What does one do when the CEO is drinking or drugging too much?

Some of the most innovative, creative, intelligent, passionate, successful, business people may be addicted to drugs and/or alcohol. It is more common than one would imagine. The drug epidemic is present in every segment of society, even in the boardroom. What happens when the leader of a company is drinking on the job, stops showing up to critical meetings, or is inappropriate? When does the CEO's substance abuse cross the line and need to be discussed?

In 2006, when I was the CEO and Founder of my first rehab, we had a client who had taken over the leadership of a large family-owned business after his father had passed away. Our Client was addicted to crack cocaine and actively seeking buyers for the company.  

During his assessment for admission to rehab, he told our intake people his goal was to stay clean and sober as long as it took to get his company sold after which he would decide if he wanted to remain abstinent or return to smoking crack. He had a list of conditions before he would accept treatment at our Center.  

He wanted time while he was in treatment to negotiate with the potential buyers, talk to his attorneys, go to meetings, use his computer and phone. Our admission people said they would have to speak with the clinical leadership at the rehab to see if his requests were possible. 

I heard lots of different opinions from the clinical team on his requests including:

• He needs to put his treatment ahead of his business; this is life or death; the sale of his company can wait until he finishes rehab and it would be unprofessional of our treatment center to allow him to dictate his treatment
• He should complete the sale of his business then he can be admitted for treatment
• We can accommodate his request by building an individualized program of recovery and services around his business commitments

As the CEO of the treatment center, people may wonder if I decided on whether to admit him; I did not. It is not that I don't have an opinion on the subject, but I viewed my role as empowering our clinical team to develop and operate our program using their experience, education while relying on evidence-based best practices for the treatment of addiction and mental health disorders.

At the end of a protracted discussion between members of the clinical team, our Clinical Director made the decision. She admitted him and built an individualized program of services that allowed him to use our treatment center as an extended office to conduct his affairs while providing a suite of personalized, comprehensive and multi-dimensional modalities to treat his addiction and underlying mental health disorder. 

Our client did very well. After three months in rehab, he was able to sell the company and find a passion for recovery. Our clinical team in conjunction with business advisors helped him navigate how much to disclose about his addiction, treatment and the sale of the company to different stakeholders including family, executives, and team members. Our Client actively engaged in the Center's recovery activities and came to understand the importance of the work.  

I would caution on using this one example as a treatment template for a similar situation. One positive outcome does not constitute a best practice. The difficulty with addiction and mental health treatment is that it is fraught with complexities. It is terrific when results are positive, and it may be tragic when they aren’t. 

Personally, I believe that treatment needs to be a team sport that includes multidisciplinary, experienced, and educated professionals who work together in partnership with the client to develop a lifestyle of recovery.  

I’ve written about one situation where the CEO voluntarily sought help for his addiction. What can be done when a CEO does not recognize she has a problem or she won't won’t get help?  

I wish I could give you a simple answer to the above question; I can’t. Many factors will affect the approach you take including:

• The size and durability of the organization 
• Whether the company is public or private
• Is the company owned, controlled or managed by single or multiple individuals
• The severity of the leader’s addiction and mental health condition
• How many of your colleagues recognize the problem
• The culture of the organization

Many people have heard of doing an “intervention” but how do you do that? I’d recommend consulting with a professional interventionist who can help. I did a quick search and found 30 pages of Interventionist listed on Linkedin. If I were going to choose an Interventionist for this type of situation, I’d want one that understands the dynamics and complexity of a business. The show Intervention portrayed a style of Intervention that was TV friendly. That model of intervention may not be useful for a business leader. Do your due diligence, getting an experienced interventionist will make a huge difference in the outcome.  

Many Interventionists view their work as getting the individual into residential treatment. I’d personally choose an interventionist that could match the treatment approach with the client and her situation. Residential rehab is only one type of treatment, and they do not all operate the same way. It is possible to find rehabs that will be more accommodating than others.  

Another challenge is knowing whether to choose residential, sober living, outpatient, or at-home. The admissions people at the rehabs may talk about individualizing care, but when you get into the details, you may be disappointed. From the research reports I’ve read treatment needs to be personalized, comprehensive, trauma-informed, medically-assisted, and long-term.  

This article of course only scratches the surface of working with a business leader. I welcome your comments, suggestions, and insights. 

With gratitude,

Alex