How to combat addiction and substance abuse in the workplace

James Schuster, MD, MBA, Chief Medical Officer, Community Care, UPMC Insurance Services Division

Substance abuse and addiction are serious problems throughout society, so it only makes sense that the problem carries over into the workplace. According to labor statistics, vast majorities of the people who are drug users, heavy or binge drinkers or have other substance abuse problems, are employed.

A 2007 survey indicated that 8.4 percent of all full-time workers used illicit drugs and 8.8 percent reported heavy alcohol use.

“There is a cost to addiction that impacts the workplace and should be of concern to all employers,” says James Schuster, MD, MBA, the chief medical officer for Community Care, a behavioral health organization that is part of the UPMC Insurance Services Division. “The cost in terms of productivity can often be substantial.”

Smart Business spoke with Schuster about addiction in the workplace and what employers need to know about it.

How does addiction or substance abuse manifest itself in the workplace?

The most obvious effects are absenteeism, reduced productivity and tension between the employer and the employee. You can also see its effects in increased accidents and decreased productivity. Because addiction impacts every facet of a person’s life, the problem needs to be addressed at many different levels, including in the workplace. Dependency on drugs or alcohol can severely compromise an employee’s ability to contribute to the success of the company.

In addition, addiction does not just impact the employee. Nearly 40 percent of industrial fatalities and 47 percent of industrial injuries can be tied to alcohol consumption or alcoholism. The U.S. Department of Labor estimates that employees who abuse substances are 25 to 30 percent less productive and miss work three times more often than non-abusing employees.

How can an employer know if an employee has an addiction issue?

This is not always easy and that fact only compounds the problem. There are few explicit warning signs connected to it. Also, many addicts are almost experts in hiding their addiction from others.

Diagnosing a substance abuse problem is not something an employer should ever do, but there are signs to look for that may indicate that an employee may be a substance abuser. Extreme fluctuations in mood and productivity, for instance, can be indicative. Alcoholism is often connected with slurred speech, belligerent behavior and decreased inhibition. Frequent tardiness, unexplained absences and unusual weight loss or gain can also be signs.

What should employers do if they suspect an employee of alcohol or drug abuse?

As an employer, you should be focused on helping the employee get back on track, not offering a diagnosis for his or her condition. There is no need to form an opinion of your employee based on his or her addiction. It is important to understand that substance abuse definitely has the markers of a disease. There are clear genetic relationships and people who metabolize alcohol more quickly are more likely to have alcohol problems.

When should an employer do something about an employee’s substance abuse?

If the employee’s drug use directly affects his or her performance at work and relationships with co-workers, an employer can justify taking some kind of action. A logical first step would be to refer the employee to human resources, or, if possible, an Employee Assistance Program (EAP). An accurate assessment of the problem is possible by following this route and an EAP can assist with an evaluation of disciplinary options if needed.

Employers should also start by refusing to ‘enable’ the employee. The employee needs to be held accountable for his or her actions. He should not be permitted to continue his self-destructive behavior at work. This limitation must be communicated to supervisors and co-workers alike.

Can the workplace be an effective place to deal with substance abuse?

Yes. For one thing, the workplace can serve as a framework to counteract the denial and manipulation that often goes with alcoholism. An employee needs to work to make money and the risk of losing that can be strong motivation to get help for problems. The workplace is also the best place where behavior patterns can be accurately documented and that documentation can convince an employee to seek help and change behavior.

EAPs were originally created to deal specifically with alcohol problems, so it is not surprising that studies have shown that 70 to 80 percent of persons with alcoholism who are referred to EAP programs are productive employees within one year after being referred to a program.

Are small businesses affected by addiction and substance abuse?

Yes, they are. In fact, smaller businesses might be more adversely affected. Roughly half of all U.S. workers are employed by a small business — that is, a company with 500 or fewer workers — and 90 percent of small businesses employ either current illicit drug users or heavy drinkers. However, smaller firms are generally less likely to test for substance abuse and less likely to offer programs designed to combat the problem.

Can addiction problems be completely handled in the workplace?

That would be extremely rare. It is difficult to overcome an addiction without some kind of outside help. An employee needs the encouragement and support of his or her employer to make it through, but that person may need more than the workplace can provide.

James Schuster, MD, MBA, is the chief medical officer at Community Care, a behavioral health organization that is part of the UPMC Insurance Services Division. Reach him at (412) 454-2153 or [email protected]