Illicit Drug and Alcohol Use: The Underlying Causes of Unsafe Behavior

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Organizations are challenged daily by one of the most common causes of workplace incidents; the unsafe behavior of people.

The reasons for unsafe behavior vary, and there are some factors, such as drug and alcohol use, that are directly linked to unsafe behavior. “The overwhelming cause of most industrial accidents and injuries can be contributed to the unsafe acts of employees (Unsafe Acts - Human Behavior).”

To reduce the occurrence of unsafe behavior, employers must address both the immediate and root causes behind them. This is not a one-off project, and what it requires is a long-term plan to address the “catalysts” that make workers perform unsafe acts. There are means by which organizations can address unsafe behavior. Whether it’s side effects from fatigue from pulling all-nighters with small babies, substance use, or stress caused by financial problems, action should be taken so that they don’t have the chance to cause damage in the first place.

Opioid epidemic

The opioid epidemic in the US has brought a new series of risks to the workplace. Drugs and alcohol alter human behavior, and even when not used onsite they cause side effects that can pose risks to workers’ safety. In low-risk jobs these side effects have less of an effect; however, when it comes to high-risk jobs, all possible dangers must be evaluated.

Employees are not likely to approach superiors about their personal issues, particularly when it’s something as sensitive as illicit drug use - therefore a more systematic approach is needed. Misuse of opioids, drugs, and other substances should not be taken lightly by anyone.

Opioids killed more than 42,000 people in 2016, and 70% of the estimated 14.8 million Americans using illegal drugs are currently employed. According to an analysis by Quest Diagnostics, employee drug use is at its highest for a decade.

Safety, Illicit Drugs, and Alcohol

The opioid epidemic in the US and the legalization of Marijuana (2015) in 26 states have raised questions about the impact drugs can have on workplaces and their safety. This increasing substance use has proven to reduce safety. Marijuana, opioids, and non-alcoholic drugs are already a far more common cause of traffic incidents than alcohol.

Some statistics reflect the nationwide increase in drug use and the risks they pose to our safety (Forbes). A study released by the Governors Highway Safety Association (2016), reveals that 44% of fatally injured drivers tested positive for drugs and 36% for alcohol.

Over half of the drug-affected drivers had marijuana, opioids, or a combination of the two in their system. OSHA (The Occupational Safety and Health Administration) states that “Overdoses from the non-medical use of drugs or alcohol while on the job increased from 165 in 2015 to 217 in 2016, a 32-percent increase. Overdose fatalities have increased by at least 25 percent annually since 2012.

Side-effects & After-effects

Different substances cause severe side-and after-effects and alter worker behavior. “Alcohol and drug use increase the risk of problems in the workplace such as absenteeism, presenteeism, low productivity and inappropriate behavior (BMA) .” Also, fatigue, poor decision-making, and needless risk-taking are some of the most common symptoms of both alcohol and drug use.

Some facts about workplace accidents related to alcohol use:

  • Workers with alcohol problems were 2.7 times more likely than workers without drinking problems to have injury-related absences
  • A hospital emergency department study showed that 35 percent of patients with an occupational injury were at-risk drinkers
  • Breathalyzer tests detected alcohol in 16% of emergency room patients injured at work
  • Analyses of workplace fatalities showed that at least 11% of the victims had been drinking

Drugs and alcohol cause workers to be less aware. They cause them to be less concerned for their and others’ safety. Drugs and alcohol slow reaction time. They put co-workers and careers at risk.” If an employee is under the influence of an impairing substance at work, their inhibitions get lower and the tendency for violent behavior rises.

Even if a worker is not intoxicated during work, after-effects of substance use (e.g. hangover, withdrawal) will impact their job performance. Friends and family members of alcohol or drug user may also suffer from lower job performance. Besides safety issues, alcohol and drug use can make organizations lose time and have a negative impact on the workplace culture.

Prescription medication

The problem with drug use doesn’t limit itself to illicit drugs. People react differently to prescription medication. Prescription opioids (used to treat moderate-to-severe pain) have created a nationwide addiction spiral. According to the National Safety Council, four out of five new heroin users started out by misusing prescription opioids.

It is therefore essential to make sure workers are aware of the risks involved with opioid painkillers and that they know better than to share their personal opioid prescriptions with their colleagues, for example. Many users are unaware of the fact that opioids are as addictive as heroin and can cause dependence in a matter of days.

EHS professionals can help fight the opioid crisis. Since opioid painkillers are being prescribed for workplace injuries, occupational injuries are one of the reasons workers get exposed to opioids. Occupational Health & Safety also holds the responsibility to protect their workforce from occupational exposure to these substances at work (Mark Ames). Addiction is not the only risk. Like other substances, prescription opioids have strong side effects:

Some of the hidden side-effects of opioid painkillers include rapidly developing addiction, withdrawal, constipation, permanent changes to brain chemistry, nausea, respiratory depression, increased sensitivity to pain, driving impairment and decreased sex drive (National Safety Council).

By addressing substance use, companies will not only be helping to fight the national crisis but will also benefit themselves. By reducing substance use, employers can expect to see reduced incident rates, higher productivity, and better overall workplace culture.

Approaching alcohol and drug use at work

There are actions employers can take to reduce the use of impairing substances. Educating employees about the risks involved in substance use and the ways they jeopardize our safety is essential. Implementing drug testing, having professional support services onsite, establishing wellness programs, and encouraging safe behavior across departments are great ways to approach the problem.

To support those suffering from alcohol/drug abuse, or other health and/or personal problems, companies can offer services and programs, such as the Employee Assistance Program (EPA). According to NCADD, this program should offer: “…short-term counseling, assessment, and referral of employees with alcohol and drug abuse problems, emotional and mental health problems, marital and family problems, financial problems, dependent care concerns, and other personal problems that can affect the employee’s work.”

Having counselors from outside the workplace makes it easier for employees to approach and get help for their problems. In addition to providing professional support, organizations can implement drug-free workplaces and other written substance abuse policies. These kinds of programs and policies have been proven successful:

  • alcohol and drug treatment has been proven to reduce healthcare costs,
  • EAPs and drug-free workplace policies improve workplace productivity and morale, and decrease accidents, absenteeism, downtime, turnover, and
  • Organizations with long-term programs have better health status and lower use of medical benefits amongst their workforce (NCADD). “

Implementing such strategies will reduce costs related to worker wellbeing, injuries, absences, and productivity.

Drug/alcohol testing

Drug testing is an efficient way to establish a drug-free workplace. However, employees may feel that their privacy is being invaded and that they’re not being trusted by their employer. This is a valid point; however, if it’s made clear what the policy is, why it’s been implemented and in what circumstances testing is to be done, employees may accept it better.

Both government and private sector employers can legally test their employees. Job applicants may also be required to go through drug testing prior to receiving a job offer, and in some industries, drug testing is a prerequisite; such as transportation, aviation, and industries that require the operation of heavy machinery or a motor vehicle.

There is no federal law to regulate drug testing in the private sector; however, it depends on the state law and the company policy whether this is a contingency for an offer ( In high-risk jobs, the state law is already likely to require drug testing. In the US, federal and state laws provide guidelines on the policies workplaces are allowed to set for substance abuse.

Addressing the cause of unsafe behavior

Changing human behavior is difficult, and there are aspects that are challenging to control. Nevertheless, in the case of intoxicating substances, the reason for behavioral change is something that can be taken out of the picture. Prescription opioids, illicit drugs, and alcohol are all traceable causes of unsafe behavior.

So, if the use of drugs and alcohol at work is eliminated, we have a better chance to reduce the unsafe behaviors rooted in their use. Employers can, by establishing drug-free workplace programs, send a clear message that the safety of the workforce comes first. Even if drugs were used outside of work hours, they have severe side effects that can at worst endanger other people’s lives in the workplace.

Employee drug use is at its 10-year high, and opioid painkillers have exposed many workers to the dangerous addiction spiral. Employers should therefore invest in supporting programs and take the measures to eliminate the known (controllable) root cause of work incidents and injuries.

The action taken by workplaces could make a huge difference and help many of those struggling with addiction. If companies say no to drugs, then employees (70% out of the 14.8 million employed drug users) would have to say no.  

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