Alcohol is the most widely used and abused drug among working adults. Over 80 percent of problem drinkers are employed full-time.¹ Unhealthy drinking patterns contribute to a host of preventable problems including increased workers' compensation and disability claims, hospital costs and job turnover. In addition, 20 percent of employees have been injured by, had to cover for, or worked harder because of a colleague's drinking.² Alcohol abuse and dependency cause employees to miss more work days, have lower productivity, and higher medical costs than those without active drinking problems.

Screening for alcohol problems can motivate some to temper their drinking while others—whose drinking may be dangerous or disruptive—may seek treatment, recovery and success. Business leaders willing to invest in screening and brief interventions (SBI) for alcohol problems can realize a return on investment of at least 215% by making interventions available for problem drinkers.³ To reap these rewards, employers need to first make screening available and accessible.

Tools for Screening
Alcohol screenings are usually completed in 5-10 minutes. One of the most useful alcohol screening tools is the 10-question AUDIT⁵. The AUDIT asks detailed questions about quantity and frequency of alcohol intake, addictive symptoms, and negative consequences. The National Institute on Alcohol Abuse and Alcoholism (NIAAA)⁶ also has a screening tool that captures individual drinking patterns.

In the Workplace
Many employers support activities and offer benefits that facilitate employee alcohol screening. Employee assistance programs that offer screening are linked to reductions in healthcare costs and increased productivity.⁷ New staff orientations are opportune events to inform employees about alcohol abuse and dependency resources. Company health fairs, and workplace wellness programs—when led by clinicians equipped to perform confidential alcohol screening—are also key events to identify and help problem drinkers.

In Healthcare Settings
Alcohol screening enables healthcare providers to address problem drinking before it becomes life-altering. By ensuring that health plans cover alcohol SBI, employers provide the necessary healthcare tools for employees to monitor their drinking. Screening can take place in the primary care setting as part of routine health exams. It can also be offered to women as part of their pregnancy-preparedness and prenatal care.⁸ Physicians' offices, hospitals, emergency rooms, urgent care centers and behavioral health clinics are all safe environments to assess addictive behaviors.

In the Home
Online resources are also available for employees and their families to assess their own problem drinking and seek help independent of workplace resources. Websites like AlcoholScreening.org provide validated screening tools, recommended actions and local resources for those seeking treatment and further information.

After Screening
Alcohol screening tests are similar in accuracy as tests for diabetes and high blood pressure.⁹ While screening does not provide a specific diagnosis, it does help identify people who may benefit from a comprehensive assessment by a trained professional. There are two possible courses of action for someone who screens positive for alcohol problems:

1. If the person exhibits signs of dependency, a referral to a treatment program more equipped to handle and assess addiction is appropriate (e.g., inpatient treatment), or

2. If the person's behavior is more associated with problem drinking, a brief intervention of low intensity and short duration can be conducted.

For information on interventions after screening positive for alcohol abuse, review Ensuring Solutions Brief Intervention: Cost-Effective Help for Problem Drinkers.

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Footnotes:
¹Substance Abuse and Mental Health Services Administration. 2006. Results from the
2005 national survey on drug use and health: national findings. http://oas.samhsa.gov/NSDUH/2k5NSDUH/2k5results.htm
²Ensuring Solutions to Alcohol Problems. The alcohol cost calculator for business. http://www.alcoholcostcalculator.org/business/.
³Ensuring Solutions to Alcohol Problems. The alcohol cost calculator for business: return on investment. http://www.alcoholcostcalculator.org/roi/.
⁴World Health Organization. WHO guide to mental and neurological health in primary care. http://www.mentalneurologicalprimarycare.org/page_view.asp?c=16&did=2215&fc=019010
⁵University of Rochester. Alcohol use disorders identification test. http://www.rochester.edu/UCC/online/audit.html 
⁶National Institute on Alcohol Abuse and Alcoholism. A pocket guide for alcohol screening and brief intervention. 2005. http://pubs.niaaa.nih.gov/publications/Practitioner/PocketGuide/pocket_guide5.htm
⁷Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment. Issue brief 9 for employers: an EAP that addresses substance abuse can save you money. In Press.
⁸National Institute on Alcohol Abuse and Alcoholism. Screening for alcohol use and alcohol-related problems. Alcohol Alert. 2005; 65:1-8. http://pubs.niaaa.nih.gov/publications/aa65/AA65.htm.
⁹Fleming M. Strategies to increase alcohol screening in health care settings. Alcohol Health Res World. 1997; 21(4):340-7.