This is a randomized controlled trial comparing three distinct treatments for employees with alcohol problems newly-identified on-the-job. A 3-4 week mandatory hospitalization, followed by a year of job probation, requiring regular AA attendance, sobriety at work, and weekly monitoring by a labor-management employee assistance program (EAP), will be compared to an identical regimen without the hospitalization, and to a third in which the individual decides where to undergo formal therapy, while being held to account for work attendance and job performance. About 360 workers will be allocated randomly among the three treatments. Positive and negative effects of simpler, less costly and less intrusive nonhospital approaches will be compared with the inpatient treatment. Outcome variables include job termination, work performance, absenteeism, drinking practices, and life problems and adjustments. Effects on treatment outcome of employees' personal characteristics and perceptions of their jobs and marriages will be analyzed, as will relative economic costs and benefits of the three treatments. Subjects will be followed for two years after intake. Interviewers who are independent of program staff and blind to treatment assignments will collect extensive data in a total of 13 personal interviews with each subject, a collateral and a job supervisor. The project began in February 1981. With the cooperation of the International Union of Electrical Workers (IUE), and of management at General Electric (GE) in eastern Massachusetts, 85 employees have been randomized into the study, 91% of those asked to participate. In 29 months 323 interviews have been completed; only 2% of subjects have been lost to follow-up. Arrangements have been made to expand the study to another large GE plant, in Louisville, KY, again with IUE concordance. Occupational alcoholism programs have been proliferating rapidly. Yet the roughly 5,000 such programs lack a solid base of empirical data comparing alternative strategies. The proposed project overcomes major obstacles which have blocked rigorous research in corporate settings. With strong support from management and labor in one of the nation's largest business firms, it thus represents an unusual opportunity to conduct what may be the first randomized trial in industry comparing alcoholism treatments.
| Walsh, D C; Hingson, R W; Merrigan, D M et al. (1992) The impact of a physician's warning on recovery after alcoholism treatment. JAMA 267:663-7 |
| Walsh, D C; Hingson, R W; Merrigan, D M et al. (1991) Associations between alcohol and cocaine use in a sample of problem-drinking employees. J Stud Alcohol 52:17-25 |
| Walsh, D C; Hingson, R W; Merrigan, D M et al. (1991) A randomized trial of treatment options for alcohol-abusing workers. N Engl J Med 325:775-82 |
