Contrary to conventional wisdom, substance abuse is fairly common among full-time employees in the U.S. With a new government study revealing that nearly one in 10 full-time workers in the U.S. has had an alcohol or illicit-drug disorder in the previous year, it’s vital that management understand the magnitude of substance abuse in the workplace and know how to identify and help impaired or under-the-influence employees.

The Substance Abuse and Mental Health Services Administration reports that 10.8 million full-time workers have a substance abuse disorder — which makes up more than half (55.1%) of adults aged 18-24 with a substance abuse disorder.  And it certainly looks like these numbers could climb. The latest Quest Diagnostics Drug Testing Index shows an upsurge in the positivity rate of drug tests by 9.3% — rising from 4.3% in 2013 to 4.7% in 2014.

Says Dr. Barry Sample, director, science and technology, Quest Diagnostics Employer Solutions, in a statement, “American workers are increasingly testing positive for workforce drug use across almost all workforce categories and drug test specimen types. In the past, we have noted increases in prescription drug positivity rates, but now it seems illicit drug use may be on the rise, according to our data.”

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If you’re a small business, these costs could cripple you. Most large employers screen applicants for substance abuse and randomly screen existing employees — testing that’s cost-prohibitive for most small businesses. In fact, the 2014 HireRight Small Business Spotlight report found that only two-thirds (68%) of small business say they perform drug and/or alcohol testing on all employees.

So, it reasons that people with substance abuse issues are more likely to seek employment in small businesses. The result?  While positive rates for illegal drug use average about 3.7% for employees working for employers of all sizes, the Quest Diagnostics Drug Testing Index data show that rates for employees working for small employers are almost three times as high.

The consequences of substance abuse in the workplace range from low productivity to increased workplace accidents — consequences felt even stronger at small businesses where the actions of employee have a huge impact on the business and its customers.  According to the National Clearinghouse for Alcohol and Drug Information, alcohol and drug-related abuse by employees costs U.S. companies $100 billion a year. This is because employees with substance abuse issues are more likely to injure themselves or someone else, and are five times more likely to file workers’ compensation claims. These employees accrue health care costs that are three times higher than the average employee, and miss 10 workdays for every one that is missed by other employees.

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Even if an employee struggling with substance abuse issues does come to work, you’ll likely have a case of presenteeism on your hands — when an employee attempts to work even though they are impaired. Studies show that substance abusers are 33% less productive than their peers.

Warning signs

Unfortunately, employers often miss the warning signs of substance abuse — signs that at times can be subtle. While none of these signs is proof of anything by itself, showing two or more is an indication the employee needs help. The most prominent signs of abuse include:

• Frequent tardiness, unexplained absences or sluggishness when first reporting to work

• Inconsistent or poor performance

• Unusual physical symptoms or behaviors (unsteady gait, hyperactive/manic activity, sudden weight loss, dental problems, wearing long sleeves on hot days, etc.)

• Sudden mood swings, irritability, or angry outbursts or periods of unusual hyperactivity or agitation

• Paranoia or overreaction to criticism or helpful suggestions

• A sudden lack of concern over personal appearance and hygiene

So you know the signs of drug abuse. You’ve taught your supervisors about them and have made sure they’re documenting any performance issues.  Now what?  It’s important to remember that while you’re educated about spotting these signs, contacting a professional such as a doctor or a drug treatment counselor can help you evaluate what you’re seeing.  Is the employee really showing signs of substance abuse or an indication of something else?

If it’s deemed to be drug or alcohol abuse, a professional can help you explore and evaluate possible courses of action for treatment. What’s available? What has the best record of success? At the very least, it’s helpful to get a professional opinion and backup before you go to the next steps.

Stieber is director of clinical outreach at Kiva Recovery.

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