Employers Guide to Substance Misuse in the Workplace

Substance misuse is a significant issue in society. According to the UK Government alcohol and drug misuse and treatment statistics:

• The overall prevalence of drug use reported in the UK has remained relatively stable throughout the last decade. However, the most recent surveys covering England, Wales and Scotland reported the highest prevalence in the past ten years.
• The most commonly used drugs have not changed over time. Cannabis is the most prevalent, followed by powder cocaine, MDMA, ketamine and amphetamine.
• There were 270,705 adults in contact with drug and alcohol services between April 2019 and March 2020. This is similar to the previous year (268,251).
• Further information on alcohol statistics can be found on the NHS Digital website.

Substance misuse in the workplace can put employees’ health and safety at risk. According to a report by the British Medical Association, the use of alcohol or illicit drugs can impair a person’s performance at work, through poor decision-making and impaired reaction times, causing lost productivity, inferior goods/services, errors and accidents.

The CIPD 2020 report in managing drug and alcohol misuse at work highlighted that:

• Just over a third of employers have disciplined someone in the past two years for alcohol misuse and just over a quarter for drug misuse.
• Around a fifth of employers have dismissed someone in the last two years where a significant reason was drug and/or alcohol misuse.

The above shows that substance misuse is a significant issue that all employers should effectively manage within their businesses. Human resources (HR) and line managers play a key role in drug and alcohol management in the workplace. Therefore, they will need to understand their role and responsibilities and what they can do to support employees with a substance problem.

This article will cover what substance misuse is, the effects it can have and some of the signs. It will also look at what employers, HR and managers can do to control and manage the risk.

What is substance misuse?

Substance misuse (or abuse) can severely impact a person’s physical and mental health, social situation and responsibilities.

It is defined by the World Health Organisation (WHO) as:

“The use of a substance for a purpose not consistent with legal or medical guidelines, as in the non-medical use of prescription medications. The term is preferred by some to abuse in the belief that it is less judgmental”.

It includes the:

• Use of illicit drugs.
• Misuse of prescription drugs, over-the-counter drugs and solvents.
• Misuse of alcohol.

An example of substance misuse is someone regularly drinking alcohol over the recommended units, which can be harmful to their health.

If an individual frequently misuses substances, it can lead to dependence. It is important not to confuse the two as they are different. Being dependent on alcohol and drugs is an addiction, which is where a person cannot quit.

They may also have unpleasant withdrawal symptoms if they try to stop. There are different levels of dependence, and excessive quantities do not have to be consumed. It does not matter whether drugs are illegal or legal, as people can still become dependent on them.

Substance use does not necessarily mean it will lead to misuse or dependency; for example, correctly using prescription medication or having a glass of wine at dinner. These substances may still cause some side effects, but if a person is consuming them within legal and medical guidelines, they are not misusing or dependent.

It is vital that employers, HR and managers know the difference between substance use, misuse and dependence (addiction). All forms of substance use can introduce health and safety risks and be potentially problematic in the workplace.

The effects of substance misuse in the workplace

Being under the influence of drugs and/or alcohol can impair a person’s judgement. In the workplace, impaired judgement can increase the likelihood of accidents or near misses. In safety-critical jobs, such as rail and aviation, substance misuse can have serious consequences.

If substance misuse is not managed appropriately, as well as causing accidents, it can also result in other negative impacts, such as:

• A loss of productivity and efficiency.
• Poor performance and conduct.
• A high employee turnover rate.
• Reduced morale amongst workers and in the organisation as a whole.
• A strain on working relationships.
• Poor company image.
• Potential enforcement action, compensation claims and legal costs.

These impacts can result in considerable financial losses for businesses, so it is within their interest to assess the risks associated with alcohol and drugs at work and manage them accordingly.

Substance misuse not only has negative impacts in the workplace, but it can also adversely affect an individual’s day-to-day life and have a severe impact on their health. People have also lost their jobs and struggled to maintain work, which can result in financial problems. It can also affect relationships with family and has even resulted in homelessness for some.

Employers, HR and managers need to be aware that these effects may also be due to other issues, such as stress and illness.

Signs of substance use in the workplace

Substance use, misuse and dependence can be problematic for employers, and any issues must be dealt with sensitively. It may be difficult for managers and colleagues to tell whether an employee is using, misusing or dependent.

However, many different signs can indicate an employee has a problem with substances, for example:

This list is not exhaustive. Taking substances can have wide-ranging effects on a person’s behaviour and physical and mental health.

The effects a substance has, and the signs, will depend on:

• The substance(s) involved and the quantity taken.
• The strength of the substance.
• When the substance was last taken.
• The way it is abused, e.g. inhaling a solvent or smoking cannabis.
• Whether the person is mixing substances, e.g. combining different drugs and mixing them with alcohol.

Some of the signs of alcohol misuse can also be the same as those for drugs. They may also be due to other physical or mental health issues. It is, therefore, important to consider this when managing a potential substance problem.

Workplace drug and alcohol policy

Employers should have a drug and alcohol policy, so they can make employees (and others working for them) aware of their expectations regarding substances in the workplace. It is not mandatory or a legal requirement, but it is advisable to ensure there are no grey areas if an employee is under the influence or impaired when they are at work. The policy should always be written in consultation with employees and their representatives.

The policy should ensure that any alcohol and drug-related issues are dealt with quickly but also fairly. Some employers choose to have a no-tolerance approach, particularly in safety-critical roles.

It is recommended, where possible, that employees are given genuine support if they have problems with alcohol or drugs. However, employees should be made aware of the circumstances when disciplinary action may be taken or where the police may be involved, e.g. possession or dealing of illicit substances.

Often, employers will include drug and alcohol testing in their policies. It is usually required in safety-critical roles, such as those in transport (train drivers, pilots and LGV drivers) and energy generation (e.g. working with high voltage electricity). In these roles, impaired judgement could have fatal consequences in the event of an accident.

Alcohol Focus Scotland has a sample workplace policy that employers can use to help them with their own drug and alcohol policy. The CIPD report on managing drug and alcohol misuse at work also provides further guidance on policies.

Workplace drug and alcohol testing

Drug and alcohol testing are not legally required and are not enforceable. However, employers have general legal duties, under the Health and Safety at Work, etc. Act 1974 to ensure (so far as reasonably practicable) the health, safety and welfare of their employees. Testing, particularly in safety-critical roles, can be one way of managing the risk.

Employers need to have a justification for testing, and it should be part of their policy. It should also be written into contracts of employment so that employees are clear that it is a requirement of the role and what to expect. Before implementing any testing programme, employees and their representatives must be consulted.

Employees must consent to testing, and this must be in writing. It is a sensitive issue, and it can cause suspicion and mistrust if managed incorrectly. It could also be a legal issue (e.g. data protection and human rights). Therefore, employees must be involved and have to consent.

An employee cannot be forced to take a drug or alcohol test. However, they may be subject to disciplinary action if they refuse and the employer has grounds for testing.

If employers choose to test for drugs and alcohol, appropriate test procedures must be followed. There must be no doubt of the results. To ensure this, employers may choose to use an accredited external company to carry out testing.

Examples of tests

Some examples of the type of tests that can be carried out are:

• Pre-employment – Some roles may require prospective employees to be tested for drugs and alcohol before they start with the company, e.g. train drivers.
• Random testing – Employees are picked at random for testing. This is used to deter employees, e.g. drinking heavily the night before work. Senior management should be included.
• For-cause testing – A person is tested if they are showing signs of alcohol or drug misuse.
• Post-incident testing – A person may be subject to testing after an accident, damage incident or near miss. This is sometimes included as for-cause testing.

There are many different tests for detecting certain substances. Some examples are:

• Alcohol breath testing.
• Sweat drugs testing.
• Urine alcohol and drugs testing.
• Saliva/oral fluid alcohol and drugs testing.
• Hair drugs testing.

Testing can include the collection of samples and sending them to an external laboratory for analysis. Some testing can be completed on-site, and a result obtained within a few minutes.

The type of tests required will depend on an employer’s policy and the risks. Laboratory and on-site testing both have advantages and disadvantages regarding cost, time, accuracy and sampling effort. Therefore, employers must consider this when choosing tests.

Impairment assessments

If a driver is stopped by the police and they are suspected of being intoxicated or impaired, they may be asked to do a field impairment assessment.

This can include the following tests:

• Pupil measure test – Measures the pupil of the eye and also looks for watering/reddening. Drugs can increase or decrease the size of the pupil.
• Romberg test – A person has to stand still, tilt their head back and count for 30 seconds to check their balance and time judgement.
• Walk and turn test – A person must walk heel to toe and count the steps out loud to see if they can walk in a straight line.
• One leg stand test – A person stands on one leg and counts out loud to check balance.
• Finger to nose test – A person tilts their head back, closes their eyes and is asked to touch their nose with their finger to check for coordination.

These tests are typically used where the police believe drugs are involved. They use a breathalyser to test for alcohol.

Employers can use the field impairment assessment tests in the workplace to assess whether employees are intoxicated or impaired. Like other drug and alcohol tests, employees must give their consent, and it must be part of the employer’s policy. It is also based on an observer’s judgement, so extreme care must be taken when making an assessment.

Further information on drug and alcohol testing and relevant laws can be found in the CIPD guide for managing drug and alcohol misuse at work.

How can someone help?

Support

An employer’s policy should, first and foremost, help and support employees who have a substance problem. They should encourage employees to come forward and seek help, as substance misuse and dependence are medical issues. If an employer uses an occupational health provider, they can refer the employee or advise them to go to their GP.

An employer may want to give an employee some time off to seek help, which could be handled under their sickness absence policy. Alternatively, they may want to consider moving the employee to another job where possible, especially if they are currently working in a safety-critical role.

There will be a point where employers may have to go down the disciplinary route if support does not help, if it is refused, or the problem continues. The policy must be clear when disciplinary action will be taken.

Training

To support employees and manage substance misuse in the workplace, managers should have adequate and appropriate training.

Some examples of the topics to cover in training include:

• Their role and responsibilities in implementing the drug and alcohol policy.
• How to recognise the signs of substance misuse amongst workers.
• The company’s rules with regards to substance misuse.
• The actions to take if an employee is suspected of having problems with substances.
• What to do if an employee informs them they have a problem.

Managers should have adequate resources and support to help employees in the best way they can. They should also have regular contact with HR and health and safety to assist them where required.

Campaigns and promotions

Campaigns can help employees with substance misuse.

Employers can promote national campaigns, such as:

• Alcohol awareness week.
• Dry January.
• Sober for October.
• Addiction awareness week.

They can also access support and use materials from various organisations and charities for their own internal campaigns. The HSE has a list of useful organisations on their alcohol and drugs site.

Putting campaign materials and guidance on noticeboards is recommended. Employees who are aware they have a problem but do not feel comfortable talking to someone in the workplace can take relevant information from noticeboards. Posters or labels with useful contacts can also be put on toilet doors and in cloakrooms.

The information provided should never be used to shock or scare employees, as this can cause further distress for those with substance problems. Employers should aim to use materials that promote health and wellbeing for the workforce as a whole.

The CIPD report has some recommendations on managing drug and alcohol misuse at work that employers may find helpful.

Summary

Substance misuse in the workplace is a complex area that requires a high degree of sensitivity and empathy. When an employee is having problems with substances, such as alcohol and drugs, it can severely affect their lives and others around them.

Creating a working environment that is friendly and non-judgemental is vital in helping support employees who have issues with substances. Employees should feel comfortable coming forward and speaking to their managers or know where to go for help if they don’t.

Effectively managing substance misuse within a business can prevent financial losses. Also, including substance misuse in risk assessments and employee health and wellbeing programmes can help prevent it from becoming a significant problem in the workplace. Employers should always seek professional advice where there are doubts in managing this complex area and where there could be legal ramifications.

We have a Drugs and Alcohol Awareness Course that gives a detailed insight into how drug and alcohol misuse impacts someone’s life. It also covers the various ways to treat addictions, such as detoxification, rehabilitation and various methods to cope while in recovery.