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Brown Bagger

This section is set up to provide a ready-made Brown Bag Session for you to use with employees and/or managers. Use as is, or adapt this information for a general employee group. You may reproduce as many copies as needed.

Partners in Addiction EAPs, HR Must Work Together to Raise Awareness ost people believe that employees have easy access to alcohol and other drug addiction (AODA) treatment — when the reality is that more than one-third of companies surveyed said that none of their workers have ever sought treatment. Those were among the key findings from workplace addiction surveys conducted by the Minnesota-based Hazelden Foundation in recent years.

One particular survey revealed a stunning disconnect: HR professionals recognize that addiction treatment works and understand that recovering employees often return from treatment as productive members of their company or other organization.

However, in too many cases, these beliefs aren’t directing employees into treatment — most likely due to the stigma and lack of knowledge about addiction.

As a result, it seems clear that EA and HR professionals need to work together better to raise awareness about alcohol and other drug addiction in the workplace. The following are among other key survey results uncovered by Hazelden:

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 Over half (54%) of HR respondents reported a lack of experience or expertise in knowing how to identify addiction.  More than one-third (36%) reported a lack of experience or expertise in understanding how to obtain treatment.  An overwhelming 94% of HR respondents believe that employees have easy access to treatment — but 38% of companies say that none of their employees has ever sought treatment for an alcohol or other drug addiction.  One quarter (25%) reported a belief at their company that treatment provided by their company is too expensive.

Impact of Substance Abuse is Widespread Moreover, substance abuse has an even greater impact on co-workers and family than suspected, according to Hazelden: April 2009

 More than one-third (36%) of employees admitted that at least one of their co-workers had been distracted, less productive, or missed work because of alcohol or other drug abuse addiction within their family.  More than two-thirds (69%) said that if a family member were struggling with alcohol or other drug problems, it would negatively affect their ability to concentrate and be productive at work.  Of the employees with family substance abuse or addiction who reported being distracted or less productive at work — more than half (57%) said they missed a deadline or their work or attendance suffered, 46% said they made errors in judgment, and 14% said they forgot safety or security procedures required by their job.  Nearly half (47%) of employees said they’d use their company’s EAP to get help if they were struggling with abuse or addiction issues in their family, but nearly one in five (19%) weren’t sure if their employer even had an EAP.  Almost three-fourths (73%) of employees said employers should offer counseling for family members of addicted workers, not just to those with an addiction.

Impact on Employers In addition to individuals suffering from substance addiction and their family and co-workers, employers should also be motivated to action since alcohol and other substance abuse has a tremendous impact on their bottom line. Consider:  Absenteeism is two to three times higher for drug and alcohol users than for other employees;  Employees with chemical dependence problems may claim three times as many sickness benefits and file five times as many workers’ compensation claims;  In many workplaces, 20% to 25% of workrelated accidents involve intoxicated people injuring themselves and innocent victims; and EA Report Brown Bagger 1

Brown Bagger  On-the-job supplies of drugs and alcohol account for 15% to 30% of all accidents at work.

Copyright ©International Labour Organization, 1996-2008.

The Good News Not all Hazelden survey results were negative.

The Hazelden Foundation also found that:  More than 80% would recommend treatment for an addicted executive or rank-and-file worker, rather than merely firing them.  Nearly all (89%) of respondents believe that addiction treatment programs are effective in helping employees beat addiction.

Lack of Diagnosis a Key Barrier The failure to address alcohol dependence begins with an inability to adequately identify people with alcohol problems. Although approximately 8% of working adults suffer from alcohol dependence or a related condition, only about .06% of health plan members receive such a diagnosis, according to Ensuring Solutions, which analyzed data from more than 250 health plans nationwide.

This percentage is extremely low compared to other diseases. By comparison, health plans identify about 40% of patients with depression, 65% with diabetes, and 70% of those with high blood pressure.

“Imagine discovering an illness that kills about 85,000 people annually, and then imagine that we identify only one in 20 of those people — even though we have effective treatments that can be administered by primary care physicians or specialists,” noted Eric Goplerud, director of Ensuring Solutions to Alcohol Problems at the George Washington University Medical Center. “Our approach to alcohol treatment is unlike what we expect and demand for treatment of diabetes, high blood pressure, asthma, or virtually any other health condition.”

Other key results uncovered by Ensuring Solutions:  Less than half (44%) of members identified as alcohol dependent attend even a single alcohol or drug treatment session within two weeks.  Only 16% receive the recommended three chemical dependency health care services in the month following diagnosis.

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 Only 17% of health plans make follow-up calls to members who miss appointments.

According to Dr. Goplelud, the responsibility lies not just with health plans, but also with physicians, employers, and others who have not treated alcohol dependency like other diseases. The lack of diagnosis is all the more distressing in light of the fact that — as the Hazelden surveys show — for the majority of people, treatment works.

Additional Treatment Barriers Why is there such stigma about seeking treatment? The following are among the other barriers that exist in many workplaces:  Because alcohol is legal and socially accepted, some employers are reluctant to discuss drinking problems. More than one in five insured employees fear if they seek treatment they’ll face negative consequences, such as possible dismissal.

Although laws often protect confidentiality, many employees believe that once they access their benefits, employers will know about their alcohol problems. Ironically, it is only by being in treatment that employees are covered under the Americans with Disabilities Act.  Because alcohol is socially accepted, people underestimate the impact that even casual drinking has on the workplace. This isn’t to say that alcoholics don’t cause serious problems. They do.

Rather, studies indicate a potentially even larger problem stems from individuals who don’t “overdrink” as often, but when they do — because of their vast numbers — it adds up to a big problem nonetheless. Even occasional excessive alcohol use upsets sleep and decreases concentration and in turn productivity, even if the person does not have the classic hangover symptoms of headache and nausea.

This indicates the need to re-think how alcohol is viewed in the workplace. Because employers make substantial investments to deal with workers with chronic alcohol problems, they usually pay little attention to the potential impact of alcohol use among other workers. For example, while a written policy may provide guidance about blatant cases of alcohol abuse in the workplace, it may be far less clear about other cases. For instance, a group of employees in a given work department may unwittingly encourage misuse of alcohol by stopping at a April 2009

local tavern every night after work. This doesn’t mean that companies should delve into the private lives of their employees. Rather, employers should examine their overall attitudes toward alcohol and how current alcohol policies and corporate culture may influence workers’ behavior.  There’s too little communication and awareness about alcohol and other drug addiction. Since studies show that few individuals are likely to seek treatment on their own, knowledge is crucial, and it needs to be an essential part of any awareness program. Employers and employees alike should be aware of what constitutes an alcohol problem, as well as learning the different types of alcohol problems. (Editor’s note: See the handout section on page 4.) Once the ball is rolling, so to speak, the EA and HR professionals should sit down and discuss corporate philosophy. For instance, what is it about addiction they want to communicate?

While HR should look to the EAP for guidance, both need to think of themselves as partners.

Awareness must also extend to management. Do the managers themselves understand that EAPs are available to help employees with addiction problems? If necessary, communicate to them what EAP is about and how it can help. Moreover, absenteeism, which will be a problem with any addiction, presents an opportunity to talk with the individual employee about what is going on in a straightforward, yet caring manner. Once the bases are covered, follow-up with an educational campaign about key AODA issues that can be posted on a company intranet, in a newsletter, etc.  Many people with alcohol and other drug problems worry that the cost of treatment will be too expensive. This is an understandable concern, but employees and managers need to know that treatment can actually save a company money. Since issues like lost productivity and/or absenteeism are ultimately resolved, Chevron, as one example, estimates that it saves $10 for every dollar it spends to treat employees with substance abuse problems.

One study found returns as high as $23 for every dollar invested in treatment.

Ensure that Treatment is Available If these barriers have been overcome, the next step lies in making sure that health plans include alcohol-treatment benefits. Employers may not April 2009

Brown Bagger realize that how they set up their coverage can create obstacles to needed treatment because:  Without a clear understanding of the potential needs of their employees — and thinking they will save money — employers secure health plans that don’t provide the amount and type of treatment that people with alcohol problems need.  Managed-care plans may deny coverage for treatment despite the promise of such benefits.  Health plans sometimes charge higher co-payments for alcohol treatment than for services to treat other ailments, which discourages people from getting care. Laws are slowly requiring that substance addiction treatment be covered to the same extent as other illnesses. (Editor’s note: See this month’s cover story — bearing in mind that the full effect of parity changes has yet to be determined.)

Follow-up is Crucial But providing treatment isn’t enough. Thorough follow-up can reap substantial dividends for employers — reduced alcohol-related disability claims, for one. But employer health plans don’t always cover continuing care, and when they don’t, EAP follow-up may be the only monitoring of the employee’s recovery. EAP follow-up typically continues for a minimum of six months, but research indicates that it is most effective at preventing relapse if it lasts for at least a year.

Numerous EAPs recognize the value of followup. One EAP asks clients to sign a return-to-work agreement that outlines what will be expected of them during follow-up. In some cases, such as workers suffering from severe addiction, the oneyear provision has been extended.

Summary With more than 23 million Americans suffering from alcohol and other drug addiction, it’s time for businesses to learn how to recognize addiction, banish its stigma, and encourage treatment for all employees who need it.

Additional sources: National Institute on Alcohol Abuse and Alcoholism and Robert Wood Johnson Foundation. Editor’s note: April is Alcohol Awareness Month and Counseling Awareness Month. This article should not be construed as a substitute for identification and diagnosis of an alcohol or other drug problem. Consult a professional regarding the applicability of recommendations appearing in this article.

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Brown Bagger H A N D O U T Recognizing Alcohol Problems ďƒ˘ Who develops alcohol problems? Nearly 14 million Americans — or one in every 13 adults — suffer from alcohol abuse or dependence. More men than women have alcohol problems. Rates of problems are highest among adults ages 18-29 and lowest among adults 65 and older. ďƒ˘ How can I recognize someone with an alcohol problem? Symptoms include: 5 Drinking to calm nerves, forget worries, or to boost a sad mood; 5 Guilt about drinking; unsuccessful attempts to reduce or stop drinking; 5 Lying about or hiding drinking habits; causing harm to oneself or someone else as a result of drinking; 5 Needing to drink increasingly greater amounts in order to achieve the same effect; and/or 5 Feeling irritable, resentful or unreasonable when not drinking. ďƒ˘ What questions might someone with an alcohol problem be able to answer “yesâ€? to? ˆ Have you ever felt that you should cut down on your drinking? ˆ Have people annoyed you by criticizing your drinking? ˆ Have you ever felt bad or guilty about your drinking? ˆ Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover? ďƒ˘ What are some of the different types of alcohol problems?

X Alcohol dependence, or alcoholism — This is the most severe alcohol problem and is characterized by a strong need to drink despite repeated social or other problems such as losing a job or deteriorating relationships with friends and family. In addition, a number of symptoms are present over a one-year period.

X Alcohol abuse — This problem results in impaired performance on the job, neglect of child care or other responsibilities, legal difficulties, and alcohol consumption in dangerous circumstances, such as while driving.

X Binge drinking — This is often defined as the consumption of five or more drinks at one sitting for men, and three or more drinks at one sitting for women. Binge drinking is most common among young people ages 18-21.

Source: National Institute on Alcohol Abuse and Alcoholism. The advice presented in this month’s Brown Bagger and handout should not be construed as a substitute for identification and diagnosis of an alcohol or other drug problem. Consult a professional regarding the applicability of recommendations appearing in this article.

Additional resources on this subject include: Alcoholics Anonymous (www.aa.org); Al-Anon/Alateen (www.al-anon.alateen.org); Bruce W. Cotter and Associates (www.whentheywontquit.com); Caron Foundation (www.caron.org); National Association of Addiction Treatment Providers (www.naatp.org); and National Council on Alcoholism and Drug Dependence (www.ncadd.org).

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April 2009