Setting the scene: In the last 15 years since I’ve been working with workplaces to resolve alcohol-related issues, I’ve seen a huge shift in attitudes and responses. Just a decade ago, any talk of alcohol in the workplace was more likely to focus on who’d be getting the first round in rather than the impact of alcohol on employee wellbeing. And where there was interest in tackling alcohol problems, it was purely from a safety and compliance perspective. While 90% of employers claim that alcohol is a problem for their organisation,1 they have been slow to tackle alcohol consumption as a wellbeing issue.
Since the pandemic, however, employers are starting to see the merits of focusing wellbeing strategies on how to have a healthier relationship with alcohol. After all, excessive drinking results in over 17 million sick days taken in the UK each year,2 and is linked to lowered productivity and increased presenteeism, costing the UK economy over £7.3 billion annually.3
When employees started working from home during lockdown, alcohol entered the workplace in an unprecedented and alarming way. With no daily commute, alcohol stepped in to provide a means of transitioning from the work day to home life. The lack of commute also meant no concerns about driving under the influence or getting an early night before a long drive. Given that the psychoactive properties of alcohol provide a euphoric boost to the brain within just five minutes of consumption, home drinking provided a quick fix for an increasingly anxious population. The internet was bombarded with memes joking about the effectiveness of alcohol as a coping strategy for home schooling, being stuck in the house with your partner 24/7, or living alone.
Unsurprisingly, 2020 saw an increase in off-trade alcohol sales of 25%4 and the number of heavy drinkers increased by a third.5
Why is alcohol a workplace wellbeing issue?
Let’s start with why alcohol is a wellbeing issue for everyone. Firstly, alcohol directly caused over 9,500 deaths in the UK in 2021,6 not including the average of 270 drink drive deaths. It is the largest risk factor for death, ill health and disability among working age adults.3 We also know that social isolation, job insecurity, and stress are all triggers for increased drinking.7
Targeting wellbeing initiatives at more mindful drinking and reassessing the workplace alcohol culture are likely to reap great benefits for employers and employees alike.1 Adults in employment are more likely to drink, drink heavily, and more frequently than the economically inactive; and those in professional occupations drink to a greater extent than manual workers.8 What’s more, there are strong links between alcohol consumption and poor mental health, including addictions, anxiety, and mood disorders.9 This is a bi-directional relationship, with alcohol used as a coping mechanism in response to negative feelings, and consumption increasing feelings of anxiety and low mood.10
A Norwich Union survey found that over 200,000 people turn up at work each day with a hangover and 15% of employees admit to being drunk on the job. According to the Institute of Alcohol Studies, 3.5% of employees report having to work extra hours to cover for the alcohol-related absence of colleagues2 and significant numbers blame job-related stress as the reason for drinking.
Over the last couple of years, I’ve worked with industry leaders in several sectors who have been quick to identify the personal and professional costs of excessive drinking on their workforce. Alcohol has the potential to impact any and every workplace. No-one is immune. These days, I’m less likely to be quizzed on how best to implement an alcohol policy that details sanctions for breaches, and more likely to be asked how wellbeing champions can steer their charges toward healthier drinking habits, and how to recognise when someone needs help. There is also a growing demand for Alcohol Change UK’s workplace webinars, and training for managers is at an all-time high.
Who is drinking and why?
It’s a shift in perspective from employers that is to be welcomed given that the alcohol harm reduction field warns that there will be repercussions from lockdown drinking for many years to come. This is not surprising, considering the research, which shows that stressors such as disasters, interpersonal conflict and economic downturns all lead to increased alcohol consumption and the development of alcohol problems.11
Traditionally, certain industries and occupations have been associated with heightened risks of alcohol dependence, including: hospitality and entertainment, healthcare, manufacturing, construction, law enforcement, and the military. Working environments are also linked to increased risk – long hours, exposure to trauma, low autonomy and high stress, permissive workplace cultures, to name but a few – all of which, coincidentally, are correlated with increased risk of deteriorating mental health.
Since the pandemic, however, alcohol treatment services have identified a significant shift in their client base. By the end of 2020, services were already seeing an increase in the number of clients presenting for support in controlling their drinking, but then came a shift in client demographics with more young people, executives, and in particular, more women, seeking help.
Women have traditionally been difficult to engage in alcohol recovery. They often experience many additional barriers including increased stigma, caring responsibilities, and abusive relationships. The British Medical Association1 found that female high earners were particularly susceptible to developing alcohol problems and this is echoed by the rise in ‘quit lit’ – autobiographical accounts from high-flying women about their struggles with alcohol, while trying to meet impossibly high standards of excelling, both at work and at home.
Women also face increased risks from their drinking. Alcohol consumption is a leading cause of breast cancer in women, it can worsen menopause symptoms, and can harm both the mother and the foetus during pregnancy. So, it’s important that any initiatives that support employees are sensitive to the needs of women in the workplace.
The story of Claire (not her real name), a successful bank executive and an Alcohol Change UK Community Champion, highlights the issue of ‘grey area drinking’ and how organisations can help. The ‘grey area’ lies between social drinking and addiction. It’s ambiguous and amorphous, and can disguise itself as a good time. But it is also a high-wire act that leaves the drinker feeling permanently tired, anxious and in need of another drink to ‘feel better’. Claire recognised the signs and sought help from her employers, who she thought would be supportive. They were. Not only did they help Claire to get back on track, but later, when she had given up alcohol completely, Claire approached her manager about an idea to offer support to colleagues. She was given time and funds to develop a sober support group that has helped many colleagues and inspired other UK businesses. She’s even spoken at Whitehall, campaigning for changes to the laws around alcohol dependence in the workplace.
Next in this issue
How do we change the workplace culture?
Our society is alcohol-centric – it’s everywhere from TV soaps, to billboards, to greeting cards. Drinking is often the default position and the standard quick fix. Had a bad day? Have a drink, you’ll feel better. Something to celebrate? Let’s drink to that! So, shifting something that is so integral to our culture is going to take time. But change is coming. And here are my seven top tips for changing the drinking culture within the workplace:
1 Conduct a cultural audit: Take stock of the current culture and consider your workplace from the perspective of a non-drinker by asking the following questions. Is it a safe environment for someone in recovery? How is alcohol talked about within the organisation? What is the response to drunken anecdotes? How do employees socialise? Is there so-called sober shaming (making someone feel uncomfortable for not drinking) if someone chooses not to drink? The idea is not to ban alcohol but to ensure there is sufficient choice so that those who do and those who don’t drink all feel included
2 Ask the staff: One of the most telling questions in the workplace is: Do you have any concerns about a colleague’s drinking?’ You may be surprised at the answer. Staff surveys give the employer an opportunity to raise the issue of alcohol and find out what’s working and what’s not. Do staff feel confident disclosing any difficulties, and do they know what help is on offer?
3 Create a policy or update your existing policy: Your policy is your first line of defence. It is your ethos and road map (but it’s number three on my list of tips, because the first two points need to be addressed in order to develop an effective policy). A good policy will protect both staff and employees. It will set the boundaries for behaviour and outline the offer of support. It needs to apply to everyone all of the time and its contents need to be communicated to all who are affected by it. You can access help creating or updating your alcohol policy via Alcohol Change UK
4 Train your managers: Your managers will be the organisation’s vanguard and if they’re used to managing staff, they’ll already have the skills to implement your policy in a firm and empathic way. Training will give them the confidence to tackle alcohol problems proactively. It’s not just about responding to health and safety risks – training will enable managers to identify opportunities to recognise potential issues and signpost staff to appropriate help
5 Educate your staff: Alcohol is everywhere. We’re surrounded by it and think we know all about it, but it can be hard to separate the myths from the facts. During our training sessions and webinars, I am often asked about the efficacy of placing a coin under your tongue to beat a breathalyser, or informed that red wine is really good for you (spoiler alert: no and no). Offering education sessions will allow staff to discuss the impact of alcohol on work performance and health. This can help employees to understand the importance of low-risk drinking and the negative impact of excessive consumption
6 Put alcohol on the wellbeing agenda:
Mental health, menopause, obesity, accidents, relationships – alcohol is relevant to all of these issues so it’s worth planning in regular alcohol awareness events that tie-in to your other key wellbeing topics. Alcohol Change UK offers free resources for Alcohol Awareness Week, Dry January, and Sober Spring; all supported by our brilliant free app, Try Dry
7 Be inclusive: It’s important that leaders set an example and lead from the front. Make sure you have comparable drinks provision at work events for those who don’t drink and avoid giving alcohol as a prize or reward. Call out any sober shaming and stay accountable. It’s important to normalise choice and not scrutinise anyone’s decision to drink or to decline.
What is the role of counselling and psychological support services?
Workplace counselling can help clients to recognise without shame or blame that they might be using unhelpful coping strategies because of work or other issues. It can help the client to explore the causes and alternatives, as well as help them to set goals and offer signposting to alcohol support groups. Depending upon the circumstances, it may be necessary to contract with the client about the need to attend the sessions sober.
As a therapist, you will probably already have experience of clients disclosing alcohol use as a coping strategy for difficult emotions or challenging circumstances. At this point it can be helpful to use a validated screening tool, such as AUDIT*, to assess your client’s level of drinking and the impact it’s having on them. For clients with a low AUDIT score, a brief intervention can be effective in helping them get back on track. For those whose score indicates potential dependence, your work may involve preparing the client to access further help. You can find a summary of recovery options and methodologies on the Alcohol Change UK website (www.alcoholchange.org.uk).
I suggest the use of the AUDIT for clients who don’t disclose drinking as a coping strategy too. It’s worth highlighting that NICE guidance12 recommends regularly screening all adults of drinking age, with the aim of offering brief advice to those drinking at above low-risk levels. This evidence-based intervention is an effective way of raising the topic of alcohol and supporting clients to consider whether they may be starting to rely on drinking to soothe, calm, tune out, or sleep. Encouraging mindfulness practices can be enormously helpful for clients who are struggling to control their drinking.
Research funded by Alcohol Change UK shows that families can be severely impacted by a loved one’s drinking, and how the recovery journey of a dependent drinker can markedly improve the lives of their families, for as long as their recovery is sustained.13
Statistics from the charity, Adfam, suggest that one in three adults in the UK is affected by a loved one’s drinking.14 Their research shows that this can severely impact their wellbeing – emotionally, physically, socially and financially. Family members are often reluctant to access help for themselves, focusing on changing the drinker. But evidence shows that improved coping skills and awareness of their own needs improve outcomes both for them and their loved one.
In some cases, therapeutic support may be mandated by the employer in response to an alcohol-related incident. It may be necessary to consider your contract with the client and the employer to ensure that the employer is able to monitor the employee’s progress; while the therapist maintains client confidentiality, working safely and ethically. If you identify that workplace practices may be contributing to excessive consumption, such as a boozy culture or an expectation of staff participation in alcohol-heavy events, it’s important to explore this in your clinical supervision and discuss how you feedback your concerns to the employer.
If reading this article, you have found yourself reflecting on your own drinking practices, you’re not alone – around 10 million UK adults regularly drink at above the recommended low-risk drinking guidelines.15 We are all vulnerable.
Therefore, it’s hard to overstate the importance of tackling workplace alcohol culture. Personal and professional consequences, from employee ill health through to legal liabilities, can all be improved if we create a culture of responsible drinking, and provide support and resources to employees who may be struggling with their drinking. As home working remains the norm for many of us and the after-effects of the pandemic continue to be acknowledged, now is an opportune moment to weave alcohol awareness and harm reduction into the corporate wellbeing agenda. Therapists have a key role to play both in responding to client drinking and diverting the trajectory of employees who may be unaware of the potential impact of the nations’ favourite coping mechanism.
Remember, changing a workplace culture takes time and effort, but by implementing these tips and being aware of the role of alcohol in your clients’ lives and your own, we can all make progress towards a healthier and more productive work environment.
1 British Medical Association. Alcohol, drugs and the workplace – the role of medical professionals. 2nd edition, July 2016. [Online.] www.bma.org.uk/media/1067/bma_alcohol-and-drugs-in-the-workplace-_oct_2019.pdf (accessed 26 May 2023).
2 Institute of Alcohol Studies. Factsheet. Alcohol in the workplace. [Online.] www.ias.org.uk/uploads/pdf/Factsheets/FS%20alcohol%20in%20workplace%20112017.pdf (accessed 24 May 2023).
3 Public Health England. The public health burden of alcohol and the effectiveness and cost-effectiveness of alcohol control policies. London: PHE; 2016. [Online.] www.assets.
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4 Public Health England. Impact of COVID-19 pandemic on grocery shopping behaviours. London: PHE; 2020. [Online.] www.assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/932350/Grocery_Purchasing_Report.pdf. (accessed 30 May 2023).
5 Institute of Alcohol Studies. Alcohol consumption during the COVID-19 pandemic in the UK. 2nd briefing. London: Institute of Alcohol Studies; 2020. [Online.] www.ias.org.uk/wpcontent/uploads/2020/10/sb29102020.pdf. (accessed 29 May 2023).
6 Office for National Statistics. Alcohol-specific deaths in the UK: registered in 2021. ONS; 2022. [Online.] www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/alcoholspecificdeathsintheuk/2021registrations#factors-behind-the-rise-in-alcohol-specific-deaths (accessed 30 May 2023).
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13 Alcohol Change UK. Understanding recovery from a family perspective: a survey of life in recovery for families. 2018. [Online.] www.alcoholchange.org.uk/publication/understanding-recovery-from-a-family-perspective-a-survey-of-life-in-recovery-for-families (accessed 26 May 2023).
14 Adfam. Overlooked. 2021. [Online.] www.adfam.org.uk/files/Overlooked.pdf. (accessed 25 May 2023).
15 Office for Health Improvement and Disparities. Alcohol: applying All Our Health. Gov.UK; 2022. [Online.] https:/www.gov.uk/government/publications/alcohol-applying-all-our-health/alcohol-applying-all-our-health (accessed 23 June 2023).