The cannabis conundrum: Getting value from your EAP
EAP services are geared toward both well-being and recovery. Millions of people are relying on cannabis to help with pain, sleep and other issues, with positive results. It has been helpful to people diagnosed with ADHD, multiple sclerosis and cancer.
On the flip side, cannabis can be an addictive drug, resulting in more than four million diagnoses of cannabis-use disorder. Cannabis is second to alcohol in DUIs and 9% of users become addicted. Very little research has taken place with adult users of cannabis, so long-term effects aren’t well known. This is one of the reasons the federal government is reluctant to legalize even its medical use.
However, teenage use has been well researched. Forty-five percent of high school seniors have tried cannabis and 6% use it daily. Seventeen percent of teen users become addicted as compared to only 6% of those who start as adults. Because our brains are still developing until age 25, adverse changes in the brain may occur.
Debate is ongoing in the recovery movement about whether cannabis is a gateway drug. The term itself is problematic because it implies causality when there is only a correlation. For example, if you ask people who use hard drugs, opioids, for example, if they started with readily available drugs such as alcohol and cannabis, most will say yes. However, the reverse is not necessarily true. Not everyone who uses cannabis will progress to harder substances.
In addition, cannabis is considered a drug of relapse for someone in recovery. Attend almost any support group meeting and you will hear someone speak about his or her relapse after smoking a joint. Cannabis can have the same devastating effect on recovery as taking prescription drugs such as benzodiazepines or opioids for pain.
The manager’s role in recognizing and responding to impairment
One of the most important roles of a supervisor is to notice problematic behavior and do something about it. Training for managers and supervisors on substance misuse is essential for a workplace concerned with job impairment. In many organizations, a supervisor may be the only person to lay eyes on an employee and may be the only person to notice a behavioral change in someone struggling with addiction.
Training for managers and supervisors on substance misuse may be dictated by law (as in the case of the Department of Transportation) or mandated by an organization. Training is an essential part of promoting a drug-free workplace and a culture of health. Work performance may decline when employees struggle with substance use, mental health or work-life issues. Managers shouldn’t diagnose a problem; they simply need to notice a change in behavior and start a conversation.
Managers and supervisors often struggle with confronting signs of impairment. Most managers genuinely want to help people but they can end up killing an employee with kindness. They may not know what to say or how to say it. When a supervisor notices changes in speech, appearance, mood, odor, balance and/or judgment, a conversation can begin, and the EAP is best positioned to provide support. A successful referral to the EAP may lead to recovery and may save a life.
How EAPs can help
Each year, EAPs receive thousands of calls related to substance use, mental health and work-life concerns. Licensed mental health counselors provide a sounding board and assess each caller and each situation. Counselors continually ask themselves, “Why is this person calling now?” “How much risk is there?” What have they tried in the past?” and “What would be a reasonable approach?”
Once assessed, most cannabis users are treated on an outpatient basis because there is not the typical medical detox process that is needed with alcohol. Treatment could involve an intensive outpatient program, 12-step recovery meetings and some combination of counseling and education. The EAP might serve as an advocate, help with an admission and talk with the employee’s family members.
At some point in the intake process, the counselor is looking at insurance coverage and starting to match people with the right resources while checking availability and cost. In all situations, follow-up is essential because of all the difficulties encountered in the system of care.
EAP trainers provide checklists of problematic behavior, case examples and talking points. A successful referral to the EAP can lead to recovery and may save a life.
What companies can do to help with cannabis-use disorder
As a baseline, managers and supervisors need to know the company’s drug policies, especially as the laws are changing. They also need to notice changes in employee behavior and loop in HR at an early stage.
In addition to training managers and supervisors on how to spot signs of impairment, there are a few other recommendations:
· Make sure you have a flexible, high-quality EAP. Try it out yourself to see how it works. If you have any doubts about your EAP, you may unconsciously give it a low profile. Ask a few people to test it out and give you feedback.
· Once you feel confident about the quality of the EAP, promote it heavily. The EAP is only as valuable as it is visible. Make sure postcards go home to family members, as they may be the ones who need the most help. Integrate the EAP with other benefits so it is mentioned regularly.
Work with your leadership to reduce the stigma of mental health and substance-use issues. With the right messages from the top of an organization, employees will reach out for help earlier and often.