The dual role of wellness programs and drug and alcohol testing policies

Most people recognise that drug or alcohol abuse can be a warning sign of a mental health crisis. As such, drug and alcohol testing can be the first to uncover what may well be a potential problem. Likewise, wellness programs establish positively focused activities to improve the mental and physical health of the workforce. Both are opportunities to support the mental health of the workforce but doing so comes with its own set of challenges. Ensuring your programs are, and are seen to be, fair and reasonable is essential to secure the support and participation of your stakeholders.

Wellness programs are becoming a common feature of business. The annual Employee Benefits Survey conducted by the Society for Human Resource Management found that in 2015, 70% of respondents offered a wellness program, eight percentage points higher than in 2014. While ‘wellness’ might sound soft, those on the leading edge are shifting their focus in wellness from nice-but-unmeasurable token efforts like healthy bowls of fruit in the canteen to strategically aligned risk-amelioration goals. Actions like identifying actual workforce health risk factors, introducing customised programs to lower those risks and then using a mix of financial metrics including return-on-investment and value-of-investment, as well as non-financial metrics such as shifts in short- to long-term workforce-level health are becoming best practice.

Measuring metrics is the difference between a wellness program that is known to deliver quantifiable productivity-driven outcomes and one that will likely never be more than an employer branding exercise. If management of assessments and measurements is undertaken by a third party that keeps individual records confidential, then individuals’ anonymity can be better guaranteed by the employer, and the employee less concerned about the role of wellness programs in their employment prospects.

Keeping wellness programs anonymous and voluntary while also measuring towards goals isn’t easy. Privacy concerns, especially about health matters that do not directly affect work, require wellness programs to be carefully constructed around the needs of the worker, as well as the goals of the enterprise. Developing a wellness program has its own sets of challenges around equal opportunity, privacy and voluntary participation; this is increased when drug and alcohol testing reveals a positive result.

One of the upcoming threats to individual health which will be a serious challenge for employers is that of pharmaceutical and prescription drug abuse. The US Center for Disease Control and Prevention has already called it the latest drug epidemic. US citizens reporting pharmaceutical pain medication abuse skyrocketed from 628,000 to close to three million in the 1990s. Australian reports are equally alarming: The National Drug Strategy Household Survey 2013 reports that 4.7% of Australians aged 14 or over had abused pharmaceutical medications in the past 12 months, up from 4.2% in 2010.

The ways that prescription and pharmaceutical drugs might be abused include using another person’s prescription, buying prescription drugs illegally, using one’s own prescription and pharmaceutical drugs improperly or using them outside of the direction of a doctor or chemist. Drug and alcohol testing policies will not assist in identifying these underlying issues. Because drug and alcohol abuse points to other potential concerns such as mental distress, it is important that drug and alcohol testing policies include mental health first aid. Indeed, the tester may be in the front line and therefore able to recognise a potential mental health problem as it is progressing.

For employers, this is a challenge on various levels: so-called ‘zero tolerance’ drug policies at workplaces might make it easy to take immediate action when a worker is found to have taken illegal drugs at some point, regardless of whether there has been any actual impact on work safety or performance. This approach, however, becomes problematic with prescription drug abuse: as a hypothetical, do you exercise ‘zero tolerance’ for someone taking prescription painkillers? What if those painkillers are prescribed to them? Or to someone else? How do you assess that? Pharmaceutical drug abuse is a game changer and requires some understanding not only of the issues surrounding it, but also of how it can point to deeper issues that might open up employers to accusations of discrimination unless prepared for and managed carefully.

To link drug and alcohol testing and wellness is obviously not for beginners. It gains entry to entirely different territory when drug and alcohol testing policies include awareness of mental, psychological and emotional issues that can underlie drug and alcohol abuse, or misuse if it is linked to a workplace wellness priority. But while it might appear best to just avoid the possibility altogether, the abuse of pharmaceuticals and its possible connection to mental health means that high-quality wellness programs and drug and alcohol testing regimes are linked by the need for fair and non-judgmental procedures to assist employees identified to be at risk.

It is outside the scope of this article to discuss legal implications, but the social and productive implications of drugs and alcohol policies are clear: with a shift towards prescription drug abuse and the potential for drug and alcohol testing to uncover deeper emotional and mental issues, the line between wellness programs and drug and alcohol policies is blurring. Both have roles to play in managing risk factors for the workplace, and employers would be best placed to address those risk factors fairly and effectively by considering these larger issues when constructing or reviewing these strategies.

Presuming that impairment from drugs has occurred for recreational reasons is inappropriate; as is presuming that a punitive approach to positive tests is always the best option. When those in authority treat people with respect, honesty and fairness, then the individual feels their status is not being challenged and that they are valued; commitment to desirable behaviours is promoted. Conversely, failing to treat people with respect, honesty or fairness is more likely to make the individual angry, resentful and antagonistic. The question is whether you want your wellness program and drug and alcohol testing policy to be seen as promoting workforce health and safety, or as a way for those in authority to exercise moral or ethical control over the workforce.

In some ways, it is still early days for many wellness programs and drug and alcohol testing regimes. There is still much opportunity for improvement and to make these long-term investments work. These two, however, do have some synergies that suggest an opportunity to link them in terms of identifying and supporting those with mental health risk or who are in the middle of a crisis. To do so will be challenging, but by considering the issues of privacy, measurement and potential opportunities to engage third-party management of some parts of your policies, you can improve your systems to achieve measurable results in lowering your health and wellness risk factors.

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