The Employee Assistance profession largely came into existence as a result of the impact that alcohol use was having on the workplace. Over time, while EA services have increased awareness and impact of alcohol use and abuse in the workplace, the fact remains that alcohol use concerns tend to be under-reported by clients, and is not being sufficiently assessed when clients call their EAP for services. Alcohol use concerns comprise less than 10% of the issues assessed at intake by U.S. and Canadian EAPs.
One does not have to be diagnosed with alcohol abuse or alcohol dependence to be a problem within the workplace. Employees who drink at levels above the World Health Organization’s suggested limits for alcohol consumption, but below the levels necessary to be diagnosed as having an alcohol use problem, constitute a risk to the workplace as well. Risky, hazardous, and/or harmful drinking is correlated with physical and emotional health problems, increased traffic accidents, other workplace accidents, and workplace violence. Substance abuse impacts the U.S. economy at a cost of about $190 billion annually, as a result of lost productivity, injury, health problems, and expenses related to enforcing substance abuse laws and policies.
Given the impact of alcohol and substance-related problems on workplace health, safety, and productivity, as well as the impact upon management time and health care costs, it is increasingly essential that EA organizations develop evidence-based protocols to both properly assess alcohol and substance use issues, as well as provide proper treatment recommendations.
EA organizations are strategically aligned with both employees and employers to identify and assist individuals with problematic drinking. Further, EA organizations can be best suited to early interventions that can reduce the adverse effects of problematic drinking, including helping reduce the chances an individual will become alcohol dependent.
Research and evidence-based practices have emerged that support effective ways to address problematic drinking behaviors. Common to these practices are careful screening of alcohol use behaviors, and offering brief interventions that help reduce those drinking behaviors. These screening and brief intervention approaches have been used to effectively identify alcohol use concerns, particularly with individuals who may not meet criteria for alcohol abuse/ dependence, but may in fact be engaging in risky drinking behaviors. Standard protocols involve utilizing an alcohol-screening instrument (such as the AUDIT, or AUDIT-C) to identify problem-drinking behavior, and then provide information, often in short/ brief interactions, that have been found to help reduce drinking behavior. Best practices in screening and brief intervention of alcohol use behaviors include:
- An adaptable process, to fit a variety of EA service models
- Screening, which can be a stand-alone process or integrated into a standard intake assessment, use of an established alcohol assessment tool (such as the AUDIT or AUDIT-C)
- Brief intervention, which should have core elements of sharing assessment information (including screening results), advising, informing, and motivating
- Referral resources, based upon identification of high risk and screening feedback. Referral options may include alcohol use/abuse education, referral to other EA resources, referral for insurance-based treatment, and/or community resources. Follow-up with the individual is essential to a successful referral, and should include reassessment of alcohol use behaviors.
For more information about screening and brief intervention of alcohol use behaviors, you are encouraged to speak with an EASNA Professional Practices Committee member.