Addiction is an equal-opportunity nightmare.

Even CEOs and others at the pinnacle of their careers aren’t exempt from the price an addictive dependence can exact on one’s career and personal life.

“Addiction does not discriminate, whether you’re a high-powered executive in the C-suite or a bricklayer in Detroit,” said William Moyers, the vice president of community relations at Hazelden Betty Ford, a nonprofit addiction treatment provider.

But C-suite executives who develop a problem with drinking, drugs, gambling, porn, sex or other compulsive behaviors often have more options to hide their addictions.

“We have flexibility with our schedules. We have people unknowingly able to cover for us. We have the ability to be absent at times,” said Doug Tieman, president and CEO of Caron, which runs not-for-profit addiction treatment centers in several states.

A C-suite executive’s power and status can also deflect concerns that their direct reports or board members may have when an executive starts acting uncharacteristically — e.g., showing up late to meetings, being absent from work or making rash decisions.

“If there’s a modest level of suspicion people think ‘That can’t be. Look how well he’s doing,’” Tieman said.

He should know. Despite being in the substance abuse field for decades, his drinking became a real problem in the early 2000s and he went into treatment in 2010 after getting arrested for driving under the influence. His wife and board members were shocked, he said.

“My drinking was always underground,” Tieman explained, noting that he would only drink on business trips and for a time he adhered to any one of several self-imposed rules: Drink on just one of his nights away. Only order four drinks. Drink only until midnight.

But eventually he broke all those rules.

The excuses executives lean on to indulge often center around a “reward” for all the stress they endure and their successes at work. “‘Work hard, play hard’ is a very common theme,” Tieman said.

The risk of losing it all

Thanks to the Americans for Disabilities Act, merely having an addiction is not a fireable offense, unless, for instance, the addict is actively using illegal drugs.

But the ADA protections do not excuse bad behavior or poor job performance, nor do they overwrite the terms for potential termination in an executive’s contract.

Since top executives are the public faces of their companies, having an addiction poses an especially high risk to their professional life, even if they continue to do a good job.

If the board of directors considers it harmful to the reputation of the business or its affiliates, the company is likely within its rights to terminate the executive, according to James Reidy, a management side labor and employment law attorney at the firm Sheehan Phinney.

More dire than the risk to one’s career is the harm addiction can do to an executive’s family.

For those who end up seeking treatment, the impetus often comes from a family member pushing them to do so.

But not always.

Judith Landau, a family neuropsychiatrist who founded the ARISE method of intervention and addiction treatment, also gets confidential calls from board members, colleagues or assistants of executives whose behavior is raising red flags.

In those cases she will often end up working with the board to talk with an executive about the various reports they’ve received and discuss possible treatment options.

She’ll sometimes work with both an executive’s work family and then separately with his or her home family. The two, of course, are inseparable when the addict is running a family business.

Rehab programs targeted to executives

Increasingly, treatment centers are offering rehab programs targeted specifically to business executives, which can accommodate both their busy schedules and their desire for privacy.

The actual medical and psychological treatment for addiction in high-level executives is no different than it would be for anyone else. But what sets the programs for business leaders apart are the extras, such as luxurious settings, gourmet food, yoga and massages.

And some let patients stay connected to their jobs while they’re in residence, which can be a draw for otherwise reluctant executives to seek comprehensive treatment.

They also may provide staff who can accompany the executive to press conferences or board meetings during his or her time in residence, and will offer follow-up care after treatment ends to provide support for executives as they resume their duties full-time.

Given the variety of approaches underpinning addiction treatment, and the uneven quality of services in the field, the Center on Addiction at Columbia University and the National Institute on Drug Abuse offer helpful tips for picking the highest quality programs and providers to best suit an individual’s needs.