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Addiction and recovery at work

$134-185billion a year in the US and £7.3billion in the UK is lost in productivity from alcohol alone – but investing in substance-abuse treatment can exceed costs by 12:1.

This article was originally published in Recovery Plus: Workplace, 2016

“Boozy businessmen on the at-risk list for alcohol time bomb,” the Mirror wrote of a BMJ report last year, with the Daily Mail adding that “Middle class over-50s are most likely to drink to harmful levels”. How does this affect the organisations these executives work for?

I could write that my interest in the answer is because alcohol, tobacco and other-drug use is the greatest preventable healthcare problem in business today, yet is too often expensively neglected. That is true. But what drives me to campaign for helping employers and employees is that I owe my life to the company I worked for in 1991. Its workplace policies and wonderful staff and HR department made me realise that recovery was possible – they even paid for me to go to rehab. I have been clean and sober ever since and helping others in turn repays my debt.

The cost to companies of doing nothing.

Consumption of illicit drugs and/or alcohol can lead to the following negative effects, all of which can have severe consequences for the career of the person involved, their colleagues and the success of the employing company:
>>  Increased rate of absences
>>  Fatalities and injuries – ILO estimated that up to 40% of accidents at work involve alcohol
>>  Health harms including cancers, liver and heart disease, diseases of the central nervous system (stroke, dementia), risky sexual behaviors with adverse pregnancy outcomes, and infants damaged with FASD/NAS; these health issues of course also impact negatively on work
>>  Loss of productivity – substance-abusing employees function at about 2/3rds of their capability, and employees who use drugs are 3 times more likely to be late for work
Damaged customer relations
>>  Termination of employment – eg, illicit drug users are more than twice as likely (12.3%) than others (5.1%) to have changed employers 3 or more times in the past year
>>  Impaired judgment and decision-making
>>  Poor team morale and staff relations
>>  Unwanted legal complications.

These add up to startling figures, as the figures above show: in the UK, £7.3billion a year in lost productivity from alcohol alone. No figures for illicit drugs are easily available, but Public Health England estimates that drug use costs society £15.4billion a year. In the US, lost productivity amounts to $134billion from alcohol and $120billion from illicit drugs every year (see panel).

Research is not widely available for prescribed drugs’ impact on the workplace, but the US Substance Abuse and Mental Health Services Administration estimates that over 6.5million people used prescription drugs for non-medical reasons in 2013. That’s more than cocaine (1.5 million), hallucinogens (1.3 million) and heroin (681,000) combined. In the UK, the number of long-term dependent painkiller users is estimated at over 1million.

There is also the cost of lost productivity from colleagues of the person with the substance-abuse problem: for example, 14% of employees in one survey said they had to re-do work due to a co-worker’s drinking. Colleagues might also have to both shoulder some of the dependent person’s workload, suffer damaging behaviours and have loyalties torn when considering if their colleague should be reported.

Moreover, over half of working family members of alcoholics report that their own ability to function at work and at home was negatively impacted by their family member’s drinking. There is even a book on this by New York Times bestseller Janet Geringer Woititz called Self-Sabotage Syndrome: Adult Children [of alcoholics] in the Workplace.

Even a little can have a disproportionate impact.

Impairment of skills begins with any significant amount of alcohol in the body. For example, a Modell and Mountz study of airline pilots who had to perform routine tasks in a simulator under 3 alcohol test conditions found that:

  • Before drinking alcohol, 10% of them could not perform all the operations correctly
  • After reaching a blood:alcohol concentration of 100mg/dl, the 10% rose to 89%
  • After the alcohol left their systems, 68% still could not do all operations correctly.

The after-effects of drinking (hangovers) can also impair both work attendance and performance. A survey carried out by Norwich Union found that 77% of employers believe alcohol is the No1 threat to employee wellbeing and encourages sickness absence, while 32% of employees owned up to being at work with a hangover and 15% to having been drunk at work – 85% of these confirmed it affects their performance or mood, while 10% said they “made lots of mistakes”.

Benefits of addressing substance use.

>>  Savings from investing in substance abuse treatment can exceed costs by 12:1
>>  Substance-abuse treatment improves work performance and productivity
>>  It simultaneously reduces interpersonal conflicts, absenteeism, drug- and alcohol-related accidents and insurance costs
>>  Avoid the cost of replacing valuable employees which can be 25-200% of annual compensation – and avoid the consequent loss of institutional knowledge, service continuity and coworker productivity and morale
>>  76% of people with drug or alcohol problems are employed – firing them won’t make the problem go away, but addressing the core issues can yield improvements
>>  At the extreme ends of the spectrum, errors due to substance use have cost £$millions to many individual organisations – witness oil disasters and ship/plane crashes – but reclaiming the lives of top directors and salespeople can earn extra £$millions for their companies.

The cost of comprehensive insurance for alcohol treatment is very small. Actuarial estimates by SAMHSA suggest that upgrading employment-based health insurance coverage would increase premiums by only 0.2%.

Prevention is better than cure.

Maintaining a healthier workforce can lower direct costs such as insurance premiums and worker’s compensation claims. It will also positively impact many indirect costs such as absenteeism and productivity. To improve the health of their employees, businesses can create a wellness culture that is employee-centred, provides supportive environments where safety is ensured and health can emerge, and gives access and opportunities for a variety of workplace health programmes. Here, the boss can be the hidden fighter in the war on drugs. Government should give more support to employers on this issue.

Many businesses have implemented drug-free workplace programmes to develop and maintain a safer, happier working environment. Such is recognition of their value that these are championed by unions, too – for example, click on Unison’s overview. There is a checklist from mediation specialist ACAS on what should be included in a policy on drugs misuse at work. This typically covers: An extensive policy, Supervisor coaching, Employee training, Employee assistance, Drug testing.

This last factor can encroach on an employee’s privacy/rights, so must be implemented with care. Read George Powell’s article on this.

Cannabis: clearing the haze.

Keeping workplaces drug-free is becoming more muddied by ‘medical marijuana’ legalisation: a reality for some US states and an opinion-shaper in the UK. Marijuana legalisation has clashed with drug testing in the workplace. The billionaire-funded disinformation about legalisation and ‘Big Pot’ – a potent blend of Big Tobacco and Big Pharma – has hooked many working people outside the US, who can devise sensitive dilemmas for their colleagues and employers. A recent report by drug-testing firm Quest Diagnostics revealed a 47% spike in the rate of positive oral marijuana test results in US workplaces from 2013 to 2015 – and an incredible 178% rise in that rate from 2011-2015. “Yet again, we see information that expanding marijuana legalisation policies is having serious negative impacts on the public, in this case in the workplace,” said Dr. Kevin Sabet, cofounder of Smart Approaches to Marijuana.

Employers must take steps to avoid becoming a target of an employee lawsuit, whether the employee has a strong case or not. “There are four scenarios in these types of lawsuits that I see over and over again,” shared employment lawyer Todd Wulffson; read his advice. And note the near miss at this human rights tribunal.

Safeguard your business from a legal perspective.

In the UK, there is no direct legal requirement for employing organisations to implement alcohol policies per se. But health & safety at work law requires both employers and employees to maintain a safe working environment: were an alcohol-related accident to occur, the employer, the employee concerned or both could be liable depending on circumstances. Employers are obliged to look for signs of alcohol dependent behaviour in their staff as, although an employee found drunk on duty is at risk of dismissal for gross misconduct, employment protection law means employers are required to treat dependence as a form of sickness, giving an employee the chance to overcome the problem rather than an immediate cause for discipline. This approach is supported by the Advisory, Conciliation and Arbitration Service, the ILO and the Employment Appeals Tribunal.

An existing effective alcohol and drug policy is paramount. But don’t be complacent. For example, do those rules or guidelines change when psychoactive substances are consumed outside work, to excess or not? Proving impairment to performance is absolutely key. Heavy drinking in personal leisure time can have a long-term effect on work performance, including absenteeism, inefficiency, poor decision-making and damaged customer relations. Specific productivity problems include procrastination, inconsistent performance, neglect of detail, poorer quality of work, less quantity of work,
more frequent mistakes, and interpersonal difficulties. Where there is clear evidence of alcohol affecting an employee’s behaviour or performance in the workplace – including recklessly coming to work having been drinking – dismissal is likely to be held to be fair at an Employment Tribunal, especially where there might be risk to others.

Finally, avoid becoming an organisation which tolerates heavy drinking as a way of socialising, bonding or doing business.