Assessing The (Hidden) Problem

"I know I feel more alert, more aware and accomplish more when I don't drink. When I wake up and I haven't had anything to drink, I say, 'Gee why don't I always not drink'. But I like it. I'm a hedonist. I can do without the Oxys, but alcohol's the worst. I can't kick it ... I'm addicted. But as long as my body stays in pretty decent shape I'm not going to worry about it."
"Half the corporate world is on antidepressants to cope with an otherwise untenable position. And once they're on them, it's almost impossible to get off. I'm more worried about that than chilling out with a couple of drinks and a little hashish."

The man speaking is quite well off. He lives well, and doesn't neglect much about the quality of life he believes himself to be leading. He swims, hikes, skis, plays tennis and he and his wife throw dinner parties for friends, business acquaintances and family in a home with fifteen rooms, five baths and a well-stocked bar. He's fifty years old, and his wife a little younger. He is concerned about his wife's balance. She's hooked on anti-depressants. She needs them to cope with her job and the corporate politics that involve her.

These two are the unseen, discreet faces of substance abuse and addiction. The man, Charles, doesn't consider himself to be abusive of drugs or alcohol. He would resent anyone suggesting he is addicted; he uses the word lightly, himself. He is, he claims, perfectly capable of ordering his life to suit himself. He is in control. Always. It's simply that he's made certain choices, and he's done that because they appeal to him. If he ever felt otherwise, he would simply turn things around. For the time being, there's no need to.

Recently he suffered a hangover that lasted three days. He wasn't much good at work. In fact, he just didn't show up at work. Whenever he feels stressed, in any event, he crushes an Oxycodone, snorts, and all the problems recede. It's a solution. It's a lifestyle choice. A choice arrived at through free will and the intelligence to discriminate, to decide what would work for him in the best of all possible situations. And, he feels, his current situation is pretty good. He's comfortable with it.

He has plenty of company. Alcohol and drug addiction -- oh, scratch that so-negative word, make it 'use', yes that sounds a whole lot better than the pejorative addiction: alcohol and drug use ... costs Canadian business and society $40-billion, including lost productivity and the use of the health care and justice systems, according to the Canadian Centre on Substance Abuse, using statistics from a 2008 report. Tobacco 'use' -- all right make it addiction -- costs an estimated $17-billion. Annually.

Breaking down the larger of the two figures, alcohol-related costs come in at $14.6-billion, while illicit-drugs weigh in at $8.2-billion. In contrast, the cost to the American economy of the use of illegal drugs, tobacco and alcohol is estimated to be $559-billion through lost productivity, health care and allied crime, according to the National Institute on Drug Abuse. And that sounds about equal for both countries, since the United States has ten times the population of Canada.

It's a kind of circuitous problem, in fact, employment and addictions. Work situations often cause stress leading to substance abuse, as a relief mechanism. Substance abuse, in turn creates a worsening work situation.  That, according to the Canadian Centre for Occupational Health and Safety. Gail Gauthier, clinical director of the Edward Griffiths Centre, the McGill Health Centre's addiction unit attached to the Montreal General Hospital explains how it works.

When people are involved and stuck with a work experiences exposing them to trauma, or isolation or frequent travel, when their work is either stressful or boring, and that is piled onto a wider situation of a harsh economy where workers concern themselves about cut-backs, buyouts and salary freezes, rising rents and food costs, the result can be a mind too weighted with worry to function properly. People search out relief from their stress.

There are no single causes and no easy answers. People suffering from substance abuse problems become fairly well skilled in shielding themselves from scrutiny. Often enough they're still capable of operating at a high level of production. Some of them fall into the situation through having been prescribed medications by their physicians ... like opiates for pain relief, or serotonin uptake inhibitors and tranquilizers to aid depression, anxiety and undue stress.

"It takes the edge off. It helps me get going and keeps me chilled out. Ultimately, I think it's all good for me. I never have a hangover. I work well. I think the only problem is when people start thinking it's a problem", explained a 60-year-old manager of a web design shop. He earns in the six figures but that salary is replete with upper-management deadlines and having to deal with staff to enable him to meet those deadlines.

Gail Gauthier has reached the conclusion, through her long exposure to the situation that "People lower their expectations and become resigned to it [managing substance problems]. "And at work, management has difficulty handling it. People close their eyes. Health-care professionals are uncomfortable asking the question. Doctors are better at asking, but they often don't know what to do. 

"It's hard to assess the problem."