What prevention really means in substance use care

Prevention in substance use care has been misunderstood, and that misconception is directly impacting workforce health and outcomes. While most associate prevention with school-based “Just Say No” campaigns, the reality is that’s only one piece of a much larger conversation. Prevention is just as critical for adults, especially in workplaces where the costs of inaction show up in absenteeism, safety risks, and rising medical claims. 

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), prevention encompasses three goals:

• Prevent the initiation of substance use 
• Prevent the progression to a substance use disorder 
• Prevent the consequences associated with substance use

This definition is important because it shifts the focus from a single moment in time to an ongoing strategy. Prevention is more than stopping something before it begins, it requires creating environments that support healthier choices, strengthen protective factors, and reduce risk. 

 

A common misconception is that prevention is something you address early in life and then move on from. In reality, prevention science shows that risk and protective factors exist at every stage of life:

For adolescents and young adults, prevention may mean building resilience in schools or strengthening family support. Even with the focus of prevention centering around young people, only 11% of people aged 18-25 with a SUD actually receive care. This group is both the least likely to seek treatment and the most at risk for long-term challenges. 

For working adults, prevention can often look like reducing workplace stress, improving access to care, and creating cultures where seeking help is not met with stigma. 95% of adults with a SUD did not believe they needed treatment. Prevention through education, awareness, and early engagement becomes essential when most people do not recognize the need for care. 

For employers and health plans, prevention takes shape through policies, benefits, and pathways that make it easier for people to access support before issues escalate. With 48.5 million people living with a SUD, prevention must become a core part of every workplace health strategy. 

 

When prevention is overlooked, the costs show up quickly. Employers often see them in three ways: higher absenteeism and presenteeism, elevated medical claims, and safety risks in certain industries. The CDC estimates untreated substance use costs U.S. employers more than $15,000 per affected employee every year. For most companies, that translates to millions in annual costs.

But the good news is that prevention works when barriers to care are removed. Pelago’s latest claims analysis study found that members who engaged more deeply with substance use care saved employers over $2,000 more on average compared to those with lower engagement. And 97% of members were accessing care for the first time.

This data reveals that when care is accessible, confidential, and designed to meet people where they are, they take action before issues escalate.

For workplaces and health plans, prevention means taking practical, proactive steps like:

• Offering confidential self-screening tools so employees can spot early warning signs without the fear of judgment or consequences
• Training managers to recognize changes in behavior and respond constructively with empathy and appropriate resources
• Preparing for emergencies by stocking Naloxone, using tools like the NSC Naloxone Workplace Calculator to guide planning
• Ensuring specialized, confidential care is accessible long before substance use becomes a crisis 

These steps strengthen protective factors, from culture and policy to resources and peer support, while reducing the risks that allow substance use to worsen. 

Building systems that stop problems from starting, interrupt them before they escalate, and minimize consequences when they occur makes prevention possible. For workplaces, that translates directly to healthier employees, safer environments, and lower costs.