Lost Opportunities: Gaps in Employer Support for Substance Use Disorders

You’ve seen plenty of statistics about the rise in substance use disorders during the pandemic. But as you consider how best to help support employees – who may struggle with the effects of the pandemic for years to come – it’s important to focus on individual experiences as well. In this post, we begin the story of one employee who used alcohol to cope with tough times brought on by the pandemic, until alcohol use became a source of additional harm. We’ll follow his story over the next three weeks to show how existing support systems failed to provide the timely intervention that could have disrupted his downward spiral – and discuss what employers can do to bridge gaps and ensure employees receive support when it can do the most good.

In early 2020, Randell Lee of Baltimore, Maryland experienced a major life change. The government mandated that all non-essential employees were to stay home and limit contact with others to slow the spread of COVID-19. Randell, a logistics manager in a manufacturing company, suddenly had to stop coming to the company’s headquarters, where he had spent the last 20 years. Randell loved being surrounded by colleagues and found working remotely difficult from the start. His wife, a schoolteacher, also had to work from home and their children pivoted to online classes. Interruptions and other distractions at home affected Randell’s productivity. Adding to these stressors was anxiety about contracting COVID-19 – he had underlying health conditions and was classified as high-risk. 

Randell was not alone in feeling anxious and depressed as the pandemic continued; almost half of Americans have indicated that the COVID-19 pandemic has negatively impacted their mental health. To relieve the stress of prolonged isolation and uncertainty, Randell turned to alcohol. His usual one beer with dinner became two, then it became a beer as soon as he was off the clock, and before long he was drinking casually throughout the workday. Although he made sure his coworkers didn’t see him drinking during video calls, Randell found that alcohol made the long hours in front of the computer more bearable.

Again, this behavior was quite common. A survey conducted by the NYU School of Global Public Health found that 29% of people who already drank increased their alcohol consumption during the pandemic as a response to stress. As the pandemic dragged on and Randell continued to work from home, unable to pursue his normal activities, he continued to drink -- until it became evident to the people in his life, including his employer. He had always been one of the first to arrive at work; now he started logging on after most of his colleagues and showing up late to Zoom meetings. Before the pandemic, Randell was known as someone who went above and beyond, but now he was letting some of his responsibilities fall on the shoulders of colleagues. Randell’s manager, Jenny, noticed that he had become less responsive and increasingly irritable. She had recently participated in a training on how to support team members who may be struggling with mental health and substance use issues, and approached him privately. “I’ve noticed that you are not quite yourself lately. Is there something going on that I can help with?”

Randell explained, “This pandemic has really thrown me off. The stress is unrelenting and I’m having a hard time working remotely with my family around. It’s been really hard to concentrate.”

Jenny listened and validated Randell’s emotions. She made suggestions about his work demands and suggested he consider talking to someone at the employee assistance program (EAP). Even though Randell hadn’t mentioned that he had increased his drinking – he may not have been aware yet that it was creating some concerns – he shared enough so Jenny could offer various supports.

The next day, Randell called the EAP. After 15 minutes of answering very personal questions, he was given a list of phone numbers to call to get connected with a therapist. Randell made the first call, but the therapist was not taking new patients. He called another therapist on the list, but there was no answer, so he left a voicemail. The third therapist he called was no longer in the EAP network – and even asked Randell to contact his EAP and request they remove him from the contact list. 

Four weeks later, he finally received a call back from the second therapist. He waited another three weeks for his first session. It had taken almost two months – two months! – for Randell to begin receiving meaningful support, and the frustration he felt while waiting only fueled further alcohol use. Although his drinking hadn’t seemed like such a big problem when he spoke with his manager, by the time he was in counseling, the issue was the central topic of conversation.

Unfortunately, Randell’s story is all too common. Early intervention, before substance use or excessive alcohol use progresses to addiction, is among the most cost-effective ways to address substance abuse, reduce its costs to society, and improve public health. Ensuring that managers are trained to identify potential issues – as Jenny did – is a critical first step. But to ensure that employees then move swiftly into an effective intervention may require program evaluation, gap analysis, roadmap development, and clinical assessments. 

In next week’s post, Randell eventually gets the help he needs – but only after some costly missteps.

Laura Dent, who interned at Mercer this summer, assisted in the preparation of this post.


Sandra Kuhn
by Sandra Kuhn

Partner, Total Health Management, Mercer

Courtney Blondino
by Courtney Blondino

Senior Associate, Total Health Management, Mercer

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