An old foe still is costly to employers

Prevention efforts save money

Advocates say alcoholism is chronic disease despite the tremendous amount of education delivered to Americans at home, school, and work, according to a George Washington University center devoted to studying and promoting solutions to alcohol abuse, alcohol use continues to take a tremendous toll on the work force, and employers can do a better job of providing help.

More than 7% of workers in the United States have a problem with alcohol, according to the HHS’ Substance Abuse and Mental Health Services Administration, including those who are dependent or suffer from alcoholism, and others who drink in ways that are risky to health and safety.

"Not many companies track the cost of alcohol problems or the savings they can realize from treatment, but ones that do, even smaller ones, have seen that treatment unmistakably saves money," says Eric Goplerud, PhD, director of the Ensuring Solutions to Alcohol Problems (ESAP) program at The George Washington University in Washington, DC.

"Alcohol problems take a tremendous toll on the workplace, and it’s in the interest of every workplace to confront the problem and encourage treatment. Treatment works — it saves companies money, and it saves people’s lives."

One of the efforts of ESAP is to promote, among businesses and insurance providers, the idea that alcohol treatment should not be viewed any differently from treating other serious chronic diseases.

"You can’t run an industrial health program without focusing on diabetes or asthma, and the treatment success for alcohol is as good or better," says Goplerud. "For the pre-diabetic, there are interventions and lifestyle changes that can be made that area cheaper than treating Type II diabetes, and it’s no different for alcohol."

Goplerud says the main difference between treatment for problem drinking and treatment for asthma or diabetes is that health insurance doesn’t cover treatment for alcohol the same as it does other diseases. "It is treated differently, and not in a way that promotes health or even a good bottom line for businesses," he says.

Treating alcohol abuse early can reduce health care costs right from the start, with especially noticeable savings among younger drinkers, ESAP figures show. The program even devised a calculator that can be adapted to fit a company’s size and type of business and show what the costs associated with alcohol problems might be (www.alcoholcostcalculator.org). The calculator looks at obvious costs, such as health care and time away from work, but also adds in related social costs.

"It translates it in a way a corporate medical director or occupational health nurse can see it’s relevance to their own company," Goplerud says.

ESAP has created a list of seven steps employers and employee health managers can take to reduce the cost, in dollars and health, exacted by alcohol abuse. They are:

1. Offer comprehensive health insurance. A 2002 ESAP report found that there are significant gaps in alcohol coverage in many health plans. Nonetheless, it also found that some companies can and do purchase insurance that covers the range of needed alcohol services.

2. Monitor and maintain standards of care. Coordination of EAP, behavioral, and medical services benefits both employer and employee, and ensures that a patient’s care is coordinated and, therefore, more cost-effective.

3. Enact treatment-oriented workplace policies. Strong, clear workplace policies can reduce alcohol problems and reduce legal liability, but should be nonpunitive and encourage employees to seek treatment.

4. Intensify health education. Goplerud says studies on the impact of education programs on employees’ alcohol use have found that employees where such programs are in place reported lower alcohol consumption and lower incidences of negative work performance related to alcohol use.

5. Promote confidential screening. When screened for alcohol problems, one in five men and one in 10 women who visit their primary care providers meet the criteria for at-risk drinking, problem drinking, or alcohol dependence, adds Goplerud. Confidential screening often opens the door for intervention and treatment.

6. Offer/expand EAPs. An effective EAP includes confidential screening and counseling, worksite awareness programs, web-based resources and referrals to treatment, recovery support for those in treatment, and training to help supervisors spot productivity problems that may be alcohol- or drug-related.

7. Manage employees’ time off and return to work. Employers can take an active role in managing employees who are temporarily off the job while receiving treatment for alcohol problems By making reasonable accommodations and by easing the return through flexible scheduling, allowing for time to go to medical appointments, the company can retain trained employees and avoid the high turnover costs sometimes seen in industries plagued by high rates of alcohol use.

[For more information, contact:

Eric Goplerud, PhD, Director, Ensuring Solutions to Alcohol Problems, The George Washington University, Washington, DC. Phone: (202) 296-6922 or (202) 530-2302. Fax: (202) 296-0025. Web site: www.ensuringsolutions.org.]