Recognizing Workplace Alcohol Problems

Joanna Stellato Kabat, CSW
Douglas Kabat, CSW

Alcohol problems are the single most significant health problem affecting the North American work place. Problems with alcohol are the leading mental health difficulty among adult men, and the third most significant problem (after depression and anxiety) among women. Approximately twenty percent of adult  males report a history of alcohol abuse, and ten percent a history of alcohol dependence. Ten percent report a history of alcohol abuse, and five percent a history of dependence. Since alcohol problems tend to have a pervasive effect in all areas of living, they result in significant losses in the workplace, due to absenteeism, on the job accidents, impairment of work functioning, and other alcohol related health, family and social problems.

A workplace alcohol program can effectively address alcohol problems, and thus improve workplace efficiency and morale. Workplace program do not diagnose or treat alcohol troubled employees; human resource professionals can however, identify apparently alcohol troubled employees, refer them to treatment programs and professionals, and support such employees in their efforts to resolve their alcohol related difficulties.

Identifying employees who appear to have alcohol problems is a fairly straight forward process; a number of studies demonstrate that educated lay persons are reliably accurate in identifying alcohol troubled adults. Carefully attending to twelve key areas of concern will result is identification of employees who are likely to be alcohol troubled. An employee who demonstrates difficulties in three or more of these twelve problem areas definitely merits referral for a professional alcohol evaluation. Even the appearance of problems in two areas may merit referral, depending on the intensity of difficulty.

Twelve Key Areas for Alcohol Problem Identification

1. Absenteeism: Many alcohol-troubled employees have a pattern of excessive absenteeism. This may be due to hangovers or binges, and will most commonly occur around weekends and vacation times, as well as after paydays, or during periods of personal stress due to family problems or other difficulties.

2. Impaired performance: Alcohol troubled employees will often "under-perform" due to the subtle (or not so subtle) impact of heavy drinking prior to work. Although an individual may appear sober, a weekend of heavy drinking will impair performance for up to two following days, since a period of being "high," will be followed by an equally extended period of being "low," i.e., functioning at a somewhat lower level that usual. This will be particularly noticeable for binge drinkers, as episodic intoxication will result in episodic decreases in functioning in subsequent, apparently sober, days. Daily drinkers, on the other hand, may not show signs of impaired performance, at least for many years, since a consistent daily pattern of drinking will result in a consistent daily pattern of functioning, even when not apparently "under the influence." Impaired performance among binge drinkers may be particularly noticeable after payday or bonuses.

3. Excessive drinking at lunch time: Drinking with noon time meals is a common pattern among many groups; one beer, a glass of wine, or a mixed drink, will be completely out of the individual's system approximately one hour after consumption. One drink with lunch is not a problem. However, consumption of more than one drink will result in impairment for two or more hours after consumption: for a one hundred fifty pound male, one standard drink (a twelve ounce beer, a five ounce glass of wine or one ounce of hard liquor) is metabolized every hour. Therefore, regular consumption of more than one drink at lunch (or a meal in the middle of a shift) should be considered indicative of a potential problem.

4. Tolerance: Consistent with the problem of lunchtime drinking, many alcohol-troubled persons are able to "hold their liquor," i.e., superficially function well despite considerable alcohol consumption. Such alcohol tolerance is problematic, as subtle impairment can occur despite the appearance of unimpaired functioning. "Tolerance" is both a learned and inherited response to alcohol, and is highly correlated with significant alcohol problems: the greater an individual's tolerance for alcohol, the more likely they are to develop alcohol dependence. Furthermore, individuals with a large tolerance for alcohol will often drink heavily one day and show up for work then next, believing, and feeling, they are "sober," but in fact still "under the influence," often to a very considerable extent. In fact, many alcohol-troubled persons are arrested for drinking and driving twelve or more hours after they stopped consumption.

5. "Going on the wagon": Many alcohol troubled persons will attempt to control their drinking by "going on the wagon," i.e. quitting for a period of time. Such strategies are sometimes successful in controlling problem drinking, but they often result in a pattern marked by periods of heavy drinking alternating with periods of abstinence. Such cycles are problematic, as "dry" periods are often and unpredictably followed by "wet" or heavy drinking periods, and a "wet" period can be extremely dangerous in the workplace environment. The paradox of "going on the wagon" is that, "falling off the wagon" follows all to often.

6. Loss of control: Many alcohol-troubled persons, especially those with considerable tolerance, will experience difficulty controlling their consumption, despite their best efforts and desires. This loss of control is often characterized by secretive drinking, either in the form of drinking at home before going out to a social function. Loss of control is also demonstrated by an individual's repeated inability to control his/her drinking despite sincere efforts to do so.

7. Withdrawal symptoms: Since many alcohol troubled persons have developed tolerance for large amounts of alcohol, their bodies become not only "use to," but dependent upon alcohol for normal functioning. This is similar biologically to the dependence that individuals often develop on prescription medications; in both cases, abrupt cessation of use can prove disastrous. Sweating, shakiness, and flu like symptoms most often mark alcohol withdrawal. Even mild withdrawal symptoms may result in absenteeism or markedly reduced workplace functioning; more severe withdrawal patterns are rarely seen in workplace settings.

8. Legal problems: Many alcohol troubled persons will suffer from legal problems, such as arrests for Driving Under the Influence, Driving While Intoxicated, or Driving While Impaired, as well as arrests due to alcohol related fighting or other misbehavior. Many individuals will be arrested for such behavior at some point in their lives, most typically in their 20's; alcohol troubled persons, on the other hand, have repeated brushes with the law. Useful indiscretions are different from repeated alcohol related legal problems.

9. Family problems: As with legal problems, alcohol troubled persons tend to have more than their share of family problems. Problem drinking can be a major source of family conflicts; in other cases, problem drinking is what "keeps a couple together." When problem drinking creates conflicts, bitter divorce and severe parent-child conflict are very common. When problem drinking is what defines a couple's relationship, absenteeism will often be quite pronounced.

10. Preoccupation: For many alcohol-troubled persons, life is defined by drinking. Preoccupation with alcohol is characterized by a focus on drinking as a primary social and recreational activity. Such preoccupation is often strongly correlated with tolerance, and legal and family problems. Individuals who are preoccupied by drinking will also tend to exhibit a shift in priorities, i.e., events or occupations that were previously important become increasingly less significant as drinking becomes the key priority. An office get-together without alcohol is often unattractive to an individual who is preoccupied with drinking; for many alcohol troubled persons social occasions without alcohol consumption are simply "non-events."

11. Blackouts: Many alcohol-troubled persons will suffer from memory lapses for periods in which they have been "under the influence." Such "blackouts" usually frighten social drinkers, who typically cut back on their drinking to avoid repeating such a frightening experience; individuals with serious alcohol problems become use to memory loss when drinking, and may even normalize such experiences, making it appear to be a common and unremarkable event.

12. Inappropriate behaviors: The combination of tolerance, loss of control, and blackouts, often results in inappropriate behavior. Such behaviors may not rise to the level of legal problems, but they usually result in bad feeling and embarrassment. Social or sexual indiscretions can result not only in shame and regret, but in lawsuits, resignations and terminations as well.

Any one of these twelve signs of alcohol problems is of concern; two is worrisome, and three indicates a need for referral for professional assessment.