Using the Reina trust and betrayal model as a framework for substance use disorder–supportive workplaces

Background: Substance use disorders are prevalent among employees, making workplaces important settings for prevention, treatment engagement, and long-term recovery. However, many organizations continue to rely on punitive responses that discourage disclosure, increase stigma, and contribute to costly employee turnover.Objective(s): Apply the Reina Trust and Betrayal Model as a practical framework for addressing substance use disorders in the workplace through supportive accountability, trust preservation, and recovery-oriented organizational practices.Methods: This commentary integrates the Reina Trust and Betrayal Model with federal recovery-ready workplace guidance and literature on workplace-supported recovery. The model’s three domains (contractual, communication and competence trust) are examined pertaining to substance use–related workplace events, including disclosure, treatment leave, return-to-work transitions, and return to use. The framework is used to identify managerial behaviors that balance employee support with workplace safety and performance expectations.Results: Application of the Reina framework demonstrates how trust can be maintained through collaborative renegotiation of job expectations, confidential and respectful communication practices, and strategies that preserve professional identity during treatment and reintegration. The model further positions return to use as an opportunity for structured trust repair rather than moral failure, enabling organizations to address safety or performance concerns while maintaining dignity and continuity of employment.Conclusion: Aligning recovery-ready workplace practices with Reina trust behaviors offers a pragmatic, behaviorally grounded approach to responding to substance use disorders. A trust-based strategy may reduce stigma, improve retention, support workforce stability, and mitigate the financial and operational consequences of employee turnover while promoting humane and accountable responses to recovery.