Watching Out for Signs of Trouble

It's well known that weathering a disaster or a financial setback can cause individuals to increase their consumption of alcohol, prescription medications, or illegal drugs. People with past or current substance use issues are considered more likely to have difficulties during or after such events. If your company does not have a random drug testing program and an employee assistance program in place, there are resources available from various agencies to help you understand the warning signs and provide assistance to a worker who may be experiencing this.

The Substance Abuse and Mental Health Services Administration's Center for Drug Abuse Treatment, public health agencies, and published studies confirm the link. SAMHSA even offers the Disaster Behavioral Health Information Series Resource Collections--resource collections and toolkits to help people affected in this way by disasters--and added resilience and stress management resources to them in 2010 as more and more Americans were reporting rising levels of economic stress.

An example of the phenomenon was reported 12 years ago. A group of eight researchers, some of whom were from the Johns Hopkins Bloomberg School of Public Health or the Columbia University Mailman School of Public Health, published a paper in 2002 in which they reported that smoking, alcohol consumption, and marijuana use increased substantially among surveyed residents of Manhattan, in New York City, in the two months following the 9/11 attacks. Those who increased their smoking of cigarettes and marijuana were more likely to experience post-traumatic stress disorder than those who did not increase those behaviors, the researchers reported. (

According to SAMHSA, this occurs because disasters frequently happen with little warning and also can create chaos for families and their communities. Those who are affected may feel sadness, grief, and anger. Being equipped to help individuals manage these behavioral health issues during the recovery period is part of the disaster response preparedness tools the agency considers essential.

"The trauma and upheaval resulting from a disaster can have a profound impact on those with substance use disorders, who may already be struggling with many challenges in their lives. The ability to quickly find and access resources to provide treatment and services is especially important during such an event," said Dr. H. Westley Clark, M.D., MPH, director of the Center for Substance Abuse Treatment.

"Behavioral health is essential to health, which also makes it an integral part of helping Americans overcome disasters," SAMHSA Administrator Pamela J. Hyde has said. "When disaster strikes, it is critical that people and communities get the tools and resources they need as soon as possible so that they can begin the recovery process."

SAMHSA offers a free, confidential Disaster Distress Helpline (call 1-800-985-5990 or text "TalkWithUs" to 66746) that offers crisis counseling 24/7 year round, utilizing a network of call centers. The helpline's brochure, available at, notes that disaster victims' loved ones and also first responders and rescue/recovery workers are more at risk than others.

It lists these 12 warning signs of distress that safety managers and employers should be aware of:

  • Sleeping too much or too little
  • Stomach aches or headaches
  • Anger, feeling edgy, or lashing out at others
  • Overwhelming sadness
  • Worrying a lot of the time; feeling guilty but not sure why
  • Feeling like you have to keep busy
  • Lack of energy or always feeling tired
  • Drinking alcohol, smoking or using tobacco more than usual; using illegal drugs
  • Eating too much or too little
  • Not connecting with others
  • Feeling like you won't ever be happy again
  • Rejecting help

EAPA Workplace Disaster Resources
The Employee Assistance Professionals Association, Inc. offers an online Workplace Disaster Resources page at

Incident-specific resources associated with many recent disasters and crises are there, from the West, Texas fertilizer explosion to the financial crisis of 2008-2009. Eight handouts to assist employee assistance professionals and managers, including "Identifying Traumatic Reactions in the Workplace" and "Organizational Recovery," are also available there.

Michael Botticelli, deputy director of national drug control policy in the White House Office of National Drug Control Policy, discussed his own addiction to alcohol and his recovery in a November 2013 post on the office's blog. "Despite the fact that nearly every family and community in America is affected by addiction, it remains part of our collective denial," he wrote. "According to the National Survey on Drug Use and Health, only about 1 in 10 people with a diagnosable substance use disorder get treatment at a specialty facility…. For those who do get treatment, it is often in the most acute stages where, even though effective, treatment is more challenging and costly. The economic cost of excessive alcohol use is estimated to be $223 billion, with health care accounting for $24.6 billion of these costs. The economic cost of illicit drug use is estimated to be $197 billion, with health care accounting for $11.4 billion of these costs."

How Americans think about addiction must change, Botticelli argued. "Millions of people in recovery are living meaningful, productive lives full of joy and love and laughter--and I am just one of them," he wrote. "It is time for those of us in recovery, and those that care for and love us, to join the growing movement to put a face and voice to this disease; to lift the curtain of invisibility and to show others the endless possibilities of a life in recovery. It is a time to make that simple, yet courageous decision to be counted, to be seen, and to be heard."

Posted by Jerry Laws on Mar 03, 2014