Remote workers with substance use disorders face ‘rude awakening’ in return-to-office mandates

“Yeah, maybe my eyes are red, but no one can see that on Zoom,” says Ray, a West Coast executive, who typically continues to take a puff of marijuana hourly while on the job — all the long tail of a methamphetamine addiction that he developed during pandemic lockdowns.

“If I get really tired, I can just go lay down,” says the executive, who is disclosing only his middle name for fear of damage to his career. “Now I can use in ways that I never before imagined.” 

Data suggest there could be millions in the workforce like Ray. 

A May 2022 study by the Federal Reserve Bank of Atlanta estimates that the number of working age Americans (25 to 54 years old) with substance use disorders has risen by 23% since pre-pandemic, to 27 million. A figure that’s about one in six of people who were employed around the time of the study. It’s caused a 9% to 26% drop in labor force participation that Karen Kopecky, one of the authors of the report, says continues today.

Drug recovery firm Sierra Tucson concluded from a November 2021 survey that about 20% of US workers admitted to using recreational drugs while working remotely, and also to being under the influence during virtual meetings. Digital recovery clinic Quit Genius found in August 2022 that one in five believe that substance use has affected their work performance, also according to a survey.

Bloomberg spoke with a half dozen addiction specialists who treat mostly employed patients.  All say that their treatment programs are over-enrolled in the wake of the pandemic, fueled by extended remote or hybrid arrangements that offer a dangerous triad: steady paychecks, proximity to drugs and alcohol out of view from co-workers, and incentive to maintain day-to-day functionality. As a result, undetected drug habits flourished and are only now coming to light as more companies require workers to return to the office.

“The last thing to go is the work,” says Indra Cidambi, medical director of New Jersey-based Center for Network Therapy. “Employees think it’s a temporary phase, and that they’ll get back to work and everything will be alright. They call and say, ‘Am I an addict? I can’t be — it was never an issue.’”

Employers’ antennae are up. Random workplace drug testing rose 37% from 2021 to 2022, according to a survey by screening company First Advantage. 

To be sure, hiding substance use from the boss has been around as long as there have been bosses. But pre-pandemic, most excesses were limited to after hours.

“With people working remotely, there might be a more mixed pattern,” said Daniel Angres, medical director at Chicago’s Positive Sobriety Institute, a clinic for professionals and physicians. In industries that have safety measures like drug testing and access to therapists, like health care, he sees less misuse — defined as using in ways counter to medical guidelines while negatively impacting health and functioning.

“We see it in particular where there are fewer safeguards built in,” such as in the fields of technology, finance and law, said Angres.

Ray’s workday weed use is an improvement from 2020, when he said he was regularly using crystal methamphetamine. “I didn’t have to be anywhere, money was coming in, and no one was holding my feet to the fire on projects because the world was ending. Which is a perfect storm for someone with substance abuse issues,” he says.

Fearing a tailspin, he said he enrolled in a harm reduction program and moved to a new state, away from his dealers and drug-using friends, and was stable by the end of 2020.  His goal was to minimize damage to his health, wellbeing and employment, without banning all substance use.

But rather than staying predominantly sober, Ray found himself acquiring marijuana on dog walks and smoking hourly. Even so, he was able to get hired full-time in a managerial communications role. “I’m living off the residual career benefits from my completely sober years,” he says.

Employment now continues surprisingly long into severe addiction. Cidambi frequently sees patients self-medicating  to succeed at work.

“During the pandemic they had to perform whether they were feeling good or not, so they sought out whatever pills they could get to help manage their base workloads, and that was a disaster,” she said. Access to medical care waned. “They were not given the medications they needed, so they were seeking out pills from friends.”

Few of her patients perceive themselves as addicts. “There’s huge denial. Because of their years at a company and good reputations, their addictions went completely unnoticed until their employers said, ‘You need to come back to the office.’ It was a rude awakening.” Those in-office days brought on shakes, hangovers and withdrawal symptoms. “That’s when they seek out detox.”

Substance misuse has many triggers. But hybrid work, Angres says, telescopes five-to-10 year downward spirals down to months, partially by removing an important social impediment to substance or other addictive tendencies: ample time around healthy people.

“It really is so much about relationships, and that’s why emphasizing family and a healthy workplace is so critical. A lot of that has been compromised,” he says.

Accidental overdose deaths from fentanyl have further exposed abuse by high-functioning workers.  One dramatic example: When one drug dealer delivered cocaine to three Manhattan professionals — a financial trading executive, a social worker and a lawyer — as they worked in March 2021, all three died from fetanyl overdoses.

Researchers now use fentanyl death data to estimate workday drug consumption. “It’s highlighting that people who appear to be living very functional lives with apparent professional success are abusing high quantities of cocaine on a regular basis,” said Warren Zysman, longtime clinical director of Employee Assistance Resources Services, an outpatient treatment program in Smithtown, New York. “If cocaine wasn’t laced with fentanyl, we probably wouldn’t know.”

Fentanyl, a cheap opioid that was once substituted for heroin, is common in street-bought pressed pills (powder that dealers press into pills), and experts estimate that one in 20 bags of cocaine in US East Coast cities is laced with fentanyl. It’s particularly deadly to people who have not developed a tolerance.

As for what’s driving workers to imbibe substances on the clock, addiction physicians say that workday misuse is frequently triggered by real-time professional stress alongside underlying depression or anxiety.

“A lot of people start using drugs because it makes them feel better,” says Zysman. “At least 80% of the time, they have some sort of co-occurring mental health issue.” Other common triggers, he says, are boredom, isolation and fears about the future.

Amphetamines, which are popular for spurring workday focus, are used by 80% of Zysman’s professional patients. Patients often begin on prescription stimulants, and transition to street dealers.

“Then they discover that crack cocaine can be cheaper than pills.” Zysman recently treated a manager in his forties with a pacemaker defibrillator following heart attacks. “People don’t realize that when you use crack cocaine and amphetamines, it ages your organs and really does a number on your heart. It’s like putting your body in neutral and slamming on the gas.”

Cidambi is currently seeing workplace benzodiazepine abuse that spirals into other substances.

“They take a couple Xanax to cope. Then they can’t sleep at night, so they take marijuana edibles at night, to sleep. And that’s when they have a night cap of drinking. And then it’s a mess to wake up for work, so some do a line of coke just to perk themselves up,” she says.

Though back-to-office mandates are unpopular for many reasons, addiction experts note that resistance consistently comes from millions of addicted employees.

“They are dragging their feet because they know they’re not in the same shape that they were in prior to the pandemic, and they’re trying to get a handle on their substance misuse,” says substance counselor Patrick Krill, an former practicing attorney who co-authored a national study of lawyers and substance misuse. “That’s a very real phenomenon right now.”

Krill counsels law firms to build cultures where managers check in regularly, and employees feel comfortable accessing counseling. Suspected substance misuse is best addressed supportively and empathetically by people trained to do so.

As for Ray, he has returned to sobriety during work hours.

“I had gotten so used to smoking pot all the time with work,” he said. He now works with a therapist to wean himself off weed, and smoking it is verboten, because it’s fast-acting. “The rule is that after 6pm, I can have whatever pot edibles I want, with the goal of eventually stopping altogether. For me, it’s about creating boundaries so I can’t impulsively go get stoned in the middle of the day.”