Roughly $81 billion in lost productivity is an awful lot of money to dole out. Yet that’s what alcohol and drug abuse costs American businesses each year, the U.S. Department of Labor estimates.

According to DOL, about three out of four (77 percent) current illicit drug users in the U.S. are employed. This averages out to be roughly seven percent of the workforce. Another alarming stat: Nearly eight percent of full-time workers ages 18-49 use illegal drugs, says the Department of Health and Human Services’ Substance Abuse & Mental Health Services Administration.

Could seven to eight percent of your workforce be illicit drug users? And if so, could this be a potential accident waiting to happen in your workplace? How can you know if you have employees who are abusers, and, furthermore, is it possible for you to help them overcome their problems?

Screening and assessment

While drug testing, such as through urinalysis, provides an objective measure of drug use, most drug tests do not identify historical use or drug dependence, says DOL. Drug tests only stipulate whether an individual has used a particular drug recently.

Screening and assessment is an effective twofold process that employers can use to protect their businesses from the impact of drug and alcohol abuse, according to DOL. Screening is a preliminary evaluation that determines whether drug abuse is likely to be present in an individual. It identifies as many potential or actual abusers as early in their use or abuse history as possible to allow for appropriate intervention services to be provided.

Assessment is a more thorough evaluation that definitively establishes the presence or absence of a diagnosable drug or alcohol abuse problem and identifies the nature of the problem. The results of the assessment also suggest what is likely to be the most appropriate type of treatment when drug problems do exist.

Screening tools

Two widely used self-report screening instruments for alcoholism, according to DOL, are the 4-item CAGE and the Michigan Alcoholism Screening Test (MAST). Both tools solicit “yes-no” responses to questions about common consequences of alcohol misuse.

The MAST is a 25-item questionnaire designed to provide a rapid screening for lifetime alcohol-related problems. The CAGE asks the following:

“Have you ever”:

1) attempted to Cut back on alcohol?

2) been Annoyed by comments made about your drinking?

3) felt Guilty about drinking?

4) had an “Eye-opener” first thing in the morning to steady your nerves?

The Alcohol Use Inventory (AUI) is another popular screening instrument for adults suspected of problem drinking. The AUI self-report test assesses 24 different behaviors, feelings and attitudes associated with the use and abuse of alcohol.

Another screening tool is the Substance Abuse Subtle Screening Inventory (SASSI). This single-page questionnaire is used to identify alcohol and drug abusers and differentiate them from social drinkers and general psychiatric clients. The SASSI offers ease of administration and scoring and gives clear suggestions for interpretation, making it well suited for those with Employee Assistance Programs (EAPs).

Assessment tools

Assessment tools for evaluating substance abuse treatment include the Addiction Severity Index (ASI). The ASI interview is a standardized instrument used frequently in both traditional research settings and as an outcome measure in clinical settings.

The ASI interview assesses history, frequency and consequences of alcohol and drug use, as well as five additional domains that are commonly associated with drug use: medical, legal, employment, social/family and psychological functioning. The higher the score on the ASI indicates a greater need for treatment in each of these areas. The ASI scores can be used to profile patients’ problem areas and then plan effective treatment.

DOL also recommends the Diagnostic Interview Schedule-IV (DIS-IV), an interview based on the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The most widely used structured diagnostic interview, DIS offers diagnoses on a variety of disorders, including alcohol and drug dependence. The DIS interview is effective for the diagnosis of disorders by individuals untrained in the discipline of psychiatry, according to DOL.

Make a decision

When deciding on what type of screening and assessment tools are right for your company, DOL suggests considering things like ease of use, expertise and time required to administer and score the test, the credibility of the test, and the average cost per test. But, whatever tools you use, be sure to find out whether drug abuse problems exist in your workplace — before it’s too late.

SIDEBAR: A well-designed drug testing policy should:

Explain why a policy is needed and important;

Make it clear that alcohol and other drug use on the job violates company policy;

State specific consequences for violations;

Define specific ways for employees and family members to obtain help for alcohol and drug problems;

When screening, share how, when and under what conditions employees will be tested.

Source: Department of Health & Human Services’ Substance Abuse & Mental Health Services Administration