Substance Use, Misuse and Abuse at Work
Concurrent disorder: An individual who is experiencing both a mental illness and a substance abuse problem.
Organizations must also recognize that substance use, misuse, abuse and coping strategies can have a significant impact on mental health at work. Addictions and mental health conditions are often coupled. This is called a concurrent disorder. However, it is often the addiction that first gets noticed, especially in the workplace. Substance use is very common and can even be instilled or encouraged in the organizational culture. It is therefore sometimes difficult to recognize if an employee or co-worker has a problem or is at risk of developing a problem.
Generally, substance use becomes a problem when an individual has lost control over their use and/or continues to use despite experiencing negative consequences.
Everyone has a need to reduce pain, including emotional pain, and to fill voids in life. It can be done with such things as relationships, work, hobbies or recreation. It can also be done with alcohol, drugs, Internet use, gambling or other potentially addictive behaviours.
Organizations need to respond to the person, not the addiction, because addiction is often a mask that people in pain use to cope and disguise their mental health issues. Employers should look out for warning signs that indicate an employee may be struggling with substance abuse. Some signs to look out for are:
- decreased job performance: not meeting deadlines, low productivity, frequent breaks;
- increased absenteeism: missing work, coming in late and leaving early;
- uncharacteristic behaviour: mood swings, irritability, easily angered or upset, negative attitude;
- breakdown in social skills: poor listening, uncooperative, increased conflicts with co-workers, blaming others;
- change in personal appearance: poor hygiene, inappropriately dressed, excessive weight loss or gain, does not appear physically competent (i.e., walking is unsteady, slurred speech);
- errors in judgment: increased mistakes or accidents, illogical reasoning.
Some signs of substance abuse are similar to those caused by increased stress, lack of sleep and physical or mental illness. Don’t assume that an employee has a substance abuse problem; however, ignoring warning signs will only exacerbate the problem if someone is indeed struggling.
Employees struggling with substance use problems cannot simply be pushed out of the workplace; alcoholism is recognized under employment law as a disability, so employers cannot terminate an employee suffering from alcoholism without first trying to help. Ensuring managers and teams are supportive can be a key factor to finding success. Employees who have battled these issues say that having a supportive manager say, “We need your skills, we need you here, so tell me what you need from us” can make a big difference. Employers can help employees build their self-esteem, confidence and loyalty to the organization when they make employees feel valuable and valued.
Organizations also need to ensure they have detailed substance abuse policies (i.e., use of illicit drugs at work, alcohol consumption at work, inappropriate Internet use, etc.) and make sure that all employees are aware of them. This provides a platform for managers and employers to talk to employees about their substance use. These policies let employees know that breaching the rules while at work can put their job security at risk.
Employers need to focus on finding solutions at work. That way, they are achieving success while meeting their ethical and legal obligations to the organization. Medical and therapeutic interventions need to be left to objective and qualified professionals. Employers can help employees find the medical assistance they need.
- Addiction is a set of resources created by GWL Centre for Mental Health in the Workplace. It provides free resources to assist in following a 10-step strategy for addressing addictions. The ten steps are: (1) Understand substance abuse and addiction (2) Assess your workplace risks (3) Develop a wellness & substance-free workplace committee (4) Develop a substance-free workplace policy (5) Train management (6) Educate employees (7) Respond to crisis (8) Help employees get assistance (9) The return to work (10) Follow-up. Also, this site provides a list of organizations that can help support organizations in dealing with addictions. This resource is found at http://www.gwlcentreformentalhealth.com/english/display.asp?l1=7&l2=101&l3=102&l4=107&d=107.
- When an Employee Has an Addiction Problem looks at employer’s and manager’s roles in helping employees with an addiction. See http://www.mentalhealthworks.ca/employers/faq/question18.asp.
- Directory of Canada Alcohol and Drug Education and Prevention Programs is a tool created by the Canada Alcohol and Drug Rehab. It provides links to drug and alcohol education and prevention programs. See http://www.canadadrugrehab.ca/Drug-Alcohol-Education-Prevention.html#workplace.
 American Psychiatric Association, “Diagnostic and statistical manual of mental disorders: DSM-IV 4th ed,” American Psychiatric Association, (2000), http://www.ccsa.ca/Eng/KnowledgeCentre/OurDatabases/Glossary/Pages/index.aspx (Accessed November 6, 2009).
 Centre for addiction and mental health, “Challenges and Choices: Finding mental health services in Ontario.(Glossary)” (2007) http://www.camh.net/Care_Treatment/Resources_clients_families_friends/Challenges_and_Choices/challenges_choices_glossary.html (accessed January 6, 2010).
 Dr. Joni Johnston, “Your Not the Person I Hired: How to Handle the Substance-Abusing Employee,” Work Relationships, (2000) http://www.workrelationships.com/site/articles/substance_abuse_in_workplace.htm (accessed: November 6, 2009).
 Mental Health Works, “Masking the pain: substance use and mental illness in the workplace,” Canadian Mental Health Association, http://www.mentalhealthworks.ca/articles/substance_use_and_mental_illness.asp (accessed November 23, 2009).