... Chris142’s employer should use an HR service or HR manager if they aren’t already unless the owner really know what he/she’s doing. The employee needs terminated. However, alcoholism is protected by the ADA. However, that doesn’t mean you can’t be terminated. This is where using an HR service comes in. Otherwise, he is a huge liability for the business.
I'm the guy (a Specialist Occupational Physician) the HR department would send an employee to. What I asked HR to provide was a letter (copied to the employee) reporting all of the observed problems (making no attempt at diagnosis) - times late, missed days, deteriorating work performance, objectionable behavior, falls at work, odour of alcohol at work, slurred speech, etc. In many cases I helped the HR department write the letter.
Sometimes the employee would have been terminated for cause with the admonition that they (the employer) might reconsider if they (the worker) agreed to see me and complied fully with my recommendations. Suspended for cause was good too.
I would see the employee and say something like - "From the description in this letter it sounds like you might have a drinking problem. I'll ask you a few standardized questions and have you complete a standard questionnaire." Then a full medical review and the evidence from the standardized questions would often lead to a firm diagnosis.
With a diagnosis in hand I would recommend a treatment plan which included a written contract for what the employee agreed to do. The terms of the contract were non negotiable. "If you agree to do all of this, and you do all of this you are in compliance. If you don't, you aren't and that's what my report will say."
At this point it must be apparent to the employee that I'm "the meanest SOB in the valley". There will be no room for excuses, partial compliance, or anything like that. Alcoholics are used to manipulating people and I'm not going to be manipulated.
I won't tell you all of the terms of the contract but it included abstinence, participation in AA, and (where there was one) an employee assistance program. I would frequently take the employee "off work for medical reasons" at that point (if they were still employed) for a few days to get things organized but in addition because the risk of them getting fired at that point was too great.
So the results:
a family doctor making a diagnosis of alcoholism and recommending treatment - about 10% success
a workplace occupational medicine program making a diagnosis of alcoholism and recommending treatment - between 65 and 75% success*
*Success in a workplace program being defined as still employed and with no apparent workplace problems after 10 years.
And that's pretty good going.