There is a wide range of people who are, in principle at least, in a position to assist with drug and alcohol problems when it becomes apparent that there are concerns that need to be addressed. For many people, the GP is the first port of call. This is often because problems relating to drugs and alcohol lead to a range of health problems – some minor, some major – that bring the person concerned to the attention of his or her GP. Some GPs will work extensively with people with drug or alcohol problems but, in many cases, it is likely that a referral to a specialist source of help will be made if the problems are regarded as sufficiently serious to warrant this. In addition, there are psychiatrists, psychologists, nursing staff, social workers and others who specialise in matters relating to drug and alcohol abuse. There are also various voluntary and private, profit-making organisations which provide assessment, treatment and support services (details of some of these can be found in the Resources section). Problems relating to drug and alcohol misuse exist along a continuum from fairly mild, at one extreme, to extremely serious at the other. It is therefore important not to assume that all problems will benefit from the services available – some may be too minor to warrant professional attention. If in doubt, however, you should make enquiries rather than make what could turn out to be unfounded assumptions. The various services are normally located outside of the workplace but, within the work base setting, the two usual ports of call are either the Occupational Health Unit (or equivalent) or the Employee Assistance Programme (EAP) if one exists in your organisation. One of the major problems in relation to drug and alcohol problems in the workplace is that they often go unrecognised as such. That is, they tend to emerge in other guises – for example, disciplinary or performance problems. An important ability therefore is that of recognising when drugs and/or alcohol are an issue and therefore when to involve specialist services in this area. We should be very wary of the danger of oversimplifying these matters and assuming that these problems are the sign of a weak individual who needs to pull him- or herself together (parallel with the long-standing problems of dismissing stress as a sign of a weak individual rather than recognising the complexities involved – see the section on Tackling Stress). It is normally not that simple, as it is generally the case that there are complex problems that lead to a reliance on drugs and alcohol, and the inappropriate use of such drugs can then create a vicious circle which leads to the original problems being exacerbated rather than helped. It is therefore important to draw on specialist help whenever this is needed, rather than try and fudge the issue or avoid it altogether, as these ill-conceived efforts to resolve the difficulties can actually make them worse in many cases.
Dr Neil Thompson 
Neil’s website and blog are at www.neilthompson.info
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