Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

348 IV. SPECIAL POPULATIONSshould be taught the dangers of alcohol and drug abuse to themselves and theirfamilies; the negative effects of substances on job performance, health, andsafety; company policy and consequences of violating it; the functions of theEAP; drug testing policy and confidentiality; and the ways in which they canget help.There are important limitations to EAPs. First, many executives, upperlevel managers, and company presidents do not seek treatment for substanceabuse through their EAPs. They often prefer off-site treatment programs or cliniciansfor the following reasons: (1) Their substance abuse may involve anillicit drug rather than alcohol; (2) company morale would suffer if it becameknown, for example, that the CEO was a cocaine addict; and (3) it is difficult tobe treated by someone they employ. Second, the EAP focus on substance abusecan lead to referral to broadly trained clinicians, and less careful attention toother emotional and psychiatric problems. Many of these patients benefit fromconsultation with an addiction psychiatrist.SPECIAL POPULATIONSEach of the many special work populations may differ in terms of types of drugsused, reasons for use (e.g., boredom, exhilaration, etc.), and potential consequences.AthletesAthletes are usually young adults whose jobs involve stardom, celebrations, disappointments,access to illicit drugs, large amounts of cash, great physical exertion,and great physiological reserve. Sometimes the athlete may be trying tomake the grade in any way possible, or may be little-noticed. Drug misuse maybe for enhancement of performance, recreation, pleasure, or self-medication ofpain.A vast number of substances are used by athletes to improve their performance.Many have been discovered and regulated (or banned), many moreexist now, and others will surface in the future. These substances are regulatedmostly because they affect fair competition or may endanger the user; this sortof use, often diagnosed as other substance use disorder, includes steroids, nutritionalsupplements, or stimulants or opioids.Athletes use all kinds of addictive substances recreationally, includingcocaine, marijuana, and tobacco. The use of smokeless tobacco is endemicamong baseball players (including college and high school players) (Colborn,Cummings, & Michaelek, 1989). Coaches and those concerned about playersmust be able to make recommendations for treatment regardless of “who” theplayer is.