As companies make plans to improve their products or services and expand their businesses, they also should examine their operating environment and workforce. Alcohol and drug use disorders have been estimated to cost American businesses up to $98.5 billion in productivity losses in one year.1 However, by committing to a drug-free workplace and supporting alcohol and drug use disorder treatment programs for employees, businesses experience a variety of benefits, including increased quality of performance.
The costs and benefits of workplace policies are primary considerations for businesses—no single solution will work for every organization. But understanding various approaches to alcohol and drug use disorder treatment and recovery will help employers make the right decisions for their businesses.
Prevalence of Alcohol and Drug Use Disorders in the Workplace
According to the U.S. Substance Abuse and Mental Health Services Administration's (SAMHSA's) 2002 National Survey on Drug Use and Health, most adults with alcohol or drug use disorders work. Of the 19.8 million adults with any type of alcohol or drug use disorder, 77.1 percent are employed. And out of the 16.6 million adults who use illicit drugs, nearly three quarters are employed.2 The problem is so widespread that more than 60 percent of adults know someone who has reported for work under the influence of alcohol or other drugs.3
Problems with alcohol are common among working adults. Research shows that:
Eighty-one percent of the 51.1 million adult binge drinkers (those who consumed five or more drinks on the same occasion at least once in the past month) were employed either full or part time in 2002.
Close to 12 million employed adults were classified as heavy drinkers (consumed five or more drinks on the same occasion on at least five days in the past month) in 2002.4
These disturbing data underscore the urgency for all companies, including small businesses, to implement a drug-free workplace program and to create an environment that encourages and enables employees with alcohol and drug use disorders to access treatment programs. A workplace that ignores alcohol and drug use disorders does not reflect the best interests of the company or its employees.
What Is A Drug-Free Workplace Program?
A drug-free workplace program is an alcohol and drug use disorder prevention program tailored by a company to promote a safe and productive workplace. Programs may include:
A written alcohol and drug use disorder policy that reflects the commitment of the employer to provide a workplace free of alcohol and drug use
Employee education to communicate the policy and the dangers of alcohol and drug use on the job
Supervisory training on how to recognize signs of alcohol and drug use disorders based on job performance, and guidance for intervening and making appropriate referrals for employees with alcohol or drug use disorders
Drug testing to monitor policy compliance and minimize health and safety risks to others
An employee assistance program (EAP) to provide confidential problem identification, short-term counseling, referrals to treatment and follow-up services to help resolve employees' problems.
EAPs generally are the most effective vehicle for addressing employee workplace performance issues that may stem from alcohol or drug use disorders and other personal problems. EAPs display an employer's respect for employees and their families, offer an alternative to dismissal, and can reduce injury, security, and healthcare costs.5, 6 In addition to counseling and referrals, basic EAP services may include follow-up services, management consultation, supervisory training, employee education, individual or motivational counseling, and drug-free workplace policy development and implementation.7
Small businesses are often at a disadvantage because they are less likely than large companies to have drug-free workplace programs due to the cost of such programs.
To help small businesses create and implement EAPs and other components of drug-free workplace programs, there are a multitude of government resources available that provide free assistance and grants.
SAMHSA's Division of Workplace Programs offers a toll-free Workplace Helpline (800-Workplace), as well as additional workplace resources at www.workplace.samhsa.gov.
U.S. Small Business Administration (www.sba.gov) awards grants to help small businesses establish drug-free workplace programs.
U.S. Department of Labor (www.dol.gov)'s Working Partners Small Business Workplace Kit provides introductory resources and information for making workplaces alcohol- and drug-free.
Access to Recovery
There are substantial benefits to achieving an alcohol- and drug-free workplace through alcohol and drug use disorder treatment and recovery for employees in need. They include increases in:
Employee performance, motivation, and morale
Customer satisfaction
Corporate financial savings
Numerous studies have shown that the financial and other resources required to support such treatment programs are cost-effective.8, 9 In fact, research has shown that full parity for alcohol and drug treatment services in private health insurance plans would increase family insurance premiums less than 1 percent. This means alcohol and drug use disorders, as well as co-occurring disorders, would receive the same coverage as other physical disorders.10 Co-occurring disorders include a combination of alcohol or drug use disorders and mental disorders, which refers to any mental or emotional disorder, including eating, anxiety, mood, and depression disorders, bipolar disorders, and schizophrenia.
Unfortunately, public and private insurance plans typically do not adequately cover treatment for alcohol and drug use disorders. Many of those insurance plans do not cover specific services, limit the number of services with annual or lifetime caps, or stipulate limited or no continuing care.11
To help more Americans obtain appropriate treatment and recovery services, President Bush has launched Access to Recovery, a new initiative designed to increase the availability and effectiveness of treatment programs. By providing vouchers to people in need of treatment, the Access to Recovery grant program promotes individual choice for substance abuse treatment and recovery services. It also expands access to care, including access to faith- and community-based programs, and increases substance abuse treatment capacity.
Making a Difference: What Can I Do?
Set the tone. Establish a comprehensive drug-free workplace program to demonstrate your company's commitment to an environment free of alcohol and drug use. Start by contacting some of the resources listed at the end of this fact sheet.
Make it easy to get help. Smaller businesses that cannot afford in-house resources should refer employees with alcohol and drug use disorders (and any co-occurring conditions) to appropriate local mutual support organizations and professionals, including certified alcohol and drug use disorder counselors and therapists. Resources also are available to assist individuals within a particular field. For example, a law firm may refer an attorney with an alcohol or drug use disorder to Lawyers Concerned about Lawyers, the ABA Commission on Lawyer Assistance Programs, or its bar association's lawyer assistance program.
Hire individuals in recovery. Recruiting and hiring people in recovery helps them regain control of their lives and reduces the stigma of alcohol and drug use disorders by sending a positive message that people in recovery can become productive members of society. The National Association on Drug Abuse Problems, Inc. (NADAP) has smoothed the transition from treatment to employment for nearly 10,000 men and women through its business and labor partnerships. For more information, call 212-986-1170 or go to www.nadap.org.
Provide adequate coverage. The cost of treatment for alcohol or drug use disorders can be prohibitive for many people. Many people in recovery who have health insurance often find that coverage for treatment for their disorder is limited or nonexistent. To fill this void, negotiate coverage of behavioral health services, including alcohol and drug use disorder treatment and counseling, with your health insurance company.
Making a Difference: How Can I Contribute to Recovery Month?
Each September, National Alcohol and Drug Addiction Recovery Month (Recovery Month) is celebrated by hundreds of organizations across the country to highlight the importance of treatment for alcohol and drug use disorders. Your company can make a difference by taking part in outreach efforts to promote and observe Recovery Month.
Educate your employees. The most important audience you can reach with information about alcohol and drug use disorder treatment is your staff. Provide employees with facts on the signs and symptoms of alcohol and drug use disorders, treatment options, and the company's policy on supporting employees in recovery. Deliver Recovery Month information through the company intranet, internal newsletters, e-mails, paycheck inserts, and/or bulletin boards in common areas throughout the office.
Act locally. Make a financial donation, coordinate a volunteer effort with a group of employees, sponsor a Recovery Month educational or publicity event, or offer pro bono company services to a local provider of alcohol and drug use disorder recovery services.
Go public. Distribute a press release to the local media about your company's Recovery Month activities, highlighting the company's drug education program as well. Or write an article for placement in a business publication that expresses your opinion about alcohol and drug use disorders in the workplace and what can be done about it. Support your position with relevant statistics or scientific study results (which can be found through the resources at the end of this fact sheet), personal anecdotes, or references to recent news events. Celebrate employees in recovery (with their permission) by highlighting their accomplishments in the company publication, or by posting their success stories in common work areas.
Evaluate your efforts. Survey your employees to obtain feedback on your company's workplace drug education program and determine what elements are not effective. Ensure confidentiality of their responses, and use the findings to make decisions regarding any modifications to the program.
For additional Recovery Month materials, visit our Web site at www.recoverymonth.gov or call 1-800-662-HELP.
WORKPLACE RESOURCES
Drug-Free Workplace Programs
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) Workplace Resource Center workplace.samhsa.gov www.drugfreeworkplace.gov
Workplace Helpline 800-WORKPLACE (800-967-5752) (Toll-Free)
Centralized access to information about drug-free workplaces and related topics http://getfit.samhsa.gov
U.S. DEPARTMENT OF LABOR (DOL)
Working Partners for an Alcohol- and Drug-Free Workplace
200 Constitution Avenue NW, Room S-2312
Washington, D.C. 20210
866-4-USA-DOL 877-889-5627 (TTY)
Substance Abuse Information Database
Sample policies, articles, research reports, training and educational materials, and legal and regulatory information. http://said.dol.gov
Drug-Free Workplace Advisor
Free, ready-to-use presentation materials for supervisor training and employee education www.dol.gov/elaws/drugfree.htm
EXECUTIVE OFFICE OF THE PRESIDENT
White House Office of National Drug Control Policy Information Clearinghouse
Drug-free workplace program research, costs, and successes
P.O. Box 6000
Rockville, MD 20849-6000
800-666-3332 (Toll-Free) w www.whitehousedrugpolicy.gov/prevent/workplace
Institute for a Drug-Free Workplace
Drug-free workplace program research and education
1225 Eye Street NW, Suite 1000
Washington, D.C. 20005
202-842-7400 www.drugfreeworkplace.org
National Drug-Free Workplace Alliance
Drug-free workplace program assistance and education
6868 South Plumer Avenue
Tucson, AZ 85706
877-817-6809 www.ndfwa.org
Employee Assistance Programs
Employee Assistance Professionals Association
Guide to employee assistance programs and services
2101 Wilson Boulevard, Suite 500
Arlington, VA 22201-3062
703-522-6272 www.eapassn.org
Employee Assistance Society of North America
Information for EAP professionals and organizations
230 East Ohio Street, Suite 400
Chicago, IL 60611-4607
312-644-0828 www.easna.org
Employee Health Programs
Services for employers and employees
P.O. Box 2430
Bethesda, MD 20827
800-275-7051(Toll-Free) 301-571-0067 www.ehp.com
Employment and Training
National Association on Drug Abuse Problems, Inc.
Employment, training opportunities for people in recovery
355 Lexington Avenue, Second Floor
New York, NY 10017
212-986-1170 www.nadap.org
Public Policy and Research
HHS, National Institutes of Health National Institute on Drug Abuse
Research and legislation on alcohol and drug use disorders
6001 Executive Boulevard, Room 5213
Bethesda, MD 20892-9561
301-443-1124 Telefax fact sheets: 888-NIH-NIDA (Voice) (Toll-Free) 888-TTY-NIDA (TTY) (Toll-Free) www.drugabuse.gov
Center for Alcohol and Drug Research and Education
Technical assistance, guidance, information, and expert service for individuals, organizations, governmental agencies, and a variety of local, national, and international non-profit organizations in the private sector to improve the quality of their response to alcohol and drug use disorders
6200 North Charles Street, Suite 100
Baltimore, MD 21212-1112
410-377-8992 www.alcoholanddrugs.com
National Association of State Alcohol and Drug Abuse Directors, Inc.
Supports the development of effective prevention and treatment programs throughout every state
808 17th Street NW, Suite 410
Washington, D.C. 20006
202-293-0090 www.nasadad.org
Small Business Assistance
DOL, Working Partners for an Alcohol-and Drug-Free Workplace
Working Partners helps to build a drug-free workforce by equipping businesses and communities with tools and information to effectively address drug and alcohol problems
200 Constitution Avenue NW Room S-2312
Washington, D.C. 20210
202-693-5959 www.dol.gov/asp/programs/d
rugs/workingpartners/Screen1.htm
U.S. SMALL BUSINESS ADMINISTRATION
Financial, technical, and management assistance for small businesses, including information about grants/loans and employee assistance programs
409 Third Street SW, Suite 7000
Washington, D.C. 20416
800-U-ASK-SBA www.sba.gov/news/drugfree
Treatment
HHS, SAMHSA National Directory of Drug Abuse and Alcoholism Treatment Programs SAMHSA National Helpline
Confidential information on alcohol and drug use disorder treatment and referral
800-662-HELP (800-662-4357) (Toll-Free)
800-487-4889 (TDD) (Toll-Free) 877-767-8432 (Spanish) (Toll-Free) www.findtreatment.samhsa.gov
Ensuring Solutions to Alcohol Problems
Research and tools to address healthcare and other costs associated with alcohol use and policy direction to improve access to treatment
Center for Health Services Research and Policy
George Washington University 2021 K Street NW, Suite 800
Washington, D.C. 20006
202-296-6922 www.ensuringsolutions.org
Mutual Support Groups
Al-Anon/Alateen
Support for families and friends of alcoholics
Al-Anon Family Group Headquarters, Inc.
1600 Corporate Landing Parkway
Virginia Beach, VA 23454-5617
888-4AL-ANON/888-425-2666 (Toll-Free) www.al-anon.alateen.org
Alcoholics Anonymous
Support group that provides sponsorship and a twelve step program for life without alcohol
475 Riverside Drive, 11th Floor
New York, NY 10115
212-870-3400 www.aa.org
Narcotics Anonymous
Organization for people recovering from a drug use disorder
P.O. Box 9999
Van Nuys, CA 91409
818-773-9999 www.na.org
Sources
The Economic Costs of Drug Abuse in the United States, 1992-1998. Publication Number NCJ-190636. Washington, D.C.: Office of National Drug Control Policy, Executive Office of the President, 2001, p. 5.
Overview of Findings from the 2002 National Survey on Drug Use and Health. DHHS Publication No. (SMA) 03-3774. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies, 2003, p. 5.
Addiction in the Workplace Survey. Center City, MN: Hazelden Foundation, 1996, p. 1.
Results from the 2002 National Survey on Drug Use and Health: National Findings. DHHS Publication No. (SMA) 03-3774. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies, September 2003, p. 27.
"Employee Assistance." U.S. Department of Labor (DOL). www.dol.gov/asp/program
s/drugs/workingpartners/dfworkplace/ea.asp. Summary of page. Accessed on February 11, 2004.
"Drug Free Workplace Programs." SAMHSA's Division of Workplace Programs. http://workplace.samhsa.gov/
DrugFreeWP/EAPgms.html#1, Overview, para. 1. Accessed on February 11, 2004.
ibid, Overview, para. 2.
National Institute on Drug Abuse (NIDA). www.drugabuse.gov/about/
organization/DESPR/HSR/da-pre/SteeleWorkplace.html#elmployee. Summary of page. Accessed on February 11, 2004.
U.S. Department of Labor (DOL). www.dol.gov/elaws/asp/drugfree/benefits.htm. Summary of page. Accessed on February 11, 2004.
The Costs and Effects of Parity for Mental Health and Substance Abuse Insurance Benefits. Washington, D.C.: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, 1998, Ch. 4, Parity for substance abuse benefits, para. 1.
Improving Substance Abuse Treatment: The National Treatment Plan Initiative, Changing the Conversation. DHHS Publication No. (SMA) 00-3479. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, 2000, p. 16.
