You do not have to be an addict to suffer from addiction.
Given the often-overt evidence of addiction’s impact on substance users, it is easy to understand why the traditional focus of concerned others has tended to fix on them. The “identified patients” clearly have a problem and to some extent are seen as the problem. Historically, this attitude has been true for health and social care professionals, as well their colleagues in occupational health and employee assistance programmes.
Families have largely been relegated to the periphery, if given any consideration at all. In a parallel process that is too rarely recognised as such, this mimics the focus, if not obsession, of family members relating to an addicted family member. The mind set tends to be underpinned by the belief that getting the person to stop using/drinking/gambling etc is all that matters and the answer to all ills, at whatever the cost to themselves of such exclusive concern. This approach, however, is often counterproductive.
A person in the workplace who suffers from addiction can show symptoms: volatile mood, erratic and inappropriate behaviour, errors and misjudgments, accidents and excuses and unexplained absences, not to mention problems with personal appearance including, most obviously of all, evidence of consumption. Active addiction will impact performance.
Enlightened companies have policies to deal with these situations that include provision for ensuring the person is offered help and benefits from a managed return to work if time out is taken for treatment. But what of those to whom they closely relate who are, in effect, carers of addicted people?
An employee whose life involves relating closely to someone with an addiction might not display such obvious symptoms but could be suffering quite severely, as evidence now indicates. Relating to someone in active addiction can be chronically stressful, especially where interests of children have to be taken into account. They are likely to be experiencing degrees of anxiety and depression, and can even become suicidal, fuelled as they are by feelings of powerlessness and despair. They are losing out to addiction.
In these circumstances, self-esteem and confidence tend to be badly eroded. Addiction might well have become the organising dynamic in the home, to which everyone in the family adapts more or less. This adaptation requires a measure of personal contortion to avoid confronting difficult reality, out of fear of making things worse, or just as a way of coping. Family members could have developed physical problems related to stress and tension, including a variety of chronic aches and pains, stomach upsets and other nervous complaints. Very often they fall into self-medicating to alleviate these symptoms, thereby inviting further problems.
We tend to assume that stigma attaches only to the person with the identified condition but family members feel the effects of stigma just as acutely by association. They feel such shame and guilt that they tend not to talk openly about their situation, struggling to find a solution on their own, proverbially beating themselves up as they fail to do so.
Despite their best intentions, an employee in this predicament is likely at some point to perform below par. A nagging preoccupation with the family situation with all its stressful effects will reduce mental and physical capacity, even when work can be a welcome diversion. It can be hard to be fully present when there is a serious problem festering at home, forever threatening to intrude into consciousness. The situation is on a par with that of other carers whose loved ones suffer from a life-threatening condition. Addiction can be characterised as a consuming relationship with a substance or behaviour and in the process often consumes those in a collateral relationship to the addicted individual, extending the characterisation from “consuming” to “all-consuming” relationship.
And the scale of the problem? In short, there are a great many more people in the position of family members and others relating closely to them than there are addicted people. The best estimates are that for each person with an addiction or a problem with substances, 4 to 5 other people close by will be personally affected. This means that there are millions of people affected – possibly as many as 12million.
In turn, that means that a high proportion of the UK workforce comprises people whose life is affected by their association with people who are addicted or who have significant problems with alcohol or (legal and illegal) drugs, not to mention other addictive disorders. The progressive damage to their mental and physical health will at some level take its toll on performance and productivity or put them at risk of developing long-term problems of ill-health.
In taking steps to ensure a healthy workforce, they need to be given due consideration. It will be to everyone’s benefit. But it is unlikely that people will come forward for help unless they are confident of a sympathetic and understanding reception. That is why companies must convey their recognition of circumstances that could affect valuable employees and risks to their health and wellbeing as family members. Supporting these employees to obtain specialist help will pay dividends.
The good news is that support for families affected by addiction need not be costly nor even long term. There is evidence to support the effectiveness of relatively brief interventions. The starting point is empathy with the family members’ situation and from there steps are taken to help them reorient themselves in relation to the addicted family member. Understanding the hold that addiction has on them and developing practical steps towards improving self-care are vital. Professional interventions can be well supported by mutual aid groups that are ubiquitous and free.
It does not take much for the symptoms commonly associated with personal involvement with an addicted person to abate. A company then has an employee with renewed capacity with a renewed energy and outlook.