Employer Support Services
Recognition and Referral
According to studies, 10% or more of the U.S. population are addicted or in recovery, and up to 40% are affected by drug or alcohol addiction in themselves or their families. Whether your business has twenty employees or twenty thousand, one in every ten of them is likely to have the disease; no business of any size can assume it is drug-free.
The facts on alcoholism/addiction in the workplace (**link to facts) are staggering. Still, fewer than 20% of addicts are ever diagnosed, and less than one-third of these are referred to treatment. No other life threatening disease has such a dismal record.
The people who come in contact with an addicted worker can make a real difference, not just for the alcoholic/addict, but in the workplace culture and the company’s bottom line.
Studies show that knowledge, support, and monitoring of the recovering patient at work significantly improve their treatment outcome. and the advantages are not limited to the recovering worker: proven benefits in the workplace include reduced turnover, lowered health benefit costs, greatly reduced absenteeism and on-the-job injuries, greatly improved productivity and work quality, and far better cooperation and teamwork, all of which have quantifiable impacts on a company’s profitability.
It is important to know that addiction happens to anyone. The disease of addiction respects no boundaries of age, income, lifestyle, vocation, race, religion, attitude, or background.
Signs and Symptoms
Job Performance: poor or inconsistent work quality; unexplained drop in productivity; increased mistakes or errors in judgment; unexplained inability to fulfill complex assignments or meet deadlines; excessive sick leave; frequent early departures; a pattern of absenteeism, such as Mondays, Fridays, before or after holidays, or following paydays; extended or frequent breaks; excessive time on the phone.
Behavior and Appearance: unusual changes in behavior such as irritability, moodiness, sleepiness, depression, impatience, suspiciousness, talkativeness, emotional outburst, slurred speech, unsteady movements or shaky hands; arguments with co-workers or insubordination; sudden change in choice of friends; dress that becomes sloppy or unkempt or is inappropriate, such as long sleeves in the summer or sunglasses indoors; clammy hands, dilated pupils, red eyes, unusual weight gain or loss.
Safety Issues: Drug/alcohol addicts are not safe employees, and problems may manifest in safety records, sometimes with injuries to others rather than themselves. Any indication that a worker has become inexplicably accident-prone or careless with dangerous materials or equipment is cause for concern.
Anecdotal: Rumors or concerns expressed by customers or coworkers can be meaningful, such as reports of problems at home, complaints about borrowing or stealing money or other compromise of an honest worker’s ethics.
It is important to bear in mind that none of the indicators mentioned is a certain sign. Problems listed as possible signs of addictions may also be caused by factors entirely unrelated to drug or alcohol use.
LRC maintains a staff of professionals experienced in all phases of employer consultation who can provide guidelines and/or assistance in developing such a program in your workplace.
Effects of Drug Abuse / Addiction in the Workplace
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All facts from the National Clearinghouse for Alcohol and Drug Information unless otherwise noted.
Confronting the Worker
The prospect of losing a job has more influence on a drug/alcohol user than even a spouse’s or friend’s threat to end the relationship. They can deny many signs of a worsening problem, but can no longer deny when faced with job loss. The addict’s job is important fundamental reasons: because it is, of course, where the money comes from to buy alcohol or drugs, and also, importantly, because in our culture we often define value and base our identity and self-esteem on the work we do.
People will admit to a past or present problem with drugs or alcohol more often than might be expected. Direct questions rooted in genuine concern often elicit frank and meaningful responses. Such a conversation should be framed in terms of your concern for the worker’s well-being, that of their coworkers, and that of the company. A supervisor need not assume the role of an addiction/alcoholism specialist. Rather, the discussion should be performance-based: tardiness, loss of productivity, and so on.
It is certainly reasonable to explain that the company would like to have an assessment to verify or rule out the existence of an alcohol or drug problem. Depending on circumstances, the request may be a requirement. The wisest course is to enlist the help of trained assessment specialists from the recovery community. In companies where an Employee Assistance Program (EAP) is in place, it is usually policy to do so.
By refusing to tolerate the on-the-job problems associated with the misuse of alcohol or drugs, a workplace not only protects its own interests but also helps addicted workers by giving them the motivation they need to begin recovery.
Intervention
It is a myth that an addict must hit bottom or want help in order to be helped. Most addiction specialists agree that intervention, properly conducted, can reach many very resistant addicts and start them on the path to recovery.
Many patients enter treatment still in denial of their addiction but are able to break through it while in treatment and achieve successful recovery. In fact, patients facing impending loss of employment, health, and important relationships succeed in treatment more often than those who have already suffered such losses. Even where other methods have failed and an addict continues to refuse help, intervention can succeed in motivating them to enter treatment for their disease.
Simply put, intervention is a carefully planned process wherein a group of people who care about the addict – family, coworkers, physician, and/or a professional intervention team – create a caring confrontation that forces the addict to look squarely at the damage their addiction has created. Intervention includes discussion of the treatment options available and a plan to act immediately upon a treatment decision.
Protecting the Company’s Investment
Because denial is such a common symptom of addiction, even a well-managed intervention or a true emergency is sometimes inadequate to get a person to accept treatment. If the patient claims they can abstain on their own, a useful tactic may be to ask them to test that hypothesis by trying to stop on their own. Be clear that all the workplace problems that led to this conversation, whatever they are, must disappear. Establish a reasonable timeframe, and check back with them periodically during that time.
While efforts to help alcoholic/addict employees can be awkward and frustrating, it may help to know that many of the behaviors that challenge us are symptoms of the disease rather than characteristics of the worker. It is true; too, that persistence often pays off. Playing an instrumental role in getting a worker through successful treatment for addiction and seeing the dramatic physical and psychological changes brought about by recovery can be a most rewarding experience and one that pays dividends in the workplace.
The Basics of Treatment
Regardless of how a person enters treatment, it is vital to understand that treatment is just the beginning of recovery. It is where the patient gains the thorough knowledge about their disease and the behavioral tools needed to live life without alcohol or drugs. Recovery is a lifelong process of managing a chronic disease.
Two levels of treatment are available through LRC including a full suite of outpatient services. Inpatient treatment is also available through our unique partnership with the widely acclaimed Riverside-Milam Recovery Centers of Kirkland, Washington. Inpatient treatment is most often used when the patient needs medical detoxification or suffers from complicating medical or psychological factors, when they have been unsuccessful in less intensive treatment, or when they must be removed from their present “using” environment to have any chance of recovery. The length of an inpatient stay depends on treatment response and averages 28 days.
An option for people who are not as deeply entrenched in abuse or addiction is outpatient treatment. This commonly consists of a couple of months or longer of regular treatment while the patient continues to live at home. Adults in the LRC outpatient programs attend one and a half hour to three hour groups several times a week. The number of times per week depends on the level of care.
Treatment, whether in- or outpatient, starts by allowing the patient to begin detoxifying from the acute effects of their drug use and to commence the physical healing and neurochemical changes that come with sobriety. The next step is educating the patient about their disease and physical and emotional consequences of it. Importantly, the patient begins to understand that many of their past behaviors are common, predictable symptoms of the disease and helping them work through the guilt and shame of the past is an important landmark for every addict. In treatment, patients also acquire and refine the skills they need to be active managers of their illness for their entire lifetime.
Treatment is followed by up to 6 months of continuing care as long as clinically indicated, and it is in the this important phase of recovery that employers and coworkers have a most crucial role.
Continuing Care
Continuing care is the vital system of outpatient follow up, monitoring, and bonding with sobriety groups such as Alcoholics Anonymous, Narcotics Anonymous, and cocaine Anonymous. During this period the patient attends group and individual counseling and learns to deal with the common problems that occur in early recovery.
Patients enter routine continuing care after their initial course of inpatient or outpatient treatment. This essential continuing care is proven to be extremely effective. One study found that companies can expect better than 80% abstinence after one year when recovery is monitored and linked to a Conditions of Employment agreement that requires compliance with all of the employee’s treatment recommendations.
What Happens When They Return to Work
It is clearly demonstrated that all continuing care is most effective when planned in the context of the patient’s work and home life and in collaboration with their addiction treatment specialists. Whenever appropriate, LRC makes a strong effort to secure the required consents to fully inform a patient’s employer of their diagnosis and treatment plan.
With the understanding that treatment is a just the beginning of recovery, fellows in the workplace, whether supervisors, shop stewards, executives, or co-workers, should be honest, supportive, and expectant of success.
A frank conversation upon an employee’s return to work will serve to reinforce the company’s support and define its position. This often includes a Condition of Employment Agreement with the returning worker that defines the expectations and responsibilities of both employer and employee.
An open line of communication between worker’s continuing care counselors and employer is extremely helpful and allows counselor and employer to work as a team to ensure consistency and reinforce treatment goals. Monitored recovery programs are usually one to two years in length and consist of monthly monitoring sessions at an alcoholism/addiction treatment facility.
The transition of a patient to sobriety forces everyone in a patient’s circle to change old patterns and establish new ways of connecting. Coworkers may need to learn to relate to the recovering worker differently than in the past. This education and information provided by an employer as part of an EAP can be most helpful to all in the workplace who come in contact with the recovering employee.
Relapse
It is important to understand that relapse is a common symptom of addiction. Relapse is a symptom to be treated, forthrightly and objectively. Usually, it leads to the behaviors of active addiction, including denial as bad as or worse than prior to treatment. If you see the same behaviors you noticed before a worker entered treatment, you may be seeing the precursors to relapse. The most common warning sign is the worker’s failure to maintain active participation in continuing care plans and Twelve Step support groups.
If not quickly identified and treated, the patient may wait for years before attempting sobriety again. Where relapse is discovered, the finding should immediately be shared with the patient’s addiction counselor(s) and a course of action cooperatively determined according to the patient’s history and present circumstances.
Important Things to Know about Recovery and the Returning Worker
- Most workers returning after treatment are exceptionally positive and upbeat. They are probably feeling better physically than for a long, long time, and they often want to make for lost time. Allow for an adjustment period as the worker develops greater ease and skill at living a life without drugs. The length of this period will be directly related to the degree of their sickness before treatment. Allow also for a period of fatigue; it is hard work to create and maintain a new, drug-free life.
- Treat the returning worker as you would anyone else: with a sincere welcome and an expectation of success. This is not the time to avoid an uncomfortable subject; alienation works to no one’s benefit. Do have a conversation as soon as possible that outlines your expectations, concerns, and support and invites ongoing open communication.
- Remember that having a job and being perceived as doing it well are keys to anyone’s sense of well-being and success. This is especially true for someone newly in recovery. The importance of expressions and actions of support in the workplace just can’t be overstated. Please take the opportunity to do whatever you can.
- While it is not the place of anyone except the recovering worker to inform others about anything concerning his disease or treatment, you can by your attitude create atmosphere where openness can thrive. You have a worker returning after a successful course of treatment for a well-understood disease; your perspective here is no different than toward a worker returning from any hospital stay.
- Use the same standards of performance for this worker that you do for any other. It is not helpful to protect or make excuses for them or to be demanding, critical or constantly scrutinizing. You’ll know the worker is doing well by improvements in their spirits, attendance, and work performance. If you notice the return of an old behavior or symptom, talk with the worker immediately, and involve their addiction counselors if necessary.
- A worker is at highest risk of relapse when they stop attending continuing care groups or 12-step meetings. People do not get well without help, and staying aware of a worker’s regular attendance in continuing care is one excellent means of monitoring recovery. There are no excuses or exceptions: Tens of thousands of Twelve Step meetings are held throughout every day all across the country. A worker can attend meetings no matter what their work schedule. If they stop doing so, regardless of any stated reason, it is cause for urgent concern.
- A recovering addict cannot use “other drugs,” such as switching to beer instead of whiskey or pot instead of cocaine. Addicts must remain free of all mood altering drugs the rest of their lives.
- Many legal drugs prescribed by a physician can also lead to relapse. In treatment addicts learn which prescription drugs should be avoided. It is their responsibility to inform any prescribing physician of their disease.
- Recovery is the ongoing management of a disease the addict was born with and was activated by the presence of alcohol or drugs. Workplace policy should reinforce this fact and refuse to tolerate value-judgments or blaming/shaming of the addict worker.
A Word about EAPs
Employee Assistance Programs are a well-proven, solid investment for any company, giving employers and employees the knowledge, empowerment, and a structure within which to deal with an addicted worker both before and in recovery. Typically, EAPs include ongoing education for all employees and special instruction for supervisors, shop stewards, and others in a position to notice early clues that may signal a problem. Most EPs prescribe a well defined course of action by all concerned – the employee/addict, the company, and any other involved party – with supporting documents such as the conditions of Employment Letter and Agreement. Some include provisions for drug and alcohol testing.