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Substance Abuse in the Workplace~Part 2

Last month’s column dealt with substance-abuse issues as they impact the work place. This month’s column continues with the treatment process, “sober” support groups, and mental-health issues. Marshall Glass, is a Staff Development Trainer at Pierce County Alliance in Tacoma, Wa,  and a co-founder of Lifecyclerecovery,  a service that assists in determining the most appropriate treatment options and methodologies for individuals struggling with substance-abuse issues. He is currently enrolled in the Clinical Mental-Health Counseling Masters Program at Seattle University. Marshall has clear answers on dealing with ways to support employees who are dealing with substance abuse and mental-health issues. He offers the following preliminary observations: “It is a common misconception that individuals who struggle with substance abuse and mental-health issues are unemployable and dysfunctional. A great number of people with substance issues and mental-health concerns are employed and are able to perform adequately in the workplace. It is imperative that employers remain aware of potential concerns among their employees in an effort to maintain a safe working environment. Individuals will often attempt to hide their substance and mental-health issues due to the fear of being terminated, as well as feelings of shame and guilt. If the employer demonstrates understanding and is compassionate in regard to providing assistance to individuals facing these issues, they will likely be more forthcoming and less resistant to seeking help. The first step is understanding that dependence is not personal and the negative behavior perpetuated by individuals facing these issues is most likely unintentional. An employer being knowledgeable about the treatment process can greatly assist employees in turning their lives around.”

What are telltale signs than an employee may have substance-use issues in the workplace? “Individuals will act differently depending on the substance that they are using. Some signs that point to potential substance-use are: acting hyperactive, chronically sweating, frequent fatigue, slurred speech, chronically tardy and/or absent, frequent dishonesty, neglected appearance, fast rate of speech, red eyes, bags under eyes, defensiveness, rapid weight loss, and pale complexion. Obviously these symptoms do not necessarily mean that an individual has substance-use issues, but it is important to notice significant changes in appearance and behavior.”

When someone is struggling with substance-use issues, what treatment options exist? “Treatment comes in all shapes and sizes. The following are the most common options utilized within the United States: medication-assisted treatment, outpatient treatment, and inpatient treatment. Medication-assisted treatment generally includes the use of Methadone, Suboxone, and Vivitrol to assist individuals in abstaining from non-prescribed opiates and in some cases alcohol.  Some of these medications are quite controversial and therefore it is essential to consult with professionals in advance. Outpatient and inpatient treatment consist of substance-use-disorder therapy groups and individual counseling. Inpatient treatment includes medical detox, which assists individuals dependent on substances to achieve physical detoxification in a medically safe environment.” 

What happens after treatment? “It is widely believed that the most crucial part of the recovery process is what occurs following treatment. Long-term recovery is a daily process that incorporates numerous support systems to enable an individual to overcome dependence on substances. These support systems can include: sober support groups, familial support, mental-health counseling,

12-step programs, and psychiatric services. Consulting with both treatment-placement professionals and medical professionals to provide guidance is essential. Overcoming dependence on substances is certainly not an easy task, but it is possible!” 

How do you navigate the monetary logistics of treatment? “Most treatment agencies accept private insurance, with some accepting state insurance as well. When discussing the monetary component with treatment facilities, please understand that the cost is not set in stone and negotiating is encouraged. Treatment facilities will often offer payment plans to limit the financial burden associated with treatment. Having a loved one navigate these burdensome logistics on behalf of the patient is most helpful.”

How do you ensure that you receive the proper care while in treatment? “I believe that one of the most important components is advocating for the substance user. It is the treatment facility’s responsibility to provide the services initially promised. Make sure that they provide the care and services that were advertised at the time of admission. Advocating for yourself or your loved one is a crucial part of the treatment process.”

What should you do to monitor someone who had substance-use issues once they return to work? “There are two widely debated questions regarding employees with substance-use issues. (1) When is the right time for an individual to return to work? (2) How do you monitor them once they return? I believe that the right time for an individual to return to work is not cut-and-dried. There are numerous factors to take into consideration when making this decision. What impact did they have on other employees when they were using substances? How long have they been abstinent from substances? Were there any long-lasting consequences of their previous tenure? Do you believe they deserve a second chance? There is a fine line between being forgiving and being naive. Giving someone a second chance in making an effort to turn his or her life around demonstrates compassion. Giving a second chance to someone who wreaked havoc within your workplace is not a decision to take lightly. Monitoring someone who previously abused substances is not an easy task, but it can be accomplished. Required urine tests, employment supervision, and agreeing to certain terms and conditions are often ways that employers monitor individuals who previously abused substances.”

Events over the past several weeks have raised genuine concerns regarding mental-health issues in our society. The National Alliance of Mental Illness ( offers the following startling statistics that demonstrate the probability that businesses large and small will feel the impact of the prevalence of mental illness in the workplace, with absenteeism and lost productivity being the biggest problems.

  • Approximately 1 in 5 adults in the U.S. experiences mental illness in a given year.  

  • Approximately 1 in 25 adults in the U.S. experiences a serious mental illness in a given year.

  • 6.9% of adults in the U.S. had at least one major depressive episode in the past year.

  • 18.1% of adults in the U.S. experienced an anxiety disorder.

  • Among the 20.2 million adults in the U.S. who experienced a substance-use disorder, 50.5% had a co-occurring mental illness.

My Q & A conversation with Marshall in the area of mental-health issues in the workplace continues:

How do you define mental illness? “Mental illness is defined as health conditions that are comprised of changes in thinking, behavior, or emotion. Individuals with mental-health issues often experience distress, as well as problems carrying out daily functions in their work and personal lives.”

What are some warning signs of mental illness? “Warning signs vary drastically. Individuals who suffer from anxiety will perpetuate differing symptoms from individuals suffering from depression. Common symptoms that may present themselves when an individual has untreated mental-health issues include but are not limited to: sleep changes, appetite changes, withdrawal from activities, inability to function or decrease in functioning, mood changes, and unusual behavior.”

What is a dual-diagnosis treatment center? “My belief is that due to the prevalence of individuals having both mental-health and substance-use issues, it is crucial for treatment centers to provide dual-diagnosis services. This means that the treatment center treats both the substance-use issues as well as any underlying mental-health issues that exist. The reality is that substance-use issues are often a direct result of untreated mental illness. Individuals who struggle with mental illness often self-medicate in an effort to lessen their symptoms. It is therefore imperative for treatment centers to provide mental-health services in conjunction with chemical-dependency services. Individuals who have substance-use issues may not even know that they also suffer from mental-health issues.”

Where can we start in addressing workplace mental health issues? “The warning signs above are important for employers to know, but confronting an individual who displays these symptoms can be viewed as offensive and even unprofessional. It is not up to the employer to treat or diagnose an employee’s mental health. It is crucial that when addressing potential mental-health issues in the work place, the employer outlines how specific behavior has impeded employment expectations. Making it clear that the employer supports the employee is imperative.” What are some strategies and approaches that can be used to help an employee return to work successfully? “Perpetuating support to the employee is key. It is difficult to determine the “right” time for an employee to return to work following a leave of absence due to mental health issues. It is important to consider how egregious the employee’s actions were during employment. Were there any wrong-doings or did the employee just need time off to address personal issues? Working with the employee to determine what can be done to help them complete the job successfully as well as take care of themselves is important.”

For more information on this topic or if you need advice in your place of business, please contact Marshall Glass directly. (

This article was originally published in the December issue of Cleaner & Launderer.

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