Inhalant Abuse: NIDA Report Update Sept 2012

I almost missed it (actually I did, but found it soon enough). The National Institute on Drug Abuse has updated its report on inhalant abuse. You can it here along with recent research on the subject.

Provides scientific research on the nature and extent of inhalant abuse, its potential health consequences, and hazards of chemicals found in commonly abused inhalants.

NIH Pub Number: 10-3818
Published: May 1999
Revised: Sept 2012
Author: National Institute on Drug Abuse

All materials appearing in the ​Research Reports series are in the public domain and may be reproduced without permission from NIDA. Citation of the source is appreciated.

Table of Contents
       What are inhalants?
    What is the scope of inhalant abuse?
    How are inhalants used?
    How do inhalants produce their effects?
    How can inhalant abuse be recognized?
    What are the short- and long-term effects of inhalant use?
    What are the other medical consequences of inhalant abuse?
    What are the unique risks associated with nitrite abuse?
    Where can I get more scientific information on inhalant abuse?
    Glossary
    References 

Group #9 EAP Fact Sheets Released

EAP Tip Sheets for EAPs
Group #9 is now available.

Reproducible and Editable Tip Sheets, Group #9 is now available. You can print the brochure from this link.
The titles include:

1. What to Do about Compassion Fatigue
2. Protecting Your Kids from Stealth Marketing
3. Stopping Intimate Partner Violence
4. Using Email Appropriately at Work
5. Distracted Driving and You
6. The Sleepy Employee
7. When You Are Facing Personal Change
8. Creating a Welcoming Workplace for Disabled Workers
9. Understanding Workplace Survivor Syndrome
10. Holiday Eating Tips
11. Using Emotional Intelligence to Boost Customer Satisfaction
12. Do You Know about Your Teenager's Friends?
13. Saying "No" to Your Child
14. Teaching Kids to Save Money
15. Commonsense Communication at Work

You can print the brochure from this link.

To see all available reproducible workplace wellness and productivity tip sheets, visit the following page at WorkExcel.com: 

EAPs and The Sleepy Employee

Does your employee assistance program address sleep problems. From insomnia to midnight panic attacks, dozens of issues associated with sleep and productivity are fertile ground for Employee Assistance Programs. Dig into the monographs and materials available from EAPA. I believe the Tampa, Florida national conference hand great material on this topic. Sleep matters. Studies show that a poor night’s rest negatively affects job performance in a number of ways including:

• Poor judgment
• Decreased productivity
• Difficulty learning and retaining information
• Difficulty processing complex information
• Delayed reaction time
• Irritability
• Impatience
• Negativity
• Fatigue
• Decreased concentration
• Diminished self control
• Poor reflexes
• Tardiness
• Falling asleep on the job

Sleeplessness can also be a serious safety issue. Those who work with heavy equipment have a significantly increased risk of workplace accidents when they arrive at work tired. Commuters are also at risk. The National Highway Traffic Safety Administration estimates that drowsy driving is responsible for 1,550 deaths and 71,000 injuries per year.

Let employers know what program efforts you're making to address organizational sleep problems. Attempt to put a price tag on productivity and attendance losses. Then, make an impact, claim the high ground and educate employers in the area. Try getting some media publicity. It's not hard to do.

Having a Hangover is Not a Performance Problem

That's right. It's not a performance issue to have a hangover at work. If I told you, "I have a hangover," you could not use that statement for effective documentation concerning my job performance. It wouldn't fly. However, if I had my head down on my desk and you said, "What's wrong?", and I said, "I have a hangover", then nope, that still would be a performance issue. So what's the problem? 

 The performance issue is my head on the desk and not working.

Some EAP programs are still not training supervisors effectively enough to get this across. Listen, this is crucial. Don't risk getting human resource professionals upset that you do not know how to properly teach supervisors how to document.

Documentation is not useful to HR when language is subjective, not measurable, open to broad interpretation by others, or contains emotional language that demonstrates the writer's emotionality and personal distress.

The focus will shift from the employee to the supervisor by officials (typically HR) who must examine your documentation or in other ways act on it. If they can't act, they are going to get very upset. That's not good for you, your EAP, your organization, or the employee.

Second-hand reports by others are almost always problematic as well, unless specific in their account with evidence to back them up.

Using a term like “hung over” has no common interpretation, (especially if you have never had a hang-over.) It is not a “job performance” problem to be hung over. The behaviors associated with being hung over, of course, could be problematic. These are the behaviors that should be documented. Use this example in your supervisor training and you score big points, having convinced your supervisors what is at stake in constructing proper documentation.






You may want to visit the supervisor training solutions page.

Drug Testing: When Supervisors Are Friends with Employees

Do you have supervisors who are friends with their employees? Do you have any supervisors who socialize with employees? Do any of these supervisors drink alcohol with employees (or worse use drugs) they supervise? These questions are closely associated with dual relationships, conflict of interest, and risk to the organization that comes with denial, procrastination, and avoidance of the need to confront a personal relationship. • If you are training supervisors, here's language to incorporate into your presentation on substance abuse. I believe you will find it quite effective. Be sure to raise this issue, and expect some "discussion" after you do.

"If you are friends with your employee, you will face a challenge in recommending a drug test.

•If you socialize and drink with your employee, this challenge is made even more difficult. •Most supervisors will put their own job security ahead of such friendships when drinking or drug use facilitates a crisis at work.

•Testing will not hurt a true friendship, and it may prevent a crisis that forces you to make a choice."  

Related: Alcohol and Drug Abuse Awareness Training Center.

The EAP Is Not a Place. It's a Program

The employee assistance program is not simply a “place” where counselors wait for employees to show up via self- or supervisor referral. More accurately, the EAP is a programmatic approach to the management of troubled employees and the risks that arise with human behavior and interaction in the work organization. Examples include conflict, morale issues, team building, and the need for consultative guidance offered to managers. The EAP is a tool for supervisors to use in resolving the problems with employees. Supervisors can succeed in managing a troubled employee without the employee ever going to the EAP, if in fact the employee corrects their behavior after constructive confrontation, where the EAP was used as a resource within context of the corrective interview. If the employee gets well. The "program" worked. It happens all the time. So how important are utilization rates, literally? Well, it's important to understand the level of EAP use in this more important context of using the programmatic approach to effect change actually helps salvage troubled employees. Perhaps after a supervisor referral, an employee will decline attendance, but if he or she takes the need to make personal changes seriously, which lead to better health and better productivity, it worked. It happens all the time, and where the EAP option doesn't not exist, loss of human capital more often results.

Good Supervisor Follow-Up Begins Before the EAP Referral

Are supervisors referring employees to your EAP without a referral form? Are employees still showing up telling you they were referred by the supervisor, but you have no information in hand making you aware of what the performance issues are. You need to hit the reboot switch on your supervisor training and education so you get more effective supervisor referrals. Here's what to say to your supervisors: Follow up begins before a supervisor referral is made to the EAP. This means the supervisor should pick up the phone and inform the EAP that a referral is pending. A discussion of the performance issues should take place. Then, a referral form should be used. If the supervisor does not have a referral form, then performance issues should be delineated on a piece of paper and two copies made. The employee and the EAP each get a copy. Making the supervisor use a checklist is preferred. It creates more quality and quantity in the performance documentation. The supervisor keeps the original. The EAP must have a list of written performance issues of concern to the supervisor. The assessment of the employee should occur with both the EA professional and the employee having this hard copy of performance issues as discussion points between them. Anything less will create two problems: 1) The employee will control the EAP interview and degree to which information about the performance problems is make known. And, 2) the EAP will be forced to accept the employee's version and opinion as to how serious the performance problems are, what they are, and the degree to which the employee issues are really all the supervisor's fault. The employee will also be less likely to sign a release. At this point, you've likely lost the referral and enabled growing dysfunction. Are you educating your supervisors with skills and knowledge about how to use the EAP in supervision? Consider this product as  an EAP's most valuable weapon for increasing supervisor referrals.

EA Professionals: "Watch Your Mouth!"

If you are an EA professional, you may want to examine your language. For example, labeling someone a functional alcoholic is a strong and reinforcing enabling behavior. Don't you agree? It is used to describe someone the enabler believes to be alcoholic, but also seems to “function” acceptably in their occupation or social activities. Usually these areas are where the enabler knows the alcoholic best. In truth, you know there is no such thing as functional alcoholism. The term doesn't makes sense. It foists alcoholism into a behavioral construct rather than a disease construct, and you don't want to be responsible for this terrible impact. Need more clarity? Think disease. There is no such thing as functional cancer, right? Both alcoholism and cancer are chronic potentially fatal illnesses that grow worse over time. Ok, straight up. The term functional alcoholism allows the enabler to continue the advantages of the relationship they have with the alcoholic, even while their role as an enabler grows worse. The defense is called “minimizing.” EA professionals, watch your mouths and don't join forces with the larger society that struggles to see alcoholism as a disease.

You're Taking a Big Chance Not Engaging Families to Participate in Addiction Treatment

Make an effort to reach families of employees who enter treatment for addictive disease. The behavior of the family and concerned persons upon admission of the patient, while seldom discussed, is important to treatment success.

You already know this, but it is extremely easy to postpone or not take initiative to work with the family. Do not assume the treatment program will do it. They may make only one try to engage the family, and typically, this won't cut it. Family denial and pathology necessitates more assertiveness on your part as an EAP. If you want successful treatment of the employee, be short of aggressive in convincing the family to engage with their own recovery and why.

Successful intervention does not mean successful treatment. But, this is what families desperately want. What can families do to contribute to the likelihood of successful treatment after intervention?

Here's a list of Do's and Dont's (Not Exhaustive, But a Good Start)

1) Do Attend The Family Program. The Family Program is an intensive educational/ counseling experience to help participants understand addiction and its treatment,

and to help them curtail provoking and enabling behaviors. Some family members may avoid counseling for themselves after years of "managing" an addicted person at

home. Without the correct information, however, these family members are at risk to continue enabling which may sabotage treatment.

2) Don't Take A Vacation Now. After years of self-denial, some concerned persons see admission of the patient as the best time to take a vacation. They reason, "Now that someone else is in control of my addicted person, I can let go and relax." Such attitudes can reinforce the mistaken belief that control of the alcoholic must continue after treatment, not to mention prevent participation in the Family Program.

3) Don't Phone Frequently. Avoid excessive contact with your addicted family member early in treatment. Such contact can distract the patient and thwart bonding with other patients in the inpatient community. Avoid emotionally charged issues that can wait until after treatment. Many patients have prematurely left treatment due to focusing on outside events that could have easily waited.

4) Do Speak With The Detox Counselor. The detox counselor is an expert at supporting patients and guiding family members in communication. Since family communication dynamics are highly associated with provocative behavior, intervention with this sabotaging pattern is essential. The detox counselor or other person working with families can best steer the family member toward "the right thing to do" to support the addict in treatment.

5) Do Attend Al-Anon. Don't stop attending Al-Anon now that your alcoholic is in treatment. If you haven't started you're overdue. Remember, Al-Anon is for the family, not the alcoholic, and education prior to the first meeting that helps family members stay engaged with Al-Anon is crucial. “De-mystify” 12-step programs. Don’t let family members stumble their way through these programs. If you don’t they will drop out. Alcoholism education video at WorkWell Videos.

Neil Armstrong vs. EAPs

Neil Armstrong walked on the moon in 1969. That is just about the same time that EAPs and the human "behavioral risk prevention/intervention dynamic" they naturally possess was also discovered. If you are an employee assistance professional, your first task is not to help employees. It is to help your organization understand how employee assistance programs reduce behavioral risk and help to prevent devastating losses from human behavioral factors in the workplace. No workplace program, profession, or mechanism other than a legitimately installed and functional EAP can perform this task as well. Unlike the celebration of man's landing on the moon, the EAP discovery has not been as well celebrated. A recent survey of Americans showed that 5% of people still believe that the landing on the moon was staged. (Gallup Poll, 2012) Unfortunately, the percentage is much higher if we are discussing EAPs and how many people really believe they are special programs with inherently unique life-saving dynamics that will reduce losses and save lives when properly established. Your mission is to help workplace professionals, especially CFOs, HR managers, and benefits consultants understand this reality. If you do not, you will play a role in diminishing and forcing the profession into extinction. Don't be fooled. No cost-benefit analysis or EAP program evaluation will overcome an organization's desire to financially save money by cutting your program if this belief does not exist.It takes an effective relationship between you and management and between you and employees to pulls this off. That includes communication. You must establish communication channels between you and these two sections of the workforce that are omnipresent in order to accomplish this goal. Never be a "waiting in the wings" EAP. Be proactive and omnipresent.

Human Resource Managers: Are They Your EAP Experts?

If you disagree with me, I want you to reply back: Human resource managers, the CEO, or maybe the CFO of the organization you serve all have power over your EAP. These folks cut your paycheck and control your contract or position. But, here this: These folks are not experts on EAPs, the EAP Core Technology, or reducing behavioral risk and human factors exposures to risk with regard to troubled employees. (So far, I hope we are in agreement.) You're the expert. If you took their direction on how you should run the EAP, who you should see, when you should see them, how to do assessments, what EAP activities firmly grounded in the EAP core technology that you should or should not participate in, etc. you would increase risk to your organization, lower your EAPs effectiveness, and increase risk of being "farmed out" or closed down. (So far, I hope you still agree.) Then why do so many EAPs do all of these things out of fear when the HR department phones and says "do this", "don't do that"?

Here is the problem. You live in fear. Do what the "customer says" or you may not have a job in the future. This "HR is boss paradigm" over EAP mechanisms has played a major role in diminishing the value of the EAP field. Human resource managers are educated about EAPs not from materials produced by EAPA or EAP old-timers, traditional resources, or accurate core-based materials. Instead, they have been educated by managed care, newspaper articles, feature articles in HR journals written by freelance writers, human resource management instructors in the classroom with zero EAP experience or at least nothing long term, human resource management textbooks, the Chief Financial Officer (who has been educated by the benefits consulting firm), and that's about it. (Are you still in agreement with me?) Okay, the kamikaze statement for this blog: These folks don't know what they are talking about, but you are doing what they say--modifying your EAP and its activities to match their "model" of what they think EAPs are supposed to do!

The EAP field could, in theory disintegrate in front of your eyes if you do not claim the high ground and decide that you are the expert and say so. I cannot tell you have many times I have heard this phrase from HR managers -- "EAPs don't do that". Too many EAPs are changing what they do to please customers. Would you change they dynamics of "calculus" because your student doesn't understand math? Calculus has not changed since Newton invented it. So, what are you doing with your EAP? Why are you making changes to the program to match the boss's misguided understanding of EAPs are all about? Better yet, who is backing you up as "authority" should you hold your ground? That's another blog note for the future.

Help Employees Help Their Friends

Not all attempts to help a friend are major interventions like the class substance abuse intervention. Many more are simply conversations between friends that inspire behavior change. Help employees understand more effectively how to have these conversations and you'll reach family members with the influence of your EAP. Even better, hold a brown bag or short seminar on this topic and watch your attendance at such an event sore. When guiding employees, the key is to ask if the client is seeing signs of denial in a friend with a personal problem requiring urgent action to resolve it? Personal problems with tough choices usually include denial. Others use minimization (the friend knows there’s a problem but denies it’s serious) or projection (the friend admits it is serious but says it is not their responsibility to deal with it for some reason). Absent a crisis, the friend simply isn’t motivated to get help yet. Discuss the forgoing concepts in the counseling session. Denial-laden personal problems include compulsive shopping, refusal to see a doctor, ignoring creditors, struggling with alcohol dependence, staying in an abusive relationship, and many more. Here's some brief guidance to consider offering to the client: Start by talking with your friend. Mention your concerns, but don’t threaten or be aggressive. Key is stating your observations and their impact on you, loved ones, and your friend’s life. Ask to help. Mention your obligation to support him or her as a friend. If you sense anger or defensiveness, remain calm and understanding. Rarely do friends part ways over honesty, at least not permanently. If needed, talk to an expert about the problem to get more pointers. This could be a counselor, an attorney, or even the police. Stay healthy, detached, and objective. Remember, your goal is to encourage the first action step toward help, not to “own” the problem of a friend who won’t seek it.