New Approaches to Drug-Free Workplace Programs: Evidence-Based Approaches to Preventing Alcohol and Drug Use Can Leverage EAPs to Help Promote Occupational Norms and Ethical Values

Article excerpt

This year marks the 20th anniversary of the federal Drug-Free Workplace Act. Since the law was enacted, the workplace risk from drug and alcohol impairment (as measured by the rate of positive drug tests) has decreased. Quest Diagnostics' annual report on drug testing shows a steady decrease in positive drug test rates, from the 1988 high point of 13.6 percent to just 3.8 percent in 2007. (1)

At least some of this success can be attributed to advances in drug testing practices. The range of testing samples has expanded, the experience base of medical review officers has deepened, and the interpretation of employer practices through court decisions has created a sense of reliability among employers. There are now well-tried standard methodologies for evaluating samples for adulteration, dilution, and substitution. Sound consumer information about drug testing and other drug-free workplace program (DFWP) components (including EAPs) is also readily available.

But despite these improvements in drug testing, preventing employee substance abuse remains a challenge. New evidence-based programs, however, are pointing employers, labor organizations, and EA professionals in a promising direction. In this article, we briefly review the state of DFWPs, discuss the new programs, and provide a case study of an evidence-based DFWP in a regional electricians' organization.

CURRENT STATUS AND NEW DIRECTIONS

Although the rate of positive drug tests has declined over the years, national surveys show little change in the rates of alcohol or illicit drug (AOD) use. The 2007 National Survey on Drug Use and Health shows that 8.4 percent of fulltime workers and 10.1 percent of those employed part time use illegal drugs. The prevalence of heavy alcohol use among full-time employed adults is 8.8 percent, while the rate for binge drinking is 30.2 percent. (2)

However, the prevalence of AOD use in the adult working population may be too broad a measure. Other issues, such as worker impairment from AOD use, the impact of AOD use on safety and productivity, and actual use at or just before work, may be of greater concern.

A recent national survey found that among U.S. workers, self-reported impairment or use at work during the past year was 15.3 percent for alcohol and 3.1 percent for illicit drugs. (3) These rates are much higher in some occupations than in others (such as the food service and construction industries) and range as high as 55.8 percent for any use of illicit drugs and up to 28.0 percent for use inside the workplace. The survey results also reveal clearly that workplace alcohol impairment is a major risk, one that is not yet prevented by testing for illicit drugs.

Four conclusions can be drawn from the above statistics. First, worker AOD use continues despite apparent improvements in drug-testing rates. Second, as we look beyond prevalence data, we see workers report AOD impairment and use at work. Third, significant occupational differences in AOD abuse suggest that occupational, social, and ethical norms play roles. Fourth, employee alcohol abuse remains a challenge. These conclusions have prompted consideration of new methods to better help employees comply with DFWP policies, train supervisors to identify on-the-job substance use, and leverage occupational norms to reduce impairment on the job.

NEW AOD PREVENTION METHODS

At the same time that the federal DFWP model was being adopted, behavioral researchers were developing approaches to reduce workplace AOD risks. Specifically, they were identifying methods to address factors associated with risky alcohol and drug use, including workplace and family stressors, worker tolerance for deviant substance use, and organizational norms. The National Registry of Effective Programs and Practices (NREPP) lists several of these approaches and rates them in terms of their strength of evidence and readiness to be adopted in the workplace. …