Let’s TALK a lot about your ALCOHOL problem in your Drug Program at work!

Because alcohol is often viewed as a commodity, we forget the dangers of it. We forget it’s a depressant. We forget it can be addictive. In establishing a clear and comprehensive workplace policy is one of the most effective ways to prevent workplace alcohol and drug problems, and to effectively investigate and take corrective action. Your company must decide what will work best in your environment; there is no ‘one size fits all’ policy. 

“An effective policy allows employers and employees to be clear about what is acceptable and not acceptable in the workplace,”

We have all heard it doesn’t impact me well have you seen your liver for starts!

But if you drink frequently or excessively, your body will find ways to remind you. Circumstances and situations will arise that will remind you. Aside from massive headaches and hangovers, with time you start to discover the rest of alcohol’s dark side.

The Early or Adaptive Stage

The early or adaptive stage of alcoholism is marked by increasing tolerance to alcohol and physical adaptations in the body which are largely unseen. This increased tolerance is marked by the alcoholic’s ability to consume greater quantities of alcohol while appearing to suffer few effects and continuing to function. This tolerance is not created simply because the alcoholic drinks too much but rather because the alcoholic is able to drink great quantities because of physical changes going on inside his or her body.

The early stage is difficult to detect. By appearances, an individual may be able to drink a great deal without becoming intoxicated, having hangovers, or suffering other apparent ill-effects from alcohol. An early stage alcoholic is often indistinguishable from a non-alcoholic who happens to be a fairly heavy drinker.

In the workplace, there is likely to be little or no obvious impact on the alcoholic’s performance or conduct at work. At this stage, the alcoholic is not likely to see any problem with his or her drinking and would scoff at any attempts to indicate that he or she might have a problem. The alcoholic is simply not aware of what is going on in his or her body.

The Middle Stage

There is no clear line between the early and middle stages of alcoholism, but there are several characteristics that mark a new stage of the disease. Many of the pleasures and benefits that the alcoholic obtained from drinking during the early stage are now being replaced by the destructive facets of alcohol abuse. The drinking that was done for the purpose of getting high is now being replaced by drinking to combat the pain and misery caused by prior drinking.

One basic characteristic of the middle stage is physical dependence. In the early stage, the alcoholic’s tolerance to greater amounts of alcohol is increasing. Along with this, however, the body becomes used to these amounts of alcohol and now suffers from withdrawal when the alcohol is not present.

Another basic characteristic of the middle stage is craving. Alcoholics develop a very powerful urge to drink which they are eventually unable to control. As the alcoholic’s tolerance increases along with the physical dependence, the alcoholic loses his or her ability to control drinking and craves alcohol.

The third characteristic of the middle stage is loss of control. The alcoholic simply loses his or her ability to limit his or her drinking to socially acceptable times, patterns, and places. This loss of control is due to a decrease in the alcoholic’s tolerance and an increase in the withdrawal symptoms. The alcoholic cannot handle as much alcohol as they once could without getting drunk, yet needs increasing amounts to avoid withdrawal.

Another feature of middle stage alcoholics is blackouts. Contrary to what you might assume, the alcoholic does not actually pass out during these episodes. Instead, the alcoholic continues to function but is unable to remember what he or she has done or has been. Basically, the alcoholic simply can’t remember these episodes because the brain has either stored these memories improperly or has not stored them at all. Blackouts may also occur in early stage alcoholics.

Impairment becomes evident in the workplace during the middle stage. The alcoholic battles with loss of control, withdrawal symptoms, and cravings. This will become apparent at work in terms of any or all of the following: increased and unpredictable absences, poorly performed work assignments, behavior problems with co-workers, inability to concentrate, accidents, increased use of sick leave, and possible deterioration in overall appearance and demeanor. This is the point where the employee may be facing disciplinary action.

Late Stage

The late, or deteriorative stage, is best identified as the point at which the damage to the body from the toxic effects of alcohol is evident, and the alcoholic is suffering from a host of ailments. An alcoholic in the final stages may be destitute, extremely ill, mentally confused, and drinking almost constantly. The alcoholic in this stage is suffering from many physical and psychological problems due to the damage to vital organs. His or her immunity to infections is lowered, and the employee’s mental condition is very unstable. Some of the very serious medical conditions the alcoholic faces at this point include heart failure, fatty liver, hepatitis, cirrhosis of the liver, malnutrition, pancreatitis, respiratory infections, and brain damage, some of which is reversible.

Why does an alcoholic continue to drink despite the known facts about the disease and the obvious adverse consequences of continued drinking? The answer to this question is quite simple. In the early stage, the alcoholic does not consider himself or herself sick because his or her tolerance is increasing. In the middle stage, the alcoholic is unknowingly physically dependent on alcohol. He or she simply finds that continuing to use alcohol will prevent the problems of withdrawal. By the time an alcoholic is in the late stage, he or she is often irrational, deluded, and unable to understand what has happened.

In addition to the effects of these changes, the alcoholic is faced with one of the most powerful facets of addiction: denial. An alcoholic will deny that he or she has a problem. This denial is a very strong force. If an alcoholic did not deny the existence of a problem, he or she would most likely seek help when faced with the overwhelming problems caused by drinking. While denial is not a diagnosable physical symptom or psychiatric disorder, it is an accurate description of the state of the alcoholic’s behavior and thinking and is very real.

"Alcoholism is a primary, chronic disease with genetic, psychological, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortion in thinking, most notably denial."

Alcohol is the single most used and abused drug in America. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), nearly 14 million Americans (1 in every 13 adults) abuse alcohol or are alcoholics. Several million more adults engage in risky drinking patterns that could lead to alcohol problems. The costs to society in terms of lost productivity, health care costs, traffic accidents, and personal tragedies are staggering. Numerous studies and reports have been issued on the workplace costs of alcoholism and alcohol abuse, and they report costs that range from $33 billion to $68 billion per year. Alcohol is a major factor in injuries, both at home, at work, and on the road. Nearly half of all traffic fatalities involve alcohol.

What are the Dangers of Alcohol?

Some of the effects and risks of alcohol abuse include:

• Wet brain (a serious form of brain damage that causes lack of muscle coordination, major memory problems, hallucinations and vision impairment);
• Violence resulting from poor judgement and lack of inhibition;
• Strained or broken relationships from incidents caused while under the influence;
• High blood pressure, which increases risk of heart failure, kidney damage, brain damage, and stroke;
• Depression;
• Liver damage;
• Nerve damage;
• Anemia;
• Increased risk for cancer.

Whether your alcoholism is obvious to the outside world or not, your private life will suffer heavily under the influence of alcohol. Your relationships with your partner, your children, your parents, your siblings and your friends might be damaged by tension and hurtful incidents. Or maybe you’re not having fights at home, but you’re unable to provide support to your partner or your child or your parent, even at times when they’re going through serious illnesses and need you. Even if there are no fights, the pain of your absence can still leave holes in the souls of the people who love you.

The things you do when under the influence may include lying, cheating, getting aggressive, and doing other things that might go against your values. Consistently behaving in ways that are not aligned with your values can lead to depression and self-loathing.

Not so harmless, is it?

Break the Addiction and Repair your Life

Yes you can be successful. Yes you can build fulfilling relationships again. Yes you can learn to respect yourself again. We’ll help you start healing, in your body, in your relationships, in your life.

Supervisor’s Role

As a supervisor, you have an important role in dealing with alcohol problems in the workplace, along with other agency officials. You have the day-to-day responsibility to monitor the work and on-the-job conduct of your employees. You are not responsible for diagnosing alcoholism in employees. Basic supervisory responsibilities include:

• assigning, monitoring, reviewing, and appraising work and performance;
• setting work schedules, approving or disapproving leave requests;
• taking necessary corrective and disciplinary actions when performance or conduct problems surface; and
• referring employees to your agency’s Employee Assistance Program (EAP).

At some point, you will likely encounter employees with problems related to alcohol in dealing with performance, conduct, and leave problems. In some cases, you may not know that there is an alcohol problem. In other cases, you may know, either because the employee admits to being an alcoholic, or the problem is self-evident. For example, an employee may become intoxicated while on duty or be arrested for drunk driving. Your role is not to diagnose the alcohol problem but to exercise responsibility in dealing with the performance or conduct problem, hold the employee accountable, refer the employee to the EAP, and take any appropriate disciplinary action. Your role in dealing with alcoholism in the workplace is crucial. The most effective way to get an alcoholic to deal with the problem is to make the alcoholic aware that his or her job is on the line and that he or she must get help and improve performance and conduct, or face serious consequences, including the possibility of losing his or her job.

Signs to Look for

Even though you must not try to diagnose the problem, there are many signs that may indicate a problem with alcohol, and should trigger a referral to the EAP.

Leave and Attendance

• Unexplained or unauthorized absences from work
• Frequent tardiness
• Excessive use of sick leave
• Patterns of absence such as the day after payday or frequent Monday or Friday absences
• Frequent unplanned absences due to "emergencies" (e.g., household repairs, car trouble, family emergencies, legal problems)

The employee may also be absent from his or her duty station without explanation or permission for significant periods of time.

Performance Problems

• Missed deadlines
• Careless or sloppy work or incomplete assignments
• Production quotas not met
• Many excuses for incomplete assignments or missed deadlines
• Faulty analysis

In jobs requiring long-term projects or detailed analysis, an employee may be able to hide a performance problem for quite some time.

Relationships at Work

• Relationships with co-workers may become strained
• The employee may be belligerent, argumentative, or short-tempered, especially in the mornings or after weekends or holidays
• The employee may become a "loner"

The employee may also have noticeable financial problems evidenced by borrowing money from other employees or receiving phone calls at work from creditors or collection companies.

Behavior at Work

The appearance of being inebriated or under the influence of alcohol might include:

• The smell of alcohol
• Staggering, or an unsteady gait
• Bloodshot eyes
• Smell of alcohol on the breath
• Mood and behavior changes such as excessive laughter and inappropriate loud talk
• Excessive use of mouthwash or breath mints
• Avoidance of supervisory contact, especially after lunch
• Tremors
• Sleeping on duty

Not any one of these signs means that an employee is an alcoholic. However, when there are performance and conduct problems coupled with any number of these signs, it is time to make a referral to the EAP for an assessment so that the employee can get help if it is needed.

Next Steps

Employee Assistance Program

Employee Assistance Programs deal with all kinds of problems and provide short-term counseling, assessment, and referral of employees with alcohol and drug abuse problems, emotional and mental health problems, marital and family problems, financial problems, dependent care concerns, and other personal problems that can affect the employee’s work. This service is confidential. These programs are usually staffed by professional counselors and may be operated in-house with agency personnel, under a contract with other agencies or EAP providers, or a combination of the two.

The EAP counselor will meet with the employee, assess or diagnose the problem, and, if necessary, refer the employee to a treatment program or resource. With permission of the client, the EAP counselor will keep you informed as to the nature of the problem, what type of treatment may be needed, and the progress of the employee in treatment. Before releasing this information to you, or anyone else, the counselor would need a signed written release of information from the client which would state what information may be released and to whom it may be released. The EAP counselor will also monitor the employee’s progress and will provide follow-up counseling if needed.

Sometimes, the employee will contact the EAP on his or her own. However, in some cases, the employee will be referred by you because you have noted a decline in the employee’s conduct, attendance, or performance and/or seen actual evidence of alcohol use or impairment at work.

Human Resources, or Employee Relations Program

The role of the Human Resources, or Employee Relations office in dealing with cases of substance abuse is to advise management of appropriate adverse, disciplinary, or other administrative actions which may be taken. They also advise employees of their rights and the procedures in such cases. They do not obtain confidential information from the EAP nor do they independently approach the employee regarding the problem.

As a supervisor, you are responsible for confronting the employee. Employee relations staff will work with the EAP to the extent that confidentiality is not violated, will try to assist you in working with the EAP, and will work with you to try to make sure that any adverse or disciplinary actions are appropriate and defensible. In most agencies, it is the employee relations or human resources specialist who actually prepares or drafts adverse or disciplinary action letters, including those involving a firm choice. A firm choice is a clear warning to an employee who has raised alcohol or drug abuse in connection with a specific performance, conduct, or leave use incident or deficiency. He or she must make a choice between accepting treatment for the alcohol or drug problem and improving job performance or facing disciplinary action, up to and including removal.

Confronting the Employee

It is generally a good practice to notify any employee who is being counseled for a performance or conduct problem about the availability of the EAP. However, it is crucial to make a referral to the EAP in the case of an employee with a known alcohol problem. Although you are not diagnosing the problem, you are dealing with employee performance and conduct and, possibly, alcohol-related misconduct such as using, possessing, or being under the influence of alcohol at work.

As a supervisor, you need to develop a strategy for addressing the work-related problems, as well as for encouraging the employee to get help. A good starting point is to meet with the EAP counselor, if possible, to discuss the problems observed and any other behavior by the employee that needs attention. The EAP counselor can help devise a strategy for confronting the employee and advise on techniques of addressing the problems.

Before actually meeting with the employee, you should gather any documentation of performance or conduct problems and think about what items to discuss with the employee. It is important to be specific about the problems in the employee’s performance and conduct and the particular incidents of concern. It might be helpful to rehearse this or at least go over the documentation with the EAP counselor.

Once prepared, you should notify the employee of the time and place of the meeting. The meeting should be held in a private place away from distractions. It is important to calmly but firmly explain the problems with the employee’s performance, the specific acts of misconduct or troubling behavior, and the consequences of any misconduct or poor performance. Unless the employee reveals the existence of an alcohol problem or there is immediate evidence of on-duty impairment, you must be careful not to offer any opinion that the employee may have a problem with alcohol. You should refer the employee to the EAP and explain that failure to correct any deficiencies may result in disciplinary or other action. It would be preferable to have already made an appointment for the employee with the EAP. While the employee may not be forced to take advantage of the EAP services, you should make clear that it is in the employee’s best interest to use the services.

Sometimes the employee will not accept the referral to the EAP or will deny the existence of a problem. If this happens, it is important to continue to document any problems and to take any necessary disciplinary action. It is not unusual to have additional meetings with the employee and to make additional referrals. The employee is in "denial" at this point and does not see that he or she has a problem. This is the hardest part of dealing with an alcoholic. The disease is so strong that the individual is unable to see what is happening to himself or herself. In any case, the appropriate course of action is to continue to hold the employee accountable for his or her performance and/or conduct, regardless of whether or not the employee has admitted an alcohol problem.

If an employee chooses to use the EAP at your urging, he or she may enter some type of treatment program as described earlier in this booklet. If the employee does not choose to go into treatment, the next step will be to take any disciplinary or corrective actions that are necessary.

Intervention

One technique which can be used to confront the employee is called intervention. It generally consists of scheduling a session with the employee where a number of people significant in his or her life are present, including you, the spouse, children, clergy, other family members, co-workers and other friends.

The session must be led by a trained professional, such as the EAP counselor. It involves having each of the individuals present directly tell the employee how his or her drinking has affected their lives and what the consequences of that employee’s drinking have been. If the

intervention is effective, this can be a very powerful tool to counter denial and may help the employee consider treatment. It is extremely important that such an intervention be led by a trained professional and not by a lay person, such as a supervisor, because it can be a very emotional and powerful event and, if not conducted properly, may very likely backfire. Supervisors should contact an agency EAP counselor for more information about the intervention technique.

Considerations During and After Treatment

Leave Status

During the period of time that the employee is away from work receiving treatment, he or she will usually be carried in some type of approved leave status. In most cases, it would be appropriate for the employee to be carried on any available sick leave. Otherwise, annual leave or leave without pay would be appropriate. Normally, the employee would not be charged as absent without approved leave (AWOL) unless the employee’s absence had not been approved. Check with the Human Resources office about the rules and policies regarding approval and denial of leave.

Return to Duty

When the employee has completed any treatment requiring extended absence and is ready to return to work, it is a good practice to have a back-to-work conference. The conference should be attended by you as the supervisor, the employee, the EAP counselor, a staff member from the treatment program, other appropriate personnel from human resources, and the employee’s representative if one has been elected. This back-to-work conference can help explain what has gone on in treatment, what the employee’s treatment schedule looks like, and any needed changes in work such as travel schedules or closer supervision.

Follow-up Care

After the employee’s return to duty, there will be some type of follow-up care such as a 12-Step program or other group meetings, therapy, EAP sessions, or any combination of the foregoing. These sessions should cause only minimal disruption to the work schedule. The EAP counselor can explain the importance of the follow-up program to the employee’s continued sobriety.