The Impact of Drugs and Alcohol in the Workplace

There are some topics no one likes to talk about. One of them is the prevalence and impact of alcohol and drug use in the workplace. Each year, substance abuse costs the United States an estimated $276 billion dollars in expenditures on health care, workplace injuries, and disability payments, not to mention productivity losses.[1] The reason the price tag is so high is that approximately 60% of adults with substance dependence (i.e. addiction), are full time employees and most adults who have problems with alcohol or drug use are in the workforce—meaning employers bear much of the cost associated with increased health care needs and lost productivity.[2]

The consumption of alcohol is legal, pervasive and even part of the culture in some workplaces.[3] Due to recent changes in legislation, employers now find themselves struggling to assimilate and manage the impact of the legal marijuana use in some states. Of course, the real workplace challenges arise when drug or alcohol use becomes abuse or leads to dependence and addiction. When that happens, employers can expect:

  • Higher health care expenses for injuries and illnesses;
  • Increased absenteeism;
  • Reduced productivity and flagging performance; and
  • More workers’ compensation and disability claims.[4]

The health impacts of drug and alcohol use are far-reaching and, in many cases, cumulative. One of the most significant long term impacts of substance abuse is dependence or addiction. So far, there’s no simple test that reveals who will become addicted and who won’t, just as there’s no easy way to determine what level of use of a particular substance leads to dependence. Substance abuse at work can be addressed as a performance issue when it impacts an employee’s quality of work. Addiction, on the other hand, is a disease that typically requires a different approach.

How Much is Too Much?

Drug or alcohol abuse is defined as less severe than dependence (or addiction) and involves one or more of the following in a 12-month period:

  • failure to fulfill major role obligations at work, school, or home;
  • recurrent use in hazardous situations; recurrent substance-related legal problems; or
  • continued use despite persistent social or interpersonal problems.

Drug or alcohol dependence is identified by 3 or more of the following in a 12 month period:

  • increased tolerance;
  • physical withdrawal;
  • using larger amounts or using over a longer period;
  • inability to cut down/control use;
  • considerable time spent using/obtaining/recovering from use;
  • important activities given up/reduced; and
  • continued use despite negative consequences.[5]

Work Related Risk Factors for Substance Abuse and Addiction

Certain jobs carry increased risk for substance abuse and addiction for a variety of reasons. A major study by SAMHSA looked at current drug use among 21 major occupational groups from 2002 through 2004 and identified the following five occupational groups as having the highest prevalence of current drug use among full-time workers.

  • Food preparation and serving (17.4 %)
  • Construction (15.1 %)
  • Arts, design, entertainment, sports, and media (12.4 %)
  • Sales (9.6 %)
  • Installation, maintenance, and repair (9.5 %)

Work related factors that contribute to higher than average drug and alcohol use include: 

  • High stress
  • Low job satisfaction
  • Long or irregular hours/shift work
  • Fatigue
  • Repetitive duties
  • Periods of inactivity or boredom
  • Isolation
  • Remote or irregular supervision
  • Exposure and easy access to substances

Warning Signs

There are a wide range of indicators that an employee  might be abusing drugs or alcohol or has become addicted. Although you should never try to diagnose addiction or substance abuse, you can watch for and act on these indicators.

Leave and attendance

  • Unexplained or unauthorized absences from work
  • Frequent tardiness
  • Excessive use of sick leave
  • Patterns of absence such as the day after payday or frequent Monday or Friday absences
  • Frequent unplanned absences due to “emergencies” (e.g., household repairs, car trouble, family emergencies, legal problems)

The employee may also be absent from his or her duty station without explanation or permission for significant periods of time.

Performance Problems

  • Missed deadlines
  • Careless or sloppy work or incomplete assignments
  • Production quotas not met
  • Many excuses for incomplete assignments or missed deadlines
  • Faulty analysis

It important to note that long-term projects or jobs that require detailed analysis may enable an employee to hide a performance problem for quite some time.

Relationships at Work

  • Strained relationships with co-workers
  • Increased belligerence and confrontation, especially in the mornings or after weekends or holidays
  • Increased “loner” behavior
  • Avoidance of supervisory contact

The employee may also have noticeable financial problems evidenced by borrowing money from other employees or receiving phone calls at work from creditors or collection companies.

Physical Signs

  • Euphoria – increased energy
  • Large swings in behavior and mood
  • The smell of alcohol
  • Staggering, or an unsteady gait
  • Bloodshot eyes, dull eyes, significantly dilated or constricted pupils
  • Unusually loud talk or significantly increased talkativeness
  • Excessive use of mouthwash or breath mints
  • Tremors
  • Sleeping on duty
  • Personal grooming deterioration
  • Increased physical injuries or bruises

These signs alone don’t mean that an employee is addicted to drugs or alcohol. However, when there are performance and conduct problems coupled with any number of these signs, it’s time to take action.[6]

What To Do

As an individual who uses drugs or alcohol, if you’re pretty sure you’re okay, but want to know for sure—stop all drinking and drug use for a month. If you can’t stop or have reason to believe you have a drinking or drug use problem—get help!

  • Contact your EAP
  • Talk to a counselor
  • Get an addiction assessment
  • Talk to your manager

As an employer or manager, if you have reason to believe an employee has a drug or alcohol problem because of a combination of performance or conduct issues and the indicators listed above, then it’s time to refer the employee to the Employee Assistance Program for assessment and support.

What Not To Do

  • Ignore it and hope it goes away.
  • Cover for someone who needs help.
  • Work beside someone who is impaired and presents a safety risk.
  • Assume that addiction can’t happen to you, someone you work with or someone who works for you.


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[1] Substance Abuse and Mental Health Services Administration, Office of Applied Studies; 2008 . NSDUH Series H-34, DHHS Publication No. SMA 08-4343 cited in An Employer’s Guide to Workplace Substance Abuse: Strategies and Treatment Recommendations

[2] U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.

[3] Alcohol and Work: patterns of use, workplace culture and safety.

[4] U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration .

[5] DSM-IV Substance Dependence Criteria

[6] Warning signs adapted from Alcoholism in the Workplace: A Handbook for Supervisors

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