When addiction counselors, therapists and other human services professionals develop a drug problem, what can we do to help?

Mental Health Professionals and Substance Abuse:

“Is there a relation between social work and drug abuse among professionals?”

Brandon Bruce Dellario LMSW LASAC

      Taking the ecological model into account, we are presented with a situation where mental health professionals live daily with factors which contribute to substance abuse vulnerability.

  “An ecological model of causation, which seeks to understand the transactions between the person and the environment, offers a more robust model for describing the addictive process and its effects (Rhodes, 1996).”  The term ‘substance abuse’ is identified here as an issue regarding negative professional consequences such as impairment (Siebert, 2003).   

     There are obvious realistic concerns regarding substance abusing social workers and the clients they serve.  The problem itself could be born out of the social worker’s stress in work with a particular population, possibly even a substance abusing population, where their own substance abuse vulnerability turns to onset.  Somehow, in a variety of circumstances, a tendency to misuse alcohol and or other drugs is born.  The possibility of that substance abuse being related to counter-transference from the client must be investigated.

     Several state chapters of the National Association of Social Work (NASW) have created committees to tackle this matter.  The Peer Consultation Committee of the NASW’s New York City chapter provides prevention, education, advocacy, intervention, consultation and referral information to a social worker with a substance abuse problem or to a co-worker of that social worker.  One of the problems of a situation like this is the inclination for everyone involved to simply ignore the ‘elephant in the room.’  Colleagues and employers are all too often aware of substance abuse problems within the agency, but do nothing in the way of interventions, warnings or sanctions. (Fewell, 1993)

Theories

“Alcohol and other drug use impairs job performance (Fewell, 1993).”  This being a factor in a social worker’s employment leads one to the conclusion that proactive steps should be taken.  Many social workers are in recovery themselves, from past personal substance abuse or from having a substance abusing loved one.  These workers are more perceptive in spotting the early warning signs of substance abuse in others.  In fact, it can lead to anger, depression and anxiety for colleagues of the substance abusing social worker, thereby affecting the job performance of others at the agency.

     There has been a call to the NASW for employee assistance programs, in-service education, workshops for affected colleagues and information packets on intervention.  Normally, even when a substance abusing worker is approached by a co-worker, it is ineffective.  Although there are steps one can take to be as effective as possible in helping a fellow worker.  Firstly, it is important to remember that confrontation is therapeutic and is done in the best interests of the individual.  It is done firmly, though not in anger.  It is suggested that this approach be direct, in order to aid the person in looking at the effects on themselves and the people around them.  The focus must remain on identification of the alcohol or other drug problem as to not slip into the other surrounding issues or reasons for poor job performance.

Ethical Issues 

     Of course, with the client's health at stake, the intoxicated mental health professional must be immediately suspended from work and later informed of treatment options.  The NASW Code of Ethics does not speak directly to the issue of substance abuse among social workers, but the NASW is taking steps toward helping substance abusing social workers to find recovery.  Substance abuse issues involve different intervention strategies than other mental health intervention procedures.  An adequate understanding of effects of substance abuse must be present for an intervention to be done properly.   

     It is also necessary that the problem be obviously that of substance abuse, not merely a suspicion of substance abuse.  The profession of social work has a future challenge in the respects of education and training of practitioners to work with substance abusing populations.  These areas of education will also help social workers better understand how to deal with substance abuse issues in the workplace, and in their own personal life. (Fewell, 1993)

           

           

Fewell, C. H., King, B. L., Weinstein, D. L. (1993). Alcohol and other drug abuse among social work colleagues and their families:  impact on practice. Social Work, 38, 5, 565.

Rhodes, R., Johnson, A. D. (1996). Social work and substance abuse treatment:  a challenge for the profession. Families in Society, 77, 3, 182-186.

Siebert, D. C. (2003). Denial of AOD use:  an issue for social workers and the profession. Health & Social Work, 28, 2, 89-98.