Accommodating Alcohol Abuse and Dependency in the Workplace:
Helping American Indians and Alaska Natives with Alcohol-Related Disabilities

The American Indian Rehabilitation Research and Training Center (AIRRTC) identified alcohol abuse or dependency as the specific disability most needing attention among American Indians and Alaska Natives. However, an important study finding is that the stereotype of “the drunk American Indian” is a myth. Other research findings are beginning to show that alcohol abuse and dependency are problems for some American Indians and Alaska Natives, in some places, most often during a certain time in their lives, and under certain circumstances. Unfortunately, however, the myth of “the drunk American Indian” prevails; thus, affecting employment opportunities for many American Indians and Alaska Natives. Employers are sometimes faced with employees, Native and non-Native alike, who have struggled with alcohol abuse or dependancy, or due to certain life circumstances develop an alcohol problem. If you are an employer with American Indian and Alaska Native employees and are concerned that an employee may have a problem with alcohol, this practice guideline will offer a few resources for helping your employees.

The Difference Between Alcohol Abuse and Dependence

Alcohol abuse, can also be called “problem drinking.” It is defined as a pattern of excessive alcohol use that results in adverse health and social consequences to the alcohol user and most often those close to the user (e.g., family, friends). The individual who abuses alcohol still has the ability to change his or her drinking habits. On the other hand, alcohol dependence (also known as alcoholism) is characterized as a chronic, progressive disease that can be fatal if left untreated. At this stage the individual has lost control – he or she cannot stop using alcohol despite the severe physical, mental, emotional, and spiritual consequences.

Alcohol Abuse and Alcohol Dependence: Signs, Symptoms, and Effects¹

There are numerous indicators that an individual may have an alcohol problem. The following are a list of indicators developed by the Mayo Clinic that is used to help determine alcohol dependence

• Drinking alone or in secret
• Not remembering conversations or commitments—sometimes referred to as blacking out”
• Losing interest in activities and hobbies that used to bring pleasure
• Irritability as usual drinking time nears, especially if alcohol isn't available
• Keeping alcohol in unlikely places at home, at work or in the car
• Gulping drinks, ordering doubles, becoming intoxicated intentionally to feel good or “normal”
• Having legal problems or problems with relationships, employment or finances

Recommended Supports and Other Considerations

If you have an employee who is struggling with an alcohol problem, the opportunity may arise for you to suggest sources of possible assistance. If your employee is an American Indian or Alaska Native, a 1997 national survey revealed the most effective types of treatment programs for Native people with alcohol problems. In this study, thirty-one treatment centers that provided services to American Indians and Alaska Natives were surveyed. Results from this survey indicated that the top five treatment programs were: Alcoholics Anonymous (AA), generic outpatient treatment programs, outpatient drug-free programs, 28-day Hazelden or Minnesota model inpatient treatment programs, and American Indian traditional healing. Employers wanting to help an employee struggling with alcohol issues can considering referring the employee to the following for assistance: a tribal spiritual leader; a professional counselor whose work experience includes American Indians and Alaska Native and alcohol abuse or dependence issues; a local or tribal public health agency; a member of the clergy; a college or university student health center; an employee assistance program sometimes provided by larger employers; or the closest veterans outreach center.

Guidance on the Americans with Disabilities Act (ADA) and Alcohol Abuse

The ADA does not contain a list of medical conditions that constitute disabilities; it has a general definition of disability that states a person has a disability if he or she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having such an impairment.² According to the Equal Employment Opportunity Commission (EEOC), alcoholism is an impairment. Therefore, people with alcoholism who are substantially limited in a major life activity will have a disability under the ADA. An employer, however, may discipline, discharge, or deny employment to a person with alcoholism whose use of alcohol adversely affects job performance or conduct to the extent that he or she is not “qualified.”

EEOC’s Overview of Legal Obligations ³

• An individual who is currently engaging in the illegal use of drugs is not an “individual with a disability” when the employer acts on the basis of such use.
• An employer may prohibit the illegal use of drugs and the use of alcohol at the workplace.
• It is not a violation of the ADA for an employer to give tests for the illegal use of drugs.
• An employer may discharge or deny employment to persons who currently engage in the illegal use of drugs.
• An employer may not discriminate against a drug addict who is not currently using drugs and who has been rehabilitated, because of a history of drug addiction.
• A person who is an alcoholic is an “individual with a disability” under the ADA.
• An employer may discipline, discharge or deny employment to person with alcoholism whose use of alcohol impairs job performance or conduct to the extent that s/he is not a “qualified individual with a disability.”
• Employees who use drugs or alcohol may be required to meet the same standards of performance and conduct that are set for other employees.
• Employees may be required to follow the Drug-Free Workplace Act of 1988 and rules set by Federal agencies pertaining to drug and alcohol use in the workplace.

Accommodation Considerations for People with Alcoholism⁴

Attendance Issues

Allow use of paid or unpaid leave for medical treatment
Allow use of paid or unpaid leave or flexible scheduling for counseling
Provide a self-paced workload or the ability to modify daily schedule

Maintaining Concentration

Reduce distractions in the workplace
Provide space enclosures or a private office
Plan for uninterrupted work time
Allow for frequent breaks
Divide large assignments into smaller tasks and steps
Restructure job to include only essential functions

Difficulty Staying Organized and Meeting Deadlines

Provide clerical support
Make a daily to-do list
Maintain a current calendar
Remind employee of important dates
Schedule weekly meetings with supervisor to determine goals and address employee’s questions, concerns, and work progress
Write clear expectations of employee’s responsibilities and consequences of not meeting them

Difficulty Handling Stress

Provide praise and positive reinforcement
Refer to counseling and employee assistance programs
Allow for the ability to modify daily schedule
Allow for frequent breaks
Do not mandate job-related social functions where there would be exposure to alcohol

Resources for Additional Information

AIRRTC Web-Based Catalog at http://www.nau.edu/ihd/airrtc/catalog.html#abuse 

Hayne, B. (1993). An Eagle's View: Sharing Successful American Indian/Alaska Native Alcohol and Other Drug Prevention Programs. Portland: Northwest Regional Educational Laboratory, Western Regional Center for Drug-Free Schools and Communities.

Hayne, B. (1994). Eagle's View, Volume II: Sharing Successful American Indian/Alaska Native Alcohol and Other Drug Prevention Programs. Portland: Northwest Regional Educational Laboratory, Western Regional Center for Drug-Free Schools and Communities.

Robbins, M.L. (1994). Native American Perspective. In J.U. Gordon (Ed.), Managing Multiculturalism in Substance Abuse Services, (pp. 148-176). Thousand Oak, CA: Sage.

Elk, G.T. (1993). Walking in Balance on the Red Road. Journal of Emotional and Behavioral Problems 2(3), 54-57.

Hisanick, J.J.; Erickson, P.M. (1993). Hospital Resource Utilization by American Indians/Alaska Natives for Alcoholism and Alcohol Abuse. American Journal of Drug and Alcohol Abuse 19(3), 387-39.

Substance Abuse and Mental Health Administration at http://dasis3.samhsa.gov

Job Accommodation Network at http://www.jan.wvu.edu/media/employmentalcfact.doc

Iowa Substance Abuse Information Center Online at http://www.drugfreeinfo.org

Guide to Substance Abuse and Disability Resources at http://www.ncddr.org/du/products/saguide

Association of American Indian Physicians at http://www.aaip.com

Indian Health Service at http://www.ihs.gov/MedicalPrograms/Behavioral

UW Alcohol and Drug Abuse Institute at http://depts.washington.edu/adai/links/catindex.htm

Endnotes

¹ Helpguide.org. (n.d.). Alcohol Abuse and Alcoholism: Signs, Symptoms, Effects, and Testing. Retrieved May 17, 2006 from http://www.helpguide.org/mental/alcohol_abuse_alcoholism_signs_effects_treatment.htm 
² Batiste, J. (2005, July 5). Accommodation and Compliance Series: Employees with Alcoholism. Retrieved May 17, 2006 from http://www.jan.wvu.edu/media/alcohol.html
³ Job Accommodation Network. (n.d.). Technical Assistance Manual: Title I of the ADA. Retrieved May 17, 2006 from http://www.jan.wvu.edu/links/ADAtam1.html#VIII
⁴ Batiste, J. (2005).

References

Batiste, J. (2005, July 5). Accommodation and Compliance Series: Employees with Alcoholism. Retrieved May 17, 2006 from http://www.jan.wvu.edu/media/alcohol.html

French, L.A. (2004). Alcohol and other drug addictions among Native Americans: The movement toward tribal-centric treatment programs. Alcoholism Treatment Quarterly, 22(1), 81-91.

Helpguide.org. (n.d.). Alcohol Abuse and Alcoholism: Signs, Symptoms, Effects, and Testing. Retrieved May 17, 2006 from http://www.helpguide.org/mental/alcohol_abuse_alcoholism_signs_effects_treatment.htm

Job Accommodation Network. (n.d.). Technical Assistance Manual: Title I of the ADA. Retrieved May 17, 2006 from http://www.jan.wvu.edu/links/ADAtam1.html#VIII

Schacht, R., & Gaseoma, L. (1997). A Survey of Vocational Rehabilitation Counselors Concerning American Indian and Alaska Native Clients with Alcohol and Other Drug Abuse Disorders. American Indian and Alaskan Native Mental Health Research, 7(3), 50-67.

Schacht, R., & White, M. (2002). Improving Employment Outcomes for American Indians and Alaska Natives Who have Alcohol Abuse or Dependency. Journal of Ethnicity in Substance Abuse, 2(4), 31-62.

This practice guideline was developed by Hank Scalpcane and supported by a cooperative agreement (#H235K000002) with the U.S. Department of Education’s Rehabilitation Services Administration.