Our vision of addiction prevention in a professional context

On the subject of addiction, as on all the issues on which we intervene, our approach leads us to consider any complex situation in its relational and systemic dimensions.

At first, the consumption of products (alcohol, drugs) or addictive behavior (internet, sexuality, work) can be perceived as an attempt to solve a particular problem, then they become an attempt to solve all the problems of the person , until the moment they become his main problem (see the work on drug addiction by Dr. Jacques Barsony). And the situations that present addiction-related problems are particularly complex, including in the workplace.

Addiction is one of the topics that generate the most resistance to behavior change:

• it confronts the person affected with the negative effects of their addiction which they would like to be able to get rid of and with the effects of pleasure (especially at the beginning) and temporary relief that it gives them. A fight between will and sensation, which the will very rarely wins.
• it also confronts the entourage of the affected person with disarray and the powerlessness to make him change his behavior. The entourage is often neutralized by the addictive behavior of a loved one, trapped by the ambivalence of the help they wish to provide: helping them free themselves from any addiction vs helping them relieve them of a suffering that the addiction helps him to bear.

The notion of aid is a central issue and deserves to be discussed. For example: do we help a colleague when we compensate for his lack of activity so as not to cause him any problems (and in doing so by being complicit in his addiction) or do we help him by creating the conditions where he must directly assume the effects of his addiction on his work?

For any organization concerned by addictive behavior, positioning itself on this subject is above all a matter of management . It is up to the institution itself to appropriate the subject and to implement solutions that suit it and for which it can respond.

It is not a question of placing the subject under a moral framework - should addictive behavior be tolerated or not in an organization? - , but under the framework of the work activity : is the work done correctly (by the individual affected by the addiction, by the work group to which he belongs)? if not, are we able to control and sanction adequately, as we would for a person or a work group, not affected by addiction?

This is why it seems strategic to us that, for any addiction prevention approach, management and managers can be mobilized upstream:

• The management of an institution that wishes to act against addictive behaviors impacting the quality of work must adopt a thoughtful and concerted position that it can claim when it decides to speak out on the subject:
  • what specific and damaging problems directly related to the work activity she encounters, has she had to assume in spite of herself in the past, and which she no longer wishes to assume in the future?
  • is it in a position to enforce the law (or its own rules of procedure) and what means does it acquire to enforce it? with what tolerance thresholds?
  • what forms of sanction is it ready to implement? what consequences is she ready to accept?

These questions rarely have clear and simple answers, which is why they must be discussed and make it possible to adopt a concerted position that can be relayed.

• Managers by the problem themselves. But it is as managers that they must be mobilized to be fully-fledged prevention actors.

These elements seem to us to be decisive in order to be authoritative in speaking out on the subject of addiction and to prevent a simple information conference from showing on the one hand a desire to act (at the time) and on the other , his powerlessness to act (after the fact).

How to act?

As a preventive measure (primary and secondary level)

The starting point of any preventive approach to addiction is to pay attention to the consequences of addiction on work and the work collective , in its interactional dimension and to consider the intervention system involving 3 levels strategic:

• Management, prevention representatives and any person involved in the application of a regulatory framework (HRD, elected official concerning health, occupational physician, etc.). What goals do we want to achieve? what means do we have? what types of sanctions are we ready to implement?
• Managers (in the form of a workshop) - What attitudes are adopted when faced with an employee or colleague in difficulty with an addiction problem (state of intoxication or use of narcotics at work in particular)? what alternative resources when you have tried everything with a collaborator under the influence of an addiction?
• Employees (in the form of information meetings or conferences), on a voluntary basis

Following this approach on the 3 levels, an oral restitution is made to the sponsors.

 As a curative (tertiary level)

Consultations or individual support can be set up for those employees who encounter relational difficulties specifically linked to their addictions. They do not replace medical work if it is necessary, but it complements it to help the employee restore trust with his professional environment and reinforce his return to work or his aspirations for change.

Some facts about addiction (content excerpt)

Addiction records:

- of a product: drugs, tobacco, alcohol, medicines… (classification of Lewin – 1924: euphoriants / exciting / intoxicating / sedatives / hallucinogens)

- of a practice: game, purchase, sex, Internet…

- More recently, the possibility of an addiction to almost everything has been mentioned: work (workaholism), sport (bingomania), etc.

Social cost:

• 5 million people in difficulty with alcohol in France
• Approximately 150,000 active or substituted heroin addicts
• Around 200,000 problem cannabis users

The individual cost of alcohol : too much is how much?

WHO thresholds (one drink = 10 g pure alcohol)