Here are four strategies employers can use to address drug and alcohol abuse in the workplace and keep employees safe on the job.

There was a time when you could ask prospective employees to complete a drug test and, if it came back negative, assume that the potential new hire would be capable of doing his or her job in a safe and unimpaired manner. Unfortunately, it’s just not that easy anymore.

Today, individual states are enacting their own marijuana usage laws, a national opioid addiction problem is in full swing and one in 13 American adults has an alcohol use disorder, including some who drink on the job. (A 2006 study estimated that 8.9 million workers, or 7.1 percent of the workforce, had consumed alcohol in the workplace during a 12 month period.) In this environment, employers have to do more to ensure their employees are not only following substance abuse management policies, but that they’re also alert, unimpaired and operating safely.

This is particularly relevant in the industrial space, where impairment can quickly turn into an accident, injury or even death. And it's important to remember that intoxication in the workplace isn't the only cause of impairment—excessive fatigue is considered an impairment, too. For example, according to some studies, being awake for 24 hours is the equivalent to having a blood alcohol content of 0.10. Learn more about why fatigue in the workplace is a serious safety issue.

Key Areas of Concern

In a survey conducted by American Addiction Centers and published as “The Prevalence of Substance Abuse in the Workplace,” 22.5% of people admitted to using drugs or alcohol in the workplace, during work hours. More than one in five respondents said they had recreationally used marijuana in the workplace, during work hours. Nearly 5% of people admitted to using marijuana recreationally on a daily basis, and over 13% of people said they used marijuana at work more than once a month. Finally, over 10% of people admitted to using Oxycontin or Vicodin at work, without having a medical need to do so. Codeine, Adderall and Ritalin all had similar rates of use in the workplace (just over 8%).

With that in mind, here are three key areas employers should pay special attention to:

Alcohol. According to the National Safety Council (NSC) in National Survey on Drug Use and Health, one in 13 working adults have an alcohol use disorder. Additionally, 13% of men and 5% of women reported binge drinking at least once a week. Nearly one in four people over age 12 reported binge drinking in the past month. The NSC estimates that $74 billion is lost annually in reduced work productivity due to alcohol consumption, with most of those losses attributed to work absences, reduced employee output, premature retirement or death or reduced earning potential. Employees with an alcohol use disorder miss on average 34% more days than other workers and are more likely to experience a workplace injury, the NSC adds. “In addition to missing work, workers who engage in heavy or addictive drinking are more likely to be fired or laid off than other employees,” NSC points out.

Marijuana. According to the NSC, marijuana is used by about 7.8% of people 12 or older and is the most frequently used illicit drug in the United States. Among working adults, nearly 2% indicated they were dependent on marijuana. “Changing public attitudes make marijuana an issue for employers,” the group points out, noting that legalization of marijuana at the state level—be it medical or recreational—has brought on new marijuana-infused foods, drinks and gadgets, in addition to smoking. “Workers can now use marijuana in more discrete ways,” the NSC states, “which can make it difficult to tell if employees are using on the job or come into work impaired.”

Opioids and Prescription Drugs. According to the NSC, the total costs of lost productivity due to prescription drug misuse in the U.S. ranges from $25.6 billion to $53.4 billion. One study found drug misuse responsible for a 17% reduction in productivity for men and an 18% reduction in productivity for women, noting that “worker productivity can be affected by prescription drug misuse or prescription medication use disorders because of more frequent absenteeism, job turnover and presenteeism.” Presenteeism is when employees show up for work despite not being well enough to perform their job. People who have opioid use disorders miss an extra 18.5 days of work, the NSC reports, or more than three work weeks each year compared to the general workforce.

Fatigue. While it may seem like a problem that's very different than intoxication in the workplace, it's important to remember that excessive fatigue is considered an impairment, too. According to OSHA, fatigue has played a role in many infamous industrial disasters, including the Texas City BP oil refinery explosion and Three Mile Island.

4 Steps to Take Right Now

Here are four things companies can do to prevent and/or address the top impairment issues impacting their employees and operations.

1. Know the signs of dependency and impairment. According to the Canadian Centre for Occupational Health and Safety, there are some clear signs that all managers and supervisors should be aware of. They include (but aren’t limited to):

• Physical indicators: Deterioration in appearance and/or personal hygiene, unexplained bruises, sweating, complaints of headaches, frequent use of breath mints/gum or mouthwash, odor of alcohol on breath, slurred speech and an unsteady gait.
• Psychosocial impacts: Family disharmony (e.g., how the colleagues speak of family members), mood fluctuations (e.g., swinging from being extremely fatigued to ‘perkiness’ in a short period of time), inappropriate verbal or emotional response and irritability.
• Workplace performance and professional image: Calling in sick frequently, moving to a position where there is less visibility or supervision, arriving late for work, leaving early, taking extended breaks, forgetfulness, errors in judgement, deterioration in performance and excessive number of incidents/mistakes.

2. Offer assistance with treatment and recovery. When individuals with substance use disorders receive treatment and recover, absenteeism decreases by 36% and work turnover decreases by 13% compared to a person with an active substance use disorder, according to the NSC. “For employers, providing access to treatment can produce substantial savings, exceeding costs by a ratio of 12:1,” the organization points out. Employers should make screening, brief intervention and referral to treatment a part of their health plans. “A recommended practice for primary care providers, this can catch people before they develop serious alcohol use problems and help those in need of treatment,” the NSC states.
3. Establish workplace policies. To be most effective, a workplace substance abuse management policy should establish a list of procedures to follow including testing, prevention and what to do if an infraction occurs. Rules and expectations should be explained clearly.
4. Think beyond direct usage. Depending on the substance in question, the NSC points out that users may also be more likely to experience after-effects from drug use (e.g., hangovers) that may impair their abilities on the job. For workers in occupations that require driving vehicles or heavy machinery, for example, the after-effects can be a major safety concern. “For example, people using hypnotics like benzodiazepines may still experience an increased risk of traffic accidents and reduced cognitive functioning the morning after using the drug,” the NSC warns. In addition, workers who skip work due to drug use are more likely to experience workplace conflict with supervisors or peers. “Such conflict may damage morale,” it adds, “and create an uncomfortable work environment for other employees.”

Going beyond drugs and alcohol in the workplace, take fatigue seriously, too. Remember that excessive fatigue is considered an impairment, just like intoxication in the workplace. Education is an important step here, because many workers (and even managers) may not even know how serious the safety problems posed by excessive fatigue can be. Learn more about fighting fatigue in the workplace.

Impairment is a serious problem that impacts workplace safety. Using the four steps outlined in this article, employers can address the needs of their employees, be more proactive about the issues causing impairment and create a safer workplace for everyone.