Employers, Employees Urged to Address Drug and Alcohol Abuse

Pennsylvania ranks No. 1 on a list it doesn’t want to be on.

The commonwealth is outpacing all other states in overdose deaths, having seen a 43 percent increase over the last year. According to the Centers for Disease Control and Prevention, this is the largest increase among all 50 states.

Pennsylvania’s emergency rooms have seen an 81 percent increase in opioid overdoses alone.

Gina Riordan, program supervisor with Drug Free Workplace PA, learned from the state district attorney’s office that “Philadelphia is known as the No. 1 import location on the East Coast for heroin. It’s the purest and the cheapest,” she said. “In their opinion, that is why it’s really been a challenge (for the state).”

Over the course of their lifetimes, 1 in 7 people will suffer from substance-use disorder, or addiction; of those, 77 percent are members of the workforce. The escalating effects of substance abuse amongst employees is prompting more businesses to consider the safety, financial, and legal ramifications of employing workers who are misusing drugs or alcohol.

And that keeps Riordan pretty busy.

Funded by the Pennsylvania Commission on Crime and Delinquency, Drug Free Workplace PA is a grant-funded program that assists employers with policy development, training, and resources.

“We definitely have seen an uptick, an increase in organizations reaching out to us for help,” Riordan said. “We are working also with some very large employers that have had minimal problems in the past and all of a sudden, just this last year, they have had to implement additional policies, they’ve had to train, they’ve had to deal with more.”

Through a series of hour-long sessions, the organization’s trainers educate employers, employees, and/or families on substance-use disorder, trends, and signs and symptoms of misuse.

“We do a decent amount of training in manufacturing, but then we also go into nonprofits, we go into churches, schools, universities — the workplaces really do vary,” Riordan said. “It’s professional, it’s blue collar. It’s really across the board.”

Over the course of its five-year grant, Drug Free Workplace PA has helped more than 1,000 employers and organizations with its free policy development and training. 

“Organizations will call and say, ‘I just had an OD in the parking lot yesterday, and we need help and training,’” Riordan said. “It’s sad that it takes that, unfortunately, to be on the radar.”

Employee substance misuse affects businesses in several ways. Companies whose employees misuse experience three to five times as many workers’ compensation claims, and substance-abuse disorder employees incur three times the medical costs versus non-abusers.

Substance abusers are also 2.5 times more likely to be absent eight or more days a year, which affects productivity.

Riordan said the Department of Labor and Industry developed a five-step best practice model for businesses to deal with substance-use disorder among their employees, the first of which is the existence of a drug-free workplace policy.

“You would be surprised how many [businesses] do not have one,” she said. “Eighty percent of small and medium-sized businesses do not have a policy or any kind of program in place … They don’t really understand the importance and magnitude from a legal perspective.”

Drug Free Workplace PA’s website (drugfreeworkplacepa.org) contains an online policy-builder tool that enables an employer to develop a six-page policy in 20 minutes, Riordan said.

The second — and vital — step in handling workplace substance misuse is supervisory training. Supervisors must be trained on signs and symptoms of substance misuse as well as how to approach and document the situation when they have reasonable suspicion that an employee is misusing.

This is not the case, however, in many of the organizations Riordan visits. Even if a policy is in place, without training, supervisors are uncomfortable and uneducated on how to proceed — so they don’t.

Riordan said their supervisory training takes about 45 minutes and includes a packet with step-by-step instructions for addressing a reasonable suspicion, as well as charts, scripts, and resources. Riordan also covers the five drug categories and signs and symptoms for each.

“It’s not a supervisor’s responsibility to guess what an employee is using, but it is very helpful if they are educated in all the different signs and symptoms,” she said.

“Obviously the employee has to be displaying issues with job performance beforehand — absenteeism, etc. — but the goal is to accumulate enough information and document it thoroughly to where you’d be able to support that a person is misusing a substance.”

Another hurdle Riordan encounters is that supervisors often don’t understand addiction and view it as “a moral choice.” Drug Free Workplace PA trainers begin sessions by making sure everyone understands substance-use disorder.

“We walk through the changes in the brain chemistry,” Riordan said. “Supervisors will then understand that if they are seeing an employee that is misusing, nine out of 10 times, the employee has already slid into stage two of addiction because they are bringing it into the workplace. They need the help. It is a disease.”

Step three in the best-practice guidelines is employee training.

“Even if it’s only 20 minutes at the annual meeting, we can cover a lot,” Riordan said. “We do touch on signs and symptoms of substance misuse, but we also talk about the role of the employee, how the employee could come alongside and have peer-to-peer dialogue and empower that employee to get the help that they need.”

Drug Free Workplace PA’s materials for employees are also available online for employees who may fear the stigma still attached to substance-use disorder and would prefer to review the materials at home.

During employee training sessions, trainers familiarize workers with the fourth best practice, their company’s employee assistance program, or EAP, which usually offers free and confidential counseling assistance. EAPs can be an important tool in managing mental health, one of the main risk factors for substance-use disorder.

“If you have an employee suffering from depression and anxiety, you want them to get the help from the EAP before they go through self-medicating with drugs or alcohol,” Riordan said.

If a business can’t afford an EAP, Riordan encourages them to contact Gaudenzia, which manages Drug Free Workplace PA and offers a nonprofit EAP program at lower cost.

“What’s nice about the EAP is it really takes the management out of the equation and allows the EAP to work directly with the employee,” Riordan noted. “Sometimes the topic can get heated, it can get uncomfortable — there are a lot of dynamics there.”

The fifth and final best-practice recommendation is for businesses to ensure they have proper drug-testing methods in place. Riordan said this is another area of resistance she encounters from employers in certain industries or regions who are already experiencing difficulty filling positions. They are reluctant to implement a policy that will further reduce their potential hiring pool.

“I try to come alongside some of those organizations and say, ‘Look, you don’t need to list all the substances on your policy. Take off marijuana and alcohol, for example. Or don’t offer four different types of drug testing; you offer one.’ At least it’s a beginning and gives them a start.”

Drug Free Workplace PA trainers provide extensive local and national resource information at each training session. Riordan especially likes to highlight one underused and surprisingly little-known resource: Each county has a single county authority, a “focal point” for case management, training, and sometimes even funding to assist families with their copays and deductibles.

“They are just a wealth of knowledge, and again, nobody knows they exist,” Riordan said.

She is also quick to point out that despite Pennsylvania’s problematic ranking, “the government as a whole … they are doing an amazing job. We have so many task forces and initiatives, so when we say those numbers — that we are ranked No. 1 in overdose deaths, etc. — I always make sure that I follow up with, ‘But that doesn’t mean that our government is not working very hard, because they are.’ They’re on top of it.”

Riordan also strives to remind the public that despite the attention the opioid epidemic has garnered over the past few years, alcohol remains the drug wreaking the most havoc in the workplace. According to the National Council on Alcohol Abuse, 40 percent of all hospital beds in the U.S. are being used to treat health conditions related to alcohol consumption.

“A lot of people don’t realize that. Alcohol is the leader also in deaths,” Riordan said. “And in no way am I discrediting the opioid epidemic because it is real and we have lost so many lives, but we have lost even more lives due to alcoholism.

“It’s very sad that it’s taken this magnitude of deaths to grab the attention of our public,” Riordan added. “I think it has contributed to workplace issues, but it has also raised awareness so, in turn, I think more people are asking for help.”