Competition for qualified, motivated and committed employees has never been more challenging. Stressors, pandemic related or not, have led to an increase in drug and alcohol use at home and in the workplace. Our collective sobriety has been challenged in ways never thought possible. While employers have an obligation to provide a heathy, supportive and safe work environment, new policies and procedures related to the pandemic have been difficult to implement. Current policies of “Zero Tolerance”—like the 1980’s “War on Drugs”—have largely failed to conquer the problems they were created to solve. Simply defined, zero tolerance is the swift and immediate firing of any employee found to be impaired on the job or who is suffering from a substance use disorder (SUD) due to physical, emotional, or psychological dependence on alcohol or drugs.
Background
Current federally collected data (SAMHSA) supports that over 25 million Americans suffer from some form of addiction, with only a small percentage receiving treatment. Drug overdose deaths have skyrocketed in the last 4 years—since 1999 over 841,000 people have died. Opioids, often mixed with alcohol or other substances are largely to blame. Drinking alone contributes to 261 deaths every day in the United States totaling more than 95,000 per year. In 2010, the economic cost of excessive drinking was best estimated at $249 billion per year. To suggest that these statistics do not directly impact our workforce is naïve. The overwhelming majority of substance users are fully employed—greater than 70 percent. According to a University of Chicago study, untreated substance use costs to employers have increased 30% in the last 4 years. One in every 12 employees has an untreated substance use disorder. Mining, construction and service occupations have the highest rates of substance use (and are often safety-sensitive jobs).
Initially, in an attempt to maximize jobsite safety and minimize workplace risk, “Zero Tolerance” policy would lead to an immediate and unquestioned dismissal of an employee for being impaired at work or for any positive drug test. By increasing the consequences of a positive test, employers hoped to modify these self-destructive behaviors. Human resource policies were based on the antiquated belief that excess use of substances, legal or illegal to suffer from moral weakness, character defects or simply lack of willpower and self-control. Workplaces of the past could easily design and administer “Zero Tolerance” programs and turn a blind eye to the problem. Being tough was felt to be the easiest, best approach.
Unfortunately, this strategy has backfired—creating a dangerous culture of mistrust at work. Employees play a game of “Cops and Robbers” with management, trying to not get caught or working hard to evade or manipulate the testing process. Current policies have led to an expensive cycle of lost productivity and poor performance, workplace injury or fatalities, mood and behavior problems, theft, plummeting employee morale and employee turnover. In this scenario, it is inevitable that increased medical and legal costs, as well as increased worker’s compensation claims and OSHA involvement, will follow.
Financial Costs
It is difficult to precisely estimate the amount of money that alcohol and drugs cost our workplaces. In 2010, the economic cost of excessive drinking was best estimated at $249 billion per year to US society in general. Researchers currently estimate total lost work, health care costs and lost productivity costs U.S. businesses a staggering $81 billion annually due to drug abuse alone. Estimates place the cost to employer close to $9,000 per employee annually for untreated alcohol and drug use.
Absenteeism and Turnover
Based on National Clearinghouse for Alcohol and Drug Information (NCADI) statistics, drug and alcohol users take 3 times more sick days and average close to 15 days/year of unscheduled leave. These absences are inconvenient and increase employer costs—the job still needs to get done. Over 40% of employees with SUD have switched jobs in the last year; some industries (service, entertainment) nearing 50% turnover.
Medical Costs
Healthcare costs associated with drug abuse alone, excluding alcohol, is estimated to be $25 billion annually. Emergency room visits, the most expensive location to receive medical care, are 4 times higher than those with SUD and more than twice as likely to be admitted to a hospital.
Injuries/Workers Compensation
It is estimated that 65% all jobsite injuries are related to drug or alcohol use and that up to 50% workers compensation claims are somehow related to substance use. According to NCADI statistics, drug, and alcohol users 5 times more likely to file a compensation claim. One study found that one in five workers report being put in danger, having to work more, or to cover or redo work due to a co-worker’s alcohol use.
Workplace Theft
An older study from 1994 found that 80% of drug abusers would steal from their workplace in order to support their destructive habits. American retailers lose close to $50 billion due to fraud and theft—30% of all inventory loss was due to employees stealing.
Mental Health
Anxiety and depression are doubled in workers with substance use issues and up to 4 times higher in those dealing specifically with drug use.
In summary, this is an expensive downward spiral of increased costs and decreased productivity for employers in part and society in general.
One Solution
As public perception and public attitudes have adapted and evolved, these hardline standards have softened, benefiting employer and employee alike. Healthcare leaders have adopted a medical model for substance use and have developed treatments and medications to support recovery and workplace return based on scientific, evidence-based practices. Medications have been developed that assist significantly in the safe, rapid return to the workplace. Therapy modalities have evolved beyond traditional 12-step programs, have become virtual and are based in scientific results and data collection.
Of the over 25 million suffering from a substance abuse disorder, less than 1 in 12 will receive treatment. Seeking treatment for substance use and abuse is the new goal for employers. Previously, those fired for drug and alcohol use were more likely to simply find new employment without any incentive to enroll in treatment—forcing the destructive patterns to continue. By providing opportunities for assistance, workers eliminate the culture of punishment and fear, encouraging open discussion and allowing workers to get help—knowing their position would be safe within the company. Discussion and education, especially involving substances considered “safe” such as marijuana and alcohol could more openly take place, encouraging more to see help. Supervisors and managers also would get training on recognizing impairment and adopting a proactive approach towards recovery.
Benefits of Treatment: Workplace Centered
Employer-initiated treatment, studies show, is more often successful and longer-lasting than treatment initiated by family members or friends. Each employee who enters treatment and recovers from substance use disorder (SUD) saves their employer over $8,500 on average. Comprehensive medical treatment programs, according to U.S. Department of Labor statistics have found significant job-related improvements. A single study from the state of Ohio showed a 91% decrease in absenteeism, 93% on-the-job errors and up to 97% decrease in on-the-job injuries.
Workers in recovery miss 13.7 fewer days and interestingly, miss less work time than average employees (3.6 days less). Workers in recovery tend to remain in jobs longer, are less likely to need medical services than average. In some industries, employers save more than $4000 for each worker in substance abuse treatment.
Adoption of more reasonable guidelines, manager and employee education and cultural evolution will contribute to greater personal and public health, improve workforce relations and ultimately save money in lost productivity, employee turnover, and decrease workplace injury.
Human Resources and Employee Assistance
Increasingly, employers are looking toward outside consultants to provide onsite assessment screening and especially in this situation of a possibly impaired employee. By working closely with Human Resources or with an Employee Assistance Program, one can aid them with program compliance, urine, breath or saliva testing and help guide successful long-term recovery. Consultants can also aid with the development and enforcement of workplace policies more beneficial than antiquated zero tolerance.
Education
It has become clear that education centered on options and available resources for treatment is necessary. In addition, supervisors need training and early recognition and intervention techniques to best serve employees. In addition, education of workforce on abstaining or responsible use of “safe” substances, ie. Marijuana, alcohol, kratom, prescription drugs, can occur in a trusting and supported environment. Workplaces can also provide a safe location for outside-of-work meetings focusing on recovery, growth and development and general mental health. Organizations like Alcoholics Anonymous and Smart Recovery are always willing to provide free leadership group meetings when provided with appropriate space.
It is absolutely expected, despite the failings of zero tolerance, that employees do not put themselves and co-workers at risk by being under the influence of alcohol or drugs while on the job.
Compassion, concern, and knowledge about substance use make those in a supervisory role build trust and ultimately lead to the best possible outcomes. All of this is done with the goal of returning an employee back to the workforce safely and effectively.
References
Buddy, T. (2020, September 26). The Dangers of Substance Abuse in the Workplace. Retrieved from VeryWellMind: https://www.verywellmind.com/substance-abuse-in-the-workplace-63807
Centers for Disease Control and Prevention. (2021, December). Drug Overdose Deaths. Retrieved from CDC.gov: https://www.cdc.gov/drugoverdose/deaths/index.html
French, M., JC, M., & Sindelar JL, F. H. (2011). The morning after: alcohool misuse and employment problems. Applied Economics, 2705-2720.
Frone, M. R., & Brown, A. L. (2010). Workplace Substance-Use Norms as Predictors of Employee Substance Use and Impairment: A Survey of U.S. Workers*. Journal of Studies on Alcohol and Drugs, 71(4), 526-534. Retrieved 12 31, 2021, from https://ncbi.nlm.nih.gov/pmc/articles/pmc2887922
Goplerud Phd., E., & Hodge MPH, S. (2017). A Substance Use Cost Calculator for US Employers With an Emphasis ono Prescription Pain Medication Misuse. Journal of Occupational and Environmental Medicine, 1063-1071.
Koenig, L., Siegel, J. M., Harwood, H. J., Gilani, J., Chen, Y.-J., Leahy, P. J., & Stephens, R. C. (2005). Economic benefits of substance abuse treatment: Findings from Cuyahoga County, Ohio. Journal of Substance Abuse Treatment, 28(2). Retrieved 12 31, 2021, from https://ncbi.nlm.nih.gov/pubmed/15797638
Miller, T., & Hendrie, D. (2008). Substance Abuse Prevention Dollars and Cents: A Cost-Benefit Analysis. Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration.
Substance Abuse and Mental Health Administraation. Drug-Free Workplace Toolkit. (2021, September 16). Retrieved from SAMHSA.gov: http://www.samhsa.gov/workplace/toolkit
US Office of Personnel Managment. Alcoholism in the Workplace. (2021, November 9). Retrieved from OPM.gov: http://www.opm.cov/policy-data-oversight/worklife/reference-materials/alcoholism-in-the-workplace-a-handbook-for-supervisors
