Presents Understanding and Managing Addiction in the Workplace October 8 th, 2013 Mani Alcaide, RN, CPMHN(c) Manager of Intake & Assessment Services Bellwood Health Services Inc. These materials may not be reproduced without permission from Bellwood Health Services Inc
What to Expect Today What is addiction? Pre-disposing factors Overview of various addictions Impact on the workplace Safety and other performance issues Helpful tools and resources Benefits of Addressing the Issue
What is Addiction?
Addiction A Brain Disease American Society of Addiction Medicine Definition: Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry individuals pathologically pursue reward and/or relief by substance use and other behaviors.
Addiction A Brain Disease Chronic brain disease, which requires treatment, management and monitoring over a lifetime, Addiction is comparable to other chronic conditions such as cardiovascular disease or diabetes Addictive behaviors are the manifestations of disease, not the cause
What is Addiction? An uncontrolled dependence that continues in spite of causing physical, psychological, social and spiritual harm. People are driven by a powerful force of physical and psychological dependence, into a spiral of escalating use.
Pre-disposing Factors Genetic re-neurotransmitters and receptors Psychiatric Environment past and present Preceding and/or consequences of addiction
Physical Pre-disposing Factors Family history Genetic endorphins Disease causing pain Social Trauma, PTSD Codependency Money, supply Psychological Abuse Rejection
Addictions
Various Addictions 5 basic drug classes and alcohol Acting out behaviours (Process Addictions): Pathological gambling (Sports Pools) Sex addiction Eating disorders Shoplifting Workaholic Cross-addictions Concurrent disorders
Impact on the Workplace
Addiction in the Workplace 76.8% of people with alcohol and drug addictions are employed. (Substance Abuse and Mental Health Services Administration, 2004)
Impact on the Workplace Affects all levels frontline staff to CEOs Over 60% know someone who has reported for work under the influence of alcohol or drugs - Addiction in the Workplace Survey. Centre City, MN: Hazelden Foundation, 2003).
Addicted Employees Report that prior to treatment, they were absent, late or unproductive 34-43% of their working days every second or third day. - Bellwood Outcome Research, 2013
What are the signs Lateness Absenteeism Decreased quality and productivity Changes in mood and functioning Increases in accidents or near misses Isolating
Conspiracy of Silence It s none of my business. Let s just not talk about it.
Safety Implications Accident/Error Risk being impaired/hung over/ in withdrawal while at work Crime possession, selling, theft, fraud
Safety Implications Impact can be far-reaching Hazard to: Self Other Employees Communities
Productivity Implications Annual productivity costs to Canada due to alcohol and illegal drug abuse = $11.8 billion - The Costs of Substance Abuse in Canada, 2002, Rehm et al, 2006
Productivity and Safety Implications Workers with addictions: Function at about two thirds of their capability In particular, those who use drugs, are 3 times more likely to be late for work Are 3.5 times more likely to be involved in a workplace accident compared to employees without an addiction. Slavit, et al. (2009). An employer s guide to workplace substance abuse: Strategies and treatment recommendations. Washington, DC
Workplace Morale Implications Increased stress and workload for other employees Picking up the slack Employees concerned but afraid to speak up Hoping that employer will intervene
Financial Implications Costs of decreased productivity of addicted workers Increased disability/ WSIB costs Increased costs associated with accidents, errors, clean-up, damaged equipment, lawsuits, reputation, etc.
Simple Screening Tools CAGE TACE (for pregnant women) AUDIT (MOT) High Risk Drinking Levels: Male: >5 per day, or >14 per week Female: >4 per day, or >7 per week Binge 5 or more in last 30 days
CAGE Effective 1 Minute Screener C - Cut Down A - Annoyed G - Guilty E - Eye Opener Do CAGE before asking quantities or frequencies 2 or more
Testing Urine Drugs of abuse screen Toxicology Add alcohol Immune Assay, GC / MS Creatinine Random (legal)
Early Intervention is Better
Types of Intervention Comment from colleague or supervisor expressing concern A structured interview
Benefits of Addressing the Issue
Improved Safety Prevention of accidents and errors on the job Improved health and functioning of employees Reduced risk of injury to employees/ community
Improvement in Productivity Source: 6-month follow-up study of Bellwood clients admitted from 2004-2008 (N=691)
Impact on the Bottom Line Reduced costs due to productivity drain on company Reduced costs associated with dismissal, arbitration, hiring and training Reduced costs of repairs, clean-up from accidents Reduced risk of liability/lawsuits from accidents
Proactive Employers Minimize Productivity Losses
Responsible Care The ethics and principles of Responsible Care are aligned extremely well with effective approaches for workplace management of addiction Costs and benefits of treatment
Appropriate Attention and Accommodation Involvement of Occupational Health Team Referral for appropriate assessment, and treatment Safety Sensitive Assessment if appropriate Know the outcomes/success rates of your EAP, and what they can provide. Return to work accommodation
Treatment Success Rates
Aftercare Is Key To Success Working a program of recovery in Aftercare is the highest predictor of success. Recovery Rates with Aftercare
Recovery Status By Aftercare Support Usage Source: 6-month follow-up research study of clients admitted from 2004-2007 (N=367).
Employer Referred Outcomes Recovery Rates with Employer Referral and Involvement
Bellwood Health Services
Accredited with Exemplary Standing by Accreditation Canada
Bellwood Services Treatment Programs for: Alcohol & Drugs Gambling & Gaming Sex Addiction Eating Disorders & Addiction PTSD/ Trauma & Addiction Family Education & Support Program Continuing Care/Aftercare Intervention training
Treatment Services Individual Counselling Residential/Day Treatment Programs Outpatient Groups NEW! Intensive Outpatient Program for Alcohol and Drugs
Bellwood Services Treatment Approach Eligibility Referral Process Intake & Assessment Process
Corporate Services Special Program Features: Safety Sensitive Assessments & Consultation Priority access to treatment Employer education and training program Workplace Interventions Return to work contracts Return to work planning Alcohol Breathalyzer Testing Supervised Urine Drug Screening and Testing Hair Sample Test
Questions and Discussion
Residence Day Seminar in Register Online! November 21 st, 2013
Connect with Bellwood
Contact Information Mani Alcaide, RN, CPMHN(c) Manager of Intake & Assessment Services malcaide@bellwood.ca Bellwood Health Services Inc. 416-495-0926, Toll Free 1-800-387-6198 BellwoodHealthServices @BellwoodHealth /blog