MHM Magazine

SUDs impose direct costs such as higher healthcare claims, more sick leave, property damage or theft, as well as indirect costs pertaining to lower team output, lower morale, increased supervisory burden. Looking at the work ‘team’ perspective, one member’s under-performance often creates ripple effects: others needing to cover tasks, workflow slows down, tensions can rise which directly impacts the team’s overall functioning and morale. Screening Cues for GPs Related to Work/Occupational Consider adding these work‐ related triggers to your clinical screening of suspected SUD: Repeated complaints (by employer or patient) of “I’m always sick”, “I can’t seem to function”, unexplained or vague medical leave. Frequent lateness, “hangover” presentations, injuries or bruising attributed to accidents or “falling asleep”. Reports of poor concentration, memory lapses, missing dead- lines, increased mistakes at work. Sudden deterioration in career performance or reputation (e.g., demotion, warnings, suspension). Use of medications, self-medi- cating or presenting with “work stress” but signs of withdrawal, missing appointments, inconsis- tent engagement. Financial strains related to work (lost bonuses, job loss), or dis- closures of using work as justifi- cation for increased medication/ medical leave. In your notes, linking occupational performance changes (and finan- cial stress) to possible substance use may assist in holistic care and referral pathways. Practical Responses for GPs to keep on hand Ask about employment status, recent job performance changes, absenteeism/presenteeism (not just home/family impact). Use screening tools and also ask questions such as : “Have you missed more shifts/work days lately? Has your company spoken to you about your performance? Are you using medical leave for issues you can’t explain?” If occupational impairment is present, consider referral to occupational health, employee assistance programmes (EAPs), or workplace‐based intervention. Address financial stress and refer for counselling for the family sys- tem: occupational instability often compounds family strain, relation- ship disruption, children’s stress. Evaluate for partner/family burn- out and colleague/team pressures in home context, as the patient’s occupational dysfunction often feeds relational/child outcomes described earlier. Clinical Recommendations for GPs Integrate routine screening for substance use and caregiver stress in consultations. Assess workplace and home functioning when recurrent absen- teeism or vague illnesses present. Provide psychoeducation to fam- ilies on addiction as a disease of the system, not just the individual. Refer to multidisciplinary sup- port —Registered Counsellors, So- cial Workers, or EAP programmes. Encourage self-care and bound- ary-setting among partners or caregivers to prevent burnout. References available on request. MHM | 2025 | Volume 12 | Issue 5 | The impact of substance abuse on families, relationships, and children MHM Is ue 5 | 2025 | MENTAL HEALTH MATTERS | 31 MHM