Referral to alcoholism programs in industry. Coercion, confrontation and choice.

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Abstract
Interviews were conducted with 180 alcoholic employees randomly sampled from 4 industrial alcoholism programs located in the New York City [USA] metropolitan area. About half of the alcoholics knew of the program before they were referred; a third of these initiated their own referrals. In the 2 companies having strongly worded policies on alcoholism and training programs for supervisors, 61 and 67% of all referrals were made by supervisors; in the company with a moderately worded policy and no supervisor training, 22%; in the one with a moderate policy and some supervisor training, 35%. Of those employees highly coerced to enter treatment, 67% showed improved work performance. Impaired job performance (reported by 29%) was the most common incident leading to treatment and was associated with the highest proportion of work improvement (89%); 20% had been found drinking on the job or were referred by the company''s medical section; 17% entered treatment because of family problems and 11% because they relized they could not stop drinking. Significantly fewer of those in treatment because of family problems felt that their job performance had been affected by drinking (36 vs 69%, P < .005). It appears that those problem drinkers who agreed with the program''s identification of their impaired job performance and who felt coerced by the referral are latter-stage alcoholics. Those identified through family problems may be in early stages of alcoholism.

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