Drug and alcohol addiction is one of the most serious workplace problems—yet one that employers are least likely to confront, according to recent studies. The U.S. Department of Health interviewed full-time employees and found that one in 12 admitted to using illegal drugs in the previous month. It’s not that companies are in the dark about addiction; they’re just reluctant to confront it and sometimes unsure what to do.

A national study by the Hazelden Foundation in Minnesota, a nonprofit foundation that studies and treats addiction, says 67 percent of human resource managers cited addiction as one of their top concerns, yet less than a quarter say they’ve referred an employee to a treatment center. Of the 150 Florida human resource professionals Hazelden interviewed, it found a slightly higher level of intervention: About a third of the companies say they’ve referred addicted employees to treatment.

“Companies have to be proactive,” says Dr. Jerry Thompson, CEO of Coastal Behavioral Health, a not-for-profit behavioral healthcare organization serving Southwest Florida. “You have to treat it like any other disability.”

Hazelden recommends anonymously surveying employees to find out how prevalent addiction is within your company and then making sure employees know how to access help through an employee assistance program or other community services.

Dealing with addiction

1. Confront it early. “Addiction is chronic,” says Thompson. “It doesn’t get better on its own.” Signs of addiction include tardiness, absenteeism and a decline in performance. Sometimes the smell of alcohol on an employee’s breath is a dead giveaway, but often it’s not that clear-cut. If an employee admits to a substance abuse problem, Thomson says, they fall under American with Disabilities Act guidelines and must be treated as such. Performing regular job reviews gives companies a good baseline to determine changes in performance.

2. Don’t be punitive. “If it’s a good employee, you want to go to great lengths to salvage the relationship,” Thompson says. “Say ‘We’re concerned about you.’” While you can’t force someone to admit to an addiction, you can force the issue with drug testing. If an employee refuses to admit a problem and performance continues to decline, you may have grounds for dismissal. “If an employee rejects help, you discharge your responsibility as an employer,” Thompson says.

3. Refer workers to an employee assistance program or other community services. “There is a pretty wide range of treatment options,” Thompson says, including detox facilities and residential and outpatient programs. Insurance for mental health benefits vary widely. Less costly outpatient programs can be just as effective. “Unfortunately, it’s a lot easier to get help for physical ailments than mental health,” he says. Some providers, such as Coastal, offer a sliding-fee scale. In addition, several free hotlines are available to assist employers and employees. The Center for Substance Abuse Treatment’s National Treatment Hotline (800-662-HELP) connects people to treatment within their communities. The Center for Substance Abuse Prevention’s Workplace Helpline (800-WORKPLACE) provides confidential consultations to employers, unions and community-based substance abuse prevention organizations on prevention programs.

4. Create a culture that supports treatment and recovery. “You have to provide reasonable accommodation for the employee to get treatment,” Thompson says. “You have the expectation that an employee will stay clean and sober, but people do relapse.” He says it’s worth it to hang in there, “particularly if you have someone good.”