The Heroin Addict in Your Workplace

When we read about an overdose on an inner-city street, we’re not surprised. When a rock star or Hollywood actor “ODs,” we may barely notice. We’re conditioned to expect these things. However, if I told you that your CFO was using heroin behind the closed door of an office, you’d probably look at me like I was crazy – it doesn’t fit the old stereotype.

Our country is facing an addiction epidemic – opioid abuse, dependence and addiction is at levels the nation has never before experienced. The increase is so large that the odds are good that someone in your company is dealing with the issue as you read this article. According to the Department of Health and Human Services’ 2013 National Survey on Drug Use and Health, of the 22.4 million current illicit drug users aged 18 or older in 2013, 15.4 million (68.9 percent) were employed.

When addiction issues surface, companies need to manage risk and historically termination is a default response. However, no company likes to lose valuable employees and in many cases, if proper steps are taken, they don’t have to – here are five things to keep in mind:

  1. White collar employees are more likely than ever to be addicted: What many people don’t know is that the new face of heroin use is now solidly entrenched in the middle and affluent classes. College-educated, suburban, professional individuals in communities across the nation are part of a disturbing trend driven by two decades of drastic increases in legitimate medical prescriptions for opioid painkillers. Many addicts successfully hold jobs and may not show any signs of problems. In fact, top performers may be able to hide problems even longer than others. Unlike alcohol, there is no odor from opiate use. But as an addict’s condition worsens, it’s inevitable that their performance will begin to deteriorate.
  2. Gather resources before you discover a problem: Consult your attorneys and make sure your policies are in line with federal and state employment laws, but resist putting yourself in a corner by creating policies that mandate firing – it’s your attorney’s job to help protect you from legal risk, not the costs of losing valuable employees who may simply need treatment. Know the limitations of your insurance policies and be familiar with the resources provided by your Employee Assistance Programs.
  3. Be familiar with medically-assisted therapies for opioid addiction: Maintenance treatment is among the most widely used forms of treatment for opioid addiction. Drugs like Suboxone are used to wean people off of their dependence, but it’s important to know that an employee may remain on Suboxone for months and from a liability standpoint, that person will have an opioid-based drug in their system if they’re on the job. Naltrexone is the only non-opioid drug approved by the FDA for opioid addiction and may offer a more practical alternative to employers – this drug is often used in combination with detoxification procedures to help people past the withdrawal period and to prevent relapse. Inpatient and outpatient programs make a difference too – inpatient programs often require 30-day stays or more and hefty price tags, while outpatient programs can offer more flexibility. Companies need to evaluate their options and determine which approaches are best for both the employee and the organization.
  4. Understand and encourage the importance of mental health counseling: Statistically, addicts have a much better shot at long-term recovery and abstinence if they can make it 12 months or longer without relapse. Once the withdrawal period is past them (usually within the first month) addicts need time to adjust to their emotional states without their drugs. Opioids depress emotional centers in the brain and while not everyone has mental health issues prior to becoming addiction, almost everyone does by the time they enter recovery. Because opioids alter their emotional and psychological condition, like muscles that emerge from a cast around a broken bone, it takes time for people’s brains to return to normal and for them to deal with what they’ve just experienced. Make sure that treatment providers listed in your EAP materials include mental health services as part of their offering.
  5. Confront employees with a serious but caring tone: Employers need to make their expectations clear – “get treatment or your fired” – but you’re better served to do so with a caring tone. Many people feel trapped by their addiction and have been hiding it from everyone important in their lives. Approaching an employee with a judgmental tone, may motivate them to treatment, but they’ll feel ashamed around you and are likely to seek employment elsewhere as soon as they’re able.

Demonstrating care and understanding around addiction in the office creates trust, which will encourage honesty and increase the likelihood of people proactively seeking help. Taking the right steps will help you significantly with retention long after the person is fully recovered. In many cases, addiction can and does start quite innocently. An employee may be injured and be placed on an opioid painkiller by their doctor. Most of the time, the person heals and the prescription is never filled again. But sometimes it doesn’t happen that way. Many people mistakenly believe that because a doctor is prescribing medication, it’s without risk. For those that get hooked, most never even see it coming until it’s too late. Businesses suffer blind spots too, but good businesses learn to look around corners.