Substance use impacts more than just those addicted and their loved ones. Of the nearly 15 million Americans who use illegal drugs, 70 percent are employed, and many workers spend two-thirds of their lives at work. How can employers reduce their own costs while helping their employees to be healthier and more productive? This question is examined closely within part one of this Q and A with Pablo McCabe, LCSW, the director of national and strategic accounts for the Hazelden Betty Ford Foundation. In this second installment, Pablo gives tangible ways employers can recognize and support those struggling with addiction. Q. How can an employer recognize when an employee may be struggling with a substance use disorder? A. There are symptoms of drug and alcohol addiction employers can look for, including personality changes such as increased irritability, defensiveness, and isolation. If you have someone who has normally been level-headed and a significant contributor to the team who begins to resist working with others, wants to leave early more often, begins to fight with coworkers and blame others for his or her errors instead of trying to solve the problem, those may be symptoms of addiction. In addition, physical symptoms may emerge such as low energy, slouching down, poor skin, slurred speech, loss of coordination, and unusual forgetfulness on the job. Absenteeism, lateness, decreased work performance, and lack of follow-through on commitments are more significant signs that an employee is struggling with something that may put their job at risk. An employer needs to be ready to recognize that the issue may be alcohol or drug use. Q. Is there anything that employers can do about addiction in the workplace? A. The first thing employers need to realize is that yes, they can take action that will make a significant difference both in protecting the company from loss due to addicted employees, and to support those employees who may be struggling with addiction. Many of us spend two-thirds of our lives at work. Work can be an important and effective place to address alcoholism and other drug issues. Employers can establish and promote programs focused on improving overall health, as well as on addressing addiction. In doing so, employers will reduce their own costs while helping their employees to be healthier and more productive. One significant step an employer can take is to establish or strengthen an Employee Assistance Program (EAP). These programs often work with the human resources department to help employees focus on their own wellness in a variety of ways, including: Promote alcohol and drug addiction prevention in the company Help employees already struggling with addiction by offering short-term counseling, assessment, and referral to qualified drug and alcohol treatment programs Two things are essential for an Employee Assistance Program to work well: Confidential: it must be a safe place for an employee to go to get help Educational: it must also help to train managers to recognize what employees are dealing with and how to support those employees in making healthy choices Q. What are some specific things employers can do promote a healthy, drug-free workplace? A. Some employers choose to institute random drug testing. This can be effective, but employers should be careful to implement drug testing as a way of supporting employees and restoring them to full productivity, if possible. We've seen that folks who return to work after addiction treatment are usually more valuable and productive when given a second chance. Additionally, it's essential for employers who wish to have a drug-free workplace to create written substance use policies and procedures, and to communicate those to employees ahead of time. Of course, the biggest thing an employer can do to support employees in this area is to offer health benefits that provide comprehensive coverage for substance use disorders, including aftercare and counseling. An employee who can find help to overcome addiction and maintain recovery will be a much more valuable employee in the long run. Finally, education can be helpful. Find ways to let people know what happens when we use alcohol and drugs Be candid and open about the dangers of using substances, as well as opportunities to overcome addiction Find coaches and supporters in the company to champion recovery Help to reduce the stigma attached to addiction with the goal of motivating your employees to seek help with their disease Q. How can employers help employees who are actively seeking recovery? A. A good place to start is something we call Centers of Excellence. This is about employers working with insurance providers to identify and approve excellent facilities for various kinds of treatment ahead of time. In addition, employers shouldn't necessarily be satisfied with employees simply going to addiction treatment. Follow-up and accountability after the fact are essential. When the Hazelden Betty Ford Foundation helps employers with this accountability, we call this component Connection for Employees. It is modeled on the very successful monitoring programs in place in the health care and airline industries, and it's all about supporting employees through the first, critical months of recovery. Connection includes intensive support and case management by recovery professionals, random urine drug screens, confirmation of attendance at meetings, and monthly verification letters outlining adherence to the recovery plan. The employers receive qualified reports so they can feel confident that the employee is continuing in his or her recovery effectively. Q. What is the benefit to employers of providing this level of support to employees struggling with substance use? A. Research has demonstrated that alcohol and drug treatment pays for itself in reduced healthcare costs. Employers with successful Employee Assistance Programs and drug-free workplace programs report improvements in morale and productivity with decreases in absenteeism, accidents, downtime, turnover, and theft. Employers with long-standing programs also report better health status among employees and family members and decreased use of medical benefits by these same groups.