Addressing this problem are specialists who arrange "executive interventions" for key employees. They fly into town, choreograph confrontations between addicted employees and their bosses and coworkers, and use many of the same techniques employed by families hoping to get their loved ones into treatment. Their services do not come cheap, and the process can be painful for all concerned, but both the fiscal and emotional returns on investment, they say, can be significant.

    Dr. Anderson Spickard Jr., an addiction-treatment specialist and director of the Center for Professional Health at Vanderbilt University Medical Center in Nashville, is an enthusiastic supporter of the practice. "The most powerful reason you can give a person to go for treatment is to keep their job," Spickard says. He adds that executive interventions have a much higher success rate than the more numerous interventions arranged by family or friends. He says that success, defined as the addict agreeing to seek help, occurs in about 50 percent of all interventions. The success rate for executive interventions when the boss is involved is about 75 percent.

    Bob Poznanovich, president and CEO of Addiction Intervention Resources, headquartered in St. Paul, says that this is the message he helps companies deliver: "We’re going to stand behind you while you get help. Get into recovery and stay there, and you’ll keep your job." He points out that it’s not a message that most businesspeople are equipped to deliver alone, and that in recent years the number of experts equipped to help employers has increased. While it would be an exaggeration to say that there is an executive-intervention industry, a Web search turns up at least a dozen sites of companies like AIR, plus sole practitioners who specialize in helping troubled employees face their addictions.

    Although there is no standard professional qualification for "interventionists," as they call themselves, almost all are certified drug and alcohol counselors, a title that is earned by at least a year of college-level course work and 4,000 hours of practice under the supervision of a qualified mentor. A majority, like Poznanovich, are also recovering addicts themselves.

    That experience comes in handy, Poznanovich explains, because unenlightened companies can mishandle a substance-abuse problem. He recounts how he lost his job as a vice president for sales of a Fortune 200 company 12 years ago. He was a full-blown cocaine addict. "One day, they called me in and said I was fired. They never said it was for chemical dependency. I took my severance pay and used it to stay high for the next two years." Only after losing his fiancée, house and savings did he seek help.

    To convince workforce managers and other C-level executives who contact him that AIR’s industry-average fee of $5,000 plus expenses is a relative bargain, Poznanovich outlines the potential benefits of intervention to both employer and employee. He says that keeping a drug- or alcohol-impaired manager at his desk invariably means greatly decreased work output and quality and almost certain damage to his firm’s reputation when he exhibits intoxicated behavior in public. The other significant issue is the cost of peremptorily firing and then replacing the employee, an amount that can be several times his annual salary. Company expenses can ultimately include severance pay, a possible retaliatory lawsuit under the Americans with Disabilities Act, executive-search and training fees, and the loss of the fired addict’s valuable outside contacts and intra-company relationships. His estimate of the cost-to-benefit ratio is that one dollar spent on intervention and rehabilitation results in a savings of four dollars.

    Poznanovich says that, as with most addicts, the signs of his own addiction were obvious to his employers and coworkers. Signals include alcohol on an employee’s breath, sloppy work and missed deadlines, misbehavior at company functions, and an increase in sick days, "car trouble" and "outside meetings." That’s why he and his colleagues, including Bruce Cotter, senior partner of Bruce Cotter Associates, an intervention and recovery firm near Baltimore, dismiss employers’ common fear of mistakenly confronting a clean and sober executive. "That almost never happens," Cotter says.

    Cotter founded his firm in 1990, soon after drinking himself out of a lucrative career in the broadcasting industry and eventually entering recovery. He says that sometimes problem signs are surprisingly blatant. He recalls that one of his clients, the CEO of a medium-sized corporation, flew to Las Vegas on a bender and, while drunk, signed a contract committing his company to sponsor a professional sporting event for five years. "The cost almost brought the company down," Cotter says.

    Occasionally an intervention leads to an unexpected conclusion. Ray Mitchell, director of account management service and trained interventionist for the corporate health care consulting firm Harris, Rothenberg in New York, led an intervention for an executive of a leading organization who was experienceing rapid emotional changes and displaying frightening behavior at work. The exec denied having a problem. Afterwards he was placed on a paid leave with instructions to undergo a complete physical exam. The results showed that his symptoms were caused by an undetected brain tumor.

    Most of those who conduct interventions insist that their work be authorized by a company officer who has the power to fire the abusing executive if he refuses treatment. This person, who is impervious to any retaliation from the abuser, must be in attendance at the intervention. EAP personnel, who are usually middle managers or outside vendors, don’t have the authority to fire a top-level executive and so are unsuitable for initiating these procedures, say many substance-abuse specialists.

    This is how a typical intervention works: At the request of top management, the counselor assembles a handful of the addict’s bosses and colleagues and has them write "letters" detailing their disappointments and concerns related to the substance abuse. The counselor vets the letters for nonconstructive anger or blame and then rehearses the participants, preparing them to counter their colleague’s anger or denials. She then summons the targeted employee for an unspecified "important meeting" during business hours.

    The interventionist is introduced and the real purpose of the gathering is announced. After the letters are read, the boss delivers the get-help-or-be-fired ultimatum. "It often gets very emotional," says Joyce Sundin, a sole practitioner in Seattle. "The whole thing can last anywhere from two seconds to two hours."

    When the employee agrees to treatment, she is transported or escorted to a treatment center immediately--in anything from a taxicab to a corporate jet. The substance-abuse expert arranges for treatment, which is usually covered by insurance. The company generally pays the cost of the intervention.

    Occasionally the process can be subverted. Both Cotter and Mitchell have been called in on cases where it quickly became obvious that an addicted executive’s colleagues had requested an intervention but fully anticipated that the employee would refuse treatment and that they then would be justified in firing the corporate rival. Both say that they recognized the situation and discussed it with the addict. The person in question chose rehab, returned to his job and eventually vanquished his foes.

    Counselors insist that most interventions help all concerned. And the results can have a broad impact on the workforce by sending the message that the company cares about and values the contributions of its employees. "We operate with strict confidentiality," Mitchell adds. "But it’s hard to keep the intervention process a complete secret. If it’s successful, other people know something’s happened. And if they get an inkling that it’s due to something the company has provided, it creates enormous goodwill."