
Chemical dependency disorders in the workplace are a costly and dangerous
proposition for your organization and your employees. But less than half
of Orange County adults who need care for mental health or substance abuse
services go on to receive treatment. St. Joseph Hoag Health is on the
front lines of this public health crisis, offering programs and resources
throughout Orange County to help those struggling with addiction to alcohol,
prescription painkillers and other drugs. We spoke with Marshall Moncrief,
regional executive director of the St. Joseph Hoag Health Institute for
Mental Health & Wellness, to understand the nature of workplace addiction,
why it matters to your business and how to manage it.
Q: What is addiction?
Addiction is a mental illness—a disease that afflicts the decision-making
sectors of the brain.
People tend to think of addiction as bad behavior or weak morals. We have
this image of the typical “drug addict” as a desperate indigent,
in a back alley, robbing people for drug money. While that’s an
unfortunate reality for some who struggle with addiction, it’s an
outdated image that does not apply to most. At St. Joseph Hoag Health,
we treat teachers, firefighters, executives, even nurses and physicians—professional
people and contributing members of the community, from very good families
and all walks of life.
Like almost any other disease, addiction
can be treated very effectively. But only if we first de-stigmatize addiction
and acknowledge that it’s a legitimate medical condition.
Q: What is the root cause of addiction in the workplace?
In a word, stress.
Stress is a major health hazard in the workplace, with both physical and
mental consequences. Some occupations are intrinsically stressful—especially
life-or-death jobs like nursing, firefighting, and police work. But the
leading causes of workplace stress can be found in any organization—everything
from long hours, high expectations, job insecurity, and lack of empowerment
to more extreme conditions like fear of bullying or harassment.
Some workers try to alleviate stress by relaxing after work with alcohol
or drugs. The problem is, people often don't understand the strength
of these substances—the stranglehold they can have on the brain.
For some folks, it’s a short step from self-medication to addiction.
Q: How can you tell if an employee is an addict?
The first point I should make is that “functional addiction”
can fool the most observant HR professional. This is partly because, as
I mentioned, the stereotypical image of the addict can blind us to reality.
In addition, the addictive substances of choice are changing in ways that
can be harder to detect. Say an employee is struggling with alcohol addiction.
Alcohol is a difficult substance to consume at work. Plus, chances are
someone would eventually smell alcohol on their breath. But what about
the addictive opioids we’ve all heard about on the national news?
Pills are tiny little things that are easily put in a purse or pocket,
only to be ingested sitting at a desk somewhere, without anybody knowing.
That said, thereare telltale signs that employers can look for as potential early warning
signs of addiction:
- Unexplained absences, tardiness, or accidents
- Anxiety or nervousness
- Chronic underperformance, frequently missed deadlines, less attention to detail
- Increasing withdrawal or changes in social networks
- Physical symptoms such as uncharacteristically high or low energy, bloodshot
eyes, impaired coordination, slurred speech, unusual breath or body odor
Q: Why does addiction in the workplace matter to employers?
I’ve had many conversations with employers who express skepticism
and frustration on this topic. They simply don’t understand why
their employees’ addiction is
their problem. While I understand this skepticism—and I’m completely
empathetic to their plight—there are many compelling reasons for
employers to embrace this issue.
First and foremost, undiagnosed mental illness—including substance
addiction—can cost an organization heavily through absenteeism,
“presenteeism,” diminished productivity, and excessive health
care expenses.
Second, since addiction is a legitimate medical illness, it should receive
the same high-caliber, compassionate care as any other disease. Most if
not all employers agree that employer-funded health care is appropriate
for cancer, heart disease, diabetes, or any other physical ailment. So
why not addiction?
Third, a given proportion of your employees
will suffer from addiction, no matter what. Cities in Orange County’s
coastal and southern regions have higher rates of hospitalization and
death from drugs and alcohol than other cities. But regardless of industry,
geography, or demography, a more or less consistent percentage of the
workforce—your workforce—will suffer from addiction. As I like to say, the numbers
don’t deviate, and addiction doesn’t discriminate. Therefore,
I advise employers to accept this basic reality and implement strategies
to anticipate, manage, and minimize its negative impact.
The biggest challenge with addiction in the workplace is the persistent
stigma. Addicts don’t usually appreciate how much their addiction
interferes with their performance. But even if they do understand, the
stigma of addiction prevents them from seeking help. They’re simply
not going to raise their hand and say, “Boss, I’m having a
problem with pills—I’d better take some time off and get a
handle on this.”
By the same token, many employers have an outdated conception of addiction
as a behavioral or moral problem. Nobody involved understands that addiction
is a legitimate medical illness that
can and should be treated.
Q: How should employers manage workplace addiction?
More than anything else, employers should embrace current evidence and
best practices around addiction care.
We’ve had workers—teachers, nurses, firefighters—whose
employers have a more enlightened understanding of addiction as a mental
illness. The results have been amazing. By interweaving this acceptance
into the culture of the organization—time off, appropriate medical
intervention, ongoing medical monitoring—those companies are signaling
to all their employees that it’s OK to admit you have an addiction
problem and to seek help.
Beyond this, there are a handful of straightforward strategies that seem
to work well:
- Partner with your insurance, EAP, and mental health providers to design
robust programs that have the greatest likelihood of success
- Update or reinforce your policies and testing for prescription drugs—especially
opioid-based drugs
- Invest in knowledge, education, and training for your employees—at
all levels
-
Ensure confidential access to appropriate assistance and treatment covering
(at minimum):
- Detoxification
- Counseling
- Medication replacement therapies
Q: What is the employee’s responsibility for addiction management?
When I talk to employers about addiction issues, I always stress that this
is a two-way street. Just because addiction is a legitimate medical illness,
that’s not a free pass for problematic and sometimes criminal behaviors.
It’s the addict’s responsibility to manage their illness—just
like people with type 1 diabetes have to manage
their illness. But, again, employers can play a very compelling role in creating
the environment, the openness, and the compassion—which changes
the culture at large.
At the end of the day, we should all want the same thing. Healthy individuals,
healthy businesses, and healthy communities.
For over 30 years, St. Joseph Hoag Health has had some of the best-respected
addiction treatment programs in Orange County. We’re embedding mental
health clinicians in our primary care offices—to be a stronger support
system for our primary care physicians—and to enhance screening
for substance abuse and mental health challenges.
To learn more: Contact us at (949) 381-4777 to learn more about our continuum of
mental health care, including inpatient and outpatient treatment for chemical dependency,
depression, bipolar disorder, and other psychiatric and behavioral health issues.
Sources:
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