Business see value in treating workers with addictions

VALERIE was an expert at rationalization: She didn't drink at work, she was never late for court, she met her law firm's billing expectations.

But for a decade, her life was spiraling out of control. At work, she grew more focused on getting things done quickly than on creatively helping her clients. She wasn't especially helpful to colleagues, either. At home, she downed wine by the bottle to cope with fear and self-doubt. When a psychiatrist prescribed Ambien, she replaced one vice with another.

By the time she bottomed out, in a cataclysmic event that put more than just her career in jeopardy, her health was declining and her professional life had become more tenuous than she realized.

"Being high functioning kept me sick for a really long time," she says.

Seven years after completing an inpatient and outpatient rehabilitation program designed for professionals, Valerie now is employed with a different law firm and spends many off hours helping others with their own addictions. Her story represents the challenge and the opportunity businesses face when their employees struggle.

"Businesses are not driven as much by touchy-feely as they are by what's going to help my business make money and be successful," Matt Feehery, CEO of the Memorial Hermann Prevention and Recovery Center, said after a recent symposium by Memorial Hermann Employer Solutions.

Most people come to the center on their own or with support from family, Feehery said, but patients increasingly have learned about its treatment programs through their employers. He chalks this up not just to greater awareness of addiction but also to employers' willingness to direct people to rehab.

Companies spend a lot training people and can't afford to have them walk out the door because of substance abuse, Feehery said. Treatment can return them to productive workers.

Valerie, who requested her full name not be used for this story, got sober after joining a Memorial Hermann program in 2009. Since then, she said, her productivity has skyrocketed.

"I do better work," she said. "I do more of it and I do it in less time."

Estimates of the toll that drug and alcohol abuse takes on U.S. businesses vary, but it is believed to be many billions of dollars annually. Statistics show workers with addiction are more likely to be involved in workplace accidents, file worker's compensation claims and be absent for eight days or more. They also tend to be late and less productive.

This problem affects people at all rungs of society.

"Addiction and alcoholism are non-discriminatory diseases," said Mark A. de Bernardo, executive director of the Institute for a Drug-Free Workplace and a lawyer who concentrates on workplace drug testing and substance-abuse prevention.

Some 10.6 percent of full-time employees and 13.2 percent of part-time employees 18 or older reported using illicit drugs within the past month, the 2014 National Survey on Drug Use and Health by the Substance Abuse and Mental Health Services Administration found.

Several drugs, including marijuana and the prescription pain medication hydromorphone, are showing up increasingly in workplace drug tests, according to Quest Diagnostics, a widely used drug-testing company.

Quest also reports that, after a decade of decline, more U.S. workers at private companies tested positive for illicit drugs such as marijuana, cocaine or heroin in 2013 than the year before. The numbers went up in 2014 as well. Overall, 4.7 percent of the approximately 6.6 million urine drug tests conducted that year were positive, up from 4.3 percent in 2013.

"Marijuana is clearly the largest component," said Barry Sample, director of science and technology for the employer solutions business at Quest Diagnostics. "Marijuana remains the most commonly abused illicit drug in the United States."

Positive tests for the opioid pain medication hydrocodone leveled off after doubling between 2003 and 2011, but taking its place is the rise of another opioid pain medication, hydromorphone, up 8.9 percent between 2013 and 2014 and up more than 25 percent between 2011 and 2014.

Feehery has seen an increase in people addicted to prescription opioids and heroin, which he said are often used along with other drugs or alcohol. And President Barack Obama, in his efforts to curb such abuse, is seeking $1 billion to expand access to treatment for these drugs over two years.

As the workforce ages, people have more chronic aches and pains that doctors feel obliged to treat. Many people start taking prescription drugs without intending to abuse them. Others take pills prescribed to friends or family. The stigma isn't as strong as it is for abusing illicit drugs.

"It's a little more socially acceptable, which is part of the problem," Dan Bravard, Memorial Hermann's associate vice president of risk management and safety, said during the symposium at the Prevention and Recovery Center.

Standard drug tests don't screen for prescriptions, and Bravard said employers may want to consider tests that look for certain prescription drugs. But since prescriptions are legal, it's important to work with experts and lawyers when drafting these policies.

To address drug addiction in the workplace, companies routinely screen job applicants and randomly test existing employees. This can deter workers from using drugs or from applying for jobs with drug tests.

But companies also have employee-assistance programs, which de Bernardo said are "the most effective chance" for someone to overcome addiction or alcoholism. These programs help assess employees and get them counseling and treatment. Often, companies encourage workers by allowing them to reclaim their jobs after meeting certain requirements.

Feehery said companies are more willing to give second chances to employees who make a significant impact on the bottom line or who possess skills and knowledge that take years to develop.

Glen Rust, director of health and loss control for a Houston-based oil and gas engineering and construction firm, said his company has a zero-tolerance policy and fires employees who fail random drug tests. But last year, it introduced a program that allows employees to reapply for their jobs after completing rehab. About seven or eight people have returned to work through this program.

The company, which Rust asked not to identify, has more than 3,000 employees; 4 to 5 percent of them fail a drug test each year. The company tests for illicit and prescription drugs, and it began a pilot program this month to test for synthetic drugs after employees of subcontractors had psychotic episodes on the job site, Rust said.

"A lot of them, I don't think, are looking for help," he said.

Valerie entered the Memorial Hermann program through her employer-based insurance. The law firm was supportive at first, before the rehab went on for 60 days.

That cost Valerie her job, but it saved her career. She's more engaged with clients and colleagues. She's also involved with a variety of committees and advisory boards outside of work.

"I have a life today that has dimension, and I get to be active in all kinds of ways that I wasn't before," she said. "Not only am I more productive at work, I am more productive in my profession because I participate in that profession. I'm more productive in my community because I participate in my community. I am more productive in my family because I participate in my family."

Instead of harboring ill feelings toward her former employer, Valerie feels guilty that it paid for her treatment and didn't benefit from it. She has sought to repay that law firm by helping other female lawyers there.

Unlike cancer or other diseases, Feehery said, addiction is not always treated sympathetically by bosses or colleagues because people who are impaired can be dishonest, reckless or difficult to work with.

But as with other diseases, he said, addiction can be overcome.

"I get to witness miracles on a daily basis," Feehery said. "I get to see people pull through and turn this around and go back to productive lives."