Rehab 4 Addiction

According to the 2011 census, about two-thirds of the U.K population (34.3 million in England and 1.9 million in Wales) is of working age.

Since almost three-quarters of the working-age population is in employment, the impact of use and misuse of drugs and alcohol in the workplace is quite substantial.

This shows that the workplace is an important setting in managing and preventing the use and abuse of alcohol and drugs.

Drug and alcohol misuse as an issue in the workplace

Drug and alcohol misuse in the workplace is a concern when it puts the health and safety of that individual, their colleagues or the general public at risk or when it affects an individual’s performance. Contrary to popular belief, most people who have drug and alcohol use problems are in work.

Impact of drug and alcohol misuse at work

The use and abuse of drugs and alcohol in the workplace can affect physical coordination and judgement resulting in accidents.

Other effects of substance abuse in the workplace include:

  • Poor performance
  • Lower productivity largely through sickness-related
    absence (absenteeism)
  • Shorter working lives
  • Inappropriate behaviour
  • Lateness
  • Unsafe practices and accidents
  • Poor team relations and effects on team morale
  • Damage to organisational reputation and image
  • Increased work burden on colleagues

Signs of drug and alcohol misuse in the workplace

  • Repeated short-term sickness absence
  • Sudden mood changes
  • Aggression and/or unusual irritability
  • Confusion
  • Poor concentration
  • Poor performance of tasks
  • Abnormal/ unusual fluctuations in energy
  • Poor timekeeping
  • Dishonesty and theft
  • Deterioration in relationships with colleagues, friends, customers and managers

However, it’s important to understand that all of these can also be signs of other factors such as depression, stress, and other medical conditions.

How can you manage drug and alcohol misuse in the workplace?

1. The legal framework for drugs and alcohol
and the workplace

The Health and Safety Act 1974 places a legal duty on the employer to provide, so far as reasonably possible, the safety, health and welfare of employees.

Likewise, employees must also take reasonable care of their own health and safety and others who come into contact with the workplace.

On the other hand, the Misuse of Drugs Act 1971 makes the production, possession and supply of controlled drugs unlawful except in some specified circumstances (for instance, when the drugs have been prescribed by a qualified doctor).

An employer who knowingly permits the supply, possession or production of controlled drugs on their premises could be prosecuted.

The Health and Safety at Work Act (HASAWA) 1999 lays down a duty on employers to assess the risk to the safety and health of their employees.

Employers could be committing an offence if they knowingly allow employees to work under the influence of drugs or alcohol where their behaviour places them or others at risk.

The Road Traffic Act 1988 and the Drug Driving (Specified Limits England and Wales) Regulations 2014 make it clear that anyone who is in charge of a motor vehicle with blood drug concentrations above the specified limits, is guilty of an offence.

The Railway and Transport Safety Act 2003 also makes it a criminal offence for maritime and aviation workers to have a proportion of alcohol or drugs that exceeds the limits established in the act or to have impaired ability to function as a result of alcohol or drug use.

The operators of the transport systems could also be guilty of an offence if they didn’t demonstrate due diligence in trying to prevent such offences from being committed.

2. Consulting employees

When it comes to managing drug and alcohol misuse at work and before creating and implementing a workplace substance use policy, you certainly need to consult others, especially your employees and safety representatives.

When creating a workplace substance use policy, you should start the communications process well in advance in order to:

  • Ensure the entire process is transparent and open. Remember, your goal is to support your staff, not to police them
  • Clarify any apprehensions and misunderstandings and carefully gauge the views of your workforce. Involving the workforce in drawing up the policy gives them a sense of ownership and heightens their desire to see the policy work successfully. This is particularly important with substance misuse policies, because they may impact the private lives of some employees, and you need to earn their trust

You can gauge the view of employees via consultations that can take place through employee suggestion schemes, meetings, ballots, discussions with staff and trade union representatives, or even questionnaires.

The communication approach employers use varies with the size of the organisation, work patterns, number of operating units and so on.

Consulting your employees especially at an early stage helps foster trust and credibility.

In fact, studies show that creating mutual confidence between staff and management helps improve performance.

3. Workplace policies

Drug and alcohol use in the workplace places a huge burden on employers. This makes it advisable for every organisation to design and implement a workplace substance use policy.

The policy should form part of the organisation’s commitment to workplace safety and health in order to safeguard employees, customers and the general public.

Workplace substance use programmes and policies should promote the prevention, management and reduction of drug and alcohol-related issues in the workplace.

A workplace drug and alcohol use policy should:

  • Define what is meant by use
  • Explain why the policy exists
  • Include statements on the rules regarding drugs
    and alcohol
  • Help and support available to individuals who
    have drug problems
  • Incorporate a statement encouraging employees
    with drug and alcohol problems to seek help voluntarily.

Occupational health professionals who are asked for advice by employers should make clear to the workforce their professional role.

They should also seek to understand the organisation’s drug and alcohol use policy, and the help and support that is available to the workforce.

In order for the drug and alcohol policy to be effective, the organisation should have arrangements to support employees who need help.

Although many occupational health providers can provide some professional help and rehabilitation, unless the employer has established comprehensive health support, they may have to find out what provisions are available locally, and what to expect.

4. Workplace testing and screening

Trade unions and employers in the UK accept that testing and screening is of value particularly in safety-critical occupations such as airline and railway workers.

In fact, some employers view workplace drug testing and screening as a critical part of their responsibility under the Health and Safety Act 1974.

However, in non-safety critical occupations, the benefits of drug testing and screening are less obvious.

Moreover, there’s no clear proof that workplace drug testing and screening has a deterrent effect.

Testing and screening employees for drugs and alcohol in the workplace is a contentious and complex topic involving legal, moral and ethical issues.

Legal issues surrounding testing and screening in the workplace arise from the Data Protection Act (DPA) 1998 and the Human Rights Act (HRA) 1998. Screening and testing in the workplace are only likely to be acceptable if it is designed to prevent risks to self and others.

However, testing for alcohol is a less contentious issue, especially in safety-sensitive occupations. Alcohol testing is designed to directly assess breath alcohol levels which have been associated with a particular risk of impairment.

The illegal nature of controlled substance use, the lack of demonstrable dose-effect relationships, the persistence of some substances, and the potential for confusion with medication (both over-the-counter and prescribed) create practical difficulties for workplace testing and screening programmes.

Testing and screening should only be introduced in the workplace after careful consideration and employees undergoing tests screening should be invited to declare their use of any over-the-counter, prescription or pharmacy medication.

Testing should also be introduced alongside a policy that outlines the details for testing, any roles for health professionals, and the procedures to be followed.

5. Fitness for work

Assessment of fitness for work ensures that an employee is fit to perform the tasks involved effectively without health or safety risks to self or others.

Sometimes it might be necessary to adjust or modify the job as necessary to allow them to work safely and effectively.

Occupational health experts can provide advice and information to employers and employees regarding rehabilitation back to work and fitness for work.

Employers can also arrange modified or different work duties to support employees’ rehabilitation before returning to normal work.

The employer should understand the severity of the situation and functional capacity of the employee in order to make workplace adjustments and manage the issue effectively.

For instance, an employee undergoing detoxification should not be given any safety-critical roles until they have successfully completed treatment.

Where the patient requires a period of sickness absence and they co-operate with appropriate treatment, the employee should be supported with sick leave benefits.

return to safety-critical work could involve a period of monitoring and random, unannounced testing or screening to help determine whether there’s a relapse of alcohol or drug use.

6. Support employees with drug and alcohol misuse problems

It is critical that all employers, staff and managers know how the organisations deal with alcohol and drug-related problems. This will give staff the confidence to seek help for themselves or their colleagues without fear.

Unfortunately, many managers are not properly equipped to deal with drug and alcohol misuse problems. Therefore, the manager and staff training and support is an integral part of any policy.

After identifying an individual with drug or alcohol misuse problems, the occupational health practitioner needs to consider the individual’s job including whether they are fit to attend work, perform specific duties and function safely at work, especially where the safety of that patient, the general public, and co-workers might be at risk

Work intervention programmes

1. Employee Assistance Programmes (EAPs)

Employee assistance programmes aim to assist in identifying and resolving a wide range of employee concerns which affect performance.

With respect to managing drug and alcohol misuse at work, employee assistance programmes focus on identification and assessment of employees with substance abuse problems and referring them for appropriate treatment.

Employees may refer themselves to the EAP, may be referred formally by managers as part of performance management in the workplace, or maybe referred informally by the occupational health staff or manager.

If the organisation uses EAP strategies to reduce or control drug and alcohol problems at work, these programmes should be evaluated regularly to assess their effectiveness.

2. Health promotion programmes

Workplace health promotion programmes mainly aim to improve the health and wellness of the workforce through education.

Evidence shows that health promotion programmes aimed at behaviour change and alcohol and drugs specifically can help improve job well being, decrease sickness-related absenteeism increase mental wellbeing and improve workability.

Combining activities promoting a healthy lifestyle with education and psychological methods have also been shown to reduce sickness absences.

The workplace setting provides captive audiences and ideal
venues for occupational health professionals to offer health education for workers and identify individuals with drug and alcohol use problems.

Occupational health professionals are also well placed to provide health education for the workforce and training for supervisors and managers on how to identify and deal with drug and alcohol misuse problems.



Tim has written about recovery and addiction for well over a decade. He is currently writing a book about exercise and recovery. In his spare time, he enjoys reading, cookie and spending time with his wife, children and three dogs.