Mr. J. Vinoth Kumar1, Rev. Dr. Andrew Francis2
1Research Scholar of Commerce, St. Joseph’s College (Autonomous), Tiruchirappalli, Tamil Nadu,
Alcoholism threatens families worldwide, and takes a particularly harsh toll on poor families, according to public health specialists, social scientists, and community activists. At present, alcohol accounts for 4 percent of the global burden of diseases almost the same share of death and disability that is attributed to tobacco and hypertension. Most individuals who use alcohol in an abusive way will display one or more of four drinking-related problems including disruption of daily life, legal issues, social difficulties, and drinking in dangerous situations. As a supervisor, you have an important role in dealing with alcohol problems in the workplace, along with other agency officials. You have the day-to-day responsibility to monitor the work and on-the-job conduct of your employees. You are not responsible for diagnosing alcoholism in employees. Employees who suffer from it need the agency’s compassion. However, sometimes that compassion has to be firm in order to communicate that, while the agency is willing to help the employee get assistance, the employee is ultimately responsible for his or her own rehabilitation, recovery, and performance.
Alcoholism threatens families worldwide, and takes a particularly harsh toll on poor families, according to public health specialists, social scientists, and community activists. At present, alcohol accounts for 4 percent of the global burden of diseases almost the same share of death and disability that is attributed to tobacco and hypertension. According to the International Labor Organization, 3 percent to 5 percent of the average workforce is alcohol dependent and up to 25 percent drink heavily enough to be at the risk of dependence.
While Asia’s drinking levels have historically been far lower than those in the United State, Europe, and Latin America, liquor and beer consumption in the region is rising rapidly, particularly in India, Vietnam, and China.1
Researchers are still probing the underlying causes of alcoholism, broadly seen as a mix of genetic and environment factors that vary widely across different countries and social strata. However, many health risks associated with heavy drinking are well known. Worldwide, alcohol causes 20 percent to 30 percent of liver cancer, cirrhosis, epileptic seizures, motor vehicle crashes, and murders according to the World Health Organization (WHO).2
DEFINITION OF ALCOHOLISM:
The World Health Organisation (1992) originally defined alcoholics in terms of excessive drinking but later redefined alcoholics as ‘those excessive drinkers whose dependence on alcohol has attained such a degree that it shows a noticeable mental disturbance or an interference with their bodily and mental health, their interpersonal relations, and their smooth social and economic functioning; or who show the prodromal signs of such development. They therefore require treatment’.3
CAUSES OF ALCOHOLISM:
Factors contributing to alcoholism are genetic, psychological and social/cultural. Causes of alcohol use range from a single stressful event to the interaction of genetics and culture. The complexity continues as the causes themselves are impacted by the use of alcohol. For example, a stressful life event may trigger unhealthy drinking behaviour and the drinking, in turn influences the stressful event, which then causes more stress (Hart and Fazaa, 2004).4
While many social and cultural variables may be present, genetics cannot be ignored. Recent research has shown alcoholism to be a deficiency disease related to neurotransmitters, which are chemical messengers between brain neurons (Antai-Otong, 2006)5. Certain personality characteristics, influenced by genetics, contribute to the development of alcoholism. This genetic connection is illustrated by studies that have shown that children with attention deficit hyperactive disorder are more likely to develop alcohol problems later in life. The tendency towards risk taking and aggressiveness both lead to alcoholism susceptibility. This link may also explain why men often drink more heavily than women but women often suffer more severe medical consequences as a result of alcohol abuse (Pihl et al.,). 6
The environment, both home and at work, also has a powerful influence on drinking behaviours. The environment established by the family of origin is responsible for the initial belief structures but, as adults, alcohol use decisions are also a function of social networks outside the family. Coping styles and motivations to drink can also influence alcohol consumption (Walter, H., 2003).7
The emphasis placed on alcohol in society plays an important role in alcohol use and alcoholism. Messages from peers and the media promote alcohol use for fin, improved relationships, and even wealth. Messages and information regarding alcohol, influence the decision making process. Once drinking has commenced, events combined with alcohol consumption induce cravings and "consumption related stimuli produce different responses". A progression takes place, from moderate drinking to alcohol abuse to alcoholism (Tudor, I. 2007).8
Individuals in poverty and people with less formal education are more likely to abuse alcohol. Many minority individuals have less access to health care and often receive poorer treatment, which results in negative consequences and greater treatment needs (Schmidt, et al., 2006).9
As mentioned earlier, homelessness is also strongly correlated with alcoholism. Difficulty in providing preventive services to this population plays a role in many health problems, including alcoholism. Individuals with mental illnesses may be in similar situations. It is not unusual for at least half of patients in a mental health facility to have a history of problems concerning alcohol consumption. Among other issues, antisocial and violent behaviours accentuate problem drinking (Lumsden, J. 2005).10
It is important to discuss the difficulty of maintaining abstinence during recovery from alcoholism and its relationship to alcoholism. Unfortunately, relapse during recovery is common, thereby placing the person back on the road of addiction (Chase et al., 2005).11 Because alcoholism is a progressive disease, the consumption, abstinence and relapse cycle places an individual at further risk for remaining ill.
ALCOHOLISM IN THE WORKPLACE:
Alcohol is the single most used and abused drug in America. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), nearly 14 million Americans (1 in every 13 adults) abuse alcohol or are alcoholics. Several million more adults engage in risky drinking patterns that could lead to alcohol problems. The costs to society in terms of lost productivity, health care costs, traffic accidents, and personal tragedies are staggering. Numerous studies and reports have been issued on the workplace costs of alcoholism and alcohol abuse, and they report costs that range from $33 billion to $68 billion per year. Alcohol is a major factor in injuries, both at home, at work, and on the road. Nearly half of all traffic fatalities involve alcohol.
In the workplace, the costs of alcoholism and alcohol abuse manifest themselves in many different ways. Absenteeism is estimated to be 4 to 8 times greater among alcoholics and alcohol abusers. Other family members of alcoholics also have greater rates of absenteeism. Accidents and on-the-job injuries are far more prevalent among alcoholics and alcohol abusers.
The Federal workplace is no different than any other in respect to alcoholism and alcohol abuse. Though no studies have been done on the prevalence of alcoholism and alcohol abuse among Federal employees, it is safe to assume that a similar proportion of Federal employees are alcoholics or alcohol abusers as in the national workforce. The associated increased health care costs and lost productivity are passed along directly to the taxpayer, and to each and every one of us.
As far as the Government as an employer is concerned, an employee’s decision to drink is that individual’s personal business. However, when the use or abuse of alcohol interferes with the employee’s ability to perform his or her duties, the employer does have legitimate concerns, including the proper performance of duties, health and safety issues, and employee conduct at the workplace.
As a supervisor, you have an important role in dealing with alcohol problems in the workplace, along with other agency officials. You have the day-to-day responsibility to monitor the work and on-the-job conduct of your employees. You are not responsible for diagnosing alcoholism in employees. Basic supervisory responsibilities include:
· assigning, monitoring, reviewing, and appraising work and performance;
· setting work schedules, approving or disapproving leave requests;
· taking necessary corrective and disciplinary actions when performance or conduct problems surface; and
· referring employees to your agency’s Employee Assistance Program (EAP).
At some point, you will likely encounter employees with problems related to alcohol in dealing with performance, conduct, and leave problems. In some cases, you may not know that there is an alcohol problem. In other cases, you may know, either because the employee admits to being an alcoholic, or the problem is self-evident. For example, an employee may become intoxicated while on duty or be arrested for drunk driving. Your role is not to diagnose the alcohol problem but to exercise responsibility in dealing with the performance or conduct problem, hold the employee accountable, refer the employee to the EAP, and take any appropriate disciplinary action. Your role in dealing with alcoholism in the workplace is crucial. The most effective way to get an alcoholic to deal with the problem is to make the alcoholic aware that his or her job is on the line and that he or she must get help and improve performance and conduct, or face serious consequences, including the possibility of losing his or her job.
Leave and Attendance:
· Unexplained or unauthorized absences from work
· Frequent tardiness
· Excessive use of sick leave
· Patterns of absence such as the day after payday or frequent Monday or Friday absences
· Frequent unplanned absences due to "emergencies" (e.g., household repairs, car trouble, family emergencies, legal problems)
The employee may also be absent from his or her duty station without explanation or permission for significant periods of time.
· Missed deadlines
· Careless or sloppy work or incomplete assignments
· Production quotas not met
· Many excuses for incomplete assignments or missed deadlines
· Faulty analysis
· In jobs requiring long-term projects or detailed analysis, an employee may be able to hide a performance problem for quite some time.
Relationships at Work:
· Relationships with co-workers may become strained
· The employee may be belligerent, argumentative, or short-tempered, especially in the mornings or after weekends or holidays
· The employee may become a "loner"
· The employee may also have noticeable financial problems evidenced by borrowing money from other employees or receiving phone calls at work from creditors or collection companies.
Behavior at Work:
The appearance of being inebriated or under the influence of alcohol might include:
· The smell of alcohol
· Staggering, or an unsteady gait
· Bloodshot eyes
· Smell of alcohol on the breath
· Mood and behavior changes such as excessive laughter and inappropriate loud talk
· Excessive use of mouthwash or breath mints
· Avoidance of supervisory contact, especially after lunch
· Sleeping on duty
Not any one of these signs means that an employee is an alcoholic. However, when there are performance and conduct problems coupled with any number of these signs, it is time to make a referral to the EAP for an assessment so that the employee can get help if it is needed.
Employee Assistance Program:
Employee Assistance Programs deal with all kinds of problems and provide short-term counseling, assessment, and referral of employees with alcohol and drug abuse problems, emotional and mental health problems, marital and family problems, financial problems, dependent care concerns, and other personal problems that can affect the employee’s work. This service is confidential. These programs are usually staffed by professional counselors and may be operated in-house with agency personnel, under a contract with other agencies or EAP providers, or a combination of the two.
The EAP counselor will meet with the employee, assess or diagnose the problem, and, if necessary, refer the employee to a treatment program or resource. With permission of the client, the EAP counselor will keep you informed as to the nature of the problem, what type of treatment may be needed, and the progress of the employee in treatment. Before releasing this information to you, or anyone else, the counselor would need a signed written release of information from the client which would state what information may be released and to whom it may be released. The EAP counselor will also monitor the employee’s progress and will provide follow-up counseling if needed.
Sometimes, the employee will contact the EAP on his or her own. However, in some cases, the employee will be referred by you because you have noted a decline in the employee’s conduct, attendance, or performance and/or seen actual evidence of alcohol use or impairment at work.
Human Resources or Employee Relations Program:
The role of the Human Resources, or Employee Relations office in dealing with cases of substance abuse is to advise management of appropriate adverse, disciplinary, or other administrative actions which may be taken. They also advise employees of their rights and the procedures in such cases. They do not obtain confidential information from the EAP nor do they independently approach the employee regarding the problem.
As a supervisor, you are responsible for confronting the employee. Employee relations staff will work with the EAP to the extent that confidentiality is not violated, will try to assist you in working with the EAP, and will work with you to try to make sure that any adverse or disciplinary actions are appropriate and defensible. In most agencies, it is the employee relations or human resources specialist who actually prepares or drafts adverse or disciplinary action letters, including those involving a firm choice. A firm choice is a clear warning to an employee who has raised alcohol or drug abuse in connection with a specific performance, conduct, or leave use incident or deficiency. He or she must make a choice between accepting treatment for the alcohol or drug problem and improving job performance or facing disciplinary action, up to and including removal.
Confronting the Employee:
It is generally a good practice to notify any employee who is being counseled for a performance or conduct problem about the availability of the EAP. However, it is crucial to make a referral to the EAP in the case of an employee with a known alcohol problem. Although you are not diagnosing the problem, you are dealing with employee performance and conduct and, possibly, alcohol-related misconduct such as using, possessing, or being under the influence of alcohol at work.
As a supervisor, you need to develop a strategy for addressing the work-related problems, as well as for encouraging the employee to get help. A good starting point is to meet with the EAP counselor, if possible, to discuss the problems observed and any other behavior by the employee that needs attention. The EAP counselor can help devise a strategy for confronting the employee and advise on techniques of addressing the problems.
Before actually meeting with the employee, you should gather any documentation of performance or conduct problems and think about what items to discuss with the employee. It is important to be specific about the problems in the employee’s performance and conduct and the particular incidents of concern. It might be helpful to rehearse this or at least go over the documentation with the EAP counselor.
Once prepared, you should notify the employee of the time and place of the meeting. The meeting should be held in a private place away from distractions. It is important to calmly but firmly explain the problems with the employee’s performance, the specific acts of misconduct or troubling behavior, and the consequences of any misconduct or poor performance. Unless the employee reveals the existence of an alcohol problem or there is immediate evidence of on-duty impairment, you must be careful not to offer any opinion that the employee may have a problem with alcohol. You should refer the employee to the EAP and explain that failure to correct any deficiencies may result in disciplinary or other action. It would be preferable to have already made an appointment for the employee with the EAP. While the employee may not be forced to take advantage of the EAP services, you should make clear that it is in the employee’s best interest to use the services.
Sometimes the employee will not accept the referral to the EAP or will deny the existence of a problem. If this happens, it is important to continue to document any problems and to take any necessary disciplinary action. It is not unusual to have additional meetings with the employee and to make additional referrals. The employee is in "denial" at this point and does not see that he or she has a problem. This is the hardest part of dealing with an alcoholic. The disease is so strong that the individual is unable to see what is happening to him or herself. In any case, the appropriate course of action is to continue to hold the employee accountable for his or her performance and/or conduct, regardless of whether or not the employee has admitted an alcohol problem.
If an employee chooses to use the EAP at your urging, he or she may enter some type of treatment program as described earlier in this booklet. If the employee does not choose to go into treatment, the next step will be to take any disciplinary or corrective actions that are necessary.
One technique which can be used to confront the employee is called intervention. It generally consists of scheduling a session with the employee where a number of people significant in his or her life are present, including you, the spouse, children, clergy, other family members, co-workers and other friends.
The session must be led by a trained professional, such as the EAP counselor. It involves having each of the individuals present directly tell the employee how his or her drinking has affected their lives and what the consequences of that employee’s drinking have been. If the intervention is effective, this can be a very powerful tool to counter denial and may help the employee consider treatment. It is extremely important that such an intervention be led by a trained professional and not by a lay person, such as a supervisor, because it can be a very emotional and powerful event and, if not conducted properly, may very likely backfire. Supervisors should contact an agency EAP counselor for more information about the intervention technique.12
Alcoholism is a disease. Employees who suffer from it need the agency’s compassion. However, sometimes that compassion has to be firm in order to communicate that, while the agency is willing to help the employee get assistance, the employee is ultimately responsible for his or her own rehabilitation, recovery, and performance. The best help that you as a supervisor can offer is to learn something about the disease, refer the employee to the EAP, and hold him or her accountable for his or her conduct or performance.
1. Cohen, S. and S.L. Syme. (eds.). 1985, “Social Support and Health”, Orlando, PL: Academic Press.
2. Cohen, S. and T.A. Wills. 1985, “Stress, Social Support and the Buffering Hypothesis”, Psychological Bulletin, Vol. 98.
3. World Health Organization (WHO). 1992, ICD-10 “Classification of Mental and Behavioural Disorders: Clinical Description and Diagnostic Guidelines”, Geneva.
4. Hart,K.F. and Fazaa,N.(2004), “Life Stress Events and Alcohol Misuse, Distinguishing Contributing Stress Events from Consequential Stress Events, Substance Use and Misuse”, 39(9), pp. 1319-1339.
5. Antai Otong,D.(2006), “Woman and Alcoholism-Gender Related Medical Complications: Treatment Considerations”, Journal of Addictions Nursing, 7(45), pp. 33-42.
6. Pihl,R.O., McGill,U., Peterson,J.B., (2007), “Attention Deficit Hyperactivity Disorder, Childhood Conduct Disorder and Alcoholism”, Alcohol Health and Research World, pp. l-12.
7. Walter,H.,(2003), “Gender-specific Differences in Alcoholism”, Implications for Treatment Arch Women's Mental Health.6, pp. 253-258.
8. Tudor,I.(2007), “Memory Distortions and Anxiety in Alcoholism: A Directed Forgetting investigation”, The Journal of Psychology. 141 (3), pp. 229-239.
9. Schmidt, L., Greenfield,T., Mulia,N (2006), Unequal Treatment. Alcohol Research and Health. 29(l), pp. 49-54.
10. Lumsden ,J. (2005), “The Prevalence of Early Onset Alcohol Abuse in Mentally Disordered Offenders”, The Journal of Forensic Psychiatry and Psychology. 16(4), pp. 651-659.
11. Chase, V., Neild, R., and Batey. (2005) “The Medical Complications of Alcohol Use: Understanding Mechanisms to Improve Management”, Drug and Alcohol review, 24, pp. 253-265.
12. https://www.opm.gov/policy-data-oversight/worklife/reference-materials/alcoholism-in-the-workplace-a-handbook-for-supervisors/ accessed on March 12th, 2017.
Received on 11.10.2017 Modified on 08.12.2017
Accepted on 06.02.2018 ©A&V Publications All right reserved