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Most lines of work involve some form of stress, but there are some jobs that drive individuals to desperation. Grueling hours, unhealthy working conditions, and deep unhappiness with the work can bend mental and physical wellbeing. Addiction in the workplace comes in many forms and with many causes, and it presents significant public health challenges, both in terms of office and industry economics and human life itself.
Research has identified the kind of jobs that are most likely to cause the greatest amounts of mental health stress on workers and are therefore most likely to compel suffering workers to try and ease their pain and stress with addictive substances. A study published in the journal of Neurology found that employees who have demanding jobs that offer little control tend to experience the most frustration and unhappiness in the workplace, compared with people who work in demanding professions but have a greater degree of autonomy over their responsibilities and time.
The scientists who conducted the study noted that people who work in the service industry are good examples of this. The work is often physically taxing, with bartenders and waiters having to be on their feet for hours while dealing with impatient and rude customers (who can get abusive and hostile if alcohol is served) and abusive management. Workers in the service industry make little more than minimum wage and rarely receive meaningful thanks and appreciation for what they do. Consequently, say the scientists, service industry employees experience the greatest damage to their health.
Such is the extent of the problem facing the service industry that the journal of Addiction mentioned that hotel and restaurant employees are often suspected of having higher rates of alcohol abuse than those working in other professions. There is data to back up those suspicions: An estimated 19 percent of restaurant workers use some kind of drug to keep themselves going through long and painful shifts or to fit in with the culture of substance abuse in their respective workplaces. This, says the Washington Post, is what makes the service industry one of the jobs most likely to drive its employees to drink. Another factor is that employees in the service industry have easy access to alcohol; the average restaurant makes as much as 30 percent of its sales from alcohol (and in high-profile places like Las Vegas, that can be as much as 75 percent). In such intense and bustling environments, workers are often pushed to their physical and mental limits while still expecting to be functionally invisible to customers and maintain a decorum of the utmost professionalism even in the face of unreasonable and drunk guests.
Unsurprisingly, there is often a strong (and overpowering) drinking culture at such establishments, with many workers using alcohol to make themselves feel better at the end of a bad shift or to prop themselves up to keep going. The Boston Globe notes that a large number of service industry employees force themselves to take on additional shifts and work overtime to supplement their minimum wage income, meaning that they spend more time in their restaurants and hotels than they do in their homes. This has the effect of creating an atmosphere of such tension and stress that getting drunk (and working while under the influence of alcohol or some other drug) is a universally accepted (and even encouraged) method of coping. In other words, “working in the restaurant industry can be hard on your mental health.”
Since restaurants and hotels do not report rates of substance abuse among its employees, the true scale of addiction in the service industry is not known and might never be fully known. However, notable people who have worked in kitchens and behind bars offer some insight. Jason Sheehan, the international award-winning chef and food editor for Philadelphia magazine, whose memoir Life, Sex, Love and Death in the Kitchen was one of TIMEmagazine’s 10 best nonfiction books of the year, believes that the true figure of addiction in the service industry is closer to 100 percent.
In an interview with the Daily Beast, Sheehan attributed the crowded, stifling, and hectic nature of commercial kitchens to the inhuman amounts of stress the frontline workers of the service industry have to deal with on a daily basis. Customer service is always fraught with tension and pacifying restaurant patrons who demand complicated meals, with the risk of food allergies and health standards lingering over everything, means that no restaurant kitchen is ever calm. Yelling is a normal form of communication.
The researchers who published their study in the Neurology journal noted that “high-stress jobs lead to more unhealthy behaviors,” which include a lack of exercise, poor eating habits, and substance abuse. One of the most determining factors is whether a person feels in control and respected in their job. A restaurant professional points out that “many customers don’t believe waiters to be professionals, and therefore don’t merit their respect,” even though servers and bartenders are expected to be friendly, polite, skilled, and receptive to all sorts of customers – from those who are equally polite to those who “glare at me with hate.” This, she says, is “why servers don’t get any respect.”
Doctors, teachers, scientists, and other professionals have similarly demanding jobs, but according to the Telegraph, they have a large degree of empowerment in their respective fields and do not suffer the same levels of stress and unhappiness that those in the service industry do. Wait staff and bartenders are often subject to the capricious demands of customers and management, robbing them of any autonomy they have over their workdays.
Substance abuse may be rampant in the kitchens of the service industry, but it is not only the frontline staff who are involved. The creativity that inspires celebrity chefs to come up with signature dishes also raises the likelihood of drug and alcohol use. Jason Sheehan noted that these kinds of professionals are attracted to the chaos of restaurant kitchens, finding the environments invigorating and stimulating. It is a mark of pride for them to work on just a few hours of sleep, fueled by a diet of stimulant drugs (anything from cocaine to Adderall) in their quest to concoct award-winning culinary masterpieces, not so much for fame and fortune but for the incessant need to create, experiment, and explore.
For this reason, a food writer at the Huffington Post wonders if “the heat of the kitchen” draws addiction-prone culinary auteurs, like a moth to a flame. In the words of a neuroscientist at the Johns Hopkins School of Medicine, “There is a link between addiction and things that are a prerequisite for creativity.” In the same way that some artists are infamous for their substance abuse inspiring their line of work, the same applies to chefs; according to Sheehan, “chefs are wired for drug use from the start.” To be on the cutting edge of culinary culture, chefs have to be willing to expose themselves to any combination of ingredients; that same mindset translates to many chefs developing a habit, and then a culture, of drug use in the professional kitchen.
The service industry has become a breeding ground for addiction in the workplace because of the conditions and nature of the environment, but other professions have similar problems. In the frantic white-collar startup culture, suicide rates are disturbingly high, with high-profile cases of workers as young as 22 years old taking their own lives because of the unrelenting stress and expectations. When a 29-year-old investment banker took his own life, his father told the press that his son’s line of work “did not leave much time for enjoyment,” and that the stress his son was experiencing led to the use of illegal drugs.
Mint Press News referred to this as an “epidemic of suicide by Wall Street executives,” which speaks to some of the biggest problems in that kind of workplace. Wall Street bankers typically work over 100 hours a week, rarely seeing their friends and family. “Their lives essentially belong to their employer,” said Kevin Roose, an author who followed eight Wall Street bankers in the aftermath of the 2007 financial crisis. Talking to PBS, Roose recounted something he was told by a banker: The long hours were only part of the problem; the other part was that there was no control over those hours. Thanks to smartphones and cloud technology, workers in the finance sector are expected to be on call, ready to drop everything and come into the office on weekends and holidays. The banker Roose spoke to said it was a “miserable way to spend your 20s.
In an effort to be more sensitive to the mental strain of the job, some banks and corporations have instituted “protected weekend” policies. In 2016, for example, JPMorgan told its employees that they will not have to come into the workplace on weekends if there are no imminent deals to be made. Other banks have established a fixed number of days off employees must take every month, and others have placed restrictions on the number of hours young and junior staff members can work. The measures are intended to restore “life” to the work-life balance, in the words of Business Insider, one of the most “notorious” of the problems facing Wall Street.
However, the very business model of the financial industry means that long hours (consisting of banal downtime and bursts of intense activity) are the nature of the job despite attempts to create a healthier work environment. Client demands are often unpredictable, leaving bankers with no complete say in when their work responsibilities end.
The lack of control over the infamously long hours – a typical day can start at 9 a.m. and end at 2 a.m. – engenders little good will toward the people who work in the financial industry. The jobs may pay upwards of $100,000, but thanks to the recession and a number of high-profile scandals and crimes, “Americans’ respect for the banking industry is seriously low,” says Forbes magazine. Polls showed that the general public bitterly resents the bailouts that banks and other financial corporations received from the government, extending that scorn to the individuals who work in the finance industry. A 2011 GlobeScan survey found that 55 percent of Americans have “little or no respect for the banking sector,” a dramatic rise from just six years prior, when only 25 percent felt the same way. In the United Kingdom, as much as 63 percent of the British population had no esteem for the banking sector.
All of these factors combined leads to a dangerous culture of substance abuse in the financial workplace. A black market has emerged that serves young, desperate white-collar employees. The New York Times writes of a woman whose dealer delivered stimulant pills that allowed her to work from 11 p.m. to 7 a.m. and make it to her desk by 9 a.m.
The pills were Adderall, a medication prescribed for patients with attention deficit hyperactivity disorder. Adderall’s properties of increasing focus and mental acuity have made it popular among college campuses as a “study drug,” which students use to work through the night without succumbing to fatigue. This has made Adderall (and similar drugs like Vyvanse and Concerta) popular with working professionals who fear that abstaining will allow other ambitious up-and-comers to replace them.
Since Adderall is a legal drug, it has replaced cocaine as the stimulant of choice for bankers and other people working in high-intensity professions (although cocaine use is still present). Researching his book, Kevin Roose was surprised that people in their 20s were taking Adderall, not for recreational purposes, but “so that they can stay up longer and work more.” While Adderall and cocaine are different drugs, they have some similar effects. Both cause a brief burst of euphoria, which, to a stressed and unhappy employee working into the early morning hours, can seem very tempting. Adderall consumption over a prolonged period of time will cause sleep disruptions, as well as heart problems and increased blood pressure, none of which bode well for exhausted and frustrated workers.
Adding to the problem is a significant drinking culture in the financial sector. Employees are expected to go out for drinks with their bosses and clients after work; deals are usually sealed (and celebrated) over alcohol, and the mantra of working hard and partying harder is very much alive in the banking workplace. But the easy access to alcohol means that many employees drink to cope with the despair they feel about their line of work, which only compounds both the frustration toward their job and their unhealthy drinking habits.
These are signs of “a really unhealthy industry,” according to Kevin Roose. eFinancialCareers quoted another author as saying that “there’s an epidemic of cocaine and alcohol use among 30-something bankers,” to the point where addiction in this business has become normalized, accepted, and even (tacitly and unofficially) encouraged. As employees’ incomes increase and the drugs become more affordable, self-medicating to deal with the stress becomes part of the job.
A psychologist agreed, noting that “a lot of the work culture in banking revolving around drinking or drug taking,” especially as a worker rises higher up the ranks; those in management positions are under constant pressure to produce results, with the threat of being replaced (or fired in disgrace for underperforming) always looming.
The “up or out” mindset contributes a great amount to the stress levels of financial professionals who are almost obsessively driven to devote more and more of their time and energy to their jobs to the detriment of their mental health and families. The psychologist noted that “after working 100-hour weeks during their 20s,” investment bankers and other employees in this sector struggle to have interests outside the office. Their entire sense of self-worth is derived from what they do professionally, “and failure to progress at work equates to an existential crisis.” The failure to secure a bonus or promotion can feel like a personal rejection, to the point where the employee feels severely depressed.
Bankers who are older, and who may already have families of their own, similarly struggle with finding the right work-life balance. There is a deep fear of letting people down, whether those people are in the office or at home. The idea of abusing Adderall to work 12-hour days and still having the energy for family and social commitments seems almost natural.
The problem is not limited to those on the lower and middle rungs of the corporate ladder. The CEO of Jackson Healthcare said that the strain of making executive decisions takes a mental health toll of its own, admitting to being one of the “60 percent of all CEOs [who] are on depression medicine.” Other research and events have suggested that the upper levels of big management are a breeding ground for the psychological stressors that lead to addiction, primarily depression. William & Mary College found that chief executives are more likely to become depressed, at twice the rate of the general public, as well as to have unhealthy levels of fear, anger, and narcissism. Philip Burguieres, one of the youngest CEOs to ever run a Fortune 500 company, worked himself to the point of a depression that was so severe, he resigned over fear of what the backlash would do to his career. Before his death, he became a professional counselor to other CEOs, saying that mental health problems like the ones he suffered were “chronic and widespread in the executive office.”
The drive that powers chefs and artists to explore and experiment (both professionally and recreationally), is not dissimilar to the drive that fuels executivesand business leaders to work beyond their limitations, trying to outdo the competition or prove something to their detractors (or their underlying mental health issues). Such relentless ambition makes them millionaires but creates the same conditions that increase the risk of addiction. It becomes, in the words of the New York Post, the “CEO’s secret.”
At that level, the addiction becomes yet another challenge to overcome, not a medical problem to treat; the substance abuse and the need to succeed feed into each other, creating a state known as “high-functioning” addiction. People who would meet this criteria appear to be successful – high-profile job, big family, always on the go – but hide a severe psychological dependency on alcohol (or another drug of choice). For this kind of disorder, substance abuse is the only way to balance professional commitments, family obligations, and the stress that arises from trying to walk two tightropes at the same time. “Alcohol and pharmaceuticals relieve the stress and take the edge off an overworked person in a volatile and pressure-packed workplace,” writes a doctor on Fox News Opinion. For someone who is functionally alcoholic, the chemical indulgence may be seen as a reward for all the hard work or simply another chance to prove excellence.
The higher up in the workplace the addiction takes place, the less likely juniors and underlings are to do something about it. Sarah Benton, a mental health counselor and author on high-functioning alcoholism (and herself a recovering high-functioning alcoholic) told The New York Times that “employees who suspect a problem often cover up for their bosses.” She cites the example of surgeons who operate with trembling hands because of how drunk or high they are, who are allowed to continue practicing medicine because of their seniority.
In truth, however, drug and alcohol abuse creates the same kind of problems, regardless of context. In the case of a CEO, the normal signs of addiction may not present themselves, or they may be easily disregarded. It is only when something catastrophic happens – a drunk driving charge, separation (and/or divorce) by a frustrated spouse, an accusation of sexual harassment, or some public and sensational fall from grace – that the true cost of high-functioning alcoholism reveals itself.
Because of the scope of the addiction problem, a number of corporations have instituted Employee Assistance Programs (EAPs), which allow affected workers to privately and freely reach out for help if they feel stressed or unhappy with their job. The government Office of Personnel Management explains that EAPs cover temporary counseling, referrals to mental healthcare professionals, and on-the-job follow-up services to ensure that employees who have suffered from mental or behavioral issues as a result of their workload can work in improved and healthier conditions. EAP counselors also liaise with management to identify when an employee is showing signs of addiction or overwork, and guide supervisors and upper management on how to direct and coach a struggling employee while still maintaining morale and office functioning.
It is important that in high-pressure workspaces, employees and managers should be straightforward about the reality of substance abuse in their respective professions as well as the mental health risks of the long hours and frantic schedules. This is especially necessary for younger and junior employees who may be more pressured and driven to work hard and drink harder for the sake of appearances and to make a (perceived) positive impression. Through educational outreach and interventions, Employee Assistance Programs make it clear that it is perfectly acceptable for younger workers to ask for help, which can be one of the biggest barriers when dealing with addiction in this kind of workplace.
Commercial kitchens and investment banks aren’t the only workplaces that struggle with issues of addiction, a reality that speaks to the changing nature of the American workforce. Research out of Columbia University has found that more Americans are working well into their 60s “out of financial necessity,” usually in manual labor jobs like mining, construction, and farming. Such blue-collar workers are significantly more likely to work past the age of 65 than those in white-collar industries, and they are therefore more likely to suffer from conditions like arthritis, which reduces their work productivity and is exacerbated by the physical nature of their jobs. The Columbia University study (which was published in the American Journal of Public Health) also found that the factors typically combine to reduce the quality of life and wellbeing for these workers.
The first author of the study noted that despite blue-collar workers (who have arthritis) being “in much worse health than all other workers,” they keep fighting to stay in their respective workforces, frequently because they cannot afford to retire. The farming sector, for example, generally does not offer pension plans to its workers.
To cope with the injuries and the economic and social depression, more and more employees in blue-collar industries are turning to prescription painkillers; the drugs are notoriously effective for not only numbing pain, but also for their strongly addictive properties. This has led to an explosion of painkiller abuse in rural and suburban communities across the country, creating the biggest public health crisis in modern American history.
West Virginia, for example, is traditionally home to a higher-than-usual number of manual labor jobs, such as coal mining and manufacturing; however, due to mechanization and automation, there are above-average rates of joblessness. Not coincidentally, West Virginia also has one of the highest rates of opioid-based medication prescription in the country. An entire workforce nursing injuries stemming from decades of hard labor, desperately clinging on to what few jobs remain, work through pain and age with an abundant supply of painkilling and highly addictive medication.
Coal mining has always been big business in West Virginia, and this lined up with drug manufacturers encouraging doctors to prescribe more opioids to older workers. An author and professor at West Virginia Temple University explained to Business Insider that the few doctors who work at mining camps usually “opt for the quick fix,” which entails a hasty prescription for painkillers and then returning the injured employees back to the mines. The fear of job loss is so great that workers are loathe to take time off. An addiction specialist at West Virginia University Hospital said that the industries that dominated the job market in his state (farming, timbering, and coal mining) often produced injuries, and there were always pills to make the pain go away. In a matter of a few years, West Virginia became one of the most addicted states in the country.
West Virginia also has one of the lowest household income rates in the United States, and with many workers unable to afford insurance plans that would cover their painkiller prescriptions, their physical and psychological dependence has led to a black market boom in heroin. Heroin is cheaper and more easily accessible than medications like OxyContin and Vicodin, and in regions of economic depression and manual industries, addiction rates are staggering. Huntington, known for its strategic location on the Ohio River, is home to the busiest inland port in the country, making use of the abundant coal, oil, chemicals, and steel, and it was one of the most important cities in the expansion of regional railway in the late 19th century. It is also “the town at the center of America’s opioid epidemic,” where, in August 2016, police logged 27 heroin overdoses in only four hours. The Washington Post notes that so many West Virginia residents are succumbing to their overdoses that “the state cannot keep up with the funerals.” As an older generation of Americans sees its jobs and way of life replaced by machines and outsourced labor, “it is easy for people to turn to substance use to manage despair,” says STAT News, which points out that 25 percent of Huntington’s residents are addicted to opioids.
CNBC writes of a “vicious feedback loop” regarding drug abuse and blue-collar work. In industries that require the use of heavy machinery, injuries are commonplace, and after chronic pain, surgeries, and prescriptions, employees are rushed back to work (voluntarily or otherwise), where the pain is exacerbated. Prescription drugs and heroin are routinely abused so the job remains viable.
The problem is not limited to West Virginia. The state of Ohio ranked 11th in the country for the number of blue-collar jobs, and it is similarly struggling with an addiction epidemic. The city of Portsmouth was once known for its production of steel, shoes, and bricks, but, in the shadow of empty factories, it is known by some as “the pill mill of America.” Drug smuggling rings set up fake clinics that sell stolen and redirected pain medication, attracting “customers” who cannot afford legitimate prescriptions or who are simply desperate for more pills. This has also brought heroin dealers into places like Portsmouth, where there is “no work around here,” according to a resident who spoke to The Guardian. A medical anthropologist at Ohio State Universitypointed at “the broader economic context” of her state’s drug addiction problem, explaining that the digital age ushered out the manufacturing and blue-collar jobs that gave many Ohio residents a sense of purpose and meaning in their lives. When the jobs went, they were left with “poverty, limited opportunities and hopelessness.” For many, the emphasis on going to work at factories and steel mills right out of college (or even high school) robbed them of the chance to learn coping skills or have other resources available. With minimal job and academic prospects, “drugs are cheap and plentiful.”
The director of Ohio’s Athens County’s Department of Job and Family Services attributed the increase in opioid abuse to the decline of the traditional Ohio workplace: manufacturing and blue-collar jobs. Company mining towns once covered the southeastern part of the state, but when the coal industry decreased its production in the 1970s, the industries left the state. The residents stayed, pushing themselves to work harder and longer through the chronic pain from their on-site injuries, so they wouldn’t lose what few jobs remained.
Drug addiction can manifest in any kind of workplace – from the cabs of long-distance truckers who use methamphetamine and cocaine to stay awake, to the corrections facilities that breed such tension that the officers who work there drink to numb the stress of keeping dangerous criminals in line. Substance abuse costs millions of dollars in lost productivity and damages, and exacts an even greater toll on human life and wellbeing. Because every industry is different, there is not a one-size-fits-all-solution; but incremental steps, like Employee Assistance Programs, 12-Step groups, and more general education about mental health risks and help can bring lifesaving gains in the effort to combat addiction in the workplace.