An aftercare intervention programme for employees returning from substance use rehabilitation in South Africa

• Date: 11 November 2024
• Pages: 554-571
• DOI: https://doi.org/10.1108/IJWHM-05-2023-0064
• Published date: 11 November 2024
• Subject Matter: Health & social care,Healthcare management,HR & organizational behaviour,Human resource policy,Employee welfare
• Author: Eldene Braaf,Nicolette Roman

An aftercare intervention programme

for employees returning from

substance use rehabilitation

in South Africa

Eldene Braaf

Centre for Interdisciplinary Studies of Children, Families and Society,

University of the Western Cape, Cape Town, South Africa and

Sol Plaatje University, Kimberley, South Africa, and

Nicolette Roman

Centre for Interdisciplinary Studies of Children, Families and Society,

University of the Western Cape, Cape Town, South Africa

Abstract

Purpose –Employee assistance programmes (EAPs) and wellness practitioners (WPs) are the first line of

support for employees returning from substance use rehabilitation. However, many workplaces need more

guidance and support provisions to address these needs effectively. The purpose of this paper is to present a 10-

week aftercare intervention programme that EAPs and WPs can use to support employees returning to work after

a period of substance use rehabilitation.

Design/methodology/approach –The qualitative methodological approach involved two distinct stages of data

collection and consensus search activities. Stage 1 involved three data collection activities with three

stakeholder groups, and Stage 2 consisted of two consensus-seeking engagements with the intended audience of

the intervention programme.

Findings –Participants in the consensus-seeking activities endorsed the inclusion of content in the proposed

intervention programme and structural and organisational arrangements. Specific recommendations were made,

namely, increased reliance on faith-based and spiritual support, the need to include community support

structures and ensuring that workplace interventions include counselling, skills training and motivational

speakers.

Practical implications –Those working in the EAP environment are offered a systematic and holistic plan for

managing and supporting employees recovering from substance abuse disorders (SUDs) to maintain their

recovery and return to productive work.

Originality/value –Implementing the intervention programmes can reduce the ad hoc nature of current

approaches to workplace aftercare. The WPs are placed in a central role while stressing the valuable input of

other key role players within the workplace or part of the family and community networks of the employee.

Keywords Aftercare intervention, Substance use, Rehabilitation, SUDs,

Employee assistance programmes (EAPs), Wellness practitioners (WPs)

Paper type Research paper

Introduction

The global prevalence and impact of SUDs have been steadily increasing, with significant

implications for public health, social welfare, and economic development, as evidenced by

IJWHM

17,5/6

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© Eldene Braaf and Nicolette Roman. Published by Emerald Publishing Limited. This article is published

under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute,

translate and create derivative works of this article (for both commercial and non-commercial purposes),

subject to full attribution to the original publication and authors. The full terms of this licence maybe seen

at http://creativecommons.org/licences/by/4.0/legalcode

Ethical approval: Ethical approval was received from the Faculty of Community and Health Sciences

at the University of the Western Cape (Ref No: 130416-047).

This Ph.D. study has been supported by funding from the National Research Foundation (No: 115460).

The current issue and full text archive of this journal is available on Emerald Insight at:

https://www.emerald.com/insight/1753-8351.htm

Received 14 September 2023

Revised 14 March 2024

24 May 2024

9 July 2024

29 August 2024

Accepted 17 October 2024

InternationalJournal of Workplace

HealthManagement

Vol.17 No. 5/6, 2024

pp.554-571

EmeraldPublishing Limited

1753-8351

DOI10.1108/IJWHM-05-2023-0064

numerous studies and reports from international organisations such as the World Health

Organisation and the United Nations Office on Drugs and Crime (UNODC, 2016). SUDs, as

defined by the Diagnostic and Statistical Manual of Mental Disorders, 2013 (DSM-5), are

characterised by impaired control over substance use, social impairment, risky use, and

pharmacological criteria. They encompass a wide range of psychoactive substances,

including, but not limited to alcohol, cannabis, opioids, stimulants, hallucinogens,

sedatives, hypnotics, and anxiolytics. According to the World Health Organisation (2024)

Global Statistics Report on Alcohol and Health and the Treatment of SUDs, approximately

5.3% of the global population aged 15 and older is affected by SUDS, with illicit drug use

disorders impacting around 0.9% of this demographic. Alcohol use disorders (AUD) are

prevalent among 3.2% of the global population, with a notable disparity between genders—

5.1% in men compared to 1.3% in women. The report further indicates that SUDs contribute to

approximately 450,000 deaths annually, with opioids responsible for about 70% of drug-

related fatalities. In addition, alcohol consumption is associated with over 3 million deaths

each year, accounting for 5.3% of all global mortality. Despite the significant health burden

posed by SUDs and AUDs, treatment coverage remains inadequate, with only 14% of

individuals with drug use disorders and 7.1% of those with alcohol use disorders receiving any

form of treatment, underscoring critical gaps in access to care. In South Africa, alcohol

remains the main substance of abuse, accounting for approximately 59% of substance use

cases (SACENDU, 2018;SANCA, 2018).

The workplace is not spared the negative consequences of SUDs and is considered an

important site where issues associated with the treatment and remedying of substance use must

be addressed. The workplace provides a convenient and accessible place for receiving

aftercare support. Aftercare in the context of substance use refers to the range of follow-up

services and support provided to individuals after they have completed in-patient treatment to

maintain their recovery and prevent relapse (National Institute on Drug Abuse, 2020). In the

workplace context, aftercare support fosters a sense of community and social support between

colleagues. It also offers a structured environment, making it easier for individuals to integrate

their recovery efforts into their daily routine. Workplace support programmes like EAPs are

valuable resources but, however, often fall short in addressing the complex needs of employees

with substance use disorders. Further investigation is required to enhance these programmes,

ensure comprehensive and individualized care and promote a supportive workplace

environment. Despite the importance of aftercare services, there is a lack of effective

measures being taken in workplaces to address substance use issues (Greco and Sanchez,

2018;Smook et al., 2014). Legal obligations placed on employers concerning managing

responses to substance use in the workplace are multifaceted and can vary significantly

depending on industry regulations (McCann, 2011). Employers are typically required to

maintain a safe and healthy work environment for all employees, which includes addressing

substance use issues effectively (ILO, 1981). Aftercare is an essential component of substance

use rehabilitation, providing continued support to individuals in recovery. Research indicates

that comprehensive aftercare significantly enhances the effectiveness of primary treatment

interventions by addressing ongoing challenges and reducing the risk of relapse (NIDA, 2020;

Jason et al., 2013). Integrating aftercare services into the workplace promotes holistic recovery

by addressing both personal and professional aspects of people’s lives, ultimately fostering

long-term success in sobriety (Pidd and Roche, 2014).

In South Africa, employee wellness programmes, also EAPs, are commonly used to

address substance use recovery in the workplace (Burnhams and Parry, 2015). However, no

legislative guidelines offer specific recommendations on the management of SUDs or

aftercare support in the workplace. EAP practitioners need to be equipped with a clearly

formulated and deliverable intervention programme to support employees recovering from

SUDs. This paper presents such a programme and reports on the underlying research and

consensus-seeking processes undertaken to validate its relevance and credibility. The

programme theory underpinning the intervention is the ecological systems theory model,

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