Evaluating an Individual’s Treatment Needs
Addiction Among Professions
Our occupations determine how we spend most of our time and where we channel the majority of our energy. But in addition to providing us with a sense of satisfaction, fulfillment, and identity, our jobs are also primary sources of stress. Research from the National Institute for Occupational Safety and Health(NIOSH) shows that work-related stress causes more health problems than any other life stressor, and that up to 25 percent of workers report that work is the most stressful element of their lives.
Continuous exposure to stress has been linked with a wide range of mental and physical health problems, such as the following:
- High blood pressure
- Stomach problems
- Weakened immune system
- Musculoskeletal pain
- Substance abuse
Drug and alcohol abuse take a huge toll on employers as well as employees. Employees who are actively under the influence of alcohol or drugs, as well as those who are suffering the long-term physical and cognitive effects of addiction, are more likely to miss work, make serious mistakes, or be injured on the job. The U.S. Department of Labor posts the following statistics about substance abuse in the workplace:
- Over 14 percent of employed Americans report episodes of heavy drinking.
- Over 30 percent of employees who report heavy drinking also abuse illicit drugs.
- Over 60 percent of individuals know someone who has reported to work under the influence of alcohol or drugs.
- The highest levels of reported substance abuse occur among construction workers, food service and accommodations workers, laborers, and machine operators.
- The lowest levels of reported substance abuse occur among protective service workers (law enforcement personnel, firefighters, teachers, social service workers, transportation workers, and other occupations dedicated to helping the public).
Substance abuse often goes hand in hand with depression, anxiety disorders, compulsive behaviors, and other forms of mental illness that are worsened by job stress. Although substance abuse is a universal problem, affecting people from all professions, the members of each profession tend to handle stress, addiction, and substance abuse in different ways. A comparison of these responses to addiction can help to determine the most effective approach to treatment.
Substance Abuse in Construction and Industrial Work
National surveys of substance abuse by occupation consistently show that construction workers, food service workers, machine operators, and industrial workers have the highest rates of drug and alcohol abuse. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that individuals who work in construction and mining reported the highest rates of heavy alcohol use within the past 30 days (16.5 percent of construction workers and 17.5 percent of miners). Machine operators and other industrial workers also experience high levels of drug and alcohol addiction.
In these high-risk professions, work-related injuries are common, and job stability is affected by factors such as weather, changes in the economy, and political trends. The threat of potential job loss, combined with the pressure to work efficiently under conditions that threaten one’s health or safety, contribute to stress and may cause tension at home as well as on the job. At the same time, the effects of drug or alcohol use increase the risk of accidents in the workplace, which can lead to serious and debilitating injuries.
For many construction workers, industrial employees, and laborers, addiction begins with an on-the-job injury. A disabled worker may receive a prescription for opioid medications to deal with chronic pain. After weeks of taking the medication, tolerance and dependence may develop, which can lead to abuse and addiction. Along with prescription narcotics, the individual may begin to abuse alcohol or other drugs to cope with the personal and financial losses caused by the initial injury.
A substance use disorder can prove to be enormously costly for both the worker and employer. Workers in construction, mining, and industry may be eligible for participation in an employee assistance or return-to-work program that allows them to receive affordable substance abuse treatment, followed by a structured plan to reenter the workplace. Requirements of a return-to-work program may include detox and residential rehab, family or marriage counseling, and participation in a 12-Step group, along with aftercare services such as sober housing, medication management, and ongoing therapy.
Drug & Alcohol Abuse in the Food Service and Accommodations Industries
Within the accommodations and food service industries, nearly 17 percent (16.9) of workers reported that they had had a substance use disorder in the past year. Food service workers also reported the highest rates of illicit drug use in the past 30 days (19.1 percent), according to SAMHSA. High levels of stress, pressure to work fast, and relatively low wages contribute to substance abuse in this industry. In addition, employees in food services and accommodation have easy access to alcohol through their work in restaurants and bars. All these factors contribute to a working environment with a greater-than-average risk of substance abuse.
Employee assistance programs are available through some employers; however, many workers in this industry are employed on a part-time or seasonal basis, which may make it difficult for them to participate in employer-sponsored health insurance plans. For these individuals, help is available through community-based support groups, 12-Step fellowships, and rehab programs that provide treatment on a private-pay, sliding-scale basis.
Addiction in the Legal Profession
The disease of addiction transcends all social and economic barriers, including professional boundaries. Professionals in the world of business, finance, and law are just as vulnerable to the stressors, fears, and anxieties that lead to substance abuse as workers in any other field. Statistics from the Legal Profession Assistance Conference indicate that 15-24 percent of people who work in the legal profession abuse alcohol, and that approximately one out of every five lawyers suffers from alcoholism.
Alcoholism has a direct impact on the quality of professional practice in this profession; in fact, up to 60 percent of malpractice claims and up to 90 percent of malpractice claims can be linked to alcohol use disorders, according to the above report. Yet many of these professionals hide their substance abuse for years before they reach the point of seeking treatment. To magnify the problems caused by alcoholism or drug addiction, many legal professionals also struggle with depression, anxiety, compulsive behaviors, and suicidal impulses.
What causes the high rate of addiction in corporate and legal professionals? Here are a few of the reasons that substance abuse is so common:
- High case loads and unrealistic performance expectations
- A corporate culture that rewards workaholism
- Lack of personal time for family, self-care, or recreation
- A professional atmosphere that promotes competition rather than mutual support
- Lack of education about the risks and signs of substance abuse or mental illness
Many of these professionals continue to function at a high level, hiding their substance abuse for years before they seek help. Barriers to treatment in the world of business or law — such as professional taboos against substance abuse, the demands of a high-pressure career, or fears of social and legal repercussions — may prevent them from reaching out for help.
Professional assistance programs can make it easier to overcome the social taboos against addiction and substance abuse treatment. The American Bar Association offers Lawyer Assistance Programs (LAPs) throughout the US to help attorneys with drug or alcohol addiction regain their sobriety and prevent personal and professional losses due to addiction. LAPs can provide help with the following issues, regardless of the individual’s ability to pay:
- Drug and alcohol abuse
- Depression and other forms of mental illness
- Suicidal thoughts
- Compassion fatigue
- Unmanageable stress
- Compulsive behaviors
The practice of law places a great deal of mental, emotional, and physical pressure on its practitioners. In addition to professional assistance programs, help is available at rehab programs that address the needs of legal professionals. Intensive residential treatment programs give professionals the opportunity to distance themselves from the triggers and stressors of their daily lives so they can focus completely on the recovery process. Outpatient treatment is available for individuals who require more flexibility and autonomy in order to meet personal obligations while they are in recovery.
Substance Abuse among Healthcare Professionals
Addiction affects a significant number of individuals working in the healthcare field. According to Critical Care Medicine, 10-15 percent of healthcare workers — including physicians, dentists, pharmacists, nurses, medical technicians, and others — will abuse drugs or alcohol at some point in their career. Although this number is not significantly higher than the general population, the level of responsibility placed on these individuals makes it especially important for them to avoid the physical and mental effects of substance abuse. Yet these same responsibilities often contribute to increased stress, depression, and anxiety in this group. Some of the other factors that add to the risk of substance abuse in medical professionals include:
- Chronic staffing shortages in medical facilities
- A growing demand for healthcare services
- An increased threat of malpractice lawsuits
- The physical and emotional demands of patient care
- Consistent exposure to high-risk or life-threatening situations
Physicians, pharmacists, nurses, and other highly educated clinicians may feel that their professional knowledge makes them immune to the dangers of addiction, notes the journal Substance Abuse Treatment, Prevention, and Policy, especially when it comes to abusing prescription drugs. Prescription drug addiction has reached epidemic proportions in the general population, but this form of substance abuse is especially common among doctors and nurses, who have easy access to narcotics. A study of physicians with substance use disorders published in the Journal of Addiction Medicine found that out of 55 doctors surveyed, 69 percent had misused prescription narcotics, either for recreational purposes, to manage stress, or to prevent the symptoms of opioid withdrawal.
Although the majority medical professionals are aware of the dangers of being impaired by substance abuse, many are still reluctant to seek help. The social stigma of substance abuse and the fear of losing the privilege to practice medicine are two of the most common barriers to treatment. For these individuals, admitting to a problem with drugs or alcohol could mean not only losing a specific job, but also losing their license and source of income. Medical professionals who divert prescription narcotics or who practice while impaired by drugs or alcohol can also face legal and criminal repercussions.
Peer assistance programs have helped many healthcare professionals recover from addiction, regain their professional confidence, and return to practice safely. These programs, which take a compassionate and non-punitive attitude toward substance abuse, are offered as an alternative to disciplinary action and include monitoring and support services after the individual returns to practice.
Components of a peer assistance treatment program may include:
- Intensive residential rehab or outpatient treatment, depending on the client’s level of motivation and history of chemical dependency
- Individual, group, and family therapy during and after rehab
- A structured aftercare program, with a plan for returning safely to practice
- Anti-addiction medication for clients with opioid or alcohol dependency
The terms of a peer assistance program are outlined in a contract, which the client must agree to in order to participate and to avoid job loss or criminal persecution. Peer assistance programs offer help, support, and hope to individuals who are faced with the serious challenges of drug or alcohol addiction.
Substance Abuse in Social Services and Law Enforcement
Men and women who work in social services — including social workers, teachers, police officers, and many more — feel called to help the public by improving the quality of life for others. However, many social service workers are much better at extending compassion to their clients or students than taking care of themselves. The mental and emotional demands of assisting other people — often in situations of crisis or conflict — can lead to depression, anxiety, and substance abuse. In fact, Social Work Today calls self-care “the overlooked core competency” in this profession, because many of these individuals have never been taught to acknowledge their own needs or to take the necessary steps to prevent stress and burnout. Law enforcement officers, in particular, are expected to display high levels of physical and emotional strength, while being exposed to violent situations, trauma, and constant threats to their safety.
Ironically, while many people in social services and law enforcement have been educated in the prevention and treatment of substance abuse, they may not be able to able to recognize the signs of addiction in themselves. Police officers, counselors, teachers, and nurses are held to a high standard of behavior by the community, and they may be reluctant to admit to others — or to themselves — that they have a problem with alcohol or drugs. Although the Substance Abuse and Mental Health Services Administration reports that rates of substance abuse are lowest in fields of social assistance (4.4 percent), reports from other sources indicate that drug and alcohol abuse may be more common. It is possible that substance abuse goes unreported by many of the individuals who work in this area, either out of fear of professional repercussions or out of a denial of the problem.
Counseling programs and education on the importance of self-care can help to protect the individuals in social services professions from substance abuse and mental illness. Counseling services are available to law enforcement personnel who have been exposed to violence on the job or who are at risk of drug and alcohol addiction. Rehab programs that offer trauma therapies as part of an individualized recovery plan can help police officers, emergency workers, and other first responders process the effects of life-threatening experiences.
Where Can Employees Go for Help?
For most professionals challenged by addiction, the fear of professional, financial, and even legal repercussions are barriers to seeking treatment. Employee assistance programs (EAPs) offer a way to overcome these barriers. EAPs are sponsored by a wide range of employers, from government agencies to hospitals, schools, law firms, social service agencies, and many other entities, to help employees resolve problems that interfere with their personal and professional lives. EAPs benefit employers as well as employees by reducing the tremendous costs of absenteeism, staff turnover, and workplace injuries.
These valuable programs offer assistance with a wide range of issues, such as:
- Substance abuse
- Work-related stress
- Depression and other psychiatric disorders
- Health concerns
- Relationship conflicts
- Trauma and bereavement
Resources on Occupational Stress and Addiction Treatment
Services provided through an EAP may include counseling, rehabilitation, crisis intervention, professional referrals, and many more. To find out whether an employer offers an assistance program and what services the program covers, employees can contact their human resources department, or use one of the resources listed below.
American Nurses Association: Impaired Nurse Resource Center:
Sponsored by the American Nurses Association (ANA), this online collection of resources can help nurses suffering from drug or alcohol abuse find affordable, reliable treatment programs.
American Bar Association: Lawyer Assistance Programs (LAPs):
The American Bar Association sponsors programs throughout the country on a state and local level to help attorneys with issues such as substance abuse, mental illness, suicidal ideation, and compulsive behavior recover their health and return to practice.
The Badge of Life: Psychological Survival for Police Officers:
This organization is sponsored by a group of retired police officers, medical professionals, and trauma survivors who have joined together to provide support resources and suicide prevention services to law enforcement personnel.
National Institute for Occupational Safety and Health (NIOSH):
A division of the Centers for Disease Control and Prevention (CDC), NIOSH performs research and provides resources on matters of occupational health, including stress and its consequences for individual wellbeing.
S. Department of Labor: Drug-Free Workplace Advisor:
The Department of Labor offers comprehensive statistics on the prevalence of substance abuse in the workplace and the economic and occupational costs of substance abuse. This advisory resource also includes solutions to prevent substance abuse and assist employees in recovering from addiction.
S. Office of Personnel Management: Employee Assistance Programs:
This government-based website focuses on employee assistance programs for employees of the federal government; however, it also provides information about the functions of EAPs, as well as a discussion of their history and purpose for the general public.