High Pressure Work and Drug Abuse — Will Wesch

Contributor: Ali Ahmed

Work and Life is a radio program hosted by Stew Friedman, director of the Wharton Work/Life Integration Project, on Sirius XM’s Channel 111, Business Radio Powered by Wharton. Every Tuesday at 7 pm EST, Stew speaks with everyday people and the world’s leading experts about creating harmony among work, home, community, and the private self (mind, body, and spirit).

On Work and Life, Stew Friedman spoke with Will Wesch, the VP of Admissions at Novus Medical Detox, who has spent nearly a decade working to improve the lives of those afflicted with addiction, and helping them to recover with dignity and humanity. Drug abuse in the tech industry is growing as is national use of prescription pain killers. Silicon Valley has the country’s second-highest rate of illicit drug dependence and abuse among 18 to 25-year-olds. Friedman and Wesch spoke about the trend, especially in the tech industry, of drug abuse associated with work pressures. Wesch urges tech employers to take a proactive approach to substance abuse.

Stew Friedman: California, home to Silicon Valley, the hub of the tech industry, has the country’s second-highest rate of illicit drug dependence and abuse among 18 to 25-year-olds. Emergency room visits for stimulant abuse in San Francisco, Marin, and San Mateo counties is more than 5x the national average. Why do you think those in the tech industry are taking prescription medications and drugs?  Is it new or are we, as a society, just more aware of and open about drug use?

Will Wesch: You can take this all the way back to college, or even high school, where kids have the pressures of school and use drugs like Adderall to stay awake for three days before an exam, for example.  As they get older and go into the work force, they know that they have these “tools” to help them stay awake and be more productive.

SF: So, the drugs are framed as a tool, as a resource, as something that compels one to a better performance?

WW: Exactly.  What happens is when you get into the tech industry is that you have a situation where there are deadlines; there’s a lot of pressure. People are working 18 hours a day. Some of them might not sleep for two days at a time just to meet those demands.  It’s a tough industry perhaps because they replace people that aren’t producing rapidly. So, you have a young kid sitting there and he has to be awake for 24 hours. It worked in college, it will work now.  What you’re seeing is a culture of becoming dependent on the drug to get through their day-to-day lives in that type of field where the pressures, timelines, and targets are very high.

SF: So, these patterns start earlier. And people are bringing them into the workplace from college where it’s “normal” to use these stimulants to help stay focused and get course work done?

WW: Correct. I have a son who graduated college and he would tell me the stories. His friends, who had to pass an exam or would fail, had these drug readily available to them.

SF: And what compelled them to use them?

WW: Seeing others using them, having to stay awake for long periods of time, and seeing that this could help them to be able to stay up and study for 24 hours if they needed to.

SF: So, they bring this into the workplace, and what are you seeing in your practice? What kinds of problems are people having as a result of their drug dependence and the increasing scope and scale of this problem?

WW: First and foremost, you’ve got the habit of methamphetamines, pain pills, or Adderall.  You have to have financial resources to do that. So, you will see depletion in that.

SF: You’ll see depletion in their funds you mean?

WW: Exactly. So, you’re also going to run into situations where people are overly tired. It’s not good for their bodies. They’re not eating correctly. I’m not a psychologist or psychiatrist, but you see forms of depression. There are a lot of different manifestations that come from using these medications to fulfill a need they have in the workplace.

SF: So how does an employer help notice and intervene in ways that are useful for the employee?

WW: There’s various ways to spot this. An employee abusing drugs is three times more likely to be late to work. They have two and a half times as many absences of 8 days or more. I think they use three times the normal level of sick benefits. They’re five times more likely to file worker compensation claims. And they’re 3.6 times more likely to be involved in accidents. These are things that an employer can look for.  In addition to that, drug testing in the workplace helps.

SF: You’re an advocate for that?

WW: I am. If you have somebody running a piece of machinery, and they’ve been up for 4 days, they’re fatigued and this person can really hurt themselves. Do test them.   But what’s equally important is that an employer has an employee assistance program (EAP), a place where employees can go to get help on a confidential basis. People are scared that they may lose their job.

SF: So tell us about that. How does an employee assistance program work at a typical company? And how do people get access to it without feeling stigmatized, as if there is something wrong with them which may be holding back from getting help?

WW: They can go through various Human Resources agencies and find different programs available in their area, and they can offer that benefit to employees. And it goes further than that. It can be therapy. It can just be counseling. It can be other personal problems.. But substance abuse is one of those factors where a program like that could actually have an employee reach out on a confidential basis and get help that they might not otherwise receive.

SF: So, confidentiality is key? Are there other things that an employer can do, assuming there is an EAP (Employee Assistance Program) in place in your organization? Is there anything a supervisor or co-worker can do to encourage someone whom they think is having a problem to help them to take advantage of that support?

WW:  You can always promote different resources and benefits that the company has. One of the way situations you have here, Stew, is that it gets a little bit tricky. Different states have different regulations. You have federal regulations with respect to police. My best advice for any employer is to talk with a local attorney, have them review your substance abuse policies, and then act accordingly. They will help set that program up so that it’s safe for everyone.

SF: Safe for everyone did you say? So, getting legal counsel to make sure you are proceeding within the local ordinances, and state and federal regulations is critical. But is more that can be done to encourage people to reach out? Todd is calling from Philadelphia. Todd welcome to Work and Life. What’s your question?

Todd: I had a question about Adderall. I had a problem focusing, prioritizing, being motivated, and getting things done. I’ve been self-employed for about 20 years now. I had depression. A doctor recently put me on Adderall and Zoloft. I was wondering what does that do to your body? And are there other ways of correcting those types of problems?

WW: If you’re working with a medical professional, you definitely want to go with your doctor’s advice. That being said, you also want to take a look at how the drug is affecting you. There’s a few ways of looking at this. From a medical standpoint, he probably is correct in getting you to focus, etc. From a long-term position, is taking Adderall the rest of your life a solution? In typical cases, it’s not. So, there’s got to be something else that needs to be done.

SF: Something that is more behavioral, and less chemical?

WW: It could be, absolutely. We run into it in our facility quite a bit. We will have people go to a nutritionist and have their blood drawn, and just make sure their hormones are balanced. There are people who just have trouble sleeping. They only get 3 hours of sleep a night. Well why is that? The body is supposed to produce gaba that is supposed to help you rest and go to sleep. And we find, in a fair amount of cases, that something is imbalanced.

SF: So, the key is to get data, right, to get information? To do assessments with people who know how to look for effects of different kinds of drugs on your body, and also to diagnose whether there might be some other cause?

WW: Correct. So what you want to do in a lot of cases is rule out the physical aspects of it. Mental health problems do exist. You also want to make sure you are covering the mental aspect and the physical aspect. I’ve just seen it too many times where somebody comes in, they are not doing well one way or another, having anxiety attacks and things like that. They get physicals, their hormones are out of balance, or it could be allergies, it could be a number of things. You want to attack it from both ends. That would be my advice.

SF: Todd, thanks for calling and I hope that advice is helpful. We got John calling from San Diego. John, thank you for calling Work and Life. How can we help you?

John: I heard you talking about anonymity and confidentiality, and the importance that that plays in the workplace. But I tend to think that is actually creating more of a problem. I tend to think that there is obviously a stigma with people who deal with an addiction whether they’re in the workplace or just in normal life. And I feel like anonymous approach is almost fostering a shame in which not just the addict themselves, or the person dealing with the drug issues themselves, have to deal with, but also the families of these addicts. That creates a kind of shame that really keeps people in the workplace from being upfront with what they’re dealing with. If we’re going to call it a disease, let’s treat it like a disease. I don’t understand why workplaces have punishments in place for failing a drug test. The American Medical Association looks at it as a disease. I don’t understand why the workplace doesn’t do that.

SF: So, people are afraid to ask for her help. That’s a great point, John. Will, what do you have to say about that?

WW:  Federal HIPAA laws protect the privacy of the individual. I’ll give you a perfect example. You have a CEO who is an alcoholic and he has a hundred employees.  He might not want his employees to know because he’s the guy running the company and providing the money for their salaries and everything else. Having places where the person can go on a confidential basis and get help is a good thing in that sense. Now I understand your sense as well. You look at it and say addiction is a disease. I’ve heard both sides.  But an individual isn’t going to want others to know that he has this problem. He may be looked upon really well and he’s got a lot of responsibility. So, I think the HIPAA laws laid out by the federal government are correct in a lot of ways. They’re not going to get anything 100% correct. Is it a 100% right? I don’t think anything is a 100% right.

SF:  The question I think that John is raising is how can we remove the punitive elements of disease, as it is experienced by people.  How can we make it more likely, therefore, that both employees and employers are going to be encouraging people who are suffering to seek help, right?

WW: I think in a lot of cases you’re right. But as we touched on earlier, Stew, and John, is that in some cases it’s just not a reality. We go back to running machinery where you can cut your arms off. An employer has to intervene. They have to. So, how about a school bus driver driving your kids around? So, there’s got to be scenarios where you’ve got to step in, and the employers have to say this is a drug-free workplace. But on the same point, if you’re going say that, it’s best for the employer to have an option for the employees to go somewhere and talk confidentially to somebody, and get help.

SF: So, John, quick reply?

John: I don’t really understand when you say that there are two sides to the disease aspect of addiction. I haven’t heard the other side of that.

SF: Good question, John. So, Will what did you mean ‘both sides?’ Disease versus what? Versus intentionally self-destructive behavior?

WW: You definitely have the disease portion of it. But let’s take a scenario where you have a lawyer who gets a back surgery and is given 60mg of pain pills, Oxycodone, to help with this pain.  This guy goes out and functions. He’s a good lawyer. He takes care of his family. He doesn’t abuse his script. He wants off of it, but he’s having trouble coming off of it. So, he reaches out to a facility, like Novus, and says, “Can you help me taper off of this?” So, we bring that person in. You have to realize there’s two things. There’s addiction and there’s dependency, and those are two separate categories. That’s all I was talking about. One individual has to get up every morning and take them to get high. Whereas, when you have a dependency, an individual is hooked on the drug. He’s not stealing. He’s not doing things that an addict would do. You know spending a lot of money, not taking care of his wife or kids. He just needs to come off 40 or 60 milligrams of Oxycodone. Do I say that guy has a disease? I don’t think the guy has a disease. I think he has a dependency to the drug. And he has to come off. That’s all I’m saying.

SF: So, it helps direct the treatment when you think of it in those terms.

WW: It’s a debatable point. I’m just saying there are people that say just what I said and there are people that say it’s a disease. I think both are valid.

SF: I want to thank you John for calling and raising those questions. I want to move on to another question, which is how do you approach detox? Why is personalized detox program more successful than cold turkey? Explain to us how you go about that.

WW:  In a lot of cases, depending on the individual, if they just quit taking the drug and their body could go into shock and they could go into very hard withdrawal, and then there is a likelihood that they’re going to pop another pill to help them. Now that’s going to be a very high percentage of it. In most cases, the individual has got to be tapered down, stepped down slowly for a couple of reasons. One is, what if the person has a bad heart valve and they quit taking the drug? It can spring a heart attack just like that. What if they are running on high or low blood pressure and they don’t know it.

SF: So, you really have to look at the whole picture, the whole person, and personalize it?

WW: You have to look at it from a medical standpoint. To quit drinking, if you’re an alcoholic and you’ve been drinking for many years, or quit taking drugs without medical supervision, is very dangerous. You can get seizures, strokes, and stuff like that.

SF:  If you hve a loved one who is experiencing this kind of addiction, Will, what’s your best advice?

WW: Well, I think that consulting the individual and just having a talk with them, seeing if they’re willing to acces help, and then help them find that support. There’s plenty of help out there, and it’s individualized help. What’s going to be right for one person isn’t necessarily going to be right for another person. So, you want to get on a phone with an expert. They may need a medical detox, they may not. Have an expert walk you through the different scenarios of what the options are and pick what’s right for them. Now, if that loved one is being defiant, doesn’t want to be in treatment, then hire a professional, like an interventionist, to come in and help the parents out, or whoever it may be, to get that person help. The wrong thing to do would be to do nothing about it.

SF:  I am so glad you’re concluding on that. That’s such an important idea.

WW: My last point is that you have no idea what will happen to that kid, that adult, in the next couple of days. One more shot of heroin, overdosing on pills, and there is nothing worse than saying, “I should have done something.”

To learn more about Will Wesch’s work go to www.novusdetox.xom.

About the Author

Ali Ahmed is an undergraduate senior majoring in Biological Basis of Behavior and minoring in Cinema Studies