Revisiting Employee Assistance Programs and Substance Use Problems in the Workplace: Key Issues and a Research Agenda

Abstract

This column describes employee assistance program (EAPs) and identifies key issues for contemporary EAPs. These programs began as occupational alcohol programs and have evolved into more comprehensive resources. To better understand contemporary EAPs, the authors suggest a research agenda at includes descriptive studies to provide an up-to-date picture of services; investigations of how contemporary EAPs address substance use problems, including management consultation for early identification; further study of EAPs’ effects on outcomes, such as productivity and work group outcomes; examination of the relationship between EAPs and other workplace resources; further examination of influences on EAP utilization; and development and testing of EAP performance measures. The workplace provides a unique opportunity to address the entire spectrum of substance use problems, both diagnosable abuse or dependence and other problematic use. Most adults with substance use problems are employed, and an estimated 29% of full-time workers engage in binge drinking and 8% engage in heavy drinking; 8% have used illicit drugs in the past month (1). Substance use problems contribute to reduced productivity (2), absenteeism, occupational injuries, increased health care costs (3), worksite disruption, and potential liability as well as other personal and societal harms. Employee assistance programs (EAPs), which grew out of occupational alcohol programs, have dramatically evolved into a more comprehensive behavioral health resource that is widely available. Given the current level of concern regarding health care costs and productivity— and the awareness that substance use problems are underrecognized and undertreated—it follows that interest in EAPs is stronger than ever. This column describes the contemporary EAP, explores key issues in service delivery, and proposes a research agenda to help drive the future direction of this important behavioral health resource.