Study data published in JAMA Network Open outline the association between alcohol use disorder (AUD) and workplace absenteeism. In a nationally representative sample of full-time employees in the US, mean days of missed work were significantly higher in those with AUD. Increasing AUD severity was correlated with greater absenteeism. These results highlight the importance of AUD diagnosis and treatment programs, which could be implemented by employers.

This cross-sectional study used data from the 2015-2019 waves of the National Survey on Drug Use and Health, which captures past-year alcohol use behavior and employment status from a nationally representative sample of noninstitutionalized adults in the US. Mild, moderate, and severe AUD diagnoses were generated based on answers to the alcohol behavior questions. The primary outcome was workplace absenteeism among individuals with full-time employment. Absenteeism was operationalized as the number of missed workdays in the past month. Descriptive statistics, prevalence ratios, and logistic regression models were used to assess the relationship between AUD and absenteeism.

The study sample comprised 110,701 adults with full-time employment, among whom 58,948 (53.2%) were men and 51,753 (46.8%) were women. The distribution by race/ethnicity was as follows: 11.5% Black; 16.3% Hispanic; and 62.8% White.

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Weighted prevalence of AUD was 9.3% (95% CI, 9.0-9.5%), with 6.2%, 1.9%, and 1.2% of respondents meeting the criteria for mild, moderate, and severe AUD, respectively. Respondents with AUD were most often men (60.8%), between the ages of 30 and 49 years (45.6%), and White (63.8%).

The mean number of missed workdays increased in a stepwise fashion with increasing AUD severity. Respondents without AUD reported missing 0.84 (95% CI, 0.82-0.86) workdays per month due to illness or injury, compared with 1.67 (95% CI, 1.38-1.96) days per month among respondents with severe AUD.

Total annual absences were estimated at 13.0 (95% CI, 12.7-13.2) workdays for no AUD, 17.7 (16.4-19.1) workdays for mild AUD, 23.6 (21.5-25.7) workdays for moderate AUD, and 32.3 (27.5-37.0) workdays for severe AUD. In adjusted regression models, the odds of missing work due to illness or injury were substantially elevated with AUD.

Compared with respondents without AUD, participants with mild AUD were 15% more likely to miss 3 or more workdays in the past month due to illness or injury (odds ratio [OR], 1.15; 95% CI, 1.04-1.28). For participants with severe AUD, the likelihood was 71% higher (OR, 1.71; 95% CI, 1.41-2.07).

Results from this study underline the effects of AUD on the US workforce, with nearly 10% of the study sample meeting the criteria for AUD. Study limitations include the lack of granularity on absenteeism data — absence due to nonillness reasons, such as caring for a family member, were not included in analyses. Furthermore, the effects of AUD beyond absenteeism were not explored.

“The workplace can often be the first point of prevention and intervention for individuals with AUD,” the investigators wrote. “The large fraction of work absenteeism associated with AUD in this study… provides a strong rationale for increasing investment in strategies to prevent and treat AUD.”

Disclosure: One study author reported holding a patent covering the use of certain single nucleotide variants in determining the diagnosis, prognosis, and treatment of addiction.


Parsley IC, Dale AM, Fisher SL, et al. Association between workplace absenteeism and alcohol use disorder from the National Survey on Drug Use and Health, 2015-2019. JAMA Netw Open. 2022;5(3):e222954. doi:10.1001/jamanetworkopen.2022.2954