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Q. My employee was unable to stick with a treatment program for alcoholism. Unfortunately, the employee’s job was lost due to the relapse. Why do some employees recover while others do not? I can’t help but think the relapse was somehow partly my fault.

Heroin use has increased in the suburbs, with women and those with higher incomes. The use of heroin has doubled among those 18-25 years old. There is a heroin epidemic in the St. Louis region due to being in close proximity to Chicago, decreased cost and increased availability in the powder form. Heroin addiction can be difficult to stop. Addiction can start gradually for some, or for others it can be immediate.

The Centers for Disease Control and Prevention has classified prescription drug abuse as an epidemic. While there has been a marked decrease in the use of some illegal drugs like cocaine, data from the National Survey on Drug Use and Health show that nearly one-third of people aged 12 and over who used drugs for the first time began by using a prescription drug non-medically.

The workplace is not immune to drug abuse. In fact, most substance abusers are employed. In a survey of callers to the national cocaine hotline, 18 percent confessed to stealing from coworkers to support their addiction, and 64 percent admitted that their drug use negatively affected their performance.

Q. One of our reputable employees was hospitalized and later shared his story of addiction to heroin. I was floored. The employee never showed any symptoms and didn’t look anything like a street person. There was an absenteeism problem, but I never dreamed it was drugs. Is this rare?