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Dollars & "Sense"

The Hidden Cost of Addiction

Substance Abuse (alcohol/tobacco/drugs) in the workplace has been described as the $125 Billion hangover. This staggering cost is felt in all areas of productivity. The longer a person’s use of alcohol or drugs continues, the more difficult it becomes to assist them, and the more expensive it becomes for family, friends and employers.

Early Indicators

Alcohol and drug use are very common forms of socializing, networking, and stress reduction. Approximately 15% of individuals who drink or use drugs will develop the disease known as addiction. Often, the drinker or drug user will be a “High Energy” performer. The individual’s capacity for hard work and hard play seem amazing.

It is not uncommon at this point to hear a drinker boast of the amount he or she can hold, or the frequency in which drinking occurs. When a problem is developing, you are likely to see changes in the following areas:

General Behaviors

  • Over reacts to advice

  • Co-workers complain/comment

  • Frequent Medical complaints ie: colds, flu, etc.


  • Late returning from lunch

  • Leaves work early

  • Occasional unexplained absences

Middle Phases

At this point in the chemical use, the changes you are likely to observe become more apparent. The chemical user will show wide mood swings. Frequent complaints of stress are often given as a cause for irritability. Although still capable of exceptional performance at times, the overall efficiency of the individual is about 70%.

Middle to Late Phases

The overall efficiency of the individual drops to no more than 50%

General Behaviors

  • Grandiose or belligerent

  • Personal financial problems

  • Domestic problems

  • Legal Problems (DUI)


  • Increased tardiness

  • Failure to return from lunch

  • Increased medical leave

  • Relies on others to cover

Late Phase

At this point the department has few options remaining with a member. If the member is close to retirement, a common reaction is to “carry” the member. This is done by quietly moving the individual into responsibilities that lessen exposure for client contact or malpractice liability.

General Behaviors

  • Virtually unreliable

  • Pronounced physical decline

  • Recurrent personal & legal problems interfering with work

  • Excessive use of breath mints to cover the smell of alcohol

  • High stress and irritability


  • Missed Appointments

  • Unexplained absences

  • Even when physically present, not able to contribute

These signs are present in varying degrees in most instances of chemical dependence. This list is meant as a guide only, and not for diagnostic purposes.


  • Miller, T. and Hendrie, D. Substance Abuse Prevention Dollars and Cents: A Cost-Benefit Analysis, DHHS Pub. No (SMA) 07-4298. Rockville, MD: Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration, 2008.

  • National Center on Addiction and Substance Abuse at Columbia University (CASA). Addiction Medicine: Closing the Gap Between Science and Practice. June, 2012.


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