Privacy concerns can prevent people from seeking help with a possible alcohol problem, particularly in the workplace. But online alcohol screening programs can ease these privacy worries, opening the door to intervention and treatment and helping reduce healthcare costs for employers.
According to the Pew Internet and American Life Project, 80 percent of U.S. Internet users have searched online for information about major health topics. Of those, 8 percent have searched for information about problems with drugs or alcohol. These so-called "health seekers" are often looking for diagnostic tools and ways to connect to local health resources, and appreciate the anonymity afforded by the Internet.
Providing screening tools online can go a long way toward helping reduce healthcare expenses. It is estimated that healthcare costs for employees with alcohol problems are twice as high as for other employees, and each employee with an alcohol problem that's left untreated costs his or her employer an extra $640 annually. According to the 2003 National Survey on Drug Use and Health, of the 16 million people who self-reported as heavy drinkers, 79.9 were employed at the time. Numerous studies have shown that these workers have a deleterious effect on the workplace in the form of reduced productivity, absenteeism, and turnover, increased accidents and injuries, and higher physical and mental healthcare expenditures.
An Effective Tool: AlcoholScreening.org
Alcohol screening programs have been shown to be among the most effective tools for preventing alcohol abuse as well as addiction. "Given appropriate support and assistance, people who are not alcohol dependent may reduce or stop their consumption" as a result of screening, according to the U.S. Department of Veterans Affairs. This is particularly important given that 60 percent of alcohol-related absenteeism, tardiness, and poor work quality is caused by non-dependent drinkers -- those who drink lightly to moderately.
Too often, workplace screening programs for alcohol are conducted in-person and are poorly attended. Low utilization rates may reflect fear among workers that their employers will punish those who are found to have a drinking problem. The desire for anonymity and the trend toward seeking health tools and information on the Internet prompted the creation of AlcoholScreening.org, a free public website created by Join Together. AlcoholScreening.org aims to help users understand how their drinking behavior may be affecting their health.
Since its launch during National Alcohol Awareness Month in 2001, AlcoholScreening.org has been visited by almost 600,000 people, who've completed nearly 300,000 screens. Hundreds of other websites have linked to it, including the Montana State University Employee Wellness Program, the Massachusetts State Health Department, Delta Airlines, the New York State Office of Alcoholism and Substance Abuse Services, WebMD, and many universities across the United States.
In addition to a screening tool, AlcoholScreening.org provides information about a wide range of alcohol-related health topics, including alcohol consumption guidelines, how to cut down on drinking, and what to do if someone you know has a problem. The site's help section contains links to additional support resources and a searchable database of 11,000 local treatment programs in the United States.
The screening section of the site consists of 13 questions that are a modified version of the Alcohol Use Identification Test (AUDIT), which was created by the World Health Organization and is one of the most widely validated alcohol self-screening tools. Each user receives personalized feedback based on the brief-intervention model; in face-to-face situations, brief interventions have been shown to be highly effective: drinkers who receive a brief intervention are twice as likely to reduce their drinking as others.
The feedback on AlcoholScreening.org is meant to be supportive but also to instigate changes in behavior. It does not label anyone as an alcoholic; instead, it focuses on the health risks to visitors. Feedback includes a discussion on whether the visitor's alcohol consumption is within safe limits or may be harmful to current or future health and a comparison to average alcohol consumption among others of the same age and gender. Likely dependent drinkers are referred to additional treatment resources; risky (non-dependent) drinkers are advised to cut back, and all visitors are educated about moderate drinking.
A recent study published in the journal Preventive Medicine found that visitors to AlcoholScreening.org who had greater drinking-severity levels were much more likely to take the next step toward getting help, rather than simply learning more about the topic. Although no research on the effectiveness of brief interventions provided via Web-based feedback has yet been published, this study does indicate some level of influence on visitors to AlcoholScreening.org.
Providing a validated diagnostic tool via the Internet helps employees screen themselves confidentially and anonymously, either in the workplace or from the privacy of their homes. It also provides easy access to local resources and additional information on alcohol and health. Offering such a tool allows companies to reach employees who might otherwise not participate in screening programs.
Workplace prevention programs, including screening tools, significantly reduce costs through improved productivity and fewer injuries on and off the job. And it's been proven time and again that the general health of employees will rise if they are encouraged to use, and provided with, tools for change.
April is National Alcohol Awareness Month. There's no better time than now to think about how alcohol is affecting your workplace and what employers can and should do about it.
Marc Belanger is the project manager of AlcoholScreening.org at Join Together. For more information on the project, contact Marc at marc@jointogether.org or call 617-437-1500. A more detailed, annotated version of this article appears in the April 2005 issue of the Journal of Employee Assistance Professionals.
