Alcohol Abuse: Are Employers Adequately Testing? - August 26, 2015
Alcohol Abuse: Are Employers Adequately Testing?
By John Mallios, Senior Director, Occupational Health Services
During the evening of May 30th, 2012, a drunk driver on a Louisiana highway crashed into a minivan carrying 7 people ranging in age from 6 to 64. All but one 13 year-old were killed at the scene. The 13 year-old was taken off life support 4 days later (1).
The drunk driver, whose blood/alcohol content more than 2 hours following the crash measured 0.15 (nearly twice Louisiana’s legal limit), was arrested by state police at the time of the crash, but released the next day on bond. After the 13-year old passed away, the driver was again arrested with various upgraded charges, including 7 counts of vehicular homicide.
Prior to the crash, the drunk driver had 3 DWI arrests between 2004 and 2008. He was sentenced to 70 years in prison, which was reduced to 35 years without possibility of probation or parole a year later.
This tragedy is one of many that depict the harsh reality of alcohol abuse in our society. However, many oversight organizations also monitor abuse and describe an equally unsettling truth.
Alarming Alcohol Abuse Statistics
According to the most recent National Survey on Drug Use and Health, a leading source of statistical and trend information on substance abuse among Americans:
More than 58 million adults are binge or heavy alcohol users - more than twice the amount of adults using illicit drugs. Among these users, 76.1% are employed (2).
The average annual rate of past month heavy alcohol use among full-time employees is 8.7% (3).
Across 19 industries, rates of past month heavy alcohol use by employees ranged from 4.4% in the Health Care & Social Assistance industry to 17.5% in the Mining industry (3):
According to the Centers for Disease Control & Prevention (CDC):
- Alcohol abuse costs employers more than $223 billion annually, 72% of which is attributed to lost productivity (4).
- Approximately 88,000 deaths are due to excessive alcohol use each year (4).
- More than 10,000 people were killed in 2013 by an alcohol impaired driver, accounting for nearly one-third of all traffic-related deaths (5).
- Every day, more than 700,000 Americans receive treatment for alcoholism (6).
According to the National Institute on Alcohol Abuse & Alcoholism, nearly 17 million adults had an Alcohol Use Disorder (AUD) in 2013, which is a medical condition diagnosed when a patient’s drinking brings about distress or harm (7).
Alcohol Testing in the Workplace
Alcohol is the most commonly used addictive substance in the United States. Consequently, alcohol abuse in the workplace is an issue American employers must be consistently concerned about.
SterlingBackcheck coordinates well over 1 million substance abuse tests for its clients annually, and, approximately 10% of all post-hire federally-mandated testing (such as that required by the DOT – Department of Transportation) is for alcohol. Most of this alcohol testing is for random selection, however, alcohol testing is also federally-mandated following a qualifying accident involving covered employees, reasonable suspicion of impairment, as well as return-to-duty and follow-up testing of employees who previously tested positive or refused testing. Though current alcohol abuse statistics are quite concerning, significantly less workplace alcohol testing is seen when a federal mandate to test doesn't apply.
While illicit drug use typically receives most attention, alcohol abuse does result in higher workplace costs (4, 8). Since alcohol is a “legal” substance, many view its use as an individual’s personal decision and their own business. Therefore, testing for it isn’t seen as necessary as it is for illicit drugs. Here the question should then be asked, “Why is workplace testing being conducted to begin with?” Is it conducted only to identify employees who are behaving illegally, or, to combat against tragic and costly risk to workplace and public safety? The truth is that alcohol consumption presents at least the same safety risk as illicit drug use does and, as part of an employer’s commitment to safety, zero-tolerance towards alcohol is equally necessary.
Benefits of a Sound Testing Program
Several benefits are commonly attributed to effective testing programs, and the below apply to testing for illicit drugs and alcohol abuse:
- Increased workplace and public safety.
- Improved employee availability and reduced turnover.
- More reliable employee productivity and improved quality of work.
- Decreased risk of workplace violence, theft, or damage to employer assets.
- Decreased costs associated with health care, short-term disability, and workers compensation.
- State discounts for workers compensation insurance premiums.
- Early identification and referral of employees who need help and rehabilitative assistance.
- Improved company perception, public confidence, and brand image, with fewer customer complaints.
Essential Elements of a Sound Testing Program
Continued education and a consistently-enforced testing policy will best position employers to combat impairment brought about by alcohol consumption. Overall, a sound employer program will:
- Ensure alignment with applicable regulations.
- Regularly educate and train covered employees and their supervisors regarding the employer’s program and alcohol testing requirements.
- Identify circumstances under which alcohol testing may be required, such as in instances of post-accident, reasonable suspicion or random selection.
- Identify expected and prohibited behavior by covered employees.
- Identify employee consequences of testing positive or refusing to test.
- Ensure sufficient documentation to support employment and disciplinary decisions made.
- Offer an EAP (Employee Assistance Program) where professional and confidential counseling can be accessed by employees battling alcohol abuse (many employer-sponsored health plans do provide for EAP support).
Breath sampling is mostly used for identifying alcohol impairment through instruments typically referred to as “breathalyzers”. Oral fluid sampling can also be used through a testing “kit”. For federally-mandated testing, the National Highway Traffic Safety Administration (NHTSA) maintains a "Conforming Products List" (10, 11) of testing devices (instruments and kits) that are approved for preliminary alcohol screening, as well as for confirmation testing (EBT – Evidential Breath Testing).
In all instances, use of a NHTSA device is strongly recommended, and certainly for federally-mandated testing. Pursuant to employer policy, preliminary screening of less than 0.02 typically deems the employee’s breath or oral fluid sample free from a prohibitive concentration of alcohol. If preliminary screening results 0.02 or higher, EBT testing must then be performed to confirm the presence of a prohibitive alcohol concentration prior to an employment decision from the employer.
Workplace alcohol testing is predominantly performed by Screening Test Technicians and Breath Alcohol Testing Technicians at occupational health and urgent care clinics. Breath Alcohol Testing Technicians are also separately qualified to conduct alcohol confirmation testing. As alcohol testing is almost always completed in its entirety during the employee’s clinic visit, the employer can be quickly informed of the test result.
The role of supervisors with respect to ensuring successful execution of an employer’s testing program is oftentimes overlooked and/or underestimated. In fact, supervisors have an extremely critical role in identifying and managing alcohol use by employees. Job performance of covered employees must be regularly monitored and, when circumstances arise, corrective and disciplinary actions may become necessary. This may also include referring an employee for EAP counseling.
Consequently, employers must ensure supervisors are well aware of all necessary program procedures to best promote safety, to support troubled employees, and, to actively contribute to program enhancements.
Thankfully, alcohol abuse can be successfully treated and managed, allowing troubled employees to return to a much healthier and more productive life, both personally and professionally. To this end, EAPs support troubled employees through confidential short-term counseling.
Following assessment of the employee, the EAP counselor will generally refer the employee for rehabilitation, which may include education and/or other prescribed treatment. With permission of the employee, the EAP counselor can also keep the employer informed of progress with rehabilitation, which may require a period of leave from active employment. Following successful rehabilitation, the EAP counselor will typically inform the employer regarding the employee’s return to work status.
With a successful return to work, the EAP counselor may also prescribe aftercare for the rehabilitated employee that may include additional counseling, support group meetings, follow-up testing, etc. Aftercare is meant to further supplement and support the long-term success of the rehabilitated employee, and will generally cause only minimal disruption to the employee’s work day, if any.
John Mallios, C-SAPA, is the Senior Director of Occupational Health Services for SterlingBackcheck, a leading global provider of employment background and occupational health services for more than 20,000 employers. Prior to joining Sterling in 2007, John worked with the Metropolitan Transportation Authority of New York for more than two decades, which included implementation of the new DOT testing regulations in the early 1990s, and administration of regulated and non-regulated substance abuse testing programs. John has supported drug-free workplace testing for countless employers, and can be reached at firstname.lastname@example.org.
Please note: This article was written for publication in the Fall 2015 issue of DATIA focus magazine.