The Little Acknowledged Crisis of Alcohol Abuse in the Workplace – Part 2: Preventing and Mitigating the Disaster

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In part 1 of this essay on alcohol abuse in the workplace, the nature of the crisis and scope of the disaster was laid out. This essay, seeks to summarize some of the recommendation responses and possible solutions for this major workplace crisis.

Author: Dr. Robert C. Chandler

As noted in part 1 of this essay, alcohol is the single most used and abused drug in America. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), nearly 14 million Americans (1 in every 13 adults) abuse alcohol or are alcoholics. In the workplace, the costs of alcoholism and alcohol abuse manifest themselves in many different ways. Absenteeism is estimated to be 4 to 8 times greater among alcoholics and alcohol abusers. Other family members of alcoholics also have greater rates of absenteeism. Accidents and on-the-job injuries are far more prevalent among alcoholics and alcohol abusers.

Brian Hughes reported that about 17.6 million adults in the U.S. currently suffer from alcohol abuse or dependence. Several million more people engage in risky, binge drinking patterns that can lead to alcohol addiction. Binge drinking means drinking five or more alcoholic beverages on the same occasion on at least one day in the past 30 days. About one-quarter of college students say that excessive drinking causes them to miss and fall behind in classes, perform poorly on exams, and receive lower grades overall. Binge drinking starts early, so by the time a person is ready to seriously pursue a career, these patterns may be hard to break. Heavy drinkers may find themselves in a similar situation as they did at school, but now their livelihood and financial future are at stake.

In the workplace, the costs of alcoholism and alcohol abuse manifest themselves in many different ways. Absenteeism is estimated to be 4 to 8 times greater among alcoholics and alcohol abusers. Other family members of alcoholics also have greater rates of absenteeism. Accidents and on-the-job injuries are far more prevalent among alcoholics and alcohol abusers.

We must first acknowledge the depth, scope and severity of the alcohol abuse crisis. We have to admit that there is a problem and then proceed to talk about it. Secondly, we need to explore potential responses and solutions. The further specific question arises for those us interested in sustaining profit and not-for-profit operations in the face of this widespread challenge – how do we prevent or mitigate this disastrous situation?

Mitigating the Workplace Alcohol Abuse Disaster

Workplaces provide the opportunities for preventing alcohol based contingencies and critical problems. In part because people spend a large amount of time regularly at the workplace and employers may use their employment leverage to motivate an employee to seek help for an alcohol problem. Such efforts include the the use of employee assistance programs (EAPs) and and Drug Free Workplace Programs (DFWP) designed to reduce employee alcohol problems and also to examine risk factors for alcohol problems that exist in the work environment.
Alcohol abuse problems in the workplace are usually categorized as identified in two ways:

1. The linkage of a drinking pattern with job performance problems, such as a pattern of poor-quality work, poor quantity of work, attendance problems, or problems related to interaction with clients or customers.
2. Employees’ self-assessment decisions that their drinking behaviors are causing problems for themselves

According to NCADD, the workplace “can be an important and effective place to address alcoholism and other drug issues by establishing or promoting programs focused on improving health. Many individuals and families face a host of difficulties closely associated with problem drinking and drug use, and these problems quite often spill over into the workplace. By encouraging and supporting treatment, employers can dramatically assist in reducing the negative impact of alcoholism and addiction in the workplace, while reducing their costs. Without question, establishment of an Employee Assistance Program (EAP) is the most effective way to address alcohol and drug problems in the workplace. EAPs deal with all kinds of problems and provide short-term counseling, assessment, and referral of employees with alcohol and drug abuse problems, emotional and mental health problems, marital and family problems, financial problems, dependent care concerns, and other personal problems that can affect the employee’s work.

Image: CDC

This service is confidential. These programs are usually staffed by professional counselors and may be operated in-house with agency personnel, under a contract with other agencies or EAP providers, or a combination of the two. Additionally, employers can address substance use and abuse in their employee population by: 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; reducing stigma in the workplace; and educating employees about the health and productivity hazards of substance abuse through company wellness programs.

• Research has demonstrated that alcohol and drug treatment pays for itself in reduced healthcare costs that begin as soon as people begin recovery.
• Employers with successful EAP’s and DFWP’s report improvements in morale and productivity and decreases in absenteeism, accidents, downtime, turnover, and theft.
• Employers with longstanding programs also report better health status among employees and family members and decreased use of medical benefits by these same groups.

Paul M. Roman, Ph.D., and Terry C. Blum, Ph.D. (NIH: National Institute of Alcohol Abuse and Alcoholism) authors of The Workplace and Alcohol Problem Prevention offer the following:

“Workplace programs to prevent and reduce alcohol-related problems among employees have considerable potential. For example, because employees spend a lot of time at work, coworkers and supervisors may have the opportunity to notice a developing alcohol problem. In addition, employers can use their influence to motivate employees to get help for an alcohol problem. Many employers offer employee assistance programs (EAPs) as well as educational programs to reduce employees’ alcohol problems. However, several risk factors for alcohol problems exist in the workplace domain. Further research is needed to develop strategies to reduce these risk factors.

As a domain for alcohol-problem prevention, the workplace holds great promise. In the United States and, increasingly, around the world, the majority of adults who are at risk for alcohol problems are employed. As described here, employers have several well-defined means at their disposal for intervening with problem drinking. Those methods serve not only the interests of the employer but also those of the employees and their dependents. Furthermore, the potential for a preventive impact is worldwide. Western styles of workplace organization and employment relationships have spread to influence global practices, setting the stage for the diffusion of workplace interventions and for addressing emerging economies’ increasing alcohol problems (Masi 2000; Roman in press).

Despite these possibilities, the development of prevention programs in U.S. workplaces has slowed considerably in recent years and, in fact, may be in need of revitalization (Roman and Baker 2001; Roman in press). The decline in workplace attention to alcohol problems illustrates the need for creating and maintaining an infrastructure for sustaining alcohol interventions in settings not typically associated with the delivery of health care.”

Recommendations for Responding to the Workplace Alcohol Abuse Crisis

Executives, managers, human resources specialists, business continuity experts and workplace safety technicians have several opportunities for addressing this disastrous workplace crisis. Roman and Blum suggest guidelines and measures to respond to the workplace alcohol abuse crisis including the following:

• Full-time employees spend a significant proportion of their time at work, increasing the possibility of exposure to coordinated communication including preventive messages or programs offered through the workplace. The likelihood that evidence of problem drinking will become visible to those who might have a role in intervention also is increased.
• Work plays an important role in most people’s lives. Because many adults’ roles in the family and community are dependent on maintaining the income, status, and prestige that accompanies employment, the relationship between the employer and the employee contains a degree of “leverage.”
• The employer has the right to expect an adequate level of job performance. If alcohol abuse breaches the rules of the employer-employee agreement or is associated with substandard job performance, the employer may withdraw pay or privileges associated with the job, thus motivating the employee with alcohol problems to change his or her behavior.
• Workplace programs should include both primary and secondary prevention measures. Primary prevention aims to keep alcohol problems from developing, and secondary prevention seeks to reduce existing problems. Primary prevention often is more cost-effective than secondary prevention; however, the workplace is not conducive to strategies aimed at preventing alcohol use. Most employees are adults and therefore are legally allowed to consume alcohol. Employers rarely are in a position to prevent their employees from initiating drinking as an off-the-job lifestyle practice, nor do they desire to do so.
• At the same time, employers want their employees to perform their jobs well and not disrupt or endanger coworkers’ activities. Smooth work transactions with customers and other members of the public also are important in many organizations, including the service sector.
• The principal means for addressing an employee’s off-the-job drinking is through alcohol education programs conducted at the worksite. These programs usually are associated with an EAP, a health promotion program, or both. The goal of these education programs often is to encourage behavioral change or use of the associated services (i.e., self-referral to an EAP).
• In addition to alcohol education programs, employers also may offer health promotion programs, which may motivate employees to alter their drinking behaviors. When health problems such as weight, high blood pressure, or gastric problems are identified in a health risk survey administered at the worksite, the administering health worker may suggest a reduction in drinking as a means of alleviating the primary symptom. Alternatively, employees undertaking exercise programs or other health-oriented activities might change their drinking behavior because drinking may not be consistent with their new healthy regimen.
• As part of workplaces’ “rules of conduct” or “fitness for duty” regulations, supervisors are often empowered to discipline or remove an employee from the job on the suspicion of drinking. However, if an employee is suspected of drinking based on evidence such as odor of alcohol or appearance of intoxication, the employee may object, which could lead to litigation. When alcohol use is suspected, alcohol testing can be used to establish whether the employee was in fact drinking. Specific techniques include both breath testing and blood testing.
• Compared with EAPs, prevention efforts focused on reducing risk factors in the work environment may offer the greatest potential payoff. This approach is the most problematic in terms of implementation, however. One possible avenue would be to identify and alter work environments that have “toxic” connections to alcohol problems. Employers would be reluctant, however, to participate in efforts that might highlight their liability in creating high-risk environments.

Roman and Blum also argue that “despite the potential problems in implementing interventions to reduce risk factors in the workplace, research has examined several work-related factors that may contribute to alcohol use and related problems among employees.” These identified risk factors are listed below:

1. Stress
2. Alienation
3. Dysfunctional Cultures
4. Dysfunctional Subcultures

Such situational factors that are correlated with alcohol abuse should also be addressed and if possible mitigate the variables or enhance the resilience resources for employees who are vulnerable.

Mitigation can be Effective as well as Cost-Effective

For a long time we have known that coordinated efforts for mitigation do work. One foundational study from three decades ago determined that the numerous company programs in North America that have developed countermeasures against drug and alcohol abuse in the workplace, ranging from prevention, health promotion and education, to treatment and rehabilitation, provide instructive examples of an effective approach that in most cases has more than paid for its cost. (Source: Shahandeh, Behrouz International Labour Review, v124 n2 p207-23 Mar-Apr 1985)

• According to the U.S. Department of Labor, there are numerous examples of successful prevention and mitigation of alcohol abuse disasters in the past where a concerted effort was undertaken. These include:
• “One small plumbing company in Washington, D.C., the Warner Corporation, saved $385,000 in one year by establishing a drug-free workplace program that included EAP services. The company attributed the savings to a decrease in the number of accidents, which resulted in lower workers’ compensation costs and lower vehicle insurance premiums. Warner now has a waiting list of top-flight mechanics wanting to work in its drug-free environment, saving the company $20,000 a year on personnel advertising costs. Additionally, the proportion of apprentices completing a two-year training course has increased from 25 percent to 75 percent, resulting in annual savings of $165,000.
• In 1984, CSX Transportation, a freight railroad company, implemented Operation Redblock, a response to widespread violations of Rule G, which prohibits the use and possession of alcohol and drugs. The program’s 4000 volunteers are trained to confront substance abusers, and if appropriate, refer them to the company’s EAP. Since 1990, less than one percent of the drug tests administered to safety-sensitive employees have been positive.
• After implementing a comprehensive drug-free workplace program in response to a workers’ compensation discount law, W.W. Gay Mechanical Contractors in Florida saved $100,000 on workers’ compensation premiums in 1990, and also has experienced increased productivity, reduced absenteeism, and fewer accidents.
• Only four years after implementing a workplace substance abuse program which included drug testing, Jerry Moland of Turfscape Landscape Care, Inc., in Chandler, AZ, says that his company is saving over $50,000 a year due to increased productivity, fewer accidents, and less absenteeism and turnover.
• According to the American Management Association’s annual Survey on Workplace Drug Testing and Drug Abuse Policies, workplace drug testing has increased by more than 1,200 percent since 1987. More than 81 percent of businesses surveyed in 1996 were conducting some form of applicant or employee drug testing. Likewise, the perceived effectiveness of drug testing, as assessed by human resources managers, has increased from 50 percent in 1987 to 90 percent in 1996.
• In 1995, the average annual cost of EAP services per eligible employee nationwide was $26.59 for internal programs staffed by company employees and $21.47 for external programs provided by an outside contractor, according to the Research Triangle Institute. These costs compare favorably to the expense of recruiting and training replacements for employees terminated due to substance abuse problems—about $50,000 per employee at corporations such as IBM.
• The Ohio Department of Alcohol and Drug Addiction Services conducted a follow-up survey of 668 substance abuse treatment residents one year after completing treatment. Findings indicated that absenteeism decreased by 89 percent, tardiness by 92 percent and on-the-job injuries by 57 percent.

Statistics such as these suggest not only that workplace substance abuse is an issue all employers need to address, but also, that it is an issue that can be successfully prevented. Taking steps to raise awareness among employees about the impact of substance use on workplace performance, and offering the appropriate resources and/or assistance to employees in need, will not only improve worker safety and health, but also increase workplace productivity and market competitiveness.”

Conclusion

One glimmer of good news is that there appears to have been some declines in reported alcohol abuse and binge drinking between 2002 and 2013. However, 30.2 percent of men and 16.0 percent of women [12 and older] reported binge drinking in the past month during the 2013 data collection period. And 9.5 percent of men and 3.3 percent of women reported “heavy alcohol” use at the same time.

Nonetheless, alcohol abuse is a serious crisis for workplaces. Furthermore, there is a persistent recognition of the problem and appropriate solutions/responses. For example, according to National Institute on Drug Abuse there continues to be a large “treatment gap” in this country. In 2013, an estimated 22.7 million Americans (8.6 percent) needed treatment for a problem related to drugs or alcohol, but only about 2.5 million people (0.9 percent) received treatment at a specialty facility.

Thus, the current alcohol abuse crisis in the workplace is both a challenge and an opportunity. Managers and executives are encouraged to establish responsive procedures or policies so that this challenge can be met in a professional and consistent manner as well as in a way that takes advantage of the workplace setting to better enhance potential of success. It is important for supervisors and managers to have a resource or procedure that they can rely on. Employees need to know that everyone will be treated the same way. Pre-planning and utilizing a comprehensive and coordinated communication program, as for many other occupational health and safety issues, is the best way to avoid confusion and frustration in times that are already difficult.

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