Treating Drug Problems Volume 2 (1992) / Chapter Skim
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Drugs, the Workplace, and Employee-Oriented Programming
Drugs, the Workplace, and Employee-Oriented Programming
Pages 197-244
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Drugs, the Workplace, and Employee-Oriented Programming Paul M Roman and Terry C
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The age segment focus of these data is used to obsene that younger persons have a substantially higher rate of reported drug experience than older persons, and that such a difference not only describes a major problem with drugs among persons in this age segment who are employees but also projects a workplace drug problem of continuing seriousness as workers who exhibit such behaviors move through their life careers in the work force.
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This sampling of data provides some flavor of the difficulty of producing statements with any sort of precision regarding the drug abuse problem in the American workplace. Employer Motives to Initiate Action Beyond research precision is a practical question: Why should the workplace show a concern with employee drug use?
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~ Many employers, including large, well-known companies, have implemented programs to deal with employee drug abuse; therefore, such programs must represent state-of-the-art techniques of human resources management. Drug Screening/Drug Testing and Employee Assistance Programs The combination of some set of the above-listed reasons with the perception of drug use in the employee population has led to two basic types of organizational interventions to deal with drug abuse problems among employees: drug screen~ng/drug testing programs (DSPs)
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Whereas DSPs seek objective physiological evidence of drug use, independent of behavior, performance, or self-report, the design of EAPs limits their drug-related service usage to instances of impaired job performance, peer- or self-motivated initiation of requests for personal assistance by drug-using employees, or self-motivated initiation of requests for assistance in dealing with a drug-using family member. Nearly all of these modes of identification involve subjective indices or perceptions, in contrast to the presumed objectivity of drug screening.
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Governmental pronouncements on drug abuse in the workplace give a double message. They suggest preemployment drug screening as a way of reducing the drug problem by refusing to accept drug users into the
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However, culturally based definitions of different behaviors play a large role In determining the acceptability of different responses to drug and alcohol problems, an issue considered in greater detail in the sections that follow. DEVELOPMENT OF EMPLOYER RESPONSES TO DRUG USE Historical Perspective Although the past several years have seen a great deal of attention to efforts to create a "drug-free workplace" in the United States, this is at least the "second round" in the battle against employee drug abuse.
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In between these notions is the hypothesis that the Stimulus of liberty" and its attendant demands on the mind were etiological factors in drug addiction (Thwing, 1888, in Morgan, 1974~. Although there is little evidence of drugs in the workplace as an issue of social concern in the United States until the early 1970s, one notable exception is a report of an apparently informal survey of experience with workplace drug addiction (Blair, 1919, in Morgan, 1974)
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75) , a position contrasting markedly with the philosophies of some drug screening today.
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The drug issue was escalated in the mass media by its association with the "dropped-out" youth from middle-class and more prosperous backgrounds. The image of"flower children, characterized by illicit drug use coupled with expanded sexual freedom, was reflected in the popular cultures of music, dress, and various public events of high visibility.
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Some share of the focus was also on the poor job performance of drug users, the safety hazards they created, and their morale impact on co-workers in terms of creating fear. The strategies presented to deal with the problem were both pre- and postemployment screening; identification by supervisors of the symptoms of drug use; beefing up company security to detect both drug abusers, drug distribution, and drug-related thefts; and corporate education programs designed to create An employee force that .
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are worth detailed attention. The report observes that increased employee drug use seems to be a recent phenomenon that employers generally choose to ignore.
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when "the nature of the business allows," employees with drug abuse problems should be referred to a counseling or rehabilitation program rather than be terminated; (3) in dealing with employee drug abuse, the business community should consider adopting "employee assistance" programs, using a management control system based on impaired job performance and attempting to treat the causes of the poor performance; (4)
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Why the Concern With Employee Drug Abuse? What social forces underlay this interest in workplace drug abuse problems in the early 1970s, and why did this fledgling interest seem to splay itself outs until its reemergence in a different form in the mid-1980s?
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Although objective techniques of drug screening had definitely been developed by this time, they were largely limited to detection of opiates through urinalysis. It was clear that there was considerable concern about the accuracy of this testing (Wald and Hutt, 1972)
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There were, however, a series of developments between the early 1970s and mid-1980s that are somewhat important in understanding current policy and the organizational environment surrounding drug abuse in the workplace. Developments During the 1970s and Early 1980s One of the first formal efforts to address employee drug problems was evidenced in the 1973 policy adopted by the U.S.
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An important development in the early 1970s was the establishment of the National Institute on Drug Abuse, first as a unit within the National Institute of Mental Health, but shortly thereafter emerging as a sister agency to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Mental Health (NIMH)
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Exceptions were the funding of several small contracts to the Stanford Research Institute for an overview of activities related to workers' drug abuse in a very small sample of companies and unions, one product of which was a set of guidelines for employers that essentially adapted EAP strategies to deal with employee drug abuse (Stephen and Prentice, 1978; see also Vicar and Resnik, 1982, for a later set of suggestions and guidelines in a pamphlet produced under a NIDA contract)
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The emergence of OWI occurred simultaneously with three other changes that have all contributed to the rapid growth and expansion of program implementation in the workplace to deal with employee drug abuse. The first of these was the stimulation that the federal drug-free workplace initiative created for the organization and distribution of drug screening technology.
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The interest of treatment centers in providing services to EAP-referred drug abusers, as well as the increasingly visible presence of promoters of drug screening, contributed to the growing salience of drug abuse issues among EAP service providers, including both internal EAPs and external organizations providing EAP services on a contract basis. In their attempts to establish a role in workplace programming as well as to develop supportive constituencies, the personnel of NIDA's OWI initiated a variety of interactions with representatives of the EAP field.
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EMPLOYER INTEREST IN ALCOHOL PROBLEMS The principal mission of this paper is to offer a broad understanding of the potential contribution of EAPs to efforts to deal with workplace drug abuse. Part of that understanding is centered on the context in which EAPs have arisen and on the foundations for their support.
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More importantly, it brought to the alcoholism field many times the resources than had previously been available. These resources included funds for public education about alcoholism, which could build on NCA's earlier activities.
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For patients to flow into these centers, health insurance coverage for alcoholism treatment was essential, and it was here that NIAAA's impact was the greatest. The institute offered strong encouragement through formula grants, project grant support, and, ultimately, state-directed incentive grants to support state-level lobbying efforts to mandate health insurance coverage for alcoholism treatment.
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Acceptance of the belief that alcoholism is found with equal likelihood at all social levels encourages the readiness to identify and refer employed alcoholics, who in turn utilize the new clinical facilities and have their treatment paid for through their health insurance coverage. It is also the case that creation of a new epidemiology created political potentials for the alcoholism field through confirmation that its disease was, indeed, like any other, that everyone could be at risk, and that the social and economic welfare of the larger society was being undermined by agents more insidious than skid row inebriates, namely "hidden alcoholics" (Rubington, 1974~.
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The critical effect on program outcomes is that the job performance "screen" produces cases of many personal or ~behavioral-medical" problems other than substance abuse, making the programs truly directed toward employee assistance. There is no doubt that NIAAA attached its organizational identity to this innovation, as was demonstrated in an early and widely diffused pamphlet-type publication (NLAAA, 1973~.
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Implementation of the performance-based strategy automatically transformed the focus of programs from alcohol abuse to all nonwork factors that could affect job performance. As the program model was implemented across different types of organizations and occupations, an unexpected development occurred.
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SCOPE OF EMPLOYEE ASSISTANCE PROGRAMS Elsewhere the authors have provided a detailed description of the principal functions served by EAPs and their core technology (Roman, 1988b; Blum and Roman, 1989a)
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EMPLOYEE-ORIENTED PROGRAMMING TABLE 1 Core Aspects of Employee Assistance Programs Aspect Core Technologies Core Functions Supervisory operations Benefit management activities Identify problem employees through documented performance deficits Provide consultation to supervisors in policy procedures and appropriate action Assist in constructive confrontation leading to motivation for behavioral change Provide clinical/job diagnosis and suggest most appropriate regimen of care Increase workplace influence and control over providers of treatment/counseling Generate workplace attitudes that substance abuse is primarily a medical problem 225 Provide equity and due process for troubled employees Reduce supervisory burden of counseling troubled employees Retain employees in whom there is heavy investment and change their commitment to the workplace Act to channel clients to most effective resources Control employers' health care costs Support a workplace culture with constructive orientation toward substance abuse rehabil itation
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Forty percent of worksites with 500 to 749 employees had EAPs, with 80 percent of these programs based on external service contracts. Patterns of Employee Assistance Program Utilization Data from the study of 439 internal and external EAPs indicate that an average of 5 percent of employees used the EAP in the 12 months prior to the 1984-1985 data collection.
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Supervisory referrals of subordinates were significantly more likely when the managers perceived top management support for the EAP, when they perceived EAP support by their immediate supervisors, when they believed the EAP helped improve organizational productivity, when they believed the EAP was an integral part of the company, and when they were familiar with policies related to the EAP and discipline. COMPARISONS OF DRUG SCREENING PROGRAMS AND EAPS What are the similarities and differences among EAPs and DSPs?
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sponsored by NIDA in May 1987, Dr. D.N Macdonald, the White House special advisor on drug abuse stated that the Reagan administration believed that workplace drug screening would be accepted by the American people only if it were considered fair and humane.
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The DSP may include only applicant drug testing or combinations of current employee drug testing, or both. The different types of drug screening may refer only to some categories of employees under some categories of conditions, such as probable cause.
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Coupled with the increasing awareness of drug usage in rural America as both a real and perceived issue, more worksites may adopt those practices that seem relatively straightforward, simple, and inexpensive -- such as urine sampling followed by drug testing through express mail arrangements with drug screening laboratories at distant locations. The central concern about such arrangements is that these organizations may be the least likely to be able to afford due process protections and a bundle of other employee benefits and educational opportunities that larger employers are able to provide.
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Yet although the deterrent effect of drug testing is a plausible argument for applicant testing, there are nevertheless a series of issues that may be of concern to the communities in which the organizations exist in terms of appropriate assignment of responsibility for drug problems. Currently, evidence about the impact of drug screening on employee drug usage is not available.
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Generally, the evidence from the treatment community of increases in polysubstance abuse and of the switching of drugs of choice as different chemicals are more readily available or culturally acceptable must have some bearing on workplace strategies for dealing with workplace effects of alcohol and other drug dependencies (Blum, 1989~. Furthermore, the impact of drug screening on employee morale, satisfaction, commitment, turnover, accidents, productivity, and other work-related outcomes is not known.
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DRUG SCREENING AND EMPLOYEE ASSISTANCE PROGRAMS AND POTENTIAL FUTURE DILEMMAS The workplace is involved in dealing with both drug and alcohol issues, creating in many ways a "new world" of addressing human problems and their consequences. In conclusion, the authors review two ~dilemmas" highlighted by issues involved in drug and alcohol programming in the workplace: potential conflicts among program strategies with very different intentions and the effects of broadly scoped services provided by employers.
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Does the practice of preemployment drug testing interfere, even unintentionally, with affirmative action principles? The Postal Service data confirm the findings of other epidemiological surveys, which reveal that the odds of being drug positive are higher for blacks, males, and people between the ages of 25 and 35.
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Thus, micromotives underlying workentry drug screening that excludes drug-positive persons may influence macrobehavior that unintentionally contributes to a bifurcated society. lithe micromotives for keeping drug-positive job applicants out of the work force may also interfere disproportionately with the macrobehavioral goals of affirmative action in hiring.
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~ Can the company or external contract counselor break through the cover-up and denial that usually characterizes an employed substance abuser, particularly when it is evident to the employee client that the counselor is a company employee or direct contractor? Conversely, it would appear that such a perception would both encourage and bolster denial and cover-up, not only on the parts of the affected employees but also on the part of their peers and even their supervisors.
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( 1987) Strategic Planning for Workplace Drug Abuse Programs.
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Employee assistance programs and human resources management.
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(1987) Innovations in employee assistance programs: a case study of the Association of Flight Attendants.
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An empirical evaluation of preemployrnent drug testing in the United States Postal Service: interim report of findings.
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Blum (1987b) The relation of employee assistance programs to corporate social responsibility attitudes: an empirical study.
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Trice (1986) Strategies for Employee Assistance Programs: The Crucial Balance.
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Hawks (1986) Questions and Answers: Employee Drug Screening: Detection of Dmg Use by Urinalysis.
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