What Business Leaders Need to Know about Addiction among Employees


Last Updated: July 1st, 2020

Guest Post by Dr. Indra Cidambi

With the spread of the drug epidemic from urban to suburban and even rural areas, addiction in the workplace is not uncommon anymore, and it is a serious issue. Not only is the loss of productivity from alcohol and drug abuse significant, it has negative implications for safety in the workplace, both of which raise business costs. Over 77 percent of illicit drug users are employed1 and business leaders need to know how to address substance abuse by their employees effectively.

To get a handle on the scope of the issue, consider this: in 2013, roughly 25 million2 Americans, or 9.4 percent of the population, had used an illicit drug in the past month and 33 million3, or 12.7 percent of the population, were classified as suffering from alcohol use disorder.

It also appears that no profession is immune: dependence on drugs and alcohol among nurses is roughly 10 percent4, in-line with the general population; as per a 2016 study, 1 in 5 lawyers5 reported that their use of alcohol or drugs was problematic sometime in their lives; in law enforcement, 1 out of 4 police officers6 on the street have a problem with drugs or alcohol; and, a survey7 of teachers discovered higher abuse rates of alcohol, amphetamines, and tranquilizers than the national average.

Extrapolating the numbers above it is safe to say that at least 1 in 10 employees in the workplace is impacted by substance abuse. Drug and alcohol abuse negatively impacts productivity and safety in the workplace and drives up costs. Alcoholism alone is responsible for 500 million lost work days8 each year.

Signs of substance abuse among employees, while not obvious, can be spotted with some informed observation. General signs (depending on the kind of work) include an unkempt appearance, inappropriate clothing (long sleeves in hot weather), frequent bathroom breaks, perennially sniffy or runny nose, mood swings, isolating from colleagues, volunteering for overnight or holiday work (especially among nurses), higher than normal absenteeism or tardiness, poor job performance and workplace theft.

It is important to realize that addiction is a disease, not a moral failure, and treatment is needed. Although it took time, addiction is now largely recognized by the treatment community as a chronic disease and quitting requires more than good intentions and a strong will. Drugs change the brain in ways that make quitting hard and, therefore, treatment is needed. Fortunately, treatment options have widened to include ambulatory detoxification (for all substances of abuse) and medication assisted treatment (MAT) which have delivered better results. Nevertheless, it is not easy to have this conversation with an employee.

The best approach would be to first document each instance where the employee’s behavior was unusual. If possible, include it in the employee performance records as well. Then approach a professional alcohol and drug counselor or a physician who specializes in addiction, not only to make sure you are on the right track, but also to get educated on treatment options. If you utilize the services of an Employment Assistance Program (EAP), you may want to hand over the documentation to them and let them address the issue with the employee and help him or her obtain treatment.

If you have to do it yourself, approach the employee as a concerned colleague rather than as an overbearing boss. Detail the instances where you have noticed behavior that was off and delve into the causes of such behavior. Explain why such behavior is impacting workplace productivity, safety, or morale. Make the employee understand that you believe that addiction is a disease that needs treatment. Show that you want to work with the employee and offer support if he or she wants to address the issue through treatment. Educate the employee about the treatment options available and explain that it is possible to live sober.

Hopefully, the employee will choose to leverage the support and seek treatment. Addiction is a chronic disease that usually does not spontaneously remit over time. Treatment interventions are needed. If the employee is not amenable to seeking treatment, the issue has to be dealt with under company policies and other disciplinary rules.

Indra Cidambi, M.D., Medical Director, Center for Network Therapy, is recognized as a leading expert and pioneer in the field of Addiction Medicine. Under her leadership, the Center for Network Therapy started New Jersey’s first state licensed Ambulatory (Outpatient) Detoxification program for all substances nearly three years ago. Dr. Cidambi is Board Certified in General Psychiatry and double Board Certified in Addiction Medicine (ABAM, ABPN). Dr. Cidambi is the Vice President of the New Jersey Society of Addiction Medicine.


  1. National Household Survey on Drug Use
  2. National Institute on Drug Abuse (NIDA)
  3. JAMA Psychiatry
  4. National Council of State Boards of Nursing
  5. The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys; Krill, Patrick R. JD, LLM; Johnson, Ryan MA; Albert, Linda MSSW
  6. Police On-Duty Drug Use: A Theoretical and Descriptive Examination – Kraska, Kapeller;  On the Front Lines – Hepp.
  7. A 1990 study by the Journal of Drug Education, which surveyed 500 teachers in Texas
  8. U.S. Department of Labor
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