Drug and alcohol problems exist at work with great frequency. The construction industry has one of the highest rates of substance abuse among full-time workers between the ages of 18 and 49 (17 percent of the construction population cur-rently uses illegal drugs, with 21 percent reporting regular heavy alcohol use). Small businesses may be particularly vulnerable to problems of drug abuse among their employees because drug abusers will look to work at smaller firms due to a decreased like-lihood of drug testing. The construction industry consists primarily of small businesses. A recent government survey indicated that 71 percent of illegal drug users are employed, and 60 percent of them are with companies that employ 500 or fewer workers. Many times individuals with substance abuse problems go unnoticed for a long time because those around them do not see the signs.

What are these signs, and what are the differences between casual use and having abuse when talking about drugs and alcohol? Not everyone who has a couple of beers after a long week has an abuse problem.

There seems to be three ways that people use alcohol. The first is use, when alcohol or other drugs are used in a socially or medically ac-cepted way to change someone’s mood or state of mind. Examples of use include having a drink with friends or taking an anti-anxiety agent as prescribed by a physician. It also includes experimentation with illegal drugs, social use and use as an occasional stress reliever.

The second way alcohol and drugs can be used is referred to as abuse. When the use of a substance to change or control mood or state of mind is in a way that is illegal or harmful to oneself or others, it is considered problematic use or abuse. Abuse can lead to many conse-quences for the abuser, ranging from work to home to legal issues. These consequences can include the following:

  • Accidents or injuries
  • Blackouts
  • Legal problems
  • Poor job performance
  • Family problems
  • Sexual behavior that increases the risk of STD infection

Finally, there is addiction. Some individuals can occasionally use or even abuse alcohol or drugs without becoming addicted. For many, though, abuse occurs and continues despite repeated attempts to return the use back to a more social or controlled environment. This leads to addiction. Addiction is the irresistible compulsion to use alcohol and drugs despite adverse consequences. It is characterized by repeated failures to control use, increased tolerance of alcohol or the drug of choice and increased disruption in the family. Unfortunately, it is not possible to tell early on whose use may lead to abuse and/or addiction. For one in 10 people, abuse leads to addiction.

No matter who is addicted, addiction to alcohol and other drugs has the same five characteristics. Addiction is chronic, meaning once you have developed an addiction, you always will have to deal with it. You may manage to stop using alcohol or other drugs for significant periods of time, but the disease doesn’t disappear. Should you attempt to resume “normal” use of alcohol or the drug, you will rapidly re-turn to addictive, out-of-control use and abuse.

Addiction is progressive, which means the addiction gets worse over time. With some drugs, the decline is rapid; with others, such as alcohol, it can be more gradual. But one thing is certain: It gets worse. Repeated use causes progressive damage.

Addiction is primary. An addiction needs to be medically treated as a primary illness, not just as a symptom of some underlying psycho-logical problem, a developmental stage or a reaction to stress. The addiction is the illness.

Addiction is terminal. Very simply, addiction to alcohol and/or other drugs often leads to other diseases and often death.

Addiction is characterized by denial. The user, many times, denies that his or her use is out of control or that it is causing any problems at home or work. The user often seems to be the last to know that his or her life is out of control. In order for effective treatment to take place, the user must break through this denial.

It often is said, when dealing with a drug or alcohol issue, that recognizing the problem is the first step. While this is true, unfor-tunately the person with the problem often is not the first to recognize it. Coworkers are typically the first to realize someone they work closely with has a drug or alcohol problem. This is because the coworker would be the first to see a slip in job performance and attention to detail. It is important that all workers on the site accept that drug and alcohol problems must be seen and treated as job performance or safety problems. Whatever the individual’s problem, he or she has made it everyone’s concern by allowing it to affect his or her work.

KELLY is a safety and health specialist with Intec, a safety consulting, training and publishing firm that offers on-site assistance and produces manuals, training videos and software for contractors. She can be reached at 800.745.4818 or dkelly@intecweb.com. This article was edited by Joe O’Connor.