Alcohol and Drugs in the Workplace (Part 1) | The WorkSAFE Podcast

One in four adults binge drinks, and one in ten adults uses illicit drugs. They’re not out on the street, though: research shows that most of these adults are working at jobs. In this discussion, we explore the risks that safety professionals need to know about, and best practices for mitigating them. This episode is part one of a two-part series on drugs and alcohol in the workplace. The following is a transcript of the conversation, which you can also hear using the player.

Part 1: The State of the Problem

Benskin:

Welcome to the WorkSAFE Podcast. I’m here alongside our field service manager, Terri Sweeten, and we also welcome into the studio Breck Dumas, a journalist and writer. Thank you for joining us today. We’ll start with you, Breck: tell us about yourself and why you’re here today.

Dumas:

Sure. I have a business background – I’m an MBA – but I’ve funneled in and out of working in politics. I was a U.S. Senate staffer for a number of years, I’ve been a radio show host, and then I served as the editor for the Columbia Business Times. Now, I just exclusively write.

Benskin:

And Terri, same question to you.

Sweeten:

I’m a field service manager, and those job duties are anything that can be done out in the field. So, we do a lot of claims training, claims work, subrogation and accident investigations. I work one-on-one with policyholders, employers and businesses throughout the community, in central Missouri mostly.

Performance-enhancing drugs in the workplace

Benskin:

Breck, we recently connected based on an article you’d written for the Columbia Business Times titled Performance-Enhancing Drugs in the Office. Tell us a little bit about how you came to be interested in that topic, and what your research showed when you actually started to dive into it.

Bottle of pills with alcoholic drink.
Dumas:

Sure. It actually arose out of just casual conversation with family. At a big family get-together, I believe it was an Easter or something like that, the table topic ended up turning to drugs in the workplace. The conversation started out that in high-performance, high-pressure positions, a lot of people feeling pressure for one reason or another were taking performance-enhancing drugs in order to boost their own performance at the workplace. It’s something that has largely gone under the radar because a lot of times these people tend to be top performers anyway, like top salesperson. It’s also very prevalent in the retail and food industries.

So, I started digging into it a little bit more and saw that it’s not just in academia and white collar. This is following other drugs – sometimes street drugs, sometimes prescription – into an array of industries. It caused concern, so we wanted to look into it deeper.

Benskin:

You mentioned street drugs, but it sounds like the topic of conversation there was more related to the misuse of prescription drugs. Is that right?

Dumas:

Yeah, that’s the thing, it’s an allegation of misuse. Particularly when we’re looking at drugs like Adderall, it’s very easy to get a prescription for it. So, do we need to start asking adults if they’re lying in order to get a prescription drug? Is it more accessible in certain industries, especially in medical care? Absolutely, because people know how to get their hands on it.

Of course, it used to be cocaine. In some industries it still is, for people who are wanting to work longer hours and have a different edge, maybe. But now we’re seeing that because these enhanced drugs, sometimes in microdosing or other things, are actually being proudly used in some industries, like academia, where they say, “Hey, it’s my responsibility to enhance my mind in any way that I can.”

Technician draws blood from patient.

Industries with high prevalence of drug and alcohol use

Benskin:

That’s interesting. Terri, let’s bring you into this conversation. Obviously, you spend a good number of hours and days a year on the road, working with employers in different industries. What type of an impact have you seen firsthand with drugs in the workplace here in Missouri?

Sweeten:

What we’ve seen is that the use of drugs and alcohol has contributed to some unsafe behaviors. What Breck was talking about is that people are maybe doing it for stress, so they’re trying to move faster and longer. They’re working with less sleep and less actual rest, and unfortunately, some of those behaviors are resulting in serious catastrophic workplace injuries and smaller, less serious workplace injuries. They’re leading to those workplace accidents.

Benskin:

Breck spoke about certain industries being impacted by this more – healthcare and academia for instance. Have you seen the same in your travels as well, or do you see it in other industries?

Sweeten:

We have. I’ve seen it in those industries. Some of those industries are less likely to drug and alcohol test. In the construction industry, it’s pretty well known that you’re going to get drug tested. Part of that is a requirement for employment. You have pre-employment and random tests, and they have the drug testing facilities that come in to job sites. A lot of the construction industry is pretty aware that there’s going to be testing. But when you get into retail, schools, things along that line, there aren’t as many formalized drug testing programs. So, yes, we see that in those industries quite often.

Benskin:

It sounds like this is a lot more widespread problem than what the general public thinks. Back to you, Breck: I know your article talked about high-pressure, high-stress jobs, and you mentioned that employers almost turn a blind eye to it sometimes. Do you think that the employers are encouraging this, or is it just that added pressure on the employee that leads to choosing to use these drugs on the job?

Dumas:

Great question. I think it’s a personal choice from every worker. That’s the problem, though, that there’s this undercurrent. Other workers know what’s going on. They see the person in the cubicle next to them and think, “Wow, they’re doing really well, and the boss recognizes them.” I don’t think that any employer, if they knew that there was a substance abuse issue with an employee, would let that go. I’m not saying that at all. But what we are seeing is that people in competitive jobs will do whatever it takes – some of them, not all. Some of them are willing to take drugs in order to get ahead and to share that information with other people.

Prescription drug misuse in the workplace

Benskin:

It seems that until recently, society’s view on drug use has been that the only drugs that were bad in misuse were the illegal street drugs; the harder drugs. But obviously, one of the hot topics these days in business is the use of prescription drugs. How can employers emphasize that the misuse of prescription drugs is just as bad, or maybe sometimes worse, than the use of illegal drugs?

Sweeten:

From our standpoint, they need to have a drug and alcohol policy. If an employee is using something that they do not have a prescription for, that is the same as an illegal drug. The federal laws say that. There’s more and more pressure on medical providers to limit the use of prescription drugs, especially narcotics and things along that line. I think awareness is increasing with the opioid crisis. But from a work-related standpoint, if they do not have a prescription for a drug, that is considered an illegal drug. And it could affect their working environment and ability to do their job just as much as something that would be an illegal drug.

Benskin:

What about a coworker of an employee who is abusing drugs, whether it’s prescription or street drugs – what’s the impact on their coworkers in that workplace?

Bottle of pills spilled onto table.
Dumas:

It’s going to vary. There are some privacy concerns – just from the flip side, bouncing off what Terri was saying – from the employer’s perspective. From the employee’s perspective, what right does a coworker have to question, when you’re talking about prescription drugs, the prescription of an adult? Many would argue, none. If a medical professional felt comfortable writing that prescription, what business is it of a layperson? I think that’s one of the questions that arises. It’s not a matter of being judgmental and claiming that everybody’s abusing these. The problem is that everybody isn’t abusing them. They’re drugs that some people legitimately need. But where do you draw that line? That’s where the gray area is, and that’s why there aren’t a lot of numbers on the abuse of prescription medications, because there are so many unknowns.

Sweeten:

One thing from a coworkers’ standpoint: If your employee is under the influence, or your coworker, and they’re doing something that’s unsafe behavior, a lot of times your life and safety rely on that employee. So, if you feel safe and confident that coworker has your safety in mind, and will keep you safe, then that’s one thing. But a lot of times, I think coworkers are like, “I really don’t want to work with that individual. They’re under the influence. I want to make sure he or she doesn’t do something that’s going to injure me.”

The importance of drug and alcohol policies

Dumas:

Terri, is that something that’s typically included in a policy?

Sweeten:

Yes, we would include prescription as well as illegal drugs in a policy to cover that type of thing. What we’re seeing right now is that it used to seem like people used drugs more for that one-time high or that one activity over the weekend. But everything that we’ve learned from training on recognizing drug and alcohol use, and people under the influence in the workplace, all of it says it’s becoming a norm. That’s what they do on a normal day. Kind of like what you were talking about, Breck – what do I do on a normal day? I get up and pop these pills; it’s how I manage; it’s how I function. It’s hard for employers to decide who is or isn’t under the influence of drugs, because that may be the normal day for that employee. That’s the normal way they act. It’s sometimes difficult to make a determination.

Benskin:

If an employer has had reports from employees who think they have a coworker abusing drugs, and performing unsafe acts in the workplace that may injure themselves and/or coworkers, what would the steps be for an employer to address that issue with the employee who may be abusing drugs?

Sweeten:

One: there’s always suspect drug testing. We hope they have pre-employment, post-accident, random testing, and then reasonable suspicion. All of those programs kind of work together to build a pretty solid drug and alcohol policy. If they suspect someone, they need to have a program where they can get them tested. And then, if they are taking a prescription, they need to know what that is and what the consequences of that drug are. Can they drive? Are they not supposed to? Can they operate equipment? They need to know what they can and can’t do under that prescription. That employer’s liable if they put an employee in a vehicle and they’re under the influence of a narcotic or something. If they shouldn’t be operating a vehicle, the employers have a liability to understand that.

Files and policies in a drawer.
Benskin:

I’m glad you pointed out the liability concern, because I think that’s something that a lot of employers don’t think about in this situation.

Sweeten:

We’re seeing more and more positives for prescription drug use without a prescription, so that’s something employers need to make sure they have in their policy: a prescription drug without a prescription in your name is considered the same as an illegal drug.

And they should follow their policy. Whatever their personnel policy is regarding that, they follow it across the board. Don’t discriminate against an employee for legal or illegal drugs. We’re hearing a lot of claims where it’s their mom’s or their sister’s or their grandmother’s. How did you get access to it? “I don’t know; I don’t know where it came from.” Those types of things. If they don’t have a medical prescription that they can prove, that is considered an illegal drug and they’re under the influence.

Benskin:

If you have an employee who has a prescription for a drug but it’s affecting their work, how does an employer deal with that?

Sweeten:

They need to go to the next step: Have that employee prove what it is, prove they have a prescription, and have the medical director say what they can and can’t do. From there, they probably need to seek some legal counsel on their actions from there as far as dismissal, getting them through a rehab program, and programs you can offer that employee to keep them safe. Again, that employer is liable for that employee in the workforce, environment and community. If they’re doing something that benefits the employer, they’re liable for that employee.

How widespread is the drug and alcohol problem?

Benskin:

Breck, what types of stats did you uncover in your research for the article about how widespread this problem is in the workplace?

Dumas:

Good question. The answer is: It varies, and a lot of the stats are questionable, because it comes down to self-reporting a lot of times. There was one survey done in the U.S. that showed that seven out of ten workers are on some kind of medication at work. That could be over the counter; it may not mean anything. The point is that it was self-reported. They could show which industries had a higher prevalence of usage, which we mentioned earlier: retail and food services. Third and fourth were education and healthcare respectively.

I think something that’s really critical, that we may not have touched on enough, is the reduction in the stigma surrounding prescription drug usage or even street drug usage. Think about it: There are so many states in the U.S. that have legalized marijuana. There’s a lot of confusion surrounding what’s a street drug and what’s not. And of course, marijuana in particular is considered something that people take for medical reasons now, and in some areas, you get a prescription. We all know, at least early on during my working career for the past 20 years, anybody who would test positive for having marijuana in their system would probably not get certain jobs.

Now we’ve seen that happening with prescription drugs as well. I think it’s because there are, like we mentioned earlier, people with legitimate conditions. But I also had a counselor tell me that the problem is that anyone can really read up and report symptoms to obtain these drugs. When you’re looking at a self-reported system to get a prescription, it makes it pretty easy and that’s why it’s so prevalent among healthcare workers.

What was also interesting – and I don’t know how far you want to go down this road, Garrett – but another touchpoint on reducing this stigma. Some may have heard that out in Silicon Valley, in a lot of IT areas, they’ve been using something called microdosing of psychedelic drugs. That’s something that’s sort of been used by brainiacs, and really, the next cool thing to do. So, which drugs are we talking about? That’s really what it comes down to. Another worldwide study on academics showed that one in five were basically boasting about the fact that they were using drugs to enhance their performance. Those tend to be neuro-enhancers. So, hey, some people might consider marijuana to be a neuro-enhancer. Many also are going to consider marijuana to be benign in certain workplaces compared to a narcotic or something more serious – or steroids, which we have also seen too.

Role of the legalization of marijuana

Benskin:

That’s great that you spoke about the legalization of marijuana, because it blurs the lines of what we see as illegal drugs and prescription drugs and the stigma associated with those. Terri, I know in Missouri we don’t deal with legalized marijuana, but in those states that do, how do you think employers deal with that? It’s kind of a new situation where marijuana went from being an illegal substance to now being something that’s dispensed freely. How could an employer deal with that?

Sweeten:

I get that question regularly when we do training: What happens when they legalize marijuana in Missouri? What do we do? Well, alcohol is legal, and you still have a policy that says you’re not allowed to be under the influence in the workplace environment. It would fall under that same policy. It may be legal, but if an employer has a policy that says you cannot be under the influence, then that would be what their policy is, and employees would still not be able to use marijuana during the workday.

Pharmacist examines a lab test.

One thing with marijuana is that it stays in your system a lot longer than alcohol tends to, so that’s one of the questions. But many employers have what we call a “zero-tolerance” policy. If you test positive, if it’s your day to be tested or you’re somewhere along the testing process – if the company is zero-tolerance then they follow the personnel policy, whatever that policy is. Alcohol is the same way. I do think you’ll start seeing – and we’re starting to hear a lot more on it – there will be an “influence level” at some point. Now, alcohol is .08. You’ll have something like that for marijuana soon, and that will be kind of a baseline. What we tell our employers is: have a zero-tolerance policy. If they test positive, that’s what your policy is, and you follow your disciplinary action at that point.

Benskin:

You brought up an important aspect, that marijuana does stay in the system so much longer, and at some point they’re going to have to establish that level of what indicates being under the influence. Over time, if, say, an employee used it on a Saturday on their personal time, it’s still in their system on Monday, Tuesday, Wednesday of that following week. At some point, they’re going to have a to set a level of influence based on how that drug degrades in the system over time. The zero-tolerance is obviously the best practice. If there’s any influence or any drugs or alcohol in the system, then that’s cause for reprimand from an employer.

Don’t discriminate with your drug testing policy

Sweeten:

One of the other things with a drug and alcohol policy is that it’s very important for employers not to discriminate. I hear a lot of employers say, “Well, I’m pretty sure he wasn’t under the influence, so we didn’t test.” “I know him; I’ve known him for years.” Unfortunately, those are the individuals starting to test positive and we’re seeing them test positive. We’re also seeing a lot of positive tests in older employees – the ones in their 50s and 60s. They’re testing positive for illegal drugs, and in some cases, opioids and heroin and meth.

Employers should not discriminate. If you have a post-accident drug and alcohol policy, everyone should be tested across the board. It keeps legal liability from them. It takes out the “I think they are”/“I think they aren’t,” or supervisors happen to decide yes, this employee is, or no, they aren’t. It takes it completely out. If you’re injured on the job and you seek medical care, you need to have a post-accident drug and alcohol test.

Benskin:

One question back to you, Breck: You talked about these neuro-enhancing drugs. It’s kind of a question to both of you guys. All the research and surveys you saw were self-reported numbers. If you have an employee who is using the neuro-enhancing drugs, not necessarily marijuana or cocaine or some of the harder drugs, are those substances going to show up on a standard drug panel if an employer tests them?

Sweeten:

It will not show up on a five-panel. You’re going to have to go closer to a 10- to 14-panel to get some of these enhancement-type drugs to show on a panel. A lot of our employers are starting to do a higher panel because you have bath salts, all of those different things that are out there in the industry, and you have to get a higher panel to get those. They’re a little more expensive but they’re going to find out what a person has in their system. We’re also seeing a lot of employers do more hair follicles, blood testing, things like that, which show you more than just a urine test will show.

Hiring practices and final thoughts

Dumas:

If I could jump back to marijuana, and then we’ll get back to prescription. I followed this story of a welder actually who was moving from Missouri to Colorado because it was his understanding that the welding industry there has a real need for workers who can pass a drug test. I wanted to ask Terri – we were talking about, on the prescription and enhancement side, with white collar in particular, that some employers may not want to do the testing even if they could do so appropriately. When we’re talking about that specifically, have you seen on your side of things that employers are going to turn a blind eye due to worker shortages?

Sweeten:

Exactly. We’re seeing that now. In a lot of areas in central Missouri, and throughout the state actually, I have employers say that they can’t hire someone that has a clean drug test. They’re having problems with that. We have some employers with a sign on the door, and they say over half the people look at that sign and turn around and walk out. So yes, it is becoming an issue and like you said on the white collar, some of that is, that’s how employers get the best performance. It’s how they get them to put in longer hours and things along that line. But what comes with that tends to be an increased accident rates, and burnout, and stress claims resulting from a work comp standpoint.

Dumas:

Circling back to the prescription drugs and neuro-enhancers. If there is a prescription for it, and an employer becomes aware of alleged abuse, I’d think that there could be liability on the other end if that employee was let go. Because who’s to say that their work was impacted? That’s what Terri’s speaking to – having a policy in place that’s more specific would be helpful. Otherwise, there’s the flip side of getting sued for wrongful termination for somebody who might have a legitimate prescription. That’s what’s tough.

Benskin:

I think that brings us to the end of this episode. Thank you both for joining us today; I think we covered some topics that are going to get people thinking differently on alcohol and drugs in the workplace.


Thanks to Terri and Breck for sharing their expertise on the podcast. Check out our other WorkSAFE Podcast episodes, and subscribe for more workplace safety stories and insight.

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