Occupations Associated with Substance Abuse

Substance Use by Occupation

Some individuals in certain occupations may be more susceptible to substance misuse, addiction, and drug overdose.¹

Occupations with Higher Rates of Drug Overdose Deaths

According to the National Vital Statistics Report, compiled by the Department of Health and Human Services and the Centers for Disease Control and Prevention, 8 occupations experienced higher drug overdose death rates than workers in all other occupations combined. The study analyzed drug overdose deaths by usual occupation and industry across 46 states and New York City in 2020. The occupations with higher rates of drug overdose death rates include:¹

• Construction.
• Accommodation and food services.
• Other services (except public administration).
• Management, administrative, and waste services.
• Mining.
• Arts, entertainment, and recreation.
• Transportation and warehousing.
• Agriculture, forestry, fishing, and hunting.

Additionally, in 2020, unintentional drug overdoses—from nonmedical use of drugs accounted for 388 workplace deaths. That’s an increase of almost 500% from 2012.²

Professions with the Highest Rates of Substance Misuse and Addiction

Work-related stress, especially among employees who interact with customers and those who work in industries where substance use is the norm, contributes to a heightened prevalence of substance use and substance use disorder (SUD).¹

For instance, workers in the accommodation and food services industries report the highest rates of illegal drug use and SUDs.¹

Additionally, military personnel tend to have a higher risk of substance use disorders compared to their civilian counterparts. The stresses of deployments and other factors, unique to military life, present risks. Deployment is associated with smoking initiation, unhealthy drinking, drug use, and risky behaviors. Studies indicate that more than 1 in 10 Veterans is diagnosed with a substance use disorder, which is higher than the general population, especially among males aged 18-25.³

Factors That Contribute to Substance Use Disorder

There isn’t a single factor that contributes to the development of a substance use disorder. Instead, a combination of factors influences an individual’s risk for addiction, and the more risk factors present, the greater the risk of the development of a SUD. The factors that impact the development of addiction include:⁴

Biology. An individual’s genetic makeup accounts for nearly half of their risk for addiction. Other mental disorders may also influence the risk of drug or alcohol addiction.

Environment. From family and friends to economic status and general quality of life, there are so many different environmental influences that can impact the likelihood of substance use and addiction, including peer pressure, physical or sexual abuse, early exposure to drugs and alcohol, and work-related stress.

Substance Use in Active-Duty Military Personnel

In the military, certain substance types tend to be misused more often than others. Alcohol and prescription drugs (including opioid painkillers) are more commonly misused than illicit drugs.⁵

Alcohol

Research on military conflicts in Iraq and Afghanistan has shown that both deployments and exposure to combat are correlated with increased alcohol intake, heavy use, binge drinking, and other alcohol-related problems.⁶ Studies indicate that rates of alcohol use have been highest for those with combat-specific jobs or those with a greater number and higher intensity deployments. Additionally, for military personnel diagnosed with post-traumatic stress disorder (PTSD), there is a significant risk of co-occurring alcohol use disorder.⁷

Illicit Drug Use

The military has a zero-tolerance policy for illicit drug use. Testing positive for an illegal substance on a random drug screen may result in a dishonorable discharge and potential criminal charges. In fact, less than 1% of active-duty military service personnel across all branches report any illicit drug use.³

Prescription Medications

While a zero-tolerance policy on drug use has resulted in low levels of illicit substance use among active-duty military members, service members are not immune to the ongoing epidemic of prescription drug misuse.³

Opioid use disorders among military personnel may begin with a legitimate opioid prescription for pain following an injury during deployment. However, these painkillers are extremely addictive, and when there are other mental health conditions present, regular use can lead to addiction.³ Research from a cohort study suggests that approximately 2.4% of service members and 15% of service members, who have engaged in recent combat, report misusing pain relievers in the past year.⁸

Risk Factors for Substance Abuse and Active Military Personnel

There are numerous risk factors that may make substance misuse more likely for some individuals. Certain types of military service, whether past or present, may be associated with additional, unique risk factors.

Combat Experience

The most salient risk factor associated with substance misuse and the development of substance use disorders among military service personnel is active deployment in a combat zone.

Those who have multiple deployments may be at an even higher risk of developing substance use issues, as several deployments can have a cumulative effect in terms of the related stress and trauma. Studies consistently find adverse effects of deployment on the mental health of military personnel. These mental effects commonly include PTSD, depression, substance use disorders, and drug and alcohol dependence. Research suggests that the increased risk to mental health conditions, like substance use disorders, is mainly due to the hazards of war, combat exposure—firing weapons; roadside bombs; and seeing fellow soldiers, friends, and civilians injured, maimed, or killed.⁹

Psychological Distress

A meta-analysis that looked at several studies of deployed and non-deployed military personnel indicated that for long-term outcomes, the risk of screening positive for depression increased for participants in the deployed groups. The same meta-analysis found that individuals who had combat exposure had higher odds of screening positive for (PTSD).⁹

Studies indicate that the onset of SUDs can emerge secondary to other mental health problems such as PTSD or depression.¹⁰

Additionally, interpersonal traumas—histories of physical or sexual abuse, for instance—have been shown to mediate the risk of developing a SUD among military members and Veterans.¹⁰

Psychiatric symptoms associated with PTSD or depression can also exacerbate drug and alcohol misuse, and psychological distress can increase cravings for substances.¹⁰

The Culture of the Military

For many, drinking is an accepted part of military culture. Turning to alcohol to unwind or otherwise cope with the challenges of military life is common. Historically, alcohol has had an integral role in military life and has been seen as an acceptable behavior in building social bonds and comradeship.⁷

A meta-analysis found that the communities in which military service personnel live can significantly impact their alcohol use. Active-duty soldiers, who participated in the studies, reported getting free or reduced admission fees and drink specials or heavier pours for being an active-duty military service member.⁷

Additionally, research indicates that drinking has been described as an acceptable way to relax and cope with the stress brought on by military life.⁷

Increased Risk for Injury

Research has found that misuse of prescription opioids is on the rise among Veterans. Often prescribed to help Veterans deal with chronic pain associated with active-duty injuries, these painkillers have a high potential for misuse and addiction.¹⁰

Addressing Substance Use in the Workplace

Because issues with substance use may decrease productivity and negatively impact the workplace in other ways, it is in an organization’s interest to offer resources for individuals with substance use problems. Some organizations offer employees the opportunity to participate in counseling for issues with stress, mental illness, and substance misuse.

Many organizations now offer Employee Assistance Programs (EAPs), which are voluntary programs that offer free assessments, transient counseling, referrals for further treatment, and follow-up services for employees who have work-related problems or personal issues. These programs can be used to assist employees with various difficulties, including family issues, stress, grief, mental health disorders, and substance use.¹¹

Counselors in EAP programs may also work with managers and supervisors to help tend to organizational and individual needs and problems.

The law, specifically the Americans with Disabilities Act (ADA), provides some protections for employees who have a history of addiction but are not currently using illegal drugs. The ADA insists that employers must provide reasonable accommodations to qualified individuals. For example, reasonable accommodations for an individual in recovery from drug addiction (who is not currently using any illegal drugs) may include an altered work schedule to enable the individual to attend 12-Step meetings or a leave of absence to attend treatment.¹²

Why Do Some Industries Have a Higher Incidence of Substance Use?

Prevalence rates of heavy alcohol use, illicit drug use, and substance use disorders are not consistent across all industries. The construction, accommodation and food services, and other services (other than public administration) are a few of the fields that are consistently among the highest when it comes to rates of substance use and drug overdoses among the workers in these industries.^1,2 However, it is important to remember that correlation does not equal causation. Simply being employed in a specific industry does not cause a person to use or misuse any kind of substance or to develop a substance use disorder.

This is why employers should offer assistance for their employees who struggle with substance use. These employers may implement prevention programs, screen employees for issues with substance use, and/or provide treatment-related resources to their workers.

Treatment for Substance Use Disorder

If you or a loved one struggle with addiction, help is available. You can disrupt the addiction cycle and claim your recovery. Treatment is not a one-size-fits-all program. Instead it’s typically a combination of interventions and therapies to meet your specific needs and may include:¹³

Detox. Medically managed detoxification provides supervised withdrawal from substance use and is often the first step in a more comprehensive treatment plan.

Outpatient treatment. In outpatient care, you live at home or in a sober living facility but attend regular counseling and therapy sessions at the treatment center. Outpatient programs vary in intensity and time spent in treatment each week.

Inpatient treatment. Sometimes referred to as residential care, inpatient treatment requires you to live at the treatment center so you can focus completely on your recovery.

American Addiction Centers (AAC) operates addiction treatment centers throughout the country, offering multiple levels of care at each one. Many of our facilities also provide specialized treatment programs for certain populations and professions. Our Veterans program, for instance, addresses the unique needs and experiences of military Veterans. Our impaired professionals program addresses the needs of individuals who work in healthcare and other licensed fields. And our first responders program provides specialized care, including trauma-focused treatment, for firefighters, police officers, and EMTs, among others.

Call AAC at to get information on these and other programs. Our knowledgeable and compassionate admissions navigators can listen to your needs, explain your options, and help you begin your journey to recovery.