Supporting alcohol harm reduction in the workplace
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The document discusses strategies and research related to reducing alcohol misuse in the workplace, highlighting the importance of early intervention, self-awareness, and identification of problem drinking. It presents findings from various studies that indicate the effectiveness of brief interventions and alcohol screening tools in altering drinking behaviors and reducing negative workplace outcomes associated with heavy drinking. Recommendations for companies include fostering an alcohol-aware culture, encouraging self-identification, and providing clear signposting to support services.
Supporting alcohol harm reduction in the workplace
- 1. Supporting individuals to monitor and reduce their alcohol intake Don Shenker Alcohol Health Network Recovery Festival 2nd July, 2015
- 2. Overview ‘What works’ to reduce alcohol harm at work Prevention vs. Treatment - Recognising signs of problem drinking ‘Identification and Brief Advice’ – what the research tells us Findings from AHN and UCL / Middlesex study Copyright: Alcohol Health Network
- 3. Alcohol Health Network Our objective: Early intervention and prevention of alcohol misuse • Encourage alcohol self-awareness and identification • Provide alcohol awareness campaigns and advice • Signpost heavy drinkers to local services Collaboration with UCL’s E-Health Unit and Camden and Islington NHS Trust Copyright: Alcohol Health Network
- 4. Awareness of alcohol units – Health Survey England Good news - heard of daily drinking - 75% Not so good: 35% of men / 47% of women don’t know recommended guidelines “Those who attempted to define the recommendations were more likely to be wrong than right” People can underestimate their alcohol intake by around 40 to 60% (UCL, 2014) Copyright: Alcohol Health Network
- 5. Proportion of drinking patterns – England Copyright: Alcohol Health Network 4% Dependent 5% High Risk 17% Increasing Risk 62% Low Risk 12% Abstain 1.6m people 7.1m people
- 6. Normalised workplace culture? • Alcohol is the most widely used substance among working adults • Almost 80% of risky drinkers are employed • One UK study found that: ⁻ 1/3 employees admitted having been to work with a hangover ⁻ 15% reported having been drunk at work ⁻ 1 in 10 reported hangovers at work once a month; 1 in 20 once per week Copyright: Alcohol Health Network 6
- 7. ‘Social’ drinking - a problem at work? • Time off work due to hangovers or feeling unwell in the morning • Poor sleep affects performance at work • Long term poor health or mental health problems • Concealed from colleagues or tolerated and this causes stress and tension for the whole team Copyright: Alcohol Health Network
- 8. Impact of heavy drinking on the workplace • Heavy drinking is associated with multiple negative workplace outcomes: ⁻ Increased presenteeism; ⁻ Higher rates of absenteeism; ⁻ Accidents; ⁻ Reduced academic performance; ⁻ Increased risk of unemployment; ⁻ Premature mortality. • Heavy drinking Reduced productivity tangible costs to both employee AND employer Copyright: Alcohol Health Network
- 9. Why ask employees questions about their drinking? • Majority of heavy drinkers are of working age and in work • Majority of individuals poorly informed of health risks • NICE: Questions lead to behaviour change • Duty of care Copyright: Alcohol Health Network
- 10. Alcohol Use Disorders Identification Test (AUDIT) NICE : Identification and Brief Advice (IBA) one of most cost effective measures to identify, prevent and reduce risky drinking Use of AUDIT alcohol screening to identify problem drinking in GP / A&E / Hospital settings now well established Review of 32 controlled trials: 1 in 8 problem drinkers reduced drinking to lower-risk levels (Moyer 2002) Project Treat in US – use of IBA in GP settings – found cost savings at 12 / 48 month in terms of alcohol related hospital / A&E costs (Fleming 2002) Copyright Alcohol Health Network
- 11. Copyright: Alcohol Health Network
- 12. International evidence for impact of IBA at work Hermansson 2010 – Scandinavian transport company - 20% of employees drank excessively • Following IBA at 12m follow up 28% reduced excessive drinking • Baseline 51% scored >8 on AUDIT - 23% at 12m follow up Saitz et al 2006 - US web-based study of 4,000 students – 33% of women and 15% of men drinking at increased risk reduced their drinking to low risk one month later. Doumas 2007 found e-based IBA and personalised feedback reduced heavy drinking by 30% among young workers compared to assessment-only Quanbeck et al 2010 developed a US cost benefit model - Benefit to cost ratio of 4.4 – 1 for spend on IBA delivery in workplace Copyright: Alcohol Health Network
- 13. Identification and Brief Advice approaches – in the workplace Reactive approach – Occupational Health / EAP Proactive approach - Encourage employees to use AUDIT tool privately - to measure own drinking rates Online Induction Market stall / Health Days Training managers Signposting – services and self-help resources Copyright: Alcohol Health Network
- 14. AHN Online IBA Studies Middlesex University 2013 - Evaluation of the Better Drinking Habits Online Tool University College London / Newcastle University 2013 - Feasibility study of electronic screening and brief intervention for alcohol misuse in workplace settings • Online alcohol / health assessment tool - Promoted via intranet / posters • Confidential risk-based feedback on drinking and health measures • Baseline measure and follow up 3-m later Copyright: Alcohol Health Network
- 15. Copyright: Alcohol Health Network
- 16. AHN Online Awareness Study findings Middlesex University 2014 • 17% completion rate • Statistically significant reduction in drinking • 38% respondents reduced consumption • 68% found feedback useful University College London 2014 • < 35% completion rate • 7% reduction in proportion of staff drinking at Increasing or High Risk levels Copyright: Alcohol Health Network
- 17. Learning from workplace alcohol awareness prevention approaches Majority of employees using tool value this approach Anonymity very important Approach appeals to increased/high risk drinkers Staff want to understand more about health risks for different levels Alcohol focus attracts larger proportions of heavy drinkers compared to health focus Copyright: Alcohol Health Network
- 18. Recommendations for companies and organisations Review Policy – encourage staff to come forward and seek support Alcohol awareness programmes should encourage self-identification Pro-actively make workplaces “alcohol aware” – change the culture Ensure prominent signposting to support services Act as “champions” to engage other companies and organisations Copyright: Alcohol Health Network
- 19. References / Further Reading Doumas DM, Hannah E. Preventing high-risk drinking in youth in the workplace: a web-based normative feedback program. Journal of substance abuse treatment. 2008;34(3):263-71. Epub 2007/06/30. Fleming M.F, Mundt M.P, French M.T, Manwell L.B, Stauffacher E.A, Barry K.L. (2002) Brief physician advice for problem drinkers: long-term efficacy and benefit-cost analysis. Alcohol Clin Exp Res. 26(1), 36-43.36 Hermansson U, Helander A, Brandt L, Huss A, Ronnberg S. (2010) Screening and brief intervention for risky alcohol consumption in the workplace: results of a 1 year randomised controlled study. Alcohol and alcoholism. 45 (3) 252-257 Khadjesari Z, Murray E, Hewitt C, Hartley S, Godfrey C. Can stand-alone computer-based interventions reduce alcohol consumption? A systematic review. Addiction (Abingdon, England). 2011;106(2):267-82. Epub 2010/11/19 Middlesex University / NHS North Central London / Alcohol Academy / IHWUK (2011) Alcohol and the workplace? The importance of early intervention and workplace policies in reducing the health and business impact of alcohol misuse Moyer, A., Finney, J., Swearingen, C. and Vergun, P. (2002) Brief Interventions for alcohol problems: a meta-analytic review of controlled investigations in treatment -seeking and non-treatment seeking populations, Addiction, 97, 279-292. NICE Public Health Guidelines 24 (2010) Alcohol Use Disorders – Preventing the development of hazardous and harmful drinking, NICE Quanbeck A, Lang K, Enami K and Brown R. (2010). A Cost-Benefit Analysis of Wisconsin’s Screening, Brief Intervention, and Referral to Treatment Program: Adding the Employer’s Perspective. Wisconsin Medical Journal ; 109(1): 9–14 Roche AM, Pidd K, Berry JG et al. (2008). Workers’ drinking patterns: the impact on absenteeism in the Australian work-place. Addiction, 103:738–748. Seymour L. (2010) Common mental health problems at work. What we now know about successful interventions. A progress review. BOHRF/Sainsburys centre for mental health Wallace P, Murray E, McCambridge J, Khadjesari Z, White IR, et al. (2011) On-line Randomized Controlled Trial of an Internet Based Psychologically Enhanced Intervention for People with Hazardous Alcohol Consumption. PLoS ONE 6(3): e14740. doi:10.1371/journal.pone.0014740 Watson H, Godfrey C, et al (2009) Reducing Alcohol-related Harm In The Workplace - A Feasibility Study Of Screening And Brief Interventions For Hazardous Drinkers Alcohol Research UK Copyright: Alcohol Health Network
- 20. Thank you – please contact us! Alcohol Health Network donshenker@alcoholhealthnetwork.org.uk www.alcoholhealthnetwork.org.uk 4th Floor, 17-23 Willow House, London SW1P 1JH Tel. 020 3151 2420 Copyright: Alcohol Health Network 20
Editor's Notes
- #3: Lessons leant from international studies - ‘what works’ to reduce alcohol harm at work and the impact if its not addressed Prevention vs. Treatment – why alcohol harm prevention is better than cure and how to achieve it Recognising signs of problem drinking behaviour – what systems to use IBA – what the research tells us about this approach Findings from AHN and UCL collaborative study of ‘online alcohol awareness’ across 6 organisations
- #4: AHN is a new social enterprise that aims to prevent alcohol related harm in the workplace Our objective: Early intervention and prevention of alcohol misuse Encourage alcohol self-awareness and identification Provide alcohol awareness campaigns and advice Signpost heavy drinkers to local services Collaboration with UCL’s E-Health Unit and Camden and Islington NHS Trust
- #5: Good news - percentage of people who had heard of daily drinking limits increased from 54% in 1997 to 75% in 2009 Only a third of men and half of women know the correct alcohol guidelines for their gender The majority of heavy drinkers are unaware of the maximum recommended units 25% of drinkers drink 5 or more drinks in one sitting Health Survey for England 2007 Ibid APHO (2007) Indications of Public Health in the English Regions – Alcohol (Chapter 8)
- #8: The impact of drinking leads to time off work due to hangovers or feeling unwell in the morning Drinking leads to poor sleep and this affects performance at work Drinking leads to long term poor health or mental health problems Drinking behaviour is concealed from colleagues or tolerated and this causes stress and tension for the whole team
- #10: Off-duty drinking has an impact on absenteeism and presenteeism Majority of heavy drinkers are of working age and in work The act of asking evidence-based questions leads to behaviour change on drinking rates (NICE, 2010) Employers have duty of care to ensure employees drinking at higher rates are aware of this and know how to get help
- #14: Proactive approach - Encourage employees to use AUDIT tool to measure drinking rates and provide confidential personalised feedback on drinking levels and risk score
- #18: Anonymity very important for self-assessment Approach appears to appeal most to increased/high risk drinkers – higher proportions than national average Staff appear to use alcohol assessment tools more than once to understand more about health risks for different levels An alcohol focused approach appeals to larger proportions of heavy drinkers than a general health focus
- #19: Adopt a comprehensive, written, alcohol workplace policy – for long-term impact Implement health-related alcohol programmes, as comprehensively as resources allow – including as part of a wider health and well-being agenda Pro-actively make their workplaces “alcohol free” Review working practices and management styles that can cause stress and perpetuate or worsen heavy drinking Where they have experience of alcohol policies and interventions, consider acting as “champions” to engage other companies and organisations