Alcoholism in the Workplace
The National Institute on Drug Abuse estimates that costs of healthcare related to alcohol use disorders in the United States is in the neighborhood of $25 billion yearly and the overall costs in United States are upwards of $224 billion. The National Council on Alcoholism and Drug Dependence reports that:
- Workers with alcohol-related problems are nearly three times as likely to have injury-related absences as those without alcohol-related problems.
- Nearly one-quarter of workers reported drinking during the workday at least once during the year that they were surveyed.
- One-fifth of workers and managers reported that one of their coworker’s drinking behaviors (either on or off the job) jeopardized their own safety or work productivity.
- One study from a hospital emergency department indicated that about 35 percent of patients with occupational injuries engaged in at-risk drinking behavior.
- Workers who have an alcohol use disorder present a particularly complex problem for businesses, managers, and coworkers, not to mention themselves.
Signs and Symptoms of an Alcohol Use DisorderThere are specific symptoms that go into the diagnosis of an alcohol use disorder and specific signs that may occur in the workplace that may indicate the presence of an alcohol use disorder or related issue. There is some overlap in these symptoms, and there are also some specific situations that apply to the signs of alcoholism in the workplace.
The formal diagnostic criteria for an alcohol use disorder address the following domains of behavior in order to identify the presence of a clinically significant issue. These guidelines are a general summary of the criteria used by the American Psychiatric Association:
- The person’s inability to control alcohol use
- Numerous attempts to cut down or quit drinking that are unsuccessful
- The continued use of alcohol by the person despite negative consequences to health, relationships, work, etc.
- Spending significant time either drinking or recovering from drinking
- Using alcohol in potentially hazardous situations
- Demonstrating the symptoms of physical dependence to alcohol
Formal diagnostic criteria require a certain set of symptoms to be present for at least a year before an alcohol use disorder can be diagnosed. For the most part, these diagnostic symptoms can only be inferred from someone observing a coworker’s behavior in the workplace. Individuals who are concerned about coworkers may not often have insight into how often people have unsuccessfully tried to quit drinking, how long they spend recovering from drinking, etc. Coworkers of an individual with a suspected alcohol abuse problem are not qualified to determine a formal diagnosis of a clinical disorder. However, coworkers are able to determine if an individual is drinking on the job and if this use is in violation of company statutes and presents a danger to other workers or to the individual.
Some general signs that may suggest that there is a serious issue include:
There are some signs that may indicate that a coworker may be suffering from an alcohol use disorder that is interfering with functioning in the workplace. If these signs are present, a further clinical evaluation would be necessary to determine if an individual has an actual alcohol use disorder.
- The individual is frequently late to work.
- The person has a number of unexplained absences.
- Lower levels of productivity occur often in the morning hours (or at the start of a shift), or general sluggishness and lethargy are present when the person first comes to work.
- Unusual behaviors or other signs are present, such as an unsteady gait, hyperactive or even manic behavior, weight loss, slurring words, and periods of confusion or odd behaviors.
- The individual performs inconsistently on the job.
- The person seems suspicious or paranoid, or is defensive to criticisms or suggestions.
- Secretive or dishonest behaviors occur on the job, such as spending time in one’s car during break, stealing from work, spending lengthy periods in the restroom, etc.
- Physical symptoms are present, such as bloodshot eyes, symptoms that suggest that the person suffers from a lack of sleep, or a sudden lack of concern over hygiene or personal appearance.
Obvious signs that the individual is drinking on the job are also important red flags. These can include the person drinking at lunch, drinking alcohol at work, smelling of alcohol, frequently complaining of being hungover, etc.
First, make sure you understand the company’s policy on drug and alcohol use and reporting suspected instances. No matter how close a friend the suspected coworker may be, it is not worth getting terminated because one did not voice one’s concerns about another individual’s potentially unsafe behavior. While the decision to report the person can be difficult, most employees are required to report such safety concerns per the formal policies of the company.The issue of confronting a coworker with a potential alcohol use disorder is complicated by the fact that individuals may strongly deny they have an issue with alcohol. Such people may become very reactive to any such suggestions or concerns expressed by another person. Often, the person may react very angrily and defensively to any suggestions that they cannot control their drinking or that they are drinking at work. However, ignoring the issue will only make the situation worse. One of the best initial approaches is to consult with someone who has experience with this issue, such as a supervisor or human resources manager.
If the decision is made to confront the individual on a private one-to-one basis, here are a few suggestions to follow:
- Be nonjudgmental.
- Express your concerns for the person and other coworkers.
- Do not accuse. Only report facts, such as how often you may smell alcohol on the person, if you have seen the person drinking, etc.
- Make sure to express concern for the person’s safety, including the person’s job security.
- If possible, use examples of others you may know who have dealt with similar problems and gotten help.
Depending on the situation, you may need to discuss the issue with a manager or supervisor. If you decide to do this, it is often best to get corroboration from another coworker regarding the person’s alcohol use on the job or any potential dangerous behaviors that occur as a result of the alcohol use.
There is strength in numbers.
An alternative to the above approach would be to have several coworkers who are concerned for the individual get together and plan a coworker intervention.
An intervention involves:
- A group of individuals get together with the person and discuss their concerns regarding that person’s substance abuse.
- Individuals should only report facts and concerns; there should be no accusations or judgments.
- The goal is to let the person understand that the team is concerned and to get the individual to consider treatment.
- Each member of the team speaks individually to the person, expresses their concerns, and lets the person know they care.
- When every member of the team has spoken, the team offers 3-4 potential solutions to the issue; the goal here is to suggest some type of treatment option.
- If the team consists of coworkers, managers, and supervisors, the process may have more relevance to the subject of the intervention. This is because suggestions can also be tempered with potential consequences.
- Interventions are more successful if a trained addiction specialist or interventionist is part of the team.
Interventions are most effective if they are planned and organized as opposed to being haphazard and performed right on the spot; however, sometimes an individual’s behavior produces a potentially dangerous situation that requires that concerned coworkers confront that person immediately.
If possible, the team of coworkers, managers, and others who will be part of the intervention should get together beforehand and plan the intervention. Individuals should have written statements prepared and checked by other team members to make sure they are not judgmental or accusatory. Then, the team leaders can organize the intervention such that everyone has a specific amount of time to make their concerns known. The team can work together on the list of treatment options and consequences for noncompliance that will be presented to the individual in question.
Treatment Options for Alcohol Use Disorders
There are a number of treatment options for individuals with substance use disorders; however, there are also core central components that are required to increase the probability of success. The general components of a good treatment program include:
Supervision from an addiction specialist physician or a psychiatrist: Individuals with severe alcohol use disorders who have also developed a physical dependence on alcohol will need a physician to supervise them as they begin treatment, because these individuals will inevitably experience withdrawal symptoms. This period of withdrawal should be addressed in inpatient treatment center via medical detox; however, in certain circumstances, it can be done in an outpatient environment. Even those who do not have a physical dependence on alcohol can benefit from a physician following them through their recovery to assist them with medical issues and pre-existing psychological issues.
Therapy: Individuals in treatment for alcohol use disorders can choose from a number of different types of counseling/therapy approaches. This therapy will assist them in developing coping strategies, developing a plan of relapse prevention, and addressing the issues that drove their alcohol abuse in the first place. Therapy can occur in a group format or an individual format (or the individual can do both).
A plan for long-term aftercare: Therapy is typically time-limited. Thus, individuals also need to engage in some ongoing support that will assist them on a long-term basis. This can be in the form of support groups such as 12-Step meetings (e.g., Alcoholics Anonymous), a church group, some other type of peer-support group, etc.
Social support from family and friends: This support is crucial to long-term recovery. Many individuals that they have to make new friends since their old friends still engage in substance abuse; social support and 12-Step groups can assist them in building a new social network.
It is not easy to approach a coworker who has a suspected alcohol use disorder. However, the cost of ignoring the issue far outweighs the costs of actually confronting someone in a respectful, caring manner. Whenever possible, seek the help of others who have experience in confronting people with substance use disorders, such as professional interventionists and human resources managers. Make sure to consult with your supervisor before approaching anyone at work regarding such an issue.