Alcohol & Substance Misuse Evaluation Measures
Once a company has conducted assessment and planning for alcohol and substance misuse programs, and developed the specific tasks of implementation for these programs, it is time to develop the evaluation plan. This evaluation plan should be in place before any program implementation has begun.
Metrics for worker productivity, health care costs, health outcomes, and organizational change allow measurement of the beginning (baseline), middle (process), and results (outcome) of workplace health programs. It is not necessary to use all these metrics for evaluating programs. Some information may be difficult or costly to collect, or may not fit the operational structure of a company. These lists are only suggested approaches that may be useful in designing an evaluation plan.
These measures are designed for employee group assessment. They are not intended for examining an individual’s progress over time, which would raise concerns of employee confidentiality. For employer purposes, individual-level measures should be collected anonymously and only reported (typically by a third party administrator) in the aggregate, because the company’s major concerns are overall changes in productivity, health care costs, and employee satisfaction.
In general, data from the previous 12 months will provide sufficient baseline information and can be used in establishing the program goals and objectives in the planning phase, and in assessing progress toward goals in the evaluation phase. Ongoing measurements every 6 to 12 months after programs begin are usually appropriate measurement intervals, but measurement timing should be adapted to the expectations of the specific program.
Alcohol misuse can result in a number of adverse health and social consequences.
- More than 700,000 Americans receive alcoholism treatment every day, but there is growing recognition that alcoholism (i.e., alcohol dependence or addition) represents only one end of the spectrum of “alcohol misuse”1
- There are approximately 79,000 deaths attributable to excessive alcohol use each year in the United States2
Many problem drinkers have medical or social problems attributable to alcohol (i.e., alcohol misuse or “excessive drinking”) without typical signs of dependence, and other drinkers are at risk for future problems due to chronic heavy alcohol consumption or frequent binges. Nondependent drinkers who misuse alcohol account for the majority of alcohol-related disability and death in the general population.3
Alcohol misuse is associated with high costs to employers including absenteeism, decreased productivity (due to poor work performance), turnover, accidents, and increased health care costs.
- The cost of alcohol misuse in the United States was estimated to be $185 billion in 1998. About $16 billion of this amount was spent on medical care for alcohol-related complications (not including fetal alcohol syndrome [FAS]), $7.5 billion was spent on specialty alcohol treatment services, and $2.9 billion was spent on FAS treatment. The remaining costs ($134 billion) were due to lost productivity. Lost productivity due to alcohol-related deaths and disabilities impose a greater economic burden than do health care costs4
- Over 15% of U.S. workers report being impaired by alcohol at work at least one time during the past year, and 9% of workers reported being hung-over at work5
Many substances, both illegal and legal, have the potential for misuse. Common examples include cocaine, ecstasy, heroin, inhalants, marijuana, methamphetamine, PCP/Phencyclidine, and prescription narcotics. Workplace approaches for employees with alcohol or substance misuse problems are similar.6
1. National Institute on Alcohol Abuse and Alcoholism. New advances in alcoholism treatment. Alcohol Alert [serial on the internet]. 2000 Oct [cited 2008 Dec 5]; 49: [about 5p.]. Available from: http://pubs.niaaa.nih.gov/publications/aa49.htmexternal icon.
2. Centers for Disease Control and Prevention. Alcohol-Related Disease Impact (ARDI). Atlanta, GA: CDC; 2008 [updated 2008 Aug 6; cited 2008 Dec 5].
3. Campbell KP, Lanza A, Dixon R, Chattopadhyay S, Molinari N, Finch RA, editors. A Purchaser’s Guide to Clinical Preventive Services: Moving Science into Coverage. Washington, DC: National Business Group on Health; 2006. Available from: http://www.businessgrouphealth.orgexternal icon.
4. Harwood H. Updating estimates of economic costs of alcohol abuse in the United States: estimates, update methods, and data. Rockville (MD): National Institute on Alcohol Abuse and Alcoholism; 2000. NIH Publication No. 98-4327. Available from: http://pubs.niaaa.nih.gov/publications/economic-2000/external icon.
5. Frone MR. Prevalence and distribution of alcohol use in the workplace: a U.S. national survey. J Stud Alcohol 2006;67:147-56.
6. Substance Abuse and Mental Health Services Administration. Integrated health promotion/wellness and substance abuse prevention in the workplace[monograph on the internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration; [cited 2008 Dec 5]. Available from: http://www.workplace.samhsa.gov/external icon.