Chapter 18: Substance Users: Employment and Recovery—Building a Positive Future

The purpose of this chapter is to address the employment of those in recovery from substance use disorder (SUD). It focuses on a review and discussion of what has been learned about the impact of employment on substance recovery and the impact of substance use recovery on employment. This relationship is discussed at the individual, organizational and societal level. For years, folks with SUDs experienced closed doors, and rejections when seeking employment after justice and treatment. Background checks were a common barrier although no evidence showed that prior incarceration was predictive of negative job outcomes. Using federal opioid recovery funds, Kentucky in 2018 mounted a major initiative (Strategic Initiative for Transformational Employment [SITE]) designed to help folks dealing with addiction recovery enter or re-enter the job market. This program trained workforce specialists who provided participants with coaching and support geared toward finding and retaining employment. Results have been encouraging with, among other things, a decrease in the incidence of overdose deaths in 2024 for the first time since 2018, and increasing numbers of employers, especially those with workforce shortages, having shown willingness to give this population a fair chance through re-employment. It also appears that labor market participation rates may be showing an uptick. Employment has helped participants get and stay in recovery by engaging participants through a process focusing on purpose, health, home and community. Although this population continues to face challenges, progress on addiction recovery and employment is being made.