trouble breathing, or someone will not wake, call 911. For a mental health crisis, call or text 988. Do not stop a benzodiazepine to sound composed for the meeting. The FDA says an abrupt stop, or cutting the dose too fast, can cause seizures that can be life-threatening. Read alcohol withdrawal before you stop heavy drinking for the same reason.

You can ask for time without a diagnosis

SAMHSA tells employers that supervisors should not counsel employees about substance use and should not try to diagnose alcohol or other drug problems. If a supervisor suspects a problem tied to performance or conduct, the toolkit says the supervisor should refer the person for a professional evaluation. That describes the supervisor's role. It is not an order that you disclose a diagnosis.

You can say you need time for health care, you are asking how to request it, and you want to know which office handles the request. You can name treatment if you want a specific benefit considered. You do not have to announce a diagnosis to coworkers. A sentence that fits a hospital job can be the wrong sentence for a job that drives. A union contract, a safety-sensitive job, and a small private office can each handle the same words differently. Ask who else will hear what you say.

The same SAMHSA page lists supports a workplace might have, not a finding that yours has each one. Inside the building, that list includes human resources, unions, security, management, an in-house employee assistance program, and wellness programs. Outside, it includes an EAP vendor, treatment providers, and other health professionals. NIDA says effective treatment has to address the job, not only drug use, and that many workplaces sponsor short-term counseling or a link to local care. Occupational needs belong in a treatment plan. They do not require you to brief a supervisor on every clinical fact. Licensed jobs and boards are a separate question in rehab for professionals.

Ask what the assistance program tells a boss

Where an employee assistance program exists, SAMHSA says it usually offers education, individual and organizational assessments, management consultation, referrals, and short-term counseling. Counseling on that page includes grief, work and family, and stress. Some programs add health promotion, legal or financial help, or a focus on alcohol and other drugs. Ask what this one actually provides.

Before you describe substance use, ask what the counselor will tell a supervisor, a human resources file, or a safety officer. Ask whether a call you make yourself is handled differently from a referral your boss starts. Write down the answer. More on that benefit is in employee assistance programs and substance use.

What you say out loud is your disclosure. What a treatment program may say is a different rule. If the program is publicly identified as providing only substance use diagnosis, treatment, or referral, staff may acknowledge that an identified patient is there only with written consent or an authorizing court order. Other facilities have a narrower allowance that still must not reveal the disorder. Read who can see treatment records before admission if you can, and ask whether an employer call would be answered at all.

Leave, the shift, and the people around you

Time away from the job depends on the employer, the hours you have worked, and whatever the handbook adds. Read workplace leave for the federal picture, and ask whether a clinician's note can describe a serious health condition without a substance use label. Ask who in the building is allowed to see the note.

Read returning to work after rehab for the week you come back, and working during IOP if you hope to keep the job during those hours. Cues on the shift, once you are in care, are covered in triggers at work. Coworkers, a later interview, a positive test, and admissions questions are separate: telling coworkers, interviewing after rehab, a positive workplace drug test, and what to ask admissions.

Search FindTreatment.gov, then ask each program what it would say if your office called. Call or text (800) 653-9376 if you want help comparing programs while you decide what a supervisor needs to hear.

Additional Resources

Sources cited on this page:

• SAMHSA: Prepare Your Workplace (Drug-Free Workplace Toolkit)
• SAMHSA: Provide Support (Drug-Free Workplace Toolkit)
• NIDA: Principles of Drug Addiction Treatment, third edition (revised January 2018)
• eCFR: 42 CFR 2.13 Confidentiality restrictions and safeguards
• FDA: Boxed warning on benzodiazepines
• 988 Suicide & Crisis Lifeline
• SAMHSA FindTreatment.gov

Common Questions