alcohol and other drug problems among addiction professionals

◆◆◆◆One group noted a great deal of secrecy about issues of personal behavioramong employees who have progressed into relapse patterns, contributing tothe hidden nature of these patterns. Sometimes an air of secrecy is one of thefirst signs of relapse.On an organizational level, the reporting of such incidents and their consequencesalso varies widely. The percentage of incidents resulting in disciplinarymeasures varies widely from organization to organization, depending on companypolicies. Even where the reporting of these incidents is mandated, reportingis often inconsistent.In many cases, the term “relapse” lacks a consistent definition, with some definingit to include any recurrence of AOD use and others reserving the wordfor return to problem use. This term can also be restricted to include only thereturn to AOD use per se, or be expanded to include the progression of dysfunctionalthought, feeling, urge, and behavior patterns that may or may notlead to return to use, sometimes known as “dry drunk” syndrome.Though they could not cite prevalence figures, some participants at the symposiumreported that they had seen many professionals with significant recoverytime descend into relapse patterns.It is not only the chronic and relapsing nature of the brain disease of addictionthat contributes to the danger of recurrence among recovering professionals in thefield. It is also the over-stressed, under-funded, and under-resourced nature of theaddiction treatment field as it has evolved.The primary impact of managed care has been a climate in which “doing moreand more with less and less” is the consistent expectation. The stigma and resultingcriminalization of addiction have diverted possible resources away from peoplewith substance use disorders. Meanwhile, the depth and complexity of clients’needs, circumstances, and co-occurring disorders have increased exponentially.The addiction professional is suspended between a vast and growing need and asteadily dwindling resource base.Most people with the courage to remain in this difficult position will undergosome pressure to sacrifice their own well being for the greater good. Participantsnoted that many professionals in the field lack self-care and balance in their lives,often leading to compassion fatigue and burnout. The organizations themselvesseldom have structured programs or policies that encourage and support self-care.These factors both raise the level of turnover in the field and lead to progressivelevels of dysfunction in many of those who remain.Many sources of support that would mitigate these problems are also lacking.According to participants, many organizations lack formal employee assistance programs(EAPs), and in cases where employees do not trust management, they maybe reluctant to use existing EAPs for fear of repercussions.n 21 n