Addiction and Industry

Alan De Sousa, M.D., D.P.M., Ph.D. Hon. Prof. and Head, Department of Psychiatry, J.J. Hospital and Grant Medical College, Bombay, India. (Guest Lecture at the Third National Conference of Industrial Psychiatry, Ranchi, 29th Dec. 1988)

Alcoholism and Drug Dependence are on the increase in industry. A survey of a number of larger industries in Bombay showed that the better paid the industrial workers, the greater the chances of his resorting to alcohol and drugs, and it was discovered that 50-60% of the salaries of these industrial workers were spent on alcohol and drugs, while more than 70% of the industrial workers admitted taking alcohol or drugs at one time or the other. Statistics of this type may not necessarily give a true idea of the state of affairs, or the factors that contribute to Addiction in Industry, but there are eye-openers to the fact that industry is being undermined and inroaded by Addiction, which is responsible for Absenteeism, Physical Illness and Mental Illness, Inefficiency and Poor work output in industry.

Addiction puts a heavy toll on the industrial workers and above all on Industry. The World Health Organisation realised the heavy burden Addiction is placing of the physical and psychological functioning of individuals and has advised that efforts to combat Addiction should be instituted and campaigns against Addiction to Alcohol and Drugs should be combined, so that efforts and money may not be unnecessarily wasted, as it must be realised that those individuals who are addicted to Drugs today may be addicted to Alcohol tomorrow and vice versa. A number of surveys of Alcohol and Drug consumption among industrial workers are available and are worthy of mention.

Much of the data available with regard to use of Alcohol and Drug among industrial worker comes from North India (vide Table 1). Though the use of Alcohol and Drugs as well as Addiction is rampant in other parts of Indian especially Western India, most industries are reticent to divulge data, even if available, for fear of publication which may throw their industry in a bad light. Manoeuvres such as these only serves to increase the problem for want of the utilisation of suitable measures to prevent and root out the problem when it exists. Thus it may be interesting to note that the Employees State Insurance Scheme in Bombay though catering for more than 2 million industrial workers has no special centre for the treatment of Alcohol and Drug Addiction. It is true that these problems need measures to be instituted at the government level to control production and sale of Alcohol and Drugs as well as to mount ways and means for the prevention and cure of Addiction.

Table 1: Alcohol use among Industrial Workers
Investigator	Year	Sample	Area	Prevalence rate	Remarks
Gangarade et al.	1978	4000	Delhi	9.96	At least one a week
P.S. Gargi	1985	1605	Amritsar	54.4 12.0	In last 1 year ever used.

Our experience has been that our Government in keeping with the directive of the World Health Organisation are taking cognisance of the increasing menace of different forms of Addiction, the measures that are being instituted show that they have failed to understand the problems. Thus the production of alcoholic beverages in the country has increased more than 200 times during the last 20 years, the use of alcoholic beverages has increased out of proportion its use in industry, indicating that the nation has moved towards alcohol with a big bang. The availability of a drug like Heroin in our country has increased thirty folds in the last 15 years. The Commission appointed by the Government of India in 1978 failed to take cognisance of the fact that Heroin had become available in a big way in our country which has led to the present Heroin holocaust. Governments continue to feel impotent with regard to handling these problems and accordingly it is essential that small units will have to handle the problem of addiction with their limited resources. The industrial unit is positively posited to handle this problem and we shall now discuss suggestions in this arena.

In each industrial unit, it is essential to conduct a survey to understand the extent of the Alcohol and Drug Addiction in that particular Unit. This survey should form part of a general health survey as it does not cause suspicion, ensures the co-operation of the entire family, and helps to bring the different family members closer to the researcher carrying out the survey. The Social Worker or Health Visitor is best suited as for such a survey, which should be short and obtain data ss detailed in Table 2.

Table 2: The tell-tale signs of Addiction inIndustry are as follows: 1. Slowness in work and inefficiency, 2. Absenteeism without good cause, 3. Sleepiness and clumsiness, 4. Getting angry, irritable and cheeky easily, 5. Refusing to give in and demandingbehaviour, 6. Not attending to the requirements of thefamily, 7. Repeated physical illness with "minor"complaints, 8. Mental illness which has a direct bearingwith Addiction, 9. Poor interpersonal, inter-colleague andboss subordinate relationships, 10. Frequently coming late for work withouta good excuse 11. Moral, ethical and social deterioration, 12. Heavy unexplained debts.

Having obtained this data the next assault will be to call for particular industrial workers who from the data obtained show evidence of physical or psychological illness or any other evidence which are pointers to Alcohol or Drug Addiction as detailed earlier. They should undergo a through physical and psychological assessment, which should be supported by appropriate laboratory tests. The laboratory tests are detailed in Table 3. The psychological tests are detailed in Table 4. After these assessments, the extent of the problem of Addiction in industrial workers and the extent of damage done by alcohol or drugs would be known. The psychodynamics in some of those cases would also be clear. Industrial workers who still deny they are taking Alcohol or Drugs would have to undergo (Serum) Alcohol or Drug Estimation at the appropriate time, together with ancillary tests, which are confirmatory evidence.

Next comes the most difficult part of the programme, which is one of Motivation. The family and the industrial worker will have to be taken into confidence and explained that Addiction is a problem that can affect any individual and the idea of therapy is to assist the industrial worker to shed his problem and that nothing will be used against him and he has nothing to fear. In this manner his motivation will be assured and he will submit for treatment.

Denial may not only be at the level of the industrial worker but also at the level of the employer. Thus the survey attempted by the Directors of the large industry among industries in Britain and reported Glatt (1957) revealed that problem drinking among industrial workers was denied by Managers and Directors. The advanced alcoholic is generally totally incapacitated or is found out early and fired because of absenteeism, inefficiency, etc., but the less advanced one continues to attend work with fits and starts, and to be inefficient and serve as a burden to industry. The wastage in terms of lost man-power hours, faulty decision making, loss of efficiency and production, psychological and physical absenteeism, accidents to the self and others, loss of years of training all contribute a mammoth loss to industry. Braine, B. (1980) reported that the estimated annual loss to industry in this fashion in the U.K. was £350 million. No estimates are available in India, as the effects of Alcohol and Drug Addiction are not sufficiently appreciated, but in time this realisation would be clear. Before an alcoholic loses his job it must be realised that he continues to work well below his potential for at least 10 years. Alcoholics and drug addicts are generally covered up by their managers, their colleagues and their families for fear of them losing their jobs.

Refference: http://www.himalayahealthcare.com/pdf_files/liv188.pdf