Employers Cannot Fix What Workers Fear To Share

“We have no employees using drugs or alcohol.” Georges Petitjean has heard versions of that line for years, even while treating people who are quietly disappearing into detox, struggling in silence, or terrified their employer will find out. The problem isn’t that workplace addiction is rare. The problem is that stigma makes it easy to deny, hard to disclose, and expensive to ignore.

We’re joined by Georges, an NHS clinical director in drugs and alcohol treatment services, to talk about WARM At Work, the Workplace Addiction and Recovery Movement. We dig into what substance use disorder really means using a simple spectrum model, why addiction is a treatable chronic health condition, and why workplaces still react so differently to “I need diabetes care” versus “I need addiction treatment.” Along the way, we explore the social and cultural forces that shape use, from workplace drinking culture to high pressure environments, and why banning one substance doesn’t solve the underlying drivers.

We also zoom out to policy and prevention, including what people often miss about Portugal’s decriminalisation approach, the links between disability, chronic pain, and opioid risk, and emerging trends like ketamine harm among young people. Most importantly, we focus on practical workplace actions: building psychological safety, educating the wider workforce, supporting affected colleagues and families, and creating clear pathways to treatment and peer support such as AA, NA, and SMART Recovery. To learn more about WARM At Work, visit www.warmatwork.org or connect with Georges on LinkedIn.

Subscribe, share this conversation with a manager or HR leader, and leave a review so more people can find it and feel safe asking for help.

Transcript

Welcome And Introducing Georges

Neil Milliken 0:00

Hello and welcome to AXSChat. I'm delighted that we're joined today by G eorges Petitjean, who has been introduced to us by a friend of A XSChat, Kate Nash. So, George, welcome to the show. It's delightful to have you here. I know we talked a few weeks ago about your work, but please tell us about what you do for a day job and then also about warm, which is what you're here to talk to us about.

Launching WARM And Psychological Safety

Georges Petitjean 0:29

Well, thank you for having me, first of all. My so I work for a small family company called the NHS. You might have heard about it. Deborah, I don't know if you have, but it's a big organization. This is the government healthcare system. We are about 1.5 million people or something like that. So that's my regular work. I'm clinical director for drugs and alcohol treatment services for a company called Inclusion. It's part of the Midlands Partnership NHS Foundation Trust. And I've been working for many years in drugs and alcohol treatment services and general addiction treatment services. And about 10 years ago, I was working in a detox in somewhere in central London, and everybody was, it was one day a week, and everybody was self-funded. It was quite a posh place. And everyone was working in the city, everybody would be an employee, and everybody didn't want their employer to know. So they were always asking for me not to tell their employer. And it was always the first request. You cannot tell my employer. And even though I have no contact with their employers, but I realized they were so scared of losing their job and they didn't want to share with their employer. They preferred not to share. They say, oh, everybody believes I'm on holiday in Spain for two weeks, but they were there for an alcohol detox for two weeks. And I thought, because they were all asking the same thing, I suddenly thought probably in the city they might not have known actually the problem, and maybe employers were not aware of the prevalence of substance use or substance use disorders amongst employees. So I went, I asked a few of my friends if they could link me with a few HR directors in the city. And I met this HR director in a large bank. We're talking before the mental health awareness movement took place in the workplace. And I explained the whole thing, and then that HR director told me we have no employees using drugs or alcohol in our organization. And this is tens of thousands of employees. And I was a bit like you, that reaction of, is this a joke? Is he is he really? And then I thought, oh, it was probably best not to talk about it anymore. A few weeks later, I met another HR director in another bank, and she was lovely. And she said, We know we have employees using illicit substances, but if we admit that to the external world, it's a PR disaster. So thank you very much for coming, but we prefer not to do anything about it. Then the mental health awareness movement arrived around 2017, and we started to speak more and more about great things: stress, anxiety, depression. And I naturally assumed, and naively assumed, that addiction would be also spoken about regularly, and the stigma and the taboo subject would be tackled one way or another. Fortunately, over the years I realized addiction has not benefited from the same progress as mental health in general in workplaces, and I thought we probably need to have our own movement if we want to make a difference. And therefore, I started in October after many years of trying to sort something out to create that movement that I called Worm, the Workplace Addiction and Recovery Movement. It's a community interest company. It's not really for, well, the whole idea is really to create a movement to start opening conversations about substance use addiction and recovery in the workplace. Normalize those discussions, build psychological safety, we reduce the stigma, we build that psychological safety so employees feel able to share one way or another and get access to support as early as possible. And when I mean support, it might be treatment, it might be, it might be structured treatment, but it might be also peer support. Now, that's for employees with lived experience or living experience. You also have all the employees affected by other people. It might be other colleagues. So you have a lot of colleagues being impacted by other colleagues' problematic substance use. It might be a loved one. So if your child has a problematic substance use and calls you five times a day, you might not be completely productive at work as well. So it's for everyone needs to get support. You need people, so we need organizations ideally should do three things. The first thing is make sure they help people. The 8% of employees with substance use disorder, make sure you get you get them to ask for support as early as possible. The other 90-something percent, make sure that you do education, so you do the prevention work, because at some point, those employees, some of those people, because they use things, at some point some of them will develop some form of addiction. So the more you are recovery ready and the more your workplace culture allows people allows people for people to uh share and to access support, the better it is.

Debra Ruh 5:10

I mean, sorry.

Georges Petitjean 5:11

Yes.

Debra Ruh 5:12

And excuse me for already it right out of the base. I'm so sorry, is the only American here. But would you, I apologize. I missed what the acronym stood for, warm.

Georges Petitjean 5:23

It's the workplace addiction and recovery movement. So the whole idea is the movement to normalize conversations and make sure people who need access to support can get support as early as possible. Considering we have a fair bit of capacity, I think in America you have a completely different healthcare system.

Debra Ruh 5:41

We're failing on this. We we are so failing on this, George. We are so failing in the United States on mental health support. I I mean, I just I love my country. I just want to let you know. Please, we we need to learn from what you're doing.

Georges Petitjean 5:55

Yes, and I I'm reading all the I'm part of a of a university uh trust, and so I'm reading in the the librarians, they've been fantastic for years. So I'm reading everything I can possibly find on substance use, addiction, recovery in workplaces. There is very little information literature from the UK, to be honest. Most of it came from America, less now, but there is quite a lot from Canada, Australia. Uh I read everything from even from Turkey and China, everything I can find. But in America, there is definitely an overlap with disability. There are all sorts of overlap. There's good news and bad news with addiction. The bad news is that it's everywhere, it's highly prevalent. Now it's a treatable chronic health condition. That's the good news as well. It's treatable. Get people to treatment or support, and a lot of people go into recovery. So maybe I should define what we mean by addiction very quickly over the spectrum of what would it be useful for your audience to speak about?

Defining Addiction Across A Spectrum

Debra Ruh 6:52

I agree. And also after you do that, I know that Antonio has a question for you. Well, I mean, you know, just because what you're talking about is very powerful, but I do think that you should do the definition. And then maybe Antonio, you can come and ask your question. But thank you, George.

Georges Petitjean 7:06

So maybe if you can think of a spectrum, I think this is the easiest I can explain to people. You have a spectrum of use. We all use things. We all have to eat, to drink. Some people take uh multivitamin tablets, some people take uh cough syrup, some people take all sorts of things, three coffees a day, whatever. So you imagine one extra one one end of the spectrum, the start. It's not no use. We all use substances, otherwise, we would be dead anyway. And as we move towards the other ways, sometimes people develop patterns and habits, and sometimes those patterns or habits carry risks and higher risks. And then along those lines, sometimes people read substance use disorder and then addiction, that's the other end of the spectrum. People, the vast majority of people do not develop an addiction. But when people reach that level, so those 8% or 10% of the workforce, they will need, they have changes in the brain that make it very unrealistic to expect them to stop on their own easily. So we should do everything we can for those 10% to access to treat access treatment or support as early as possible, and the other 90% to say, you know what, we are your employer, we value you, we know some of you use stuff, we know some of you will develop over time some form of problematic use, or you might be impacted by a loved one. We prefer to know than not to know. If you are not prepared to tell us because you are scared, maybe in 10 years or in 20 years' time we'll have built enough psychological safety so that you'll be able to let us know because we have an internal pathway to support you. But if you don't want to tell us, those are the places where you can get access to support. Would you be an affected other or would you be someone with living experience? So when you reach the addiction, more or less what it means, I'm going to be incredibly I'm going to summarize to an extreme, but is continuing a behavior despite harmful consequences. You continue a behavior despite negative consequences, you continue drinking alcohol despite having liver damage, you continue gambling despite having lost your home from gambling. So when I spoke about substance use disorder, it's the same for what we call behavioral addictions. So, such as gambling, gaming, pornography, uh shopping, you name them. So everyone needs help, everyone needs support as early as possible. The good news is that in the UK, with the NHS and third sector providers in charity sector, there is quite a lot of support available, both in structured treatment at the moment and in terms of peer support. You might have heard about peer support groups, for example, 12-step groups like AA Alcoholic Anonymous or Narcotics Anonymous or Cocaine Anonymous or Overeaters Anonymous or whatever is needed. But you also have a non-12-phase base, you might have smart recovery groups. There are all sorts of groups available. We have here uh lived experience recovery organizations in the UK. So there is a lot of support available. Sorry, I speak way too much, it's too fast.

Antonio Vieira Santos 10:03

Okay, it's okay. So I know Antonia's got a question. In in 1998, I got into a job because the person that was in that job just completely disappeared from the organization due to drug addiction. He received the monthly paid, and it was not seen anywhere. So I went to replace that person. He left behind part of his life, he left everything at his desk, everything, and then nobody was able to see him anymore. And people around were not able to understand, and there was security concerns, and because they wanted to see what happened to him, is there anything you can do? And there's nothing people could do because he was an adult and people could not, they could just report to the authorities, and they felt, okay, trapped, even in trying to help him. I also worked for a moment period of my life in the military forces where you do addiction, you do analysis quite frequently to see if you're consuming any type of drugs. So that has been part of my work life. So, of course, what I'm curious to know from you is why is addiction still treated differently from other health conditions at work?

Georges Petitjean 11:23

Because I think the 75% of the population have negative perceptions around people living with addiction. You always have things like addiction is dirty, people with addiction are untrustworthy, it's their fault, it's a lifestyle choice. Why don't they just stop? And that's where when you see the brain, I could show you a PET scan today, I couldn't do that 40 years ago. But today I could show you a PET scan of someone, or the brain of someone who's using, who's never used cocaine, who's been using cocaine for a year, and who stopped using one year later, and you can see the massive differences. Now, of course, I think maybe the media have, maybe they've played a role as well in maybe the way we we see addiction is that, well, it's people, they just need to stop. And it's so difficult when you reach that level of addiction. The reward system of your brain has been hacked. So you end up somehow for people to want to use a substance more and more, even though they like it less and less. And it's completely illogical, but that's how it is. So there is something along those lines. And if you look in history, you look in the Middle Ages, it was always been one of the top three most stigmatized health conditions, actually. People in the Middle Ages, they would they would burn their arms with hot iron to make sure people wouldn't approach people. They would say it was something to do with the devil or something like that. And that's the sense maybe of being out of control. So we say you continue a behavior despite harmful consequences. There is a sense of compulsion, a sense of loss of control, and people experience cravings. But I think that's why people, that's why maybe this is full of myths, misconceptions, misunderstandings about what exactly is addiction. And therefore, there is a lot of judgment. Yeah, people are very judgmental, unfortunately. Now, of course, with what you say, Antonio, there are so many things. The first thing I would say with your the person you replaced is how do you how do you help someone? So you might have noticed some people you notice and some people you don't notice at all. So if your line manager, they might be noticing something, but they might be fearful of speaking about it. Likewise, the person might know, the employee might know there's a problem, but are fearful to talk about their problem, the struggle with their line manager. Some of the employees they just don't know they have a problem. So it's also our duty as a sector, how do we help those people as well? And I think that's why if you make, if you make it inclusive and visible, just like I think it happened probably with disabilities, well, make it talk about it, make it in your comms, make it everywhere so that the point, the day people realize, oh, it's all right to talk about it, they access support one way or another. That's really the the whole idea. But yes, it's incredibly astigmatized and very taboo topic in the organization. And in fact, if I was going to say, let's suppose you are, let's suppose you're my line manager, Antonio, and let's suppose I come over to you tomorrow and say, Antonio, do you know, do you mind if I let's take another chronic health condition like diabetes, for example? I say, you know, I have diabetes, my blood sugar level is completely out of control. Again, do you mind if I see I go and see my doctor tomorrow morning? And now let's just replace with another chronic health condition. Antonio, do you mind, you know, do you mind if I go and see my consultant addiction psychiatrist tomorrow morning because my cocaine addiction is completely out of control again? You will have two completely different reactions. Chances are that with diabetes or asthma or high blood pressure or any other chronic health condition, you'll be, of course, yes, no problem, take two hours and go and see your doctor. As soon as you say you are using cocaine, I use cocaine on purpose because it's illicit. But it would be without with alcohol, it would probably not be that dissimilar. But if you take cocaine, probably chances are you'll go suddenly very worried. George, you are driving the van. Does it need to go to occupational health? Does the CEO needs to be away? So rather than supporting the individual who needs support and who will do well, probably if he's if he gets the right support, it goes a completely different direction. So it goes with the whole stigma and the whole thing that we need to change absolutely, because 8% of employees' substance use disorder and seven out of those eight employees, every hundred employees are not receiving treatment. So the whole idea, so it's massive in your organization. The cost in terms of productivity, absentee, I mean, it's massive. And the risks and incidents.

Decriminalization Harm Reduction And Culture

Debra Ruh 15:53

We don't even know what the real numbers are, George. I bet because we don't talk about it, it's a secret. And I know sadly, here in my country, in the United States, it's it's pretty intense. It's it's you know, just the numbers, the severity of our young people that have, you know, severe mental health issues, it's uh it is quadrupled. But we have just tortured that we have tortured the people of the United States, and we're still torturing them. And but you're right, even though mental health is part of the conversation of disabilities, it's ridiculous how we do it because it's so ostracized. It's so ostracized, and people aren't allowed to be who they are, and we're not allowed to talk about the real issues, but it is really bad. The suicides are up, it has become such a crisis. I know, certainly, just speaking from the US perspective, we are in major crisis. I everybody understands why, if you look at our beautiful, stable country, but it it's really intense, George, and people don't want to admit it because we're ostracized. The employers don't don't want you to say it because then they have to, as you're saying, I have to sort of respond to that differently, what you just said to me, George. You know, you you're going to fix your leg or you're going to, what do you mean you're going to go? What do you write? And the words are scary. Words like bipolar are scary. So the amount, people are being hurt so bad over these things. And now, with all of I know you're going to solve all these problems, George. So I'm going to just say one more thing. I can't wait for you to solve this one. But with all of the pressure we have put on the world, right? The world is a really scary place right now. With all the war and the upset and the changes, and that of course impacts our workforce. So I'm just so thankful that you're looking at this, but I know it's a major, major crisis here in the United States.

Antonio Vieira Santos 17:45

But but Deborah, just a quick note in English, where I'm Portuguese, so Portugal has depenalized drugs. And that has made a huge difference because people start looking at it from a different angle.

Debra Ruh 17:57

I don't understand what you just said. I don't understand. I don't understand what you mean by penalize. Because we penalize people all day long for uh making these mistakes.

Neil Milliken 18:07

I think I mean criminalization. So it's it's it's so it's people are not penalized for using the substances.

Debra Ruh 18:14

Oh no, no, we do, we penalize you here in the States. So okay.

Georges Petitjean 18:18

So I think in America there are so many things already that you spoke about. I think, first of all, in terms of data, believe it or not, Deborah, you have much more data in the US than we have in the UK. So I feel like you are much more advanced, hopefully, you are much more prepared to do something about it than we are in the UK. From what I can read, I find that I can read many more articles for America with proper data. And uh, you have, for example, the sickness absence linked to marijuana or with cocaine use or methamphetamine news and so on, all that I can find in America is very difficult. We don't capture the data in the workforce enough in the UK at the moment, or in Europe in general. Now, with what Antonio said, the decriminalization. So those are two different different things. You can make it you can make you can make it legal to use, and some states in America, for example, in the US, have done that. Or if you go to uh I don't know, to Canada, in Montreal, you can buy stuff, you go to shops, and it's all legal, and you know that you have that amount in the product you buy has the right amount, it's not all government control. So you legalize, like they've done in some states in America, or you decriminalize, like Antonio said, in Portugal, what they've done really well. I think what they've done incredibly well in Portugal, in my opinion, is not just decriminalization, they also invested a lot of money in the healthcare system at a time. Because obviously, you might have someone with alcohol use disorder if you don't have liver specialists to take care of them, if you don't have cardiologists to take care of people who have who use cocaine, if you don't have urologists to take care of people using ketamine and those sorts of things, then the it's the whole healthcare system that needs to be to be taken care of there. I think it has value in that. And there are pros and cons in that in all the systems there. It depends also on the general population perceptions. For example, we have in Scotland they have injecting. You can inject, you have clean, clean equipment to inject if you want, injecting places to reduce the various harm you could get from injecting, including infections and so on. Everybody believes it's a good idea, but nobody wants to have it on their streets or their school's children's street. So it's a bit how do the general population as well, how do we warm up? And that's I think the whole idea behind warm is again a general raising awareness and general education. What do we mean by substance use? Substance use of the addiction and recovery. And the more people understand what we mean by that, the more people will say, you know what, it's a it's a health condition like another health condition. It's treatable, it works fairly well when we give treatment or support. Just make sure people get access to it.

Neil Milliken 21:03

So, Georges, to come in on that, right? So as a former addict, nicotine in this particular case, I got treatment that helped rewire my brain, that helped me stop my addiction because I wanted to stop smoking long before I did actually stop smoking. So classical case of addiction. And the you know, the the government in the UK invested in harm reduction policies by trying to treat addiction. So we know that you know the approach works, but it's really interesting because uh there wasn't the same social stigma with nicotine and tobacco that there was with even alcohol, which is not prescribed either. So there's more more of a social stigma with alcohol than there was with tobacco. And then the illicit substances like cocaine and marijuana and all of these other. Ones that you mentioned are another level of social opprobrium heaped upon the users. And yet they're all substances, they're all addictive, they all have various elements of harm. So there's a social construct around the different substances as to what's acceptable and what's not. And I also think that you talked about people working in the city. Well, there was a there was a culture that encouraged that, even though the HR departments weren't wanting to admit that. You just look at some of the movies like Wolf of Wall Street and stuff like that. There is a very strong culture that was encouraging the usage of stimulants and alcohol and all of these other substances. So there are definitely cultural pressures on employees to participate in drinking culture, party culture, etc. And yet when they do, and that 8% of the employee base, the behaviors tip over into addiction, there isn't then the support.

Practical Steps For Recovery Ready Employers

Georges Petitjean 23:05

That's so interesting. There are two two different aspects to what you just said. The first one is the it's not just about the substance, it's also the reason why people use in the first place or why they behave in a certain way. So I could ban alcohol from the Christmas party at your workplace. If people want to have a good time, they will have a tablet in their pocket that they will use in the toilet, you will know nothing about, and you will have exactly the same problem as you have with alcohol. So the whole idea is not just to ban one substance. I think we need to remember that we need to tackle, we need to prevent, and that knowing a substance is very important to be able to know how can we prevent. But it's also the reason why people do people use because they want pleasure? Do they use from peer pressure? Do they use because they want to self-medicate, from past trauma, from uh all sorts of reasons, because they want to feel nothing for a while. So if they want to feel stimulated, they will find a way to if they want to get stimulated on Friday night, they will get something to get stimulated. So for example, and then we go to the workplace culture where you said in Europe and in the West in general, in America is the same, alcohol has been around for such a long time. It's part of our history, if you want. If you go to Saudi Arabia, they don't have a lot of liver cirrhosis, but they have, I think it was 48% I could read of their nurses, a true cat, which is a very powerful stimulant. Human beings, we use things, and there's a trouble with substances, they work so well. If we want to feel a certain way, they work really well, those substances. So we need also to tackle that thing. And workplaces, I think the first step they can do is open those conversations, normalize, make it normal to talk about that. Make it that it's not that dirty or not that taboo anymore, not that stigmatized. The more to really tackle the stigma, you need to be able to talk about it. And that's something with disability, I find probably the invisible condition, the language, the stigma. There is so much overlap there with addiction that I hope that the movement that's happened with disability in the workplace, I hope will reach that level as well at some point with addiction and recovery in general. But I know there is just like you said, right? So it feels like there is a mountain in front of us. And that's why this year I want to do a pilot with 10, well, I don't know how many, but founding members, organizations who are willing, brave enough, to say, you know what, they don't even need to trumpet it externally if they don't want to say, let's speak on the shop floor, let's have ERG leads, employee networks, employee communities, leads open, they create two events and they open those conversations. Would they come from disability ERG leads? Would they come from neurodiversity? Would they come from obviously uh well-being, but it could be LGBTQ plus women only, minority ethnic ethnicities, and so on. So that would be so useful because again, they can, I'm more than happy to help. We we help them create those events if they want. And it's yeah.

Debra Ruh 26:01

So George, I know that we're about to close and this has been so interesting. I'm gonna make some assumptions, so I want you to tell me if I'm correct or not. But first of all, I will tell you that we consider mental health issues part of the disability community. Now we have taken the disability around the world and we've made we've lumped everybody in there, so it's almost a very difficult thing. The way it's handled by employers and stuff is very confusing. But when you're trying to get these groups together that you're talking about right now, which I agree, are you only speaking from the lens, which is fine, by the way, from the United Kingdom, were you actually looking for international conversations? Because I'd really like to see more brands step up to talk about these things because everybody is suffering, and of course, it's gotten so much worse since uh 2020. I know here in the United States.

Georges Petitjean 26:54

The more the better, Deborah. So if uh internationally would be amazing as well, and uh each country and even each region will have their own needs. So, for example, what you talked a little bit earlier about in in the US, you had a particular problem with you know prescribed medication. And when you see the pain, I was reading an article. The people with a physical disability are twice as likely to develop an opioid use disorder or experience an overdose. And this is fairly recent.

Debra Ruh 27:23

And they're not gonna die from that too, George. It's chronic pain.

Georges Petitjean 27:27

What do you do with chronic pain?

Debra Ruh 27:29

Well, you have chronic pain and you finally break down and you take those opioids, and then you buy a horrible death. And I have so many stories of that. But sorry.

Where To Find WARM And Closing

Georges Petitjean 27:38

And and in Canada, you have the fentanyl, so you have all sorts of really each country. We have at the moment in the UK and in Europe actually, we have quite a huge increase in ketamine amongst young people, amongst young people, ketamine youth, very cheap. You don't get read, they don't get off their face, meaning they can go to their parents two hours later and nobody will know. And by the time they reach treatment, they often have already damaged to their bladder, for example. So we need to read again about the prevention. So each country, I expect, would have different. So, yes, I'm more than happy internationally, of course. Anything at the moment, I'm in the point I yeah, I I would love to. Of course, I'm a I'm here based in London, so but I'm more than happy to help actually wherever people believe. Or they are they are trying to do something about it. They say, you know what? It's better to address the issue than ignoring it, because ignoring it costs us a fortune. We have risks involved that we know nothing about and therefore we can't manage them. When you see the cost associated is massive, and in America it's the same, you have nine days of sickness absence due to substance use, more or less. Uh, well, not just due to substance use. You have nine days of sickness absence. We have the same in the UK now. That was the Charlie Mayfield uh independent review published late last year, right? 9.4 days per employee per year of sickness absence, and nobody can tell me exactly how much in those are linked with substance use exactly. Because when I go to organizations, DHR director said, We have no one, I have 20,000 employees, but at zero because because we don't have that problem. I say it's not that you don't have the problem, it's that people are too scared to tell you.

Neil Milliken 29:15

So, George, I'd love to have you back at some point to tell us how you're getting on. Can can you tell people where they can find warm and the information about warm?

Georges Petitjean 29:28

Yes, so the the website is www.warm at work.org, warm at work, and then they can contact me on uh LinkedIn, which is the only place, the only social media I finally gave up, and I said, all right, I'm going to be on the social media. So I'm on LinkedIn and you can put DR, I think it's D R dot, and then Georgie O R G E S and Petijan, P-E-T-I-T, J E A N, like November. And uh, you can connect with me and send me a message. And if you're interested, I will uh yeah, I will reply to everyone who is interested.

Neil Milliken 30:02

Wonderful. Thank you so much. Need to thank our friends at Amazon for sponsoring us, keeping us on air, and thank everyone that listens. If you like this podcast, please subscribe. Please give us an upvote because all of the votes and all of the subscriptions help other people discover the conversations that we have with people like George.

Georges Petitjean 30:22

Thank you.