Vivian Marlowe
Alcohol use disorder (AUD) is a pervasive issue in the United States, affecting approximately 9% of full-time employees, or about 11 million workers. AUD is characterised by impaired control over alcohol consumption, despite negative consequences in one's social, work, or personal life. This disorder is linked to a staggering 232 million missed workdays annually in the US, with severe cases accounting for 32 missed workdays per year on average. The problem has likely been exacerbated by the pandemic, with alcohol sales increasing by 20% in its early months. AUD is more prevalent among men, younger people, those identifying as White or Hispanic, and individuals with lower incomes. Certain industries, such as mining and construction, have higher rates of heavy alcohol use, with mining at 17.5% and construction at 16.5%. Overall, the economic cost of excessive alcohol use in the US is significant, with $179 billion in lost workplace productivity in 2010.
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What You'll Learn
- Alcohol use disorder (AUD) is a clinical diagnosis of alcoholism
- Alcoholism symptoms: loss of control, withdrawal, cravings, absenteeism, poor performance, behavioural issues, and inability to concentrate
- Alcoholism is a disease with three stages: early, middle, and late
- % of full-time workers in the US suffer from alcohol use disorder
- Alcoholism treatment: agency compassion, Employee Assistance Program (EAP), Human Resources, Employee Relations, and local mental health programs
Alcohol use disorder (AUD) is a clinical diagnosis of alcoholism
The early or adaptive stage of AUD is marked by increasing tolerance to alcohol, with the alcoholic being able to consume greater quantities while appearing to suffer few effects and continuing to function. The middle stage is characterised by physical dependence, craving, and loss of control. The alcoholic loses their ability to limit their drinking to socially acceptable times, patterns, and places. The late or deteriorative stage is when the damage to the body from alcohol becomes evident, and the alcoholic suffers from a host of physical and psychological problems due to the toxic effects of alcohol on vital organs.
Genetics and family history play a role in AUD risk, with the rate of AUD being three to four times higher in close relatives of individuals with AUD. Mental health conditions and a history of trauma also increase the risk of AUD.
AUD is associated with a significant increase in the risk of accidents, violence, and suicide. Heavy drinking can impact a person's mood and make depression harder to treat. It can also cause adverse effects on the digestive system, cardiovascular system, and central and peripheral nervous systems.
Treatment for AUD includes medication, therapies, and support/self-help groups. There are currently three FDA-approved medications for AUD: naltrexone, acamprosate, and disulfiram. Behavioral treatments, such as alcohol counseling and talk therapy, are also effective in changing drinking behavior.
In the United States, AUD is linked to 232 million missed workdays annually and contributes to a significant number of absences in the workplace. Individuals with AUD miss an average of 18 to 32 days of work each year, depending on the severity of the disorder.
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Alcoholism symptoms: loss of control, withdrawal, cravings, absenteeism, poor performance, behavioural issues, and inability to concentrate
Alcoholism, or alcohol use disorder (AUD), is a disease with recognisable symptoms, causes, and treatment methods. It is a major problem in the United States, contributing to an estimated 232 million missed workdays annually. Research has found that people with severe AUD miss more than double the number of workdays compared to individuals without AUD.
The early or adaptive stage of alcoholism is marked by an increasing tolerance for alcohol and physical adaptations that are largely unseen. The drinker is able to consume greater quantities of alcohol while appearing to suffer few effects and continuing to function.
The middle stage of alcoholism is characterised by physical dependence, craving, and loss of control. The alcoholic loses their ability to limit their drinking to socially acceptable times, patterns, and places. This loss of control is due to a decrease in tolerance and an increase in withdrawal symptoms. In the workplace, this stage is evident through increased and unpredictable absences, poorly performed work assignments, behavioural issues with colleagues, inability to concentrate, accidents, and a deterioration in overall appearance and demeanour.
Withdrawal symptoms can include trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, dysphoria, malaise, feeling low, or seizures. Delirium tremens (DT) is a severe form of alcohol withdrawal that can be life-threatening, causing serious medical issues like seizures and hallucinations that require immediate medical care.
Alcohol use disorder can be treated through behavioural therapies, which help individuals develop skills to avoid and overcome triggers such as stress. Medications can also help deter drinking, with three medications currently approved by the U.S. Food and Drug Administration to help reduce drinking and prevent a return to drinking: naltrexone (oral and long-acting injectable), acamprosate, and disulfiram.
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Alcoholism is a disease with three stages: early, middle, and late
Alcoholism, a recognised disease, affects about 9% of the full-time workforce in the US, with alcohol use disorder contributing to 232 million missed workdays annually. It is a progressive disease with three stages: early, middle, and late.
The early stage of alcoholism is characterised by a gradual increase in drinking frequency and tolerance. At this stage, individuals may use alcohol to relieve stress or avoid dealing with their problems. They may also engage in binge drinking and neglect responsibilities due to impaired judgment. During this stage, individuals develop alcohol dependence and experience a higher tolerance for alcohol.
The middle stage is marked by physical dependence, craving, and loss of control. The alcoholic's body becomes accustomed to large amounts of alcohol and experiences withdrawal symptoms when it is not present. They develop a powerful urge to drink that they eventually cannot control, and they lose the ability to limit their drinking to socially acceptable times and patterns. This stage is often when impairment becomes evident in the workplace, with increased absences, poorly performed work assignments, behaviour problems, and a deterioration in overall appearance and demeanour.
The late or deteriorative stage is when the damage to the body from alcohol's toxic effects becomes evident, and the alcoholic suffers from a host of physical and psychological ailments due to damage to vital organs. Individuals at this stage may experience severe health complications such as liver cirrhosis, heart problems, and neurological issues, as well as marked cognitive decline and emotional instability. They may also display dramatic changes in behaviour, strained personal relationships, and an inability to maintain employment or daily responsibilities.
While the three stages of alcoholism are distinct, it is important to note that the progression of the disease is gradual, and individuals do not have to wait until the late stage to seek help. Treatment is available for all stages of alcoholism, and early intervention can assist with recovery and prevent further harm.
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9% of full-time workers in the US suffer from alcohol use disorder
Alcohol use disorder (AUD) is a recognised clinical diagnosis of alcoholism, or alcohol addiction. Research has found that around 9% of full-time workers in the US meet the diagnostic criteria for AUD, equating to almost 11 million full-time workers. This figure represents those who suffer from an impaired ability to stop or control alcohol use, despite adverse consequences in their social life, work life, or health.
The impact of AUD is evident in the workplace, with employees in the middle stage of alcoholism battling loss of control, withdrawal symptoms, and cravings. This can manifest as increased and unpredictable absences, poorly performed work assignments, behavioural problems with colleagues, inability to concentrate, accidents, and a deterioration in overall appearance and demeanour. AUD also contributes to a notable number of workdays missed, with individuals suffering from mild, moderate, and severe AUD missing on average 18, 24, and 32 days of work per year, respectively.
The rate of heavy alcohol use varies across different industries, with the mining industry reporting the highest rate of 17.5%, followed by the construction industry at 16.5%. It is important to note that the high rate of heavy alcohol use in the mining industry is attributed to its demographic composition, as this rate decreased when controlling for age or gender differences.
Alcoholism is recognised as a disease with distinct symptoms, causes, and treatment methods. Supervisors and employers play a crucial role in addressing AUD in the workplace. While compassion is essential, it must be coupled with a firm approach that emphasises the employee's responsibility for their rehabilitation and performance. Referring employees to the agency's Employee Assistance Program (EAP) and holding them accountable for their conduct can be part of a roadmap for dealing with alcohol problems in the workplace.
Overall, the impact of AUD extends beyond the individual, affecting workplaces and industries across the US. With AUD contributing to a significant number of missed workdays and productivity losses, employers and policymakers have economic incentives to address this issue effectively.
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Alcoholism treatment: agency compassion, Employee Assistance Program (EAP), Human Resources, Employee Relations, and local mental health programs
According to a National Survey on Drug Use and Health, the overall rate of past month heavy alcohol use among full-time workers aged 18 to 64 was 8.7 percent. Rates of past month heavy alcohol use ranged from 17.5 percent among workers in the mining industry to 4.4 percent in the healthcare and social assistance industry.
Alcoholism treatment can be approached through the following avenues:
Agency compassion
Supervisors and employers should approach employees with alcoholism with compassion. The earlier treatment is begun, the higher the probability of less expensive treatment, such as outpatient care. Beginning treatment earlier also increases the chances of success, as the employee is more likely to still have a supportive environment, including good health and a job.
Employee Assistance Program (EAP)
An Employee Assistance Program is a program offered by employers to help employees resolve a wide range of issues, including alcoholism and substance use disorders. Employees can receive short-term counseling, evaluation, and referrals for further treatment. EAP counselors will assess or diagnose the problem and refer the employee to a treatment program or resource if necessary. The employee's supervisor will be kept informed of the nature of the problem, the type of treatment, and the employee's progress in treatment with the employee's written consent. The EAP counselor will also provide follow-up counseling if needed.
Human Resources and Employee Relations
Human Resources and Employee Relations offices advise management on appropriate adverse and disciplinary actions. They also prepare and draft adverse or disciplinary action letters, including those involving a firm choice. A firm choice is a clear warning to an employee to accept treatment for an alcohol or drug problem and improve job performance or face disciplinary action.
Local mental health programs
Local mental health programs and substance abuse programs are also available to provide information and support for employees struggling with alcoholism. These programs include SAMHSA's confidential and anonymous resource for persons seeking treatment for substance use and mental disorders in the United States and its territories.
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Frequently asked questions
According to a 2022 survey, 9% of full-time workers in the US suffer from alcohol use disorder. This equates to almost 11 million full-time workers.
Alcohol use disorder is a significant problem in the US. According to the 2023 National Survey on Drug Use and Health, 10.2% of people aged 12 and older had alcohol use disorder in the past year. This equates to 28.9 million people.
The mining and construction industries have the highest rates of past-month heavy alcohol use, with rates of 17.5% and 16.5% respectively.
Alcohol use disorder is linked to 232 million missed workdays annually in the US. Individuals with severe alcohol use disorder miss an average of 32 days of work each year.
