Working Dazed Why Drugs Pervade the Workplace and What Can Be Done About It
Working Dazed Why Drugs Pervade the Workplace and What Can Be Done About It Angela Browne Miller, M.P.H., Ph.D. Kensington, California o SPRINGER SCIENCE+BUSINESS MEDIA, LLC
Library LIbrary of Congress CatalogIng-In-PublIcatIon Cataloging-In-Publication Data Browne Miller, MI11er, Angela, 1952- Working WorkIng dazed: dazed, why drugs pervade tne workplace and what can be done about It I / Angela Browne Miller. p. em. CN. 'Insight "InsIght books." Includes bibliographical bibliographical references and Index. ISBN 978-0-306-43765-6 ISBN 978-1-4899-5962-1 (ebook) DOI 10.1007/978-1-4899-5962-1 1. Drugs and employment. 1. Title. TItle. HF5549.5. D7B76 1991 658.3'S22--dc20 658.3'822--dc20 91-7247 CIP ISBN 978-0-306-43765-6 1991 Springer Science+-Business Science+Business Media New York Originally published by Plenum Press, New York in 1991 Softcover reprint of the hardcover 1st edition 1991 An Insight Book All rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher
To the men in my family Cary, Lee, George and my husband, Richard
Preface Working Dazed grew out of my long-term fascination with workplaces and workplace mental health. At work, we are confronted with pressures to produce, to earn, to cooperate, to achieve, and to obey. Economic survival and cultural reward drive us to work. One's ability to work well determines one's ability to compete. The workplace is thus one of the key arenas in human evolution. Because the majority of us spend a significant portion of our lives "at work," the destiny of the individual human adult is, in large part, being shaped in the workplace. So often we hear ourselves saying, "My life is my work." Individuals' identities are overwhelmingly determined by the work that they do. Yet how much of what we do to "earn a living" is what we would choose to do with the time of our lives were earning a living not at stake? And once we are "at work," how much autonomy do we really have? Even those who think that they have a relatively high degree of decision-making power may have succumbed to the daze of progress. There is something pervasive but subtle about this daze. Perhaps it is so difficult to recognize because we are so deeply enmeshed in it. Working Dazed also grew out of my concern regarding the narcoticization of the workforce. The influence of drugs is pervasive in the workplace. It is far too often that employees work under the influence of illegal and legal drugs. They either use vii
viii Preface these drugs during the working day or they arrive at work on the drugs, withdrawing from the drugs or craving the drugs. Whatever the case may be, they are working under the influence. They are working dazed. Their daze is a drug daze. While the greatest uproar in the 1970s and 1980s was around the use of illegal drugs by employees, it is clear that the effects of alcohol, prescription drugs, and over-the-counter drugs are taking their tolls on workplace productivity, product and service quality, and employee and consumer safety. Drugs are much more pervasive in the workforce than they appear to be if we focus entirely on the very present but more sensational problems of employee cocaine, crack, amphetamine (speed), and marijuana use. It is time that we scrutinize the effects of "acceptable" drugs such as pain killers, muscle relaxants, tranquilizers, and diet pills on employees' fine and gross motor coordination, judgment, morale, and job performance. It is also time that we investigate the effects of nicotine and caffeine upon these and other indicators of employee productivity. We must recognize employee drug use as a signal. When a portion of the workforce works under the influence of drugs, it is making perceptible a bit of the daze to which we may all have succumbed. What is it that those who use drugs are drugging? Pain? Stress? Frustration? Anger? Powerlessness? Role strain? Competition? Alienation? Disenchantment? Failure? Boredom? To the extent that these ingredients of the human condition are generated in the workplace, the workplace must be refashioned to alleviate these detractors from employee satisfaction, job performance, and consumer safety. Every working person must understand that she or he is a player in the processes of social and biological change. Are we adapting the human species to a work orientation which will bring us to the brink of mindless droneship? Or will we manage to snap out of the daze and become highly conscious of the choices we make as individuals, as businesses, and as societies?
Preface ix Going to work armed with information about employee drug use and its implications is a beginning. Every working person has a right to know what motivates working people to drug themselves, what the effects and symptoms of drug use in the :workplace are, what a company drug policy is and how it is made, how drug tests work and what the legal implications of testing are. Every working person has a right to know how drug use by co-workers threatens her or his safety. Every consumer of goods and services must also be armed with information about employee drug use and its dangers. Consumers must know enough about employee drug use to demand answers to critical questions: Is my surgeon on drugs? Is my child care worker experiencing a hangover? Were the tires put back on my car by an employee in an altered state of mind? Is my bus driver or airline pilot under the influence? Do I have a right to demand answers to these questions? Consumers do have rights. They must become educated about employee drug use in order to exercise their rights. Consumers must demand answers to these questions as they select doctors, babysitters, schoolteachers, auto servicers, airlines, etc. Ask and ask loudly what drugs, if any, have been used during the past seven days by the doctor about to perform surgery on you or a member of your family. Ask and ask regularly if any of the people in your child care center use drugs, including pills and alcohol, at any time. Ask and ask insistently to speak to the pilots of the plane you are about to fly: Will you be flying under the influence of a drug today? Know and be able to explain what the definition of "drug" is and what "under the influence of a drug" means. If you are told that you have no right to ask such questions, let every other consumer at the ticket window, or patient in the hospital, or parent at the child care center know that information is being withheld. Make some noise about this. Make yourself an involved consumer. I have written Working Dazed in an effort to inform readers of
x Preface these and other important issues regarding employee drug use as well as to connect this information to the larger philosophical matters with which we must be concerned. Where is worklife taking us? Is this where we want to go? What can we do to stop, take measure, and take action? Tiburon, California ANGELA BROWNE MILLER
Acknowledgments I wish to thank the many people who have inspired and aided in the development of this book. Among them are my husband, psychologist Richard Louis Miller, who has shared his profound clinical expertise in the area of addiction; my father, Lee Winston Browne, whose knowledge of corporate management dynamics and general wisdom has been invaluable to me; Cindy Bilbrey, who has been my long-term, unfailing, and dedicated research and manuscript production assistant and who offered many spirited and intelligent comments on my work; Don Lucas of the Lucas Dealership Group in San Jose, California, for his commitment to developing an improved workplace; Don Carlson of the Ark Foundation in Moraga, California, for his efforts to build a healthier world; and the many employers and employees who have shared their stories with me and opened their organizations and their hearts to my inquiring eyes. xi
Contents 1 Working-Class Heroes: Drugged Drones 1 2 The Ailing Company: Chemicals to Cope? 9 The Use of Illegal Drugs by Employees 13 The Legal Use of Drugs by Employees 15 Defining the Problem 16 Clinical Issues 21 Organizational Issues 22 Policy Issues 24 Employee Drug Abuse in a Societal Context 27 3 Working Dazed: Signs and Symptoms of Substance Abuse, Addiction, and Other Grave Developments 29 General Characteristics Associated with Ongoing Drug Use 30 Substance-Specific Signs and Symptoms 33 Broader Implications of Working Dazed 44 xiii
xiv Contents 4 - Keeping Company Lies: lies: The Delicate Balance 47 Coinvolvement 47 Company Codependence 56 5 -looking the Chemically Dependent Company in the Eye: Sighting the Hidden Epidemic 61 Estimate Methods 64 Estimate Reports 68 Elements of an Estimate Report 76 Factors in Employee Drug and Alcohol Use 77 Issues in Reporting Estimates of Employee Drug and Alcohol Abuse 79 Concluding Remarks 83 Appendix: Employee Survey Regarding Drugs and Alcohol 83 6 - Drug Testing: A Test of Will and Right 89 Testing Basics 99 Polygraph Testing 105 Critical Issues 112 Appendix A: Calculating Blood Alcohol Levels 118 Appendix B: Drug Presence in the Body: Detection Periods 119 Appendix C: Consent Form 120 7 - Tuning In on a Managers' Meeting: Growing Pains at Company l 123
Contents xv 8 Is There an Acceptable Level of Use? The Question of the Hour 153 Examining Typical Questions about Employee Drug Use 154 Examining the Complexities 156 Examining Typical Policy Questions and Issues 159 The Question of the Hour 162 9 Drug-Free Workplace Policy: The State of the Art 165 What Is the Purpose of a Drug-Free Workplace Policy? 167 Primary Objectives of a Drug-Free Workplace Policy 168 A Typical Policy 171 Comments on the Typical Policy 173 Employee Drug Awareness Training 173 10 Where the Buck Really Stops: Employee Use of Treatment Services 177 The Unwieldy Cost of Care 177 Gender Differences in Mental Health and Addiction Treatment Utilization 182 Variation in Mental-Health-Service Utilization among Ethnic Subpopulations 184 The Cost of Utilization of Differing Forms of Treatment 186
xvi Contents 11 Recovery in the Workplace: An Obstacle Course? 191 Obstacles to Participation in Employer-Sponsored Treatment 191 Keeping Employees in Treatment and Recovery 194 Obstacles to Evaluating the Effectiveness of Treatment 198 Rethinking "Recovery" as "Discovery" 200 Appendix: Application of Chemical-Dependence Treatment-Evaluation Quadrad 203 12 Why Can't a Woman Be More like Like a Man? Gender and Chemical Dependence in the Workplace 217 Women and Drugs 218 Addiction, Dependence, and Power 222 Men and Drugs 225 Chemical Dependence and Gender in the Workplace 230 Men and Women Who Fail to Thrive 236 13 What, Me Worried? Worklife Stress 237 The High Cost of Employees' Mental and Physical Health Problems 238 A Historical Perspective 242 The Next Steps 243
Contents xvii 14 The Choicepoint: Undrugging Ourselves 247 Shadowboxing Drug Abuse 250 Consumer Monitoring 256 Brave New Workplace 257 Synaptic Rights 258 Notes 261 Directory of Assistance for Employees and Employers 275 Hotlines 275 Prevention, Education, and Consulting Services 276 Model Employee Assistance and Workplace Programs 278 Employee Assistance Associations and Association Presidents 282 TreatJnent Treatment Programs 282 Treatment Consulting, Case Management, and General Psychological Services 284 Testing and Pharmaceutical Information and Services 285 Relevant Legal Information and Legal Services Self-Help Organizations and Clearinghouses 287 288 State, Territory, and Province Substance-Abuse Authorities 301 Publications and Publishers 315 Index 319
Working Dazed Why Drugs Pervade the Workplace and What Can Be Done About It