206 - Substance Use and Return to Work

Session Description: Substance use disorders (SUDs) present complex challenges in occupational health, particularly when assessing fitness to return to safety-sensitive or critical roles. This lecture will provide an evidence-based overview of how employers and providers can navigate the intersection of substance use, workplace safety, and regulatory requirements. The session will review current guidelines, discuss the role of medical evaluations and return-to-work agreements, and examine the provider’s role in supporting recovery while ensuring employee and workplace safety. Special attention will be given to ethical considerations, confidentiality, and the integration of treatment recommendations into return-to-work planning. Attendees will leave with practical tools to apply structured, compassionate, and compliant approaches in their practice settings.

Educational Gaps: This will provide a structured approaches to identifying substance use, determining when to refer for IMEs, and making clear fitness-for-duty decisions in safety-sensitive roles for the physician. This session bridges the gap between clinical intuition and consistent, evidence-based occupational health practices.

Is this session being sponsored by an ACOEM Section or Component?: N/A

Has this session previously been presented?: Part of the session was presented at the Occupational Medicine Day in Toronto, Canada in 2024 with excellent feedback
.https://events.oma.org/en/4PigP66/13th-day-in-occupational-medicine-4a2qJRCeo5

The AOHC 2026 theme is Healthy workers. Healthy world: By identifying and addressing substance use in the workplace, this session promotes early intervention, access to treatment, and successful recovery—leading to healthier workers and a safer, more supportive work environment. The goal is also to reduce stigma. By helping individuals return to work safely not only restores productivity but reinforces a culture of care and accountability and health throughout the world.