Information About Workplace Prevention and Intervention Programs Butler Center for Research | May 1, 2015 Download the Research Update Substance Abuse in the Workplace. Despite common misconceptions and negative stereotypes, approximately 79% of heavy drinkers 18 or older are employed.1 This presents a host of problems related to safety, productivity, and the impact of workplace substance use on coworkers. Prevalence of Substance Use in the Workplace Many researchers in recent years have attempted to better quantify the prevalence of substance use in the workplace and, perhaps more important, identify what factors significantly impact it. One model suggests that three dimensions significantly predict substance use in the workplace: (1) perceived availability of alcohol and/or illicit drugs, (2) the extent to which an individual's coworkers use or work while impaired by alcohol or drugs (descriptive norms), and (3) the level of approval by coworkers of workplace alcohol/drug use or working while impaired/ intoxicated (injunctive norms).2,3 Recent research with army soldiers uncovered that, regardless of actual norms, it is the perception of these descriptive and injunctive norms among peers and coworkers that are related to problem drinking behaviors.4 Using this three-dimensional model, researchers have been able to assess the overall prevalence of substance use in the workplace and identify a number of sub-populations that are at higher risk for workplace use. According to a 2012 study of 2,148 workers in the United States, 63.09% reported easy access to alcohol in the workplace (59.05% for illicit drugs), 23% reported high descriptive norms for alcohol use (12.65% for illicit drugs), and 7.03% reported high injunctive norms for alcohol use (3.55% for illicit drugs).5 Findings suggested that men, young people, and those with higher levels of education were at elevated risk for substance use in the workplace.5 Rates for industry-specific drinking patterns are also important indicators of work environments and coworker norms. A recent 4-year national study on industry-specific patterns found that rates of problematic alcohol use were highest among those in the mining (17.5%) and construction (16.5%) industries.6 Workers in the food services industry had the highest reported rates of illicit drug use (19.1%) and substance use disorder (16.9%).6 Researchers have found that food service workers also report higher rates of coworker acceptance of workplace substance use.7 Similar social network effects have also been discovered in hotel workers, who also display elevated substance use and abuse behaviors.8 Impact on Employment Functioning In addition to the general health and wellness problems associated with alcohol and drug abuse, there are a number of implications specific to employers. Alcohol and drug use have a negative impact on worker productivity, whether the use occurs off the job or on. A Hazelden Betty Ford Foundation survey of over 300 human resources professionals found that 67% believe substance use is one of the most serious issues they face among the workforce, with consequences related to absenteeism, reduced productivity, and a negative impact on their company's reputation.9 Workers with illicit drug and/or heavy alcohol use have higher rates of job turnover and absenteeism compared to those with no illicit drug or heavy alcohol use6 and are more likely to experience job-related injuries.10,11 In 1998 (the most recent year for which the numbers are available), it was estimated that the economic cost of substance use was more than $184 billion.12 Prevention and Intervention at Work Since the enactment of the Drug-Free Federal Workplace Act in 1988, many employers have addressed the issue of employee substance use by requiring drug testing, especially in occupations that pose high risk of injury.11 Today, approximately 35 million drug tests are performed each year and have had a significant impact on reducing workplace injuries and mishaps.11 In addition, many employers have begun to offer services that provide support and assistance to employees with drug addiction or problem-drinking behaviors. Almost all (90%) Fortune 500 companies have Employee Assistance Programs (EAPs) to address substance use problems. However, the numbers are far lower for smaller businesses (66% for businesses with 100-plus employees; 29% for businesses with 50–99 employees).13,14 This disparity could be the result of the high costs of implementing EAPs, although many employers have found that a successful EAP results in the added benefit of significant cost savings, while providing much needed support and assistance to their workers.11,13 Several different workplace-centric healthy lifestyle and social health campaigns—including the Power Tools curriculum geared toward construction workers, the Workscreen program for postal workers, and Team Awareness, a broad-use alcohol reduction program for use among small business workers and young restaurant workers—have shown promising findings.14,15,16 Web-based interventions have also resulted in positive outcomes for employees with unhealthy alcohol and drug use behaviors. An evaluation of the free intervention site CheckYourDrinking.net found that the site's intervention strategies significantly reduced consumption levels in high-risk drinkers, as compared to a control group.17 The U.S. Department of Defense studied the effects of a web-based intervention program for military called PATROL (Project for Alcohol Training, Research and Online Learning), which demonstrated success in reducing drinking behaviors in soldiers through three different group options.18 While not designed for use as a workplace-specific EAP, the online curriculum Moderation Management has also demonstrated success in reducing drinking and alcohol-related problems among users.19 Summary Illicit drug and heavy alcohol use is problematic among the U.S. workforce and causes substantial consequences. Workplace prevention and intervention programs are effective in addressing substance use problems among employees. Treatment for alcohol and drug dependence is also effective in improving worker productivity and health. While few in number, cost-benefit studies have demonstrated an economic benefit to employers who implement programs and support treatment for employees.