COLUMBIA, Mo. – Mike Thibideau recalls the dread he felt that Monday morning when he called his boss to tell him he was in treatment for addiction.

“His response was, ‘I’m proud of you. We’ll do whatever it takes to support you. Know that no matter what, we just want you to get well and get the help you need.’ In that fragile moment, that was a huge weight to be lifted, to know that I had a job when I got out and to know that my workplace had my back,” said Thibideau, who is now director of Indiana Workforce Recovery.

Thibideau shared his story as part of Recovery Friendly Workplaces: Building a Stronger Workforce in Missouri , a March 18 forum organized by University of Missouri Extension in partnership with the Missouri Rural Health Association, the Missouri Hospital Association and the Missouri Chamber of Commerce and Industry.

Opioid and substance use disorder costs Missouri an estimated $34.5 million every day, or $12.6 billion in a year. At 4.2% of the state’s total GDP, that cost makes Missouri 15th in the nation, said Herb Kuhn, president and CEO of the Missouri Hospital Association. In 2018, more than three Missourians each day lost their lives to an opioid overdose.

“The workforce challenges are real related to opioid abuse and workforce impact in Missouri,” Kuhn said. “The opportunities are very real too. There is no time to waste.”

More than 300 business, recovery professional and community leaders attended the virtual forum, which was part of a two-year Building Capacity for Recovery Friendly Communities initiative. The initiative, led by MU Extension Community Health Engagement and Outreach and MU Extension Labor and Workforce Development, with the state Rural Communities Opioid Response program, will help local efforts develop the knowledge, skills and resources they need to become opioid recovery friendly communities and workplaces.

“I hope attendees came away with the sense of economic urgency that the state of Missouri is experiencing due to opioid use disorder in the workplace and its impact on employers, employees and all of society,” said Ann McCauley, director of the Rural Opioids Technical Assistance Project. “We wanted to show attendees that a recovery-friendly workplace model offers hope and solutions to these issues, and to present a model from another state (Indiana) that Missouri can use.”

According to Mark C. White, state specialist with MU Extension’s labor and workforce development program, Missouri’s economy loses an estimated 26,400 workers in eight key sectors due to opioid addiction in a given year, with substantial ripple effects in the form of losses in productivity, reduced output, diminished spending power and indirect job losses in other parts of the economy. That puts Missouri third in the nation, just behind Arkansas and West Virginia. White is co-author Economic Impact of Opioid Use Disorder in Missouri, a March 2021 analysis published by MU Extension. (See sidebar, Opioid use disorder: 'significant consequences' for Missouri's economy.)

“Our nation and our state are struggling with this problem,” said Chiquita Chanay, a specialist with MU Extension Community Health Engagement and Outreach. “How is it possible for us to advance while leaving a whole portion of our workforce and our citizens behind? Creating and sustaining recovery friendly workplaces is an important step in mitigating the impacts of substance use disorder on Missouri’s workforce and economy.”

“With the combination of the opioid crisis, the pandemic and increased mental health fragility, now is the time for this conversation and a response to the needs of our workforce today,” she said. “Today’s conversation begins a shift in the way we view addiction and recovery and is an exploration of what recovery friendly workplaces can be in Missouri.”

Missouri employers often say they have jobs but cannot find workers to fill them, observed Dan Mehan, president and CEO of the Missouri Chamber of Commerce and Industry. Drug and alcohol use disorders further intensify this trend, particularly in rural areas and small towns.

Developing a qualified workforce is Missouri’s No. 1 priority, Mehan said, but “we are sidelining a lot of people.” Recovery-friendly workplace initiatives help employers promote health and safety, reduce stigma, adopt practices that support recovery and protect employers while giving opportunities to workers in recovery to “slow the growing chasm” between the available workforce and workplace needs, he said.

This issue is key to success in addressing Missouri’s grand challenges related to the economy, education and health, said Marshall Stewart, MU vice chancellor for extension and engagement.

Data shows employers are the most effective referral source to care for opioid and other substance use disorders: Individuals referred by their workplaces have the best abstinence-based outcomes at one and five years, feel the most pressure to enter treatment and maintain the longest length of engagement with treatment. Yet employers make up only 0.4% of all referrals into treatment, Thibideau said.

“In many rural communities, workforce is lacking,” Chanay said. “How can we get people who are suffering back into the workforce? How do you educate employers so they’ll be more willing to give that person another opportunity if they were unable to pass a drug screening? The first thing a person in recovery needs is a job to sustain their sobriety. Recovery friendly workplace policies and practices are a win-win for everyone – for companies, for families, for individuals and for society.”

Addiction not only affects the employees but their families as well, said Chanay, whose own mother is in recovery. “As she struggled, I struggled. While I was at work, I was worried about my mom. I’m sure that affected my productivity.”

Building a Stronger Workforce panelists spoke about the need to reduce stigma, seeing opioid use disorder not as moral failure but as the chronic disease that it is, and creating workplace environments that are supportive of treatment and recovery.

Moderated by John Gaal, former director of training and workforce development for the St. Louis-Kansas City Carpenters Regional Council, the panel included Cristina Bravata, addiction recovery program director, Citizens Memorial Hospital in Bolivar, Missouri; Scott Kirchhoff and Sarah Swearingin, director and assistant director of nutritional services, respectively, at Citizens Memorial Health Center in Bolivar; Shawn Billings, vice president of substance use programming for the Missouri Hospital Association; and Scott Breedlove, assistant director of the Missouri Credentialing Board.

Next steps for Building a Stronger Workforce in Missouri are to survey Missouri businesses, in partnership with the Missouri Chamber of Commerce and Industry, to better understand their needs in the development of effective education and training and to identify best practice models for Missouri.

A website,, will provide links to trainings and webinars about opioid use disorder, explain how businesses can be recognized as recovery friendly and provide a place where employers and employees in recovery can share success stories.

The initiative will also work with Missouri business, education and eventually advocates to address state policy issues. The initiative will develop friendly-workplace certification for employers and human resources managers who demonstrate commitment to hiring and retaining employees in recovery.