Dealing with alcohol problems in the workplace

The employee assistance program (EAP) is the principal vehicle for intervention in the workplace directed at employees with alcohol problems. As broad-gauged programs, EAPs represent "mainstreaming" of alcohol-problem concerns into health care management. However, alcohol problems are defined broadly within EAPs, going beyond other definitions of alcohol dependence. The historical context is important for understanding EAPs and their dynamics. External environmental changes have impacted EAPs considerably over the past decade. Particularly important have been the increased prominence of employee drug abuse, managed care, and increasing prevalence of dual diagnoses. Results of research about EAPs conducted over the past decade are reviewed. The persistent issue of EAP efficacy is considered, highlighting the variable structure of EAPs and the multiplicity of motives for their voluntary adoption. Prospects for continuing research are considered in light of problems in research funding, the ambiguous identity of EAPs, and the practical orientations of those who might facilitate such research.