Substance Use and SUDs Linked to Increased Absenteeism

Employees who use substances other than alcohol have increased absenteeism—with the most missed workdays for those who meet criteria for substance use disorders (SUDs), reports a study in the November Journal of Occupational and Environmental Medicine.
Jake R. Morgan, PhD, of Boston University School of Public Health and colleagues analyzed a nationally representative sample of full-time employees, drawn from the 2018 National Survey of Drug Use and Health. The researchers assessed the impact of various categories of substance use (excluding alcohol use) on work absenteeism.
Overall, 21% of respondents reported some type of illicit substance use over the past year. For 3% of respondents, survey responses suggested that they met criteria for SUD.
Employees reporting substance use had increased absenteeism, compared to those with no illicit substance use. With adjustment for demographic factors, marijuana use was associated with 3 additional missed workdays per year, polysubstance use (more than one type of substance) with 5 additional days, and opioid use with 7 additional days.
Absenteeism was substantially greater for employees who met criteria for SUDs: 7 additional days for marijuana use disorder, 15 days for opioid use disorder, and 23 days for polysubstance use disorder. Estimated additional yearly costs ranged from $600 to $1,200 per employee with substance use without SUD and $1,200 to $3,700 for those with SUDs. National costs were estimated at $10.9 billion per year due to substance use without SUD and $5.5 billion due to SUDs.
For employers, one interpretation of the findings might be to replace or avoid hiring workers with substance abuse or SUD. However, “by excluding 21% of the current workforce, employers would be routinely overlooking highly skilled and talented labor, which would likely limit long-term productivity and success,” Dr. Morgan and coauthors write.
Rather, they argue that workplace programs to increase treatment and services would help employees while reducing downstream costs of absenteeism and turnover for employers. Dr. Morgan and colleagues conclude: “Were employers to place their substantial economic power behind the drive to increase coverage for and access to substance use treatment, they could become a major force for change and a powerful ally in the fight against the SUD epidemic in America.”
About the Author
Dr. Morgan may be contacted for interviews at
ACOEM (, an international society of 4,000 occupational physicians and other health care professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.
About the Journal of Occupational and Environmental Medicine
The Journal of Occupational and Environmental Medicine ( is the official journal of the American College of Occupational and Environmental Medicine. Edited to serve as a guide for physicians, nurses, and researchers, the clinically oriented research articles are an excellent source for new ideas, concepts, techniques, and procedures that can be readily applied in the industrial or commercial employment setting.


Morgan JR, Murphy SM, Assoumou SA, Linas BP. Estimating absenteeism related to nonalcohol substance use in a US national cohort of full-time employees. J Occup Environ Med. 2022;64(11):899-904.