ADDICTION IN THE WORKPLACEHow Em ployers Can Help Their Em ployees

Present ed by Bet ony Jacobs

M oderat ed by Brandon Law s

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Meet your presenter, Betony Jacobs.

• Family Therapy Program Supervisor at De Paul Treatment Centers

• Licensed Clinical Social Worker• 13 Years of Experience Working with

Individuals and Families• Uses Her Passion and Experience to

Empower Families to Attain Their Goals

WHAT IS ADDICTION?

DEFINING ADDICTIONWebster’s Defini t ion:A compulsive need for and use of a habit-forming substance (as heroin, nicot ine, or alcohol) characterized by tolerance and by well-defined physiological symptoms upon withdrawal.

One Working Defini t ion:Addict ion is a disease of the brain that results in abnormal behavior despite extreme consequences.

SUBSTANCE- RELATED AND ADDICTIVE DISORDERS: DSM- 5

DSM uses a di f ferent ial system to dist inguish between Mi ld, Moderate, Severe substance abuse

▸ Alcohol-Related Disorders▸ Caffeine-Related Disorders▸ Cannabis-Related

Disorders▸ Hallucinogen-related

disorders▸ Opioid-Related disorders▸ Sedative-Hypnotic-or

Anxiolyt ic-related disorders

▸ Stimulant-related disorders

▸ Tobacco-related disorders▸ Other (or Unknown)

Substance- related disorders

▸ Non-substance Related Disorders (i.e Gambling Disorder)

5%

6%

7%

8%

2010-2011 2011-2012 2012-2013 2013-2014

Past Year Alcohol Dependence or Abuse A m ong Individuals A ge d 12 or O lde r in O re gon

and the U .S . (20 10 - 20 11 to 20 13- 20 14)

Oregon United States

0%

2%

4%

2010-2011 2011-2012 2012-2013 2013-2014

P as t Ye ar Illic it D rug D e pe nde nc e or A bus e A m ong Individuals A ge d 12 or O lde r in O re gon

and the U .S . (20 10 - 20 11 to 20 13- 20 14)

Oregon United States

5%6%7%

2010-2011

P as t M onth H e avy A lc ohol U s e A m ong A dults A ge d 21 or O lde r in O re gon and the U .S . (A nnual A ve rage s 20 10 - 20 14)

Oregon United States

OREGON STATISTICS

Source: SAMHSA, Center for Behavioral Health Stat ist ics and Quality, Nat ional Surveys on Drug Use and Health, 2010–2014.

8%

92%

Past Year Treatm ent for Alcohol Use Am ong Individuals A ge d 12 or O lde r w ith A lc ohol

D e pe nde nc e or A bus e in O re gon (A nnual A ve rage 20 10 - 20 14)

Received Treatment forAlcohol Use

Did Not Receive Treatmentfor Alcohol Use

10.9%

89.1%

P as t Ye ar Tre atm e nt for Illic it D rug U s e A m ong Individuals A ge d 12 or O lde r w ith Illic it D rug

D e pe nde nc e or A bus e in O re gon (A nnual A ve rage 20 10 - 20 14)

Received Treatment forIllicit Drug Use

Did Not Receive Treatmentfor Illicit Drug Use

OREGON STATISTICS

Source: SAMHSA, Center for Behavioral Health Stat ist ics and Quality, Nat ional Surveys on Drug Use and Health, 2010–2014.

Oregon STATISTICS▸ Alcohol use is the most prevalent▸ 2006 reports the cost of excessive alcohol use to

be over $220 billion nat ionwide▸ Opioid use, including prescript ion pain relievers,

is rising

HOW ADDICTION AFFECTS THE WORKPLACE

▸ Trust▸ Boundaries▸ Covering up or lying for the other pers on▸ Res entments▸ Confus ion and anger▸ Preoccupation and dis tractibility

HOW IT AFFECTS RELATIONSHIPS

▸ Product ivity including abs enteeis m & punctuality

▸ Quality of work▸ Worker s afety and health i.e.

Accidents /injury/fatal injury▸ Theft or other illegal activity▸ Conflict in the workplace

BEHAVIORAL IMPACT ON THE WORKPLACE

▸ Family members living with someone’s alcohol or other drug us e may als o s uffer s ignificantly, impacting their work experience.

OTHER FACTORS

COMMON SIGNS AND SYMPTOMS OF SUBSTANCE USE

▸ Speech▸ Mood▸ Behavior ▸ Appearance

FOUR OBSERVABLE AREAS

▸ Speech: Slurred or slowed▸ Mood: Agitated, depressed, irritable, passive, flat

affect , euphoric, withdrawn▸ Behavior: Impaired motor skills, nodding off,

impaired judgment, drowsiness, confusion, memory lapses, gait is slowed

▸ Appearance: Bloodshot eyes, flushed skin, pinned pupils, needle t racks, eyelids droop, dry (itchy) skin

DEPRESSANTSALCOHOL AND PRESCRIPTION MEDICATION LIKE BARBITURATES, BENZODIAZEPINES, AND OPIATES

▸ Speech: Accelerated, lacks cont inuity▸ Mood: Errat ic, anxious, elevated▸ Behavior: Rest lessness, high energy, elevated

heart rate, teeth grinding occurs with MDMA (ecstasy), sniffing, appet ite suppression

▸ Appearance: Dilated pupils, dry mouth, runny nose

STIMULANTSCOCAINE, CRACK, METHAMPHETAMINE, ECSTASY

▸ Speech: Talkat ive, outbursts, louder▸ Mood: Silly, withdrawn, labile, anxious▸ Behavior: Relaxed state, slowed reflexes, impaired

at tent ion, enhanced sensat ions▸ Appearance: Dilated pupils, bloodshot eyes, dry

mouth, smoky-smell

MARIJUANA

▸ Changes in personal appearance ▸ Mood s wings or attitude changes▸ Withdrawing from res pons ibility or co-

workers▸ Unus ual behavior▸ Defens ive attitude concerning the s ubs tance

of choice

CHANGE IN WORK ATTENDANCE OR PERFORMANCE

CREATING A WORKPLACE

▸ Promote health and wellness▸ As s es s the Organization’s belief s ys tem

▸ Create policy around alcohol and other drug us e

▸ Cons ider company culture

▸ Hire people who are in recovery

▸ Offer health ins urance coverage for s ubs tance abus e treatment

▸ S upport legis lation that guarantees acces s to treatment

▸ S upervis or trainings

STEPS THAT CO- WORKERS, LEADERS, AND HR MANAGERS CAN TAKE

▸ If serving alcohol, enforce a drink limit

▸ Offer trans portation for free

HOLIDAY PARTIES

▸ EAP Employee assistance program ▸ Employee education about addiction

▸ Be clear about policies regarding alcohol and other drug us e

▸ Educate employees about treatment options and medical leave for treatment

▸ Keep track of employee performance

▸ Informally talk with employee about uns atis factory job performance (for direct s upervis ors )

▸ Be non-confrontational

▸ Be compas s ionate

▸ Cons ider motivation for treatment

HOW TO WORK WITH EMPLOYEES TO HELP THEM GET TREATMENT

▸ Al-anon▸ Alternatives to Al-anon and confrontation:

Community Reinforcement And Family Training (CRAFT)

Vis it robertjmeyers .phd.com for detailed information about CRAFT

FOR FAMILY MEMBERS, FRIENDS, AND CO-WORKERS, THERE ARE SUPPORT GROUPS AND TREATMENT OPTIONS FOR YOU TOO:

THANKS!

Any quest ions?

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Bet ony :Bet ony.Jacobs@depault c.org

Brandon:Brandon.Law s@xenium hr.com

RESOURCES:▸ Motivat ing Substances Abusers to Enter Treatment; Working with Family Members. Meyers, R. (2008). New

York, NY: the Guilford Press▸ Diagnost ic and stat ist ical manual of mental disorders (DSM-5) (5th ed.). American Psychiatric Associat ion.

(2013). Washington, DC: Author▸ "EAP Buyers Guide," Donald Jorgenson, created for the Employees Assistance Professionals Associat ion,

2005. http:/ / www.eapassn.org/ Portals/ 11/ Docs/ HOME/ EAPBuyersGuide.pdf▸ "Making Your Workplace Drug Free, a Kit for Employers," Division of Workplace Programs, Center for

Substance Abuse Prevent ion, Substance Abuse and Mental Health Services Administrat ion (SAMHSA). http:/ / www.ndwa.org/ Editor/ assets/ Making%20Your%20Workplace%20Drug-Free.pdf

▸ Management of substance abuse. World Health Organizat ion (2016)http:/ / www.who.int / substance_abuse/ facts/ alcohol/ en/

REFERENCES:▸ The Business Case for Workplace Alcohol Prevent ion: Workplace alcohol abuse need not be accepted as an inevitable

cost of doing business. By Barry Knott | Oct 01, 2012 October 2012 issue of Occupational Health & Safety▸ Motivat ing Substances Abusers to Enter Treatment; Working with Family Members. Meyers, R. (2008). New York, NY: the

Guilford Press▸ Uppers, Downers, All-Arounders (7th ed). Inaba, D. Cohen, W.. Ashland, OR: CNS Publicat ions, Inc. (2013). ▸ Diagnost ic and stat ist ical manual of mental disorders (DSM-5) (5th ed.). American Psychiatric Associat ion. (2013).

Washington, DC: Author▸ Drugs and alcohol in the workplace. Nat ional Council of alcoholism and drug dependence. (2016).

https:/ / www.ncadd.org/ about-addict ion/ addict ion-update/ drugs-and-alcohol-in-the-workplace▸ The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and

Mental Health Services Administrat ion (SAMHSA). Addit ional information about NSDUH is available at http:/ / www.samhsa.gov/ data/ populat ion-data-nsduh.

▸ SAMHSA Analyt ic Series: A-29. Larson, S. L.; Eyerman, J.; Foster, M.S. and G.froerer, J.C. Worker Substance Use and Workplace Policies and Programs (DHHS Publicat ion No. SMA 07–4273, Analyt ic Series A–29). Rockville MD: SAMHSA, Office of Applied Studies, 2007. http:/ / pubs.niaaa.nih.gov/ publicat ions/ arh342/ 175-187.htm

▸ "Prevalence and distribut ion of alcohol use and impairment in the workplace: a U.S. nat ional survey," J Stud. Alcohol, M.R. Frone, Research Inst itute on Addict ions, State University of New York at Buffalo, January 2006.

▸ The Opioid Crisis among the Privately Insured: The Opioid Abuse Epidemic as Documented in Private Claims Data. A FAIR Health White Paper (2016). FAIR Health Inc. New York, NY.

▸ Weisner C, Parthasarathy S, Moore C, et al. Individuals receiving addict ion treatment: Are medical costs of their family members reduced? Addict ion. In Press.

▸ Management of substance abuse. World Health Organizat ion (2016)http:/ / www.who.int/ substance_abuse/ facts/ alcohol/ en/

▸ Beyond Addict ion. Foote, J. and Wilkens, C.. Kosanke, N. Joggs. S. (2014). New York, NY: Scribner