Addiction in the Workplace: Creating a Culture That Values Employee Safety and Health

0:00:13 William Moyers
Hello and welcome to Let's Talk. A series of podcasts brought to you, as always, by Hazelden Betty Ford. And, as always, I'm your host, William C. Moyers. We're glad you're with us today. And today, I'm excited to share the studio with my colleague, my friend, my fellow traveler, Robert Poznanovich. To talk about workplace wellness and the impact that the use of substances and mental health issues has on employees, on management, the human resources of a company, and on a company's bottom line. Bob's the Vice President of Business Development for Hazelden Betty Ford. He joined the organization way back in 1997. But once upon a time he was known as Chicago Bob. Welcome, Bob. [grins]

0:01:02 Bob Poznanovich
[chuckles] Hi, William.

0:01:03 William Moyers
How in the world did you get the moniker Chicago Bob?

0:01:06 Bob Poznanovich
So it's gonna be 27 years ago Monday. That I went to Hazelden to start my recovery journey.

0:01:13 William Moyers
Ahh.

0:01:13 Bob Poznanovich
And I walked into my unit and they said, 'Hey, what's your name?' And I said, 'Bob.' [Moyers chuckles] And the peer said, 'Oh great, there's seven Bobs here, so you're gonna become Chicago Bob.' [Moyers laughs] And it's a moniker that's stuck ever since.

0:01:26 William Moyers
Well we're glad it stuck, we're glad that you have walked that walk a day at a time. And what a difference you've made in our organization and with our mission, now the Vice President of Business Development. What does that mean exactly?

0:01:35 Bob Poznanovich
Well I have the privilege of representing our promise of recovery. To those communities in the business world that either pay for treatment, refer to treatment—

0:01:44 William Moyers
Mmm-hmm.

0:01:4 Bob Poznanovich
—Influence treatment, and can drive cultural changes within their organizations to make recovery more available to more people.

0:01:52 William Moyers
And one of your big emphasis, one of your key messages, is all about workplace wellness. What does that mean?

0:01:58 Bob Poznanovich
Yeah. So I think if you look at the role that workplaces play in overall health, workplaces can change culture and can change behavior. You know, think about years ago smoking for example. You know, it was a desk accessory. When you'd start at an employer, they'd give you your phone, your pen, and you'd get an ashtray. [smiles, Moyers chuckles] Think about today not only do you, you know, you can't smoke on campus, you can't sometimes smoke even a mile away from campus. And there's employers like some health systems that won't even let you smoke—work there if you smoke. So we make big cultural changes. And I think substance abuse, if you look at the math and the numbers, the number of people that are impacted by this, you know, directly because of their own uses or indirectly because of their usage in the family, or in the workplace, is a huge number but it's been really underserved in the workplace as far as being addressed.

0:02:46 William Moyers
Mmm-hmm.

0:02:46 Bob Poznanovich
So I think there's a big opportunity. To, you know, change behaviors to help people get help.

0:02:51 William Moyers
Mmm. [nods]

0:02:51 Bob Poznanovich
And a lot of that could happen at the workplace. Like they've done other, you know, well-being strategies. Wellness on you know physical health and mental health.

0:02:57 William Moyers
Yeah. And mental health is an equal issue in terms of what you're trying to do around substance use issues, right?

0:03:03 Bob Poznanovich
Right. I think we're trying to raise the visibility that all behavioral health is an area that needs to be addressed. And if you think about like where we're at right now in the world, you know, we have probably the biggest psychological crisis that we've had ever in this country. If you look at the data behind COVID, you know, there is 50 percent of the people are struggling in ways that they haven't struggled before.

0:03:24 William Moyers
Mmm.

0:03:24 Bob Poznanovich
They talk about 30 percent of the workers now who are working at home have drank during work. Now that doesn't mean they're alcoholic but maybe they changed their drinking behaviors—

0:03:32 William Moyers
Mmm-hmm.

0:03:33 Bob Poznanovich
—And if you think about it, it really is starting to develop as an actuarial time bomb. That says if I have all of these people who are struggling from a mental health perspective that maybe some of the normal control mechanisms that existed by going to work every day and being around peers, and having that you know 9 to 5 kinda structure where I would drink when I got home. When all those built-in control mechanisms are gone and I'm at home all the time by myself, that usage is increasing at very significant numbers that implies that there's a lot of employees who are getting sicker. So we've got people who are struggling with mental health, we've got people who are struggling with substance abuse at higher numbers. And the question is what do you do about it in a preventive, early intervention—

0:04:14 William Moyers
Mmm-hmm.

0:04:14 Bob Poznanovich
—You know, harm reduction environment in the workplace? So that you don't end up with the consequences of the cost moving forward.

0:04:19 William Moyers
Mmm-hmm.

0:04:20 Bob Poznanovich
So I think there's organizations that a lot of organizations are looking at how do they increase the benefits to employees for mental health. But I think it's really important that they don't just stop for mental health. They've gotta look at the inclusion of substance abuse as they're building their new well-being strategies. Because if they don't have substance abuse in that strategy, they're gonna miss a big opportunity to serve their populations better.

0:04:41 William Moyers
And the well-being strategy in the workplace is making sure that the benefits, the insurance that covers the employed person and the employed person's family, includes addiction and mental health services, yes?

0:04:54 Bob Poznanovich
Right. So it's coverage for sure. To make sure that they're the right types of coverage. And at the right programs to support really good outcomes. It's also about access. So as we're building strategies that says, you know, convenience and access, how do I get my employees the opportunity to say, 'I'm okay not being okay.'

0:05:14 William Moyers
Huh.

0:05:16 Bob Poznanovich
And, you know, are there those pathways that allow them to anonymously, without fear of retribution, be able to reach out for help?

0:05:24 William Moyers
Yes.

0:05:24 Bob Poznanovich
So I think what you're seeing is organizations are starting to create new pathways either they're partnering with new companies who are starting out in the digital and virtual world, or they're partnering with existing companies who are creating new pathways for employees. To say, you know, here's easier ways to gain help, to maybe access content, to access virtual services. To start to get engaged in help. So, it's coverage and it's the convenience of access that makes it easier for people to get it. I think what they still have to address, and one of the big hopes that I have is that we use this opportunity to address stigma.

0:05:59 William Moyers
Hmm. Okay.

0:05:59 Bob Poznanovich
I think that mental health is becoming less stigmatized but it still is an issue. And substance abuse is still a huge stigma issue. You know, all the data says that most employees are so afraid of retribution in the workplace that they won't even ask what their benefits are, let alone ask for help.

0:06:14 William Moyers
Huh. [chuckles] Yeah.

0:06:16 Bob Poznanovich
So you talk about adding the right benefits, but we've also gotta get the environment created where it's okay to ask for help too.

0:06:21 William Moyers
Yes! [nods]

0:06:22 Bob Poznanovich
And I think that that is the opportunity that we're trying to advocate with organizations now. It makes sense from a lot of perspectives, you know. Employee retention, hiring today is important, healthy workplaces are important, managing risk associated with accidents and violence and harassment, are all issues that we have to face every day. And of course the growing cost of healthcare.

0:06:45 William Moyers
Mmm-hmm.

0:06:45 Bob Poznanovich
And I think a lot of organizations haven't looked at the correspondence between behavioral health and substance abuse.

0:06:50 William Moyers
Mmm.

0:06:51 Bob Poznanovich
And violence, accidents, and healthcare costs. You know, we know that somebody with substance abuse is five to ten times more expensive that somebody who's not.

0:06:59 William Moyers
Mmm-hmm.

0:06:59 Bob Poznanovich
So I think it makes sense. And you use the line in your opening about, you know, how it affects the bottom line. I think the other alternative, the other real benefit of it, is it clearly will impact the organizations bottom line. But it'll help save lives too, which is the ultimate bottom line.

0:07:13 William Moyers
Yes. So Bob, talking about stigma, there is a perception out there that people who are addicted to alcohol or other drugs or people who are struggling with mental illness are either unemployed or unemployable. But that's not true.

0:07:26 Bob Poznanovich
No. In fact, you know, when I ask people often when I give some presentations to think about the image that they have when we talk about someone who's, you know, addicted to drugs or alcohol. And most people will say they thought it was the person under the bridge. [smiles]

0:07:38 William Moyers
Hmm.

0:07:38 Bob Poznanovich
You know, statistically speaking, it's less likely it's that person than it is the person sitting next to them, you know?

0:07:42 William Moyers
Mmm-hmm. Mmm-hmm.

0:07:43 Bob Poznanovich
70 to 80 percent of the people who have a substance abuse problem are working full or part-time.

0:07:47 William Moyers
Mmm-hmm.

0:07:48 Bob Poznanovich
Which means that that, you know, that school bus driver who we trust our kids with every day, you know, on blind faith—

0:07:54 William Moyers
Yes.

0:07:55 Bob Poznanovich
You know, is that one of the people who are struggling, right?

0:07:57 William Moyers
Yes.

0:07:57 Bob Poznanovich
So, you know, it happens everywhere. Or your doctor or your pilots or your--the person in charge of, you know, corporate quality control. Or operating heavy equipment. I mean, nobody's really immune to this. There's no company that has the magic as I say water cooler that allows them to recruit you know just the right people so they don't have substance abuse problems. It affects, you know, 1 out of every 8 of us.

0:08:18 William Moyers
So, then, where does workplace well-being start? Does it start with the union? Does it start with the HR Director? Does it start with the CFO, the COO, or the CEO?

0:08:30 Bob Poznanovich
I think it starts everywhere.

0:08:32 William Moyers
Huh.

0:08:33 Bob Poznanovich
To look at that, how do we take that step to change the culture, to say that again, getting back to it's okay not to be okay, to be proactive. In helping our employees and their dependents which is another big, you know, component of well-being. Get help. So I think it's that cultural shift that says we wanna—it's okay for us to say we have this problem.

0:08:51 William Moyers
Mmm-hmm.

0:08:52 Bob Poznanovich
You know, I've been chasing this for 20 years.

0:08:53 William Moyers
Yes.

0:08:54 Bob Poznanovich
We started this campaign many, many years ago.

0:08:56 William Moyers
Making recovery America's business we called it.

0:08:58 Bob Poznanovich
When was that, what year was that? [grins]

0:08:59 William Moyers
2005, you know, almost 20 years ago practically.

0:09:01 Bob Poznanovich
And we were well ahead of our times.

0:09:03 William Moyers
Yeah.

0:09:04 Bob Poznanovich
But people didn't want—when I work with organizations, you know, for example I worked with a manufacturer, a drug manufacturer, who said, you know, we have a problem with some of our employees that use drugs, but we don't want anybody to know about it 'cause we make drugs, we don't take drugs. [Moyers chuckles] And I laughed and I said, 'Well why am I here?' You know. So clearly you do, but it's a PR issue. So I think—

0:09:22 William Moyers
Sure.

0:09:22 Bob Poznanovich
—We have to get past, you know, that we have substance abuse in our workplace because it's common nature. It's everywhere. If you do the math, if every 1 out of every 8 of us has a problem, you think about the size of a family, it's like 1 of every 3 of us has got something going on somewhere.

0:09:36 William Moyers
Yes.

0:09:36 Bob Poznanovich
Either ourselves, at the workplace, or in our homes.

0:09:39 William Moyers
Yes.

0:09:39 Bob Poznanovich
So, you know, not to address it is a big miss. So I think it's that saying we're okay from a risk perspective to say that we're gonna provide resources. We're gonna address this issue. We're gonna make, you know, the cultural change that makes it okay for people to come out and ask for help? We're gonna create pathways that makes it easier for people to address this. And then when they get back to the work, which is the other cultural change that they can make, it's to accept them.

0:10:02 William Moyers
Yes.

0:10:02 Bob Poznanovich
You know, it's to create—and I know there's organizations out there who made big steps, that their funding initiatives or affiliation groups within the employer groups where they're making it okay for people who are in recovery, however they got into recovery, to get together on company time or using company resources, and communities and virtual services—

0:10:19 William Moyers
Mmm-hmm. Mmm-hmm.

0:10:21 Bob Poznanovich
—To be able to peer support each other, you know, and to address not only recovery issues but recovery in the workplace issues. And to make it more normal.

0:10:29 William Moyers
Yes.

0:10:30 Bob Poznanovich
Now they've done this for other diseases, right? I mean they've done this for, you know, there's programs when people leave for pregnancy to have time off and return slowly, and—

0:10:37 William Moyers
Yes.

0:10:38 Bob Poznanovich
And to partner with other, for example, young mothers who've had young children. But when you think about the number of people that are impacted by mental health and substance abuse, like why not there, too?

0:10:48 William Moyers
Right.

0:10:48 Bob Poznanovich
So I think we've got the models, we just need the courage. To say let's extend it to substance abuse. I don't think we have to overthink it, you know?

0:10:54 William Moyers
Yes.

0:10:55 Bob Poznanovich
We've put a lot of strategies in place for the workplace. To address illnesses that are really expensive. We've built centers of excellence programs to make sure people get to the best place to provide a heart transplant. So we know how to do that. We know how to pick really good providers that provide good outcomes. We know how to address diseases—

0:11:15 William Moyers
Mmm-hmm.

0:11:16 Bob Poznanovich
—That are costly and deadly.

0:11:17 William Moyers
Mmm-hmm.

0:11:18 Bob Poznanovich
You know, we just have to implement those same strategies—

0:11:19 William Moyers
Mmm-hmm. Mmm-hmm.

0:11:21 Bob Poznanovich
—With substance abuse. And make sure you've got great coverage, that you've got good facilities that provide good outcomes, that you've got good return to work strategies to support these employees. I think it's just about courage. You know, it's that courage to change that we talk about for the alcoholic and the addict.

0:11:33 William Moyers
Yes. [chuckles]

0:11:34 Bob Poznanovich
It's also the same for the organization, the courage to change.

0:11:37 William Moyers
And one of the big changes since you and I had launched that initiative 'Making Recovery America's Business,' is what happened back in 2008 when Congress passed and President Bush signed into law parity legislation. That really helped to level the playing field in terms of employees being able to access addiction treatment or mental illness treatment through their insurance. Talk more about that.

0:12:00 Bob Poznanovich
Yeah. So, parity did some really great things. And I know you worked hard to accomplish that and help, you know, the country get there. The good side is it made care much more available to more people. It also opened the door for some of the people who knew how to profit—

0:12:20 William Moyers
Yes.

0:12:20 Bob Poznanovich
—From the availability of many more patients in the market. And some of these providers that were for-profit, you know, chased the revenue, created programs that sometimes were unethical.

0:12:33 William Moyers
Mmm.

0:12:34 Bob Poznanovich
Even many who've been illegal. And they've employed some patient recruiting strategies that are really bad for the patient, bad for their experience, and bad for their outcomes.

0:12:45 William Moyers
Huh.

0:12:46 Bob Poznanovich
There's been many of those have flocked to warm climate markets like California, Arizona, and Florida.

0:12:55 William Moyers
Mmm-hmm.

0:12:55 Bob Poznanovich
Particularly Florida who's had a disdain for some of the regulations around this. You know and now there's crackdowns—I think almost every day you'll read about somebody or some group of people being arrested—

0:13:08 William Moyers
Mmm-hmm.

0:13:09 Bob Poznanovich
—For abusing insurance laws, patient safety, patient brokering or in cahoots with drug testing companies or whoever, paying people to relapse—

0:13:22 William Moyers
Mmm. Mmm-hmm.

0:13:20 Bob Poznanovich
—Paying people to recruit other people who are struggling. So I think what's happened, and this is one of the things that has gotten the employers' that I'm working with attention, is the impact on the individual who gets help. And the cost. Those organizations are typically much more expensive.

0:13:36 William Moyers
Hmm.

0:13:36 Bob Poznanovich
They don't tell the whole story, they often leave the patient with not a lot of care and support. And they return to the workplace sometimes even sicker than they were—

0:13:44 William Moyers
Mmm.

0:13:45 Bob Poznanovich
—And they paid thousands and thousands and thousands of dollars out of network benefit costs.

0:13:49 William Moyers
Mmm-hmm. Mmm-hmm. [nods]

0:13:51 Bob Poznanovich
So that's raised the awareness of employers—help us to help them navigate what is legitimate care.

0:13:58 William Moyers
Mmm-hmm.

0:13:58 Bob Poznanovich
So how do we get their employees to the right level of care at the right time for the right, you know, cost/value outcome ratio? So that they could get in recovery at higher rates without having the trauma—

0:14:09 William Moyers
Mmm-hmm.

0:14:11 Bob Poznanovich
Of having to deal with bad providers.

0:14:12 William Moyers
We've got about two minutes left, Bob, and I know that people who watch this Let's Talk podcast, some of them will be employees, some will be employers. What is your closing message to employees who are struggling with a substance use or a mental health issue?

0:14:30 Bob Poznanovich
With employees?

0:14:31 William Moyers
Yes.

0:14:33 Bob Poznanovich
That nothing could ever be gained in waiting.

0:14:36 William Moyers
Ah.

0:14:36 Bob Poznanovich
That if you woke up in today and today is the day that you know you're struggling, then make it today is the day that you make that first phone call.

0:14:42 William Moyers
Mmm.

0:14:43 Bob Poznanovich
You know, I know your story, I know my story, if we would've gotten the treatment earlier—

0:14:47 William Moyers
Mmm-hmm.

0:14:48 Bob Poznanovich
—It would've been a lot easier. And a lot less expensive. And not as traumatic on us and our family.

0:14:53 William Moyers
Mmm-hmm.

0:14:54 Bob Poznanovich
So there's nothing, you know, I think there's some myths around addiction that you can't help an alcoholic and addict until they hit bottom.

0:14:59 William Moyers
Right.

0:15:00 Bob Poznanovich
That just—there's a lot—most things we know about addiction is wrong. [Moyers chuckles] And I think waiting and hitting bottom is one of those. So don't—don't wait to hit bottom, if you think today is the today, today is probably the day.

0:15:10 William Moyers
[chuckles] Well I've always said the only bottom with this illness is death and anything short of that is a way out.

0:15:14 Bob Poznanovich
Right.

0:15:14 William Moyers
Before we go though, so that's the message to employees, don't wait. Ask for help. What's the message you wanna leave employers with?

0:15:23 Bob Poznanovich
Yeah. I think the same message. There's nothing that could be gained in waiting. That the problem exists. This is—this problem has existed for a long time. But now there's enough momentum behind the problem because of opiates. And there are people dying in offices from overdoses on floors, you know, that now is the time to take action. It's a little bit of a culture shift, it's a little bit of a PR, you know, conversation. But the benefits to the workplace, to the safety, to the costs, to the ability to save lives and change behavior, is bigger than the risk of not doing it.

0:15:54 William Moyers
And, insurance in most instances, covers addiction—

0:15:57 Bob Poznanovich
Yeah. Yeah.

0:15:58 William Moyers
—And mental illness.

0:15:59 Bob Poznanovich
Most of their plans already cover it, they just need to be—make employees feel that it's okay

0:16:03 William Moyers
Yes.

0:16:03 Bob Poznanovich
—To get help earlier and to help them recover when they do get help. No matter how they find what help is.

0:16:09 William Moyers
Bob Poznanovich, thank you for taking the time to be with us today. For turning your own personal passion and your expertise into your role today at Hazelden Betty Ford. Of not just strengthening our mission, but reaching out and connecting to the community, and indeed making recovery America's business.

0:16:28 Bob Poznanovich
Thank you, William

0:16:27 William Moyers
Thanks a lot for being with us, Bob.

0:16:28 Bob Poznanovich
Thank you too.

0:16:29 William Moyers
[turns to camera]And thank you all for joining us today. We hope that you will tune in for another edition of Let's Talk. Our podcast series that comes to you from Hazelden Betty Ford. And remember, if you have a question or a comment, a criticism, my email address is wmoyers@hazeldenbettyford.org. Send me an email, I'd love to hear from you. And remember, it's never too early to ask for help. So, if you're struggling, you have an employee who's struggling, a family member, ask for help. Thanks for tuning in to Let's Talk. We'll see ya again.