Addiction in the workplace: How can I help employees with an alcohol or drug problem?
Let’s get down to brass tacks, as they say: If you’re a business owner, executive, manager, team leader or decision maker and you’re not thinking, “How can I help employees with an alcohol or drug problem?,” then your business is suffering.
To be fair, it’s already suffering because of addiction and/or alcoholism, to some degree: According to the U.S. Substance Abuse and Mental Health Services Administration (SAMSHA) , “Combined data from 2008 to 2012 indicate that an annual average of 8.7 percent of full-time workers aged 18 to 64 used alcohol heavily in the past month, 8.6 percent used illicit drugs in the past month, and 9.5 percent were dependent on or abused alcohol or illicit drugs in the past year.”
Those numbers were obtained from the 2013 National Survey on Drug Use and Health, but since the turn of the century, polling techniques and more astute surveys have shed light on a growing problem that, even if it’s not always readily apparent on the surface, can undermine the efforts of any business to reach its full potential. Going back to SAMSHA’s 2007 survey , alarm bells were being sounded even then:
- In 2007, of the 17.4 million current illicit drug users age 18 and over, 13.1 million (75.3 percent) were employed.
- Similarly, among 55.3 million adult binge drinkers, 44.0 million (79.4 percent) were employed, and among 16.4 million persons reporting heavy alcohol use, 13.1 million (79.6 percent) were employed.
- Of the 20.4 million adults classified with substance dependence or abuse, 12.3 million (60.4 percent) were employed full-time.
Preliminary numbers from the 2018 survey are still being tabulated, but of the information available, there is cause for concern: According to the 2018 annual national report , “In 2018, an estimated 21.2 million people aged 12 or older needed substance use treatment in the past year” … but only “3.7 million people aged 12 or older received any substance use treatment in the past year.” In other words, the number of people who needed treatment for addiction and/or alcoholism was roughly seven times greater than the number of individuals who actually received it.
And given the number of working men and women who make up the populations who both suffer and need help, it’s clear that businesses have a role to play — not just in safeguarding their employees and ensuring they receive care for what’s classified as a medical condition , but in pushing back an epidemic that killed more people in 2017 alone than the number of American servicemen and women who died in the entirety of the Vietnam War .
“How Can I Help Employees With an Alcohol or Drug Problem?” Start With the Numbers
If you’re wondering, “How can I help employees with an alcohol or drug problem?,” it’s probably better to start by asking why you should help them (setting aside, of course, that you’re a company made up of decent human beings who don’t want to see others suffer). And like most things business-related, it comes down to the bottom line.
According to the National Institute on Drug Abuse (NIDA) , “Abuse of tobacco, alcohol, and illicit drugs (costs) more than $740 billion annually in costs related to crime, lost work productivity and health care.” Some of those costs, according to the University of Pennsylvania , are only tangentially related to the business sector, but some have a direct impact:
- Roughly 52 percent of traffic fatalities are attributed to alcohol and drugs;
- “Due to the rise in insurance premiums and lower productivity, drug and alcohol abuse costs corporations 93 billion dollars a year”; and
- “Addictions also significantly impact on the tax burden, due to costs for treatment incarceration and social welfare to care for addicted individuals and their families.”
That particular UPenn report goes on to detail other ways in which the abuse of alcohol and drugs on the job is “eclipsing AIDS as the primary workplace concern of the decade”:
- Lost employment, reduced productivity and medical costs take away another $100 billion from industries annually.
- According to the NIDA, more than two-thirds of individuals who report using or abusing drugs and alcohol are employed, 50 percent of them full-time and half of them part-time.
- Some experts believe that between 10 and 23 percent “of all workers use drugs on the job and that these regular drug abusers frequently come to work impaired.”
- One survey compiled by a cocaine hotline “reported that 75 percent of the callers to the hotline had used drugs on the job” and “nearly 70 percent of those who called for help stated they worked regularly under the influence of cocaine.”
Bottom line: A lot of people struggle with drugs and alcohol. The majority of them hold down jobs. Their problems cost money, including money paid out by their employers. Astute business leaders likely recognize that while they may never catch employees snorting lines of coke off of their desks or cracking the seal on a fifth of Dickel on the assembly line, the problem still exists.
How Does It Affect Job Performance?
Good question, and one that many employers are concerned with. No one wants to police what an employee does during his or her off time, but the nature of addiction is that it isn’t so easily compartmentalized. According to the national occupational safety and health magazine EHS Today , the National Council on Alcoholism and Drug Dependence lists a number of ways in which addiction and alcoholism can affect an employee on the job:
- The after-effects of substance use — withdrawal, hangovers, etc. — that can affect job performance;
- “Preoccupation with obtaining and using substances while at work, interfering with attention and concentration”;
- “Illegal activities at work including selling illegal drugs to other employees”; and
- “Psychological or stress-related effects due to drug use by a family member, friend or co-worker that affects another person's job performance.”
And that’s with employees who are already working for your company. What about the empty positions you have available? Have you noticed difficulty in obtaining qualified applicants to fill them? Substance use and misuse may have something to do with that as well: In a 2017 report by the financial magazine Fortune , Princeton University economic Alan Kreuger reported that his research showed that “20 percent of the drop in men’s labor force participation is attributable to the drugs.” In addition, the June 2018 OECD Economic Survey  went even further: “Death rates have surged in the past decade, particularly as (illicit) synthetic opioids have become more available around the country. The correlation with nonparticipation in areas most beset by opioid addiction suggests that addiction ultimately impairs participation. This contributes to costs to the economy of lost wages and productivity, as well as fiscal costs from foregone revenue and spending on emergency care and the treatment of addiction.”
So what does substance abuse cost your business? It’s difficult to say, but you can get a rough estimate thanks to the nonprofit organization Shatterproof and the National Safety Council (NSC), which have put together an online tool called “The Real Cost of Substance Use to Employers.” According to the website , “This tool combines the latest research on employment costs with data from National Survey on Drug Use and Health (NSDUH) to calculate how much substance use in your workforce costs employers.”
‘How Can I Help Employees With an Alcohol or Drug Problem?’ Recognize Them As Problems!
A book can be written — and many have — about the debate over whether addiction and alcoholism are diseases. As it relates solely to the economic underpinnings of a business, it’s important to leave personal beliefs out of the equation and proceed down a path of sound fundamentals. In other words, leave it to the professionals.
Because the professionals — doctors, scientists, psychiatrists, psychologist, sociologists and the vast majority of experts in the field of medicine, biology and human behavior all agree: These are ailments that are biological in origin, and treating them as anything other than legitimate illnesses only compounds the problems associated with them.
“The stigma and shame of addiction has much to do with the perception that people with substance use disorders are weak, immoral, or simply out for a good time at society’s expense,” writes Dr. Michael Bierer for the Harvard Health Blog, a publication of Harvard Medical School . “Understanding that addiction impairs the brain in many important ways may reduce such stigma.”
Bierer points to a landmark 2016 article in the New England Journal of Medicine  that addresses the complications surrounding how addiction is received by laypersons: “The concept of addiction as a disease of the brain challenges deeply ingrained values about self-determination and personal responsibility that frame drug use as a voluntary, hedonistic act … This concept of addiction appears to some to excuse personal irresponsibility and criminal acts instead of punishing harmful and often illegal behaviors.”
For the purposes of medicine, addiction is classified as “substance use disorder,” while alcoholism is referred to as “alcohol use disorder.” Eleven qualifiers are listed for each, and the number of qualifiers an individual checks then denotes a diagnosis of mild, moderate or severe. It’s important to understand that “addiction” and “alcoholism” are colloquial terms, not scientific ones, but given the severity of the conditions, they’re used interchangeably in literature about the illnesses.
So what are the biological components? Without going into lengthy scientific detail, the NIDA describes it best :
- “Drugs interfere with the way neurons send, receive, and process signals via neurotransmitters.”
- “Drugs can alter important brain areas that are necessary for life-sustaining functions and can drive the compulsive drug use that marks addiction.”
- “When some drugs are taken, they can cause surges of these neurotransmitters much greater than the smaller bursts naturally produced in association with healthy rewards.”
- “Just as drugs produce intense euphoria, they also produce much larger surges of dopamine, powerfully reinforcing the connection between consumption of the drug, the resulting pleasure, and all the external cues linked to the experience. Large surges of dopamine "teach" the brain to seek drugs at the expense of other, healthier goals and activities.”
- “As a result, the person's ability to experience pleasure from naturally rewarding (i.e., reinforcing) activities is also reduced.”
- “Now, the person needs to keep taking drugs to experience even a normal level of reward — which only makes the problem worse, like a vicious cycle.”
Breaking the Cycle: What Can an Employer Do?
According to the National Business Group on Health , once employers have an understanding that substance abuse is widespread, likely affects their employees and has an impact on the ledger, it should stand to reason that they come to a simple conclusion: “Substance abuse is treatable, particularly when it is addressed as a chronic disease. Reducing employee substance abuse can help employers improve productivity, reduce workplace injuries, and decrease health care costs.”
Agreement with that assessment, however, is the easy part. Putting a plan in place is much more complex, may require some expenses on your part and, in some cases, may mean an entire cultural shift in your business about how you recognize, acknowledge and deal with substance abuse. It’s important to consider what you’re already spending, however, especially if you require potential employees to submit to a drug screen as a condition of employment.
The Drug Free Workplace Act of 1988, which went into effect more than three decades ago, mandates that employers who contract with or receive grants from the federal government implement drug testing. In addition, the Omnibus Employee Transportation Employee Testing Act of 1991 “requires drug and alcohol testing of all safety-sensitive transportation employees in aviation, trucking, railroads, mass transit, pipelines, and other transportation industries,” according to SAMSHA . In other words — if you’re an employer whose business is regulated by a number of federal agencies (the Federal Aviation Administration, the Federal Railroad Administration, the National Highway Traffic Safety Administration and a handful of others), you’re going to be subjected to drug testing.
And if you’re a leader in any of those companies, then you’re aware that such testing has an impact on your budget. But then again, so do drug-related accidents for which your employees are liable: A 1987 Amtrak crash in Chase, Maryland, killed 16 people and cost the company $9.3 million in damages . The financial hit was a minuscule part of the overall costs to Amtrak, however: The engineer, who attributed his responsibility to marijuana use, spent four years in prison, and the aftershocks led to an overhaul of drug and alcohol standards by the Federal Railroad Administration.
Needless to say, preventative measures before an employee joins an organization are well and good, but to cut down on incidents that can be as benign as addicted employees taking exorbitant amounts of sick days to as catastrophic as the aforementioned Amtrak crash, companies need to have in place an avenue that allows employees to seek help for a substance abuse problem, as well as a plan to get them the help needed when they do.
‘How Can I Help Employees With an Alcohol or Drug Problem?’ Be Proactive
How can you help employees with an alcohol or drug problem? Start by examining what sort of benefits you offer. Most people look at their health insurance plans in terms of coverage of medical events that fit the conventional definition of illness or injury: bronchitis, a broken bone, the flu, pneumonia. However, many plan recipients don’t realize that they’re entitled to some level of compensation for behavioral health benefits that cover alcohol and drug treatment.
“Under a 2008 federal law, insurers have to consider drug and alcohol addiction the same as any other medical problem, as far as access to treatment goes,” according to a 2015 piece by NPR . In addition, according to the online insurance news agency Insurance Quotes , “With the exception of Arizona, Georgia, Indiana, Iowa, Idaho, Oklahoma, and Wyoming, all states currently require commercial group health insurers to cover addiction treatment services as they would any other prescribed medical treatment.”
However, stigma surrounding mental and behavioral health issues often means those benefits are left untouched, even when they’re needed most. What can employers do to help employees with an alcohol or drug problem? Recognize the sensitivity of the situation and create a supportive culture, writes Dr. Dan Jolivet for the website BusinessPRO.com, a resource guide for health benefit professionals :
“Behavioral health conditions can arrive without notice,” Jolivet says. “Almost anything can trigger a condition, whether it is losing a loved one or stress from a job. While symptoms can be mild, an employee may feel uncomfortable or scared to confide in a co-worker or supervisor for fear of getting stigmatized.
“Ultimately, handling the condition is up to the employee, but their employer can help support them during this trying time. Employers can provide support by creating stigma-free work environments or find help for employees through employee assistance programs (EAPs). Having a supportive and open-minded workplace is important to supporting the mental well-being of employees.”
The National Business Group on Health offers a number of suggestions for employers to do that :
- “Implementing drug-free workplace and other written substance abuse policies;
- “Offering health benefits that provide comprehensive coverage for substance use disorders, including aftercare and counseling;
- “Educating employees about the health and productivity hazards of substance abuse through company wellness programs, Employee Assistance Programs (EAPs) and Work/Life programs;
- “Utilizing EAP services to help employees with substance abuse;
- “Respecting employees’ privacy; and
- “Reducing stigma in the workplace.”
In addition, according to the Small Business section of the Houston Chronicle , it’s important to offer support for employees who do choose to get help. Granted, it’s a sensitive issue, and many employers and even EAP representatives may not be certain where the boundaries between personal concern and company responsibility lie. However, according to the Chronicle, “by encouraging employees to attend treatment, you increase their likelihood of following through. If you establish specific requirements your employee must meet — such as being sober for 30 days — you can also help increase the likelihood that treatment works. Employers who refer employees to specific programs can exert even more control by ensuring that employees don't waste time and money on ineffective treatment.”
So … ‘How Can I Help Employees With an Alcohol or Drug Problem?’
- Recognize that addiction and alcoholism are widespread problems.
- Acknowledge that whether it’s blatant or not, these problems likely affect your business.
- Understand that substance use disorder and alcohol use disorder are legitimate medical conditions categorized as such by the majority of medical professionals and organizations. (It’s also worth noting, according to the Houston Chronicle , that the Americans With Disabilities Act classified substance abuse as a disability: “Consequently, firing an employee instead of allowing her to undergo treatment could subject you to legal sanctions. Of course, the ADA doesn’t prohibit you from firing a drug abuser who steals or otherwise violates company policy. Allowing an employee to take some time off work to attend treatment will make it clear that you did not discriminate against an employee if you eventually have to fire her.”)
- Realize that the costs of not addressing the problem can be devastating.
- Embrace opportunities to get involved with employees who may suffer, so that you’re able to help get on top of a problem before it spirals out of control, costs you money and personnel and possibly endangers others.
Substance abuse in the workplace is a complicated issue, and a 3,000 word blog post only begins to scratch the surface of the conundrums it poses and the solutions that are possible. One suggestion: Reach out to a reputable drug and alcohol treatment center for a consultation or for workplace training if you’re unsure how to begin to address it, or if you would like assistance in changing the culture from one of stigma to one of understanding. Many times, treatment professionals offer these services for free, and availing yourself of their expertise — as well as the resources they may be able to provide for your company and your employees — is invaluable.
Finally, recognize that drug and alcohol treatment doesn’t just help the individual — it helps your business as well. According to the National Safety Council , “When individuals with substance use disorders receive treatment and recover, absenteeism decreases by 36 percent and work turnover decreases by 13 percent compared to a person with an active substance use disorder.” In addition, the NSC reports , “Workers in recovery who report receiving substance use treatment in the past and have not had a substance use disorder within the last 12 months miss the fewest days of any group — even the general workforce — at 9.5 days.”
Addicts and alcoholics aren’t “bad” people who need to shape up: They’re sick people who need to get well. Companies and businesses that not only recognize this but work toward solutions that give those employees an opportunity to heal aren’t just doing their part to push back against a raging epidemic — they’re ensuring that the individuals who return to their jobs after treatment are happy, healthy, more productive and, in many cases, better employees than many of their non-addicted peers.