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Substance wellness in the workplace:
Safety and substances for employers

Substance misuse and addiction cost employers and employees billions of dollars a year. This guide aims to help business leaders understand the basics of the problem and to present opportunities to improve ways the issue is addressed in the workplace.

1. What is addiction?

Understanding addiction

When we eat, listen to music or make major accomplishments in our lives our brains release the reward chemical dopamine. (1)

When we use drugs or drink alcohol, dopamine is also released. While regular life events provide a whisper of dopamine, drug and alcohol use provides a megaphone blast’s worth causing feelings of euphoria.

Substance misuse overloads and thus desensitizes the dopamine receptors in the brain. As a result, users develop a tolerance to the substance and therefore must increase their intake in order to achieve feelings of happiness and enjoyment. After prolonged abuse, the levels of dopamine achieved through natural rewards (food, music, etc) are no longer able to stimulate the brain’s dopamine receptors. Drug and alcohol use become one of the only ways to activate those receptors.

According to the Surgeon General and numerous other credible medical and government agencies, addiction is a chronic disease—meaning it lasts for more than 3 months, cannot be prevented by vaccines or cured with medications, and won’t go away on its own if left untreated. Consider two other chronic diseases: heart disease and diabetes. No one chooses to have these diseases, and they rarely occur spontaneously. They usually manifest over time through a series of unhealthy lifestyle habits (poor diet, smoking, etc). Management of these diseases requires lifestyle changes and professional treatment. The same is true for addiction. (2)

2. Addiction and the workplace

A growing problem

If you run a business that employs people, it’s very likely that you’re dealing with the impact of addiction among your employees. We’d all like to believe our own organizations are immune to this problem, but neglecting to address addiction within your workforce could affect your company’s bottom line.

Statistics regarding drug and alcohol abuse in the United States are startling. In 2014, about 8% of the population (or 20 million people) met the full criteria for substance use disorders. (3) On average, 10.2% of adults employed full time and 11% of adults employed part time are substance-dependent. (4) These numbers tend to be much higher in industries such as transportation and construction.

You may be wondering: “If I already have substance abuse issues in my workforce, and I am relatively happy with the way things are going, why should I care?”

Because addiction and substance abuse is on the rise—so much so that the surgeon general
published the first-ever landmark report on addiction in November 2016. (5) The report especially sheds light on the growing opioid addiction epidemic in the U.S. And, a 2014 report showed the highest rate of illicit drug use in the U.S. since 2001. (6)

All of this means that there are more and more people in the workforce struggling with addiction and affecting workplace safety. On average, workers who drink 3 or more times per week are 70% more likely to have an accident on the job. (7) Accidents in the workplace affect company morale, hamper productivity and cost employers money.

3. Financial impact of addiction

How substance misuse costs employers

Since drug and alcohol use have such a big effect on workplace safety and productivity, employers who choose not to address the issue could be costing their companies. The National Institute on Drug Abuse estimates that abuse of tobacco, alcohol, and illicit drugs cost the US $700 billion per year in terms of lost productivity, health care, and criminal justice. (8)

The CDC reported that in 2010, excessive alcohol consumption alone cost the United States $249 billion.9 They estimated that 72% (or $174 billion) of that figure was attributed to lost workplace productivity. (6)

That means that employers are shouldering most of this financial burden. Therefore, in helping employees address substance misuse there is potential for saving on health care expenses, increased productivity and enhanced employee engagement. Early-stage interventions for addiction produce a massive return on investment: for each dollar spent on treating addiction early, employers can expect a return of $2-$10—a clear win-win. (10)

4. What can employers do to help?

Common approaches and why they fail

Punitive measures: Typically, employers deal with addiction issues by implementing various disciplinary measures, and eventually firing employees struggling with substance use especially if they are drinking or using on the job. However, research suggests that punishment-based drug policies are ineffective (even law enforcement agencies are turning less punitive approaches to substance misuse), and firing employees could land employers in legal trouble.

Drug testing: Subjecting employees to drug testing is another common approach, especially in industries like transportation and construction where on-the-job safety is extremely important. This method, too, has its shortcomings. Drug tests may not detect certain substances which are highly addictive. It’s also fairly easy for employees to manipulate the tests, or evade them completely. Furthermore, employer-implemented drug testing programs are costly; require significant internal resources; have a negative effect on employee morale; and are fraught with ever-changing legal regulations.

Even if employers manage to implement drug testing programs despite all of these challenges, they fail to address the real issues of addiction and substance misuse.

Employee Assistance Programs: EAPs are problematic because they fail to reach most employees. The Society for Human Resource Management estimates that overall EAP utilization is between 4-8%, but among employees with substance use problems utilization is even lower (about .02%). (11) If employees do make use of their companies’ EAPs, there is little support for lasting success once they have completed the programs.

What should employers do?

Hopefully, the information presented thus far in this guide has helped you as an employer to understand the need for a better, more lasting addiction and substance abuse intervention. Employers are in a unique position to help the people in their workforces to achieve substance wellness. Many of us spend more time with co-workers than with our family members, and indeed our jobs are tied to our sense of self-esteem and purpose. And so, the workplace is a perfect place to start.

5. What does a good substance wellness program look like?

Accessibility is key. Making the decision to change addictive behavior is hard, and so a good substance wellness program should do everything possible to make that first step a little easier. (6) Substance wellness programs should be ongoing. It’s important to keep in mind that substance wellness is a process that takes time. In many cases, those struggling with substance abuse have built relationships around drug or alcohol use, and they are constantly facing pressure to use or drink. For this reason, it’s important that a good program is ongoing and supportive.

Well researched, clinically-back programs are best. Remember that addiction is a chronic disease, and to treat other chronic diseases like heart disease or diabetes we turn to expert doctors. It’s important to do the same for addiction and substance misuse.

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