An Examination of the Relationship between Substance Abuse and the Workforce

While there has been much discussion concerning the causes of substance abuse in general, this has not been the case for workplace substance abuse. Misconceptions about employment and substance abuse are partially to blame for a lack of interest in the etiology of employee substance abuse. In looking at the situation, it does raise a lot of valid questions that are not being answered as readily as others in the overall discussion about substance abuse.

Is there any kind of correlation between causes of addiction and employment? Why do certain professions and industries have a higher rate of abuse than others? What impact does a person's employment status have on their addiction? On their diagnosis? On treatment? Recovery? This article hopes to answer some of these questions and generate an interest in the etiology of employee substance abuse.

What Is Etiology?

Unless it is a regular part of your daily conversation, chances are you are unaware of what etiology is. By definition, etiology is the cause of conditions, diseases, and other anomalies. Within the scientific communities, etiology focuses on finding the origins of medical diseases. Some diseases have been around for so long that their etiological origins pre-date available analytic methods.

The information gained from a disease's etiology in incredibly valuable for researchers. It can be used to track its progress as a whole and predict future patterns. Diagnostic tests can be calibrated for more precise identifiers. Tactics for prevention and treatment can be improved exponentially in an effort to wipe out the disease completely. Any attempts at curing a disease will involve the interpretation and implementation of that disease's etiological data.

The etiology of substance abuse, in general, hasn't really been nailed down; there are enough theories present to garner attention, but nothing absolute. For employee substance abuse, as a specification, it could go either way. There could be a singular concrete origin that resulted the union of employment and substance abuse. On the other hand, employee substance abuse etiology could be as ambiguous as substance abuse in general. Based on current data, things seem to be leaning more towards the latter.

The Role Employment Has

 Most of what has been analyzed by researchers involves the role and impact that substance abuse has on a person's employment, rather than the other way around. Historically, people only started paying attention to employment as a factor in substance abuse when employers began noticing their employees' addictions. Efforts to combat workplace drug use started in the 1970s, after the government began to notice an uptick in heroin usage amongst military personnel during the Vietnam War. The focus was more on detecting existing cases of substance abuse in employment, not on stopping them or finding out how they were happening.

In the years since, theories have developed as to why substance abuse continues to occur in the workplace and what role employment has in the matter. The explanations range from workplace environment, interpersonal forces, community, and the individual themselves. Here's what they entail:

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  • Environment--There has been some correlation between substance abuse and a person's environment. Specifically the factors around them that influence the employee's decision to use. Preventative measures in the workplace are designed to fight against these environmental factors to halt their influence on employees. Some theories on environment and substance abuse etiology suggest that employees use in the workplace because of their comfort levels. It's a space that they feel safe enough to use in, which may be something their home environment may not offer. However, this does not explain employee substance abuse in hostile working environments; it is doubtful that a place that causes a person stress will be a place where they feel safe.

  • Interpersonal--Interpersonal theories involve the people in the environment. For employee substance abuse, this means co-workers, supervisors, their employer, and any clients they encounter during the work day. The attitudes of these people and how they interact with the employee can impact the development of addictive behaviors. A person may have their first contact with illicit substances and addiction through these people, directly or indirectly. Interpersonal and environmental factors in employee substance abuse can influence each other. For example, lax rules in the workplace can prompt certain behaviors from employees if there are no repercussions for their actions. Hostility from co-workers or employers can force an employee to search for an effective--but not necessarily safe--way of coping and dealing with the corresponding stress.

  • Community--Extending outside of the workplace and the people in it, the community around the employee can contribute to their substance abuse. Interactions a business and its employees have with the community around them tend to shape the internal atmosphere of the company. A business that is located in an area where substance abuse is rampant will undoubtedly expose and tempt their employees. With continuous exposure, coupled with negative issues in the workplace, an employee finds no issue with substance abuse.

  • Individual--The employees themselves are a cluster of factors that employers cannot control with absolute certainty to prevent workplace substance abuse. The existing views and beliefs they have when they come into the company are going to impact how the other three aspects impact their potential for employee substance abuse. The individual elements can serve as a filter, in either a negative or positive manner, on environmental, interpersonal, and community elements.

While the above largely focused on the negative result--addiction and substance abuse--it does not mean that elements of those aspects cannot have a positive result--sobriety and abstinence. Workplace environments can still make a person feel safe and discourage substance abuse. Respect and kindness amongst staff can foster friendliness and trust instead of hostility. The community could be completely addiction-free and include alternative activities that don't involve getting high. Even if the individual remains the same, changes in the other areas can shift the outcome in either direction.

Why Some Profession Are More Prone To Substance Abuse

Based on studies and surveys on substance abuse, there are certain industries that have significantly higher rates amongst employees compared to others. Research conducted by SAMHSA between 2008 and 2012 found that over the course of a month, substance abuse was much more prevalent in the accommodation and food services than any other profession. This remained the same when looking at substance abuse in the same industries, but over the course of an entire year. The only time this changed was when rates of heavy alcohol use were separated from the rest of the data. When that happened, idustry rankings shifted, with accommodation and food services dropping to third highest and mining rose from seventeenth to first place.

So why does this happen? Part of it involves the factors of environment, community, interpersonal, and individual. Others suggest it may have to do with the identifying traits of the industry itself. The prevalence of addiction and substance abuse tends to be higher amongst lower socioeconomic groups. Many of the industries with higher rates of drug abuse provide employees with lower levels of income, isolating them to a lower socioeconomic group. Fluctuations based on the type of substance abused may be a result of the availability of that drug in the areas where certain industries are most active. For example, the mining industry operates more in rural areas where illicit drugs lack the prevalence they have in the urban areas. This could explain why illicit usage is so low for that profession but the usage of alcohol, which has few geographical limits to its availability, is so high.

Additional theories put the blame more on the people who go into these industries, thereby clouding them with their own potential for substance abuse. One point made by the Chicago Tribune in a 2015 article discussing these very same rates stated that many of the industries with high alcohol abuse rates were dominated by young, male workers. Drug and alcohol usage amongst men is noticeably heavier compared to women, and amongst younger verses older users. However, this doesn't seem to have an effect when looking solely at drug usage.

The Effect on Treatment and Recovery

If employment is going to have an effect on the development and prevalence of substance abuse, then chances are it's going to affect other aspects of addiction. Identifying and treating substance abuse in employees can already present some difficulties. If co-workers or the person's employer isn't aware of or paying attention to the signs of addiction, it can go unnoticed and generate issues in the workplace. The way a person's workplace is setup may even make it harder for the employee themselves to recognize that they have developed an addiction. Their work activities may even justify any denial of any substance abuse issues. All of this can serve as blockades preventing employee substance abuse from being diagnosed and properly treated.

There are some additional ways that employment can affect substance abuse care that doesn't involve detection in the workplace

  • Finances--Financial roadblocks presented through a person's employment can deter any attempts at seeking help. It is not unusual for a person to recognize that they are practicing dangerous addictive behavior. They may want to seek help, and maybe they have even made previous attempts to. However, seeking out help can pose a financial burden on employees of lower-income industries. Simply taking the time off from work to go to a doctor or treatment provider is lost income that is vital for the employee beyond just fueling their addiction. Some necessary treatment measures can be expensive and well outside of the person's budget. There are some free or heavily discounted treatment programs available for substance abuse throughout the country, but they may not be enough for serious cases. Some insurance providers do provide coverage for substance abuse treatment, but there are still some developing issues. Under the Affordable Care Act (a.k.a. Obamacare), treatment coverage for substance abuse disorders was expanded and around 2.8 million people are now covered under the law. Efforts to dismantle and cut down on the ACA has prompted concern from both political parties as to what effect this might have financially for those 2.8 million people if their coverage disappears along with the law.

  • Education--Workplaces that lack the understanding and knowledge to effectively help support their employees with addiction often end up contributing to the problem. Employees may face stigma or ridicule from their colleagues for even admitting that they are seeking help for addiction. Employers may not be lenient enough to allow a recovering employee leave work or take additional time off for treatment. They may be penalized or treated unfairly for their addiction even with the protections afforded to them under the Americans with Disabilities Act. A hostile environment can be full of triggers for a person trying to recover from addiction, which may result in relapse and further dangerous behavior.

  • Resources--Even if there isn't any hostility and the person's employer is understanding of the situation, there may not be sufficient resources available in the workplace to help an employee who is seeking treatment for substance abuse. A lack of resources may be a result of a lack of education and understanding in the workplace about employee substance abuse. In many industries, continued sobriety is key to ensuring workplace safety. Without sufficient resources, any efforts on the part of an employee recovering from substance abuse may have built-in disadvantages. Resources like the Employee Assistance Programs discussed in lesson twelve may be the primary resource an employee can turn to in the event of relapse, cravings, or other bumps on the road to recovery at work. Without those resources in place, getting through those rough patches during the work day get significantly harder. In the early stages of treatment, relapse is much more prevalent and harder for the person to fight against; they're still learning how to deal with their cravings and their last instance of usage is much more recent.