The pandemic has increased the number of employees misusing drugs and alcohol. We explore what this means for safety at work, and what IOSH members can do to keep on top of the problem.
Addiction, according to Michael Rawlinson, is ‘an illness of isolation. It wants you to be on your own’. When Michael, a treatment consultant at the Forward Trust’s Clouds House – a centre that helps people overcome drug and alcohol issues – heard the news that there had been a 54% leap in positive drug test results in the workplace since 2019 (AlphaBiolabs, 2022a), he wasn’t surprised.
‘One of the harms of lockdown was that, by law, members of the addicted population had to isolate. So it was a breeding ground for people to use drugs and develop dependencies,’ Michael says.
Compared with pre-pandemic figures, the presence of opiates more than doubled, while positive cocaine readings climbed by 37% and cannabis by 30% (AlphaBiolabs, 2022a).
Michael says these statistics reflect what he has seen on the ground: ‘It represents how people have been behaving and matches some of the research we’ve done.’
As many as 27% of people surveyed last year by the Chartered Institute of Personnel and Development (CIPD), said they had increased their alcohol consumption due to the pandemic (CIPD, 2020a).
Meanwhile, almost two-thirds of employees working in hospitality saw their mental health at work deteriorate over the past year (Wildgoose, 2022).
While drug and alcohol misuse in the workplace is far from new, the knock-on effect of the lockdowns meant that more employees were ‘seemingly turning to illicit substances to cope’, AlphaBiolabs says.
‘Additionally, with more people working from home and employers unable to carry out routine drug and alcohol testing – even with a robust policy in place – many people who were already struggling with dependency were left to their own devices,’ says Barbara Wainwright, AlphaBiolabs’ workplace company trainer.
Barbara acknowledges that the spike in opiate use could be attributed to an increase in prescribed painkillers, but could not rule out the possibility of a rise in painkiller misuse since the pandemic began.
As opioids can impair employees, this could be dangerous for those in safety-critical roles such as machine operators or those working with patients, she warns.
Codeine is the most common prescription drug to show up in workplace drug tests, yet many employers have a ‘lack of knowledge concerning the use of prescription medications, and the potential harm abuse of such drugs can cause’, she adds.
It’s a serious issue. The National Institute for Health and Care Excellence (NICE) recently updated its guidelines on treating chronic primary pain, advising GPs against prescribing opioids to these patients because they could be ‘harmful’ and lead to addiction (NICE, 2021).
Environments with numerous slip or trip hazards or where heavy-duty work is carried out are at greater risk of recording opiate misuse among employees, as are workplaces that do not offer enhanced sick leave or where job security is low, Barbara says.
‘Many people are not aware of the risks when taking opioids. After all, they are often coming from a trusted source such as a GP or pharmacist and can be obtained legally over the counter. People rarely read the side effects leaflet and pay little attention to the warnings displayed on the packets such as “Don’t drive and don’t operate machinery.”’
Under the Health and Safety at Work Act 1974, employers have a duty of care to the health, safety and welfare of their employees as well as other people who might be affected by their business.
‘This means making sure that workers and others are protected from anything that may cause harm, and this would include ensuring workers are not endangering themselves or others while under the influence of alcohol or drugs,’ GB Health and Safety Executive inspector Tracy McTaggart says.
‘Understanding the signs of alcohol and drug misuse will help an employer manage health and safety risk in their workplace, and talking to workers will not only provide an opportunity to give information, but also allow them to listen and take account of what they say. Employers may find it beneficial to develop a policy to deal with alcohol/drug misuse that can be included in their overall health and safety policy.’
Drug misuse alone currently costs society almost £20bn a year – approximately £350 for every man, woman and child in England (HM Government, 2021).
Case study: Drug tests in the workplace
Joe Guilfoyle, safety health and environmental director for the Robertson Group, a UK-based construction, infrastructure and support service business, discusses the company’s approach to drug and alcohol testing.
How long have you performed employee drug and alcohol tests?
For several years, but in 2021, to ensure that our workplace was as safe as we could make it, we introduced mandatory drugs and alcohol testing at induction for all employees and subcontractors, no matter the role.
What other tests do you carry out?
Random testing is regularly carried out and is applicable to both employees and contractors. An agreed percentage of the workforce across the group will be tested on an annual basis for both drugs and alcohol. Our KPI is set at 20% of our workforce; however, last year, we randomly tested 30%.
A drug and alcohol test will be carried out if a person displays difficulty walking or incoherent speech. Behaviour such as aggression, euphoria, hyperactivity or lethargy gives good reason to question whether a employee/contractor is being affected by unauthorised drugs or excessive alcohol use.
Additionally, testing may occur where evidence of unauthorised drugs is found in an employee/contractor’s possession but is being disputed. For example, if drugs are found in an employee’s work area, it may be necessary for that person to take a test. Employees/contractors will be monitored on-site until a collection technician can administer a test. Also, in the event of a serious accident or incident, the individuals involved will be tested for drugs and alcohol.
Drug and alcohol testing will be carried out for all employees and subcontractors in safety-critical roles such as plant operators or from the outcome of a task-specific risk assessment.
What’s the procedure regarding a positive or non-negative result?
The person is removed immediately from the workplace with suitable arrangements to travel home. For alcohol tests, an employee testing positive is suspended, pending investigation. Contractors’ employers are informed, and they are then subject to their own company’s processes and procedures.
In the event of a non-negative drugs test result, the employee is suspended pending laboratory analysis and further investigation.
If the lab result is negative, the individual will be asked to sign a record of the test and the result and is free to return to work. If the lab result is positive, the individual will remain suspended, awaiting disciplinary investigation. They receive a copy of the results from the sample test. The results of all internal testing are referred to HR, and disciplinary action taken if necessary.
What support mechanisms are in place for employees?
Any employee who says they have a drug and/or alcohol problem is tested immediately in line with our policy. After the results, a follow-up programme is run alongside an agreed course of counselling and rehabilitation with support from our partners Axa and the employee’s GP. Employees in the follow-up programme are tested regularly to ensure they follow it. Contractors are subject to their company processes and procedures.
What are the benefits of workplace testing?
Since introducing mandatory testing at induction, the number of positive results has dropped. We have also noticed a shift in attitudes and behaviours. Many say they feel much safer at work knowing that everyone on site was tested at induction and that there is a committed ‘random’ and ‘for cause’ regime in place. The health, safety and wellbeing of our employees, and all others affected by our operations, is our number one priority. Our policies are in place to ensure that every person goes home safe from the workplace every day. The message is clear: if you are working with us, you will be tested.
Worryingly, a fifth of businesses do not offer proactive support to employees who are struggling with drug and alcohol issues, a survey found (CIPD, 2020b). The Managing drug and alcohol misuse at work report also revealed that only 27% of organisations provide information for employees on how to disclose a problem they may have with alcohol or drugs.
Furthermore, only 26% of organisations trained managers to recognise the symptoms of drug and alcohol problems, yet 35% of employers had disciplined someone in the past two years for alcohol misuse and just over a quarter (26%) for drug misuse (CIPD, 2020b).
A similar picture was found by AlphaBiolabs when it surveyed 500 senior managers in the construction, manufacturing, engineering and logistics industries about their companies’ substance misuse policies.
‘Shockingly, 20% of respondents admitted that their business has no such policy in place,’ Barbara notes. ‘Worse still, 10% didn’t even know if their company had a drugs and alcohol policy… Out of 500 respondents, one in five senior managers said they were not confident they’d be able to spot the signs of someone struggling with substance misuse, highlighting an urgent need for awareness training [AlphaBiolabs, 2022b].’
While employers must have employees’ consent to test for drugs, workers can be disciplined if they refuse. Businesses should also limit testing to those who need it, ensure tests are random and should not single out employees, unless their specific role requires testing.
So why is there such a gap in knowledge and how should organisations respond? ‘It’s a very important issue in an area that, truthfully, people are still scared about because they don’t understand it,’ Michael explains.
‘Alcohol dependency is not a choice. Addiction is not a choice. People do not set out to become dependent. It can be a mental health illness that can be treated.’
Rachel Suff, the CIPD’s senior policy adviser for employment relations, encourages organisations to have a clear policy that focuses on health and wellbeing support, including employee rehabilitation, and strike an appropriate balance between the need for disciplinary procedures and providing support for individuals.
‘There will be instances where disciplinary action is required, but it shouldn’t be the default position just because substance use is identified,’ she says.
The CIPD’s findings also showed that around half of all employers do not provide even unpaid time off for treatment for alcohol or drug misuse.
‘We advocate that support and a general concern for the individual’s wellbeing are provided,’ Rachel says. ‘Employee rehabilitation and providing time off for someone to get treatment or support relating to substance misuse is important, and employers should signpost to external expert services.’
Kicking the habit: How can employers stay on top of substance misuse?
- Implement effective drug and alcohol awareness training
Occupational health and senior managers can ensure that individuals at every level are aware of the risks associated with drug or alcohol misuse, including opioids. This can help safeguard employers from potential incidents or accidents, reduce the cost of sickness absence and boost productivity.
- Spot the signs of drug or alcohol misuse
These can include frequent or unexplained absences, poor concentration and decision-making, and more conflict with colleagues.
- Introduce a substance misuse policy
Or review your existing policy. Employers in safety-critical industries are more likely to be able to justify mandatory testing and have an appropriate policy. Some employers include terms in contracts to make clear the expectations and processes involved.
- Support employees
Risk assessments should be carried out on a case-by-case basis. A vital part of rehabilitation is support when employees return to work following substance misuse treatment. It’s an opportunity to check in, see if further support or adjustments to the job role or ways of working are required, and enable the individual to make a successful, sustainable return to work.
- Consider all options when choosing drug and alcohol testing solutions
Companies recruiting for safety-critical roles may consider a pre-employment screening using hair or nail testing, which provides a picture of an individual’s drinking or drug use for a period of up to 12 months prior to the samples being collected.
So are there any sectors that are more prone to drug and alcohol misuse?
According to AlphaBiolabs sales data, the highest demand for drug and/or alcohol testing between March 2020 and March 2021 came from the construction, manufacturing, engineering, chemical, transportation, environment, and food and beverage industries. ‘This does not necessarily point to drug and alcohol misuse being a problem specific to those industries. However, it does seem to indicate that these sectors view drug and alcohol testing as a priority,’ Barbara explains.
Ian Bloxsome, director at Safepoint Professional Services, agrees. In his experience, many construction firms (see Case study, below) are ahead of the game with drug and alcohol testing, operating ‘clear and concise’ policies. However, he cautions that employees working in certain sectors, such as hospitality, may struggle due to the long hours and nature of the industry.
‘How often have you seen the barman being the DJ and drinking or making a cocktail and tasting it so that it’s just right?’ Ian says. ‘They might have a hard day, drugs and alcohol might be easily accessible, and there’s that temptation.’
Spotting the signs
Rachel says HR departments should help to ensure the work environment is not part of the problem, ‘including the extent to which alcohol features, for example as part of frequent client entertaining or as part of work social events’.
What are the clues that may indicate a colleague is struggling?
‘People might not hit targets, the quality of their work may drop, and they might be short-tempered,’ Ian says.
Michael identifies a change in personality as one of the clearest signs, along with periodic attempts to go ‘on the wagon’. Alcoholic blackout can also affect those who drink to the extent they have no recollection of what they’ve done.
‘People can go to work in alcoholic blackout and don’t remember their work conversations the next day,’ Michael explains. ‘That’s very scary. An alcoholic will feel shame and might try and cover it up. They might be embarrassed and feel like they can’t face you and become absent from work, or they might not want a colleague to tell anybody else and take on a more aggressive tone to try and control the colleague.’
Line managers and HR play a critical role in preventing and identifying issues and providing support when someone needs it, Rachel says. She urges HR staff to create an environment where people can ask for help. ‘They should feel confident and capable of responding appropriately if someone discloses they have a problem,’ Rachel adds.
Encouragingly, over two-thirds (69%) of the organisations surveyed by the CIPD said the most recent employee they had referred for treatment or rehabilitation support had remained working for them (CIPD, 2022b).
This suggests that employer support can have positive long-term effects on people’s careers, the retention of staff and, of course, promote safer workplaces.
‘For businesses, it’s worth the investment because if they’ve got an emotionally well workforce that feels cared for and looked after, the people are more productive,’ Michael says. ‘Caring and looking after staff is not a fad or a fashion but a commercially wise thing to do. It’s full engagement.’
- Managing drugs and alcohol at work: iosh.com/drugs-alcohol-misuse
- Drugs and alcohol awareness at home and at work: iosh.com/drugs-work
Alcohol Change UK. (2022) Alcohol in the workplace. (accessed 23 May 2022).
AlphaBioLabs. (2022a) Workplace drug use on the rise as AlphaBiolabs reports 54 per cent increase in positive drug test results. (accessed 25 April 2022).
AlphaBioLabs. (2022b) Alcohol and drugs at work – why every business needs a drug and alcohol policy. (accessed 25 April 2022).
CIPD. (2020a) A proactive and preventative approach to managing drug and alcohol misuse at work is essential. (accessed 25 April 2022).
CIPD. (2020b) Managing drug and alcohol misuse at work. (accessed 25 April 2022).
HM Government. (2022) From harm to hope: a 10-year drugs plan to cut crime and save lives. (accessed 25 April 2022).
NICE. (2021) Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain. (accessed 25 April 2022).
Wildgoose. (2022) The Employee Mental Health & Remote Working report: is post-pandemic trauma impacting the mental health of the UK workforces? (accessed 25 April 2022).
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