Creating a Culture Where Healthcare Workers Can Seek Help with Substance Use
Somewhere along the way, most of us in healthcare learned how to keep moving forward even when we were hurting.
The message wasn’t always said out loud, but it was clear enough:
Don’t let them see you struggle.
I remember the early years—feeling like I had to have it together all the time. There wasn’t much talk about burnout, mental health, or addiction.
Definitely no encouragement to say, "I’m not doing okay."
So we learned to survive. And survival, with whatever coping skills we found—including substance use for some—quietly became the culture.
Today, there’s more awareness that healthcare practitioners are human first. But recognizing the problem isn’t enough.
We have to actually build systems that make seeking help—especially for substance use—safe, accessible, and free of stigma. Not just in theory. In everyday practice.
Leadership Sets the Tone
Culture starts at the top.
When leaders are willing to talk openly—not just about mental health, but about the very real risks of substance use in this profession—it gives everyone else permission to be honest too.
That kind of honesty shifts a culture. Quietly at first. But it spreads.
Policies Have to Back It Up.
It’s one thing to say you care about practitioners’ well-being. It’s another to have real structures in place to support it.
Institutions need clear, confidential pathways for practitioners to get help with substance use without fear of being thrown away:
Access to safe, confidential reporting and recovery programs.
Paid leave options for treatment.
Policies that prioritize rehabilitation over punishment whenever possible.
If the system still punishes vulnerability, the culture will too.
Normalize the Conversation.
One of the most damaging myths in healthcare is that resilience means silence.
That toughness means hiding.
We have to replace that myth with regular, real conversations about substance use risks, recovery, and support—without judgment.
Not once a year during mandatory training.
All the time.
Like it’s normal. Because it is normal.
Imagine if every new hire was told, right from day one:
"This work is hard. You are human. If you ever struggle, there’s a path forward—and you’ll be supported."
It would change everything.
Start Small, Start Now
Culture change can feel overwhelming. But it almost always starts small:
A leader telling their story.
A department making space for real check-ins.
One policy change that makes it safer to ask for help.
One moment where a colleague listens without judgment.
Changing a culture doesn’t happen overnight.
But it does happen.
It happens when we stop pretending we’re fine when we’re not.
Culture starts at the top.
When leaders are willing to talk openly—not just about mental health, but about the very real risks of substance use in this profession—it gives everyone else permission to be honest too.
That kind of honesty shifts a culture. Quietly at first. But it spreads.
Policies Have to Back It Up.
It’s one thing to say you care about practitioners’ well-being. It’s another to have real structures in place to support it.
Institutions need clear, confidential pathways for practitioners to get help with substance use without fear of being thrown away:
Access to safe, confidential reporting and recovery programs.
Paid leave options for treatment.
Policies that prioritize rehabilitation over punishment whenever possible.
If the system still punishes vulnerability, the culture will too.
Normalize the Conversation.
One of the most damaging myths in healthcare is that resilience means silence.
That toughness means hiding.
We have to replace that myth with regular, real conversations about substance use risks, recovery, and support—without judgment.
Not once a year during mandatory training.
All the time.
Like it’s normal. Because it is normal.
Imagine if every new hire was told, right from day one:
"This work is hard. You are human. If you ever struggle, there’s a path forward—and you’ll be supported."
It would change everything.
Start Small, Start Now
Culture change can feel overwhelming. But it almost always starts small:
A leader telling their story.
A department making space for real check-ins.
One policy change that makes it safer to ask for help.
One moment where a colleague listens without judgment.
Changing a culture doesn’t happen overnight.
But it does happen.
It happens when we stop pretending we’re fine when we’re not.