Drug and Alcohol Policies: Are They Up to Date?

Paul Chamberlain, Asplundh Engineering Services, LLCSpring 2024 Columns, Columns, Safety Corner

On a recent family vacation to Florida, this author was amazed at the number of locations openly advertising the purchase of medical marijuana. This discovery highlighted the need to revisit current information on the legalization of medical and recreational marijuana (Figure 1). 

Figure 1: Marijuana Legalization by State
Map courtesy DISA Global Solutions, https://disa.com/marijuana-legality-by-state

With recreational or medical marijuana use now legal in many US states, workplaces should review their health and safety or human resources policies regarding alcohol and drug use. If the workplace does not have a policy, it’s high time to create one. 

WHY IS A WORKPLACE DRUG AND ALCOHOL POLICY IMPORTANT?

What if your job is considered safety sensitive, such as working with live-line voltages and a coworker shows up for their shift and smells like a distillery? Are you a supervisor and an employee calls to tell you their driver’s license was suspended over the weekend and they will be unable to show up for work without a ride? What exactly are employers, supervisors, and coworkers supposed to do when someone they depend on is clearly under the influence of alcohol or drugs? It’s a sensitive subject that affects many US citizens. 

SUBSTANCE-USE FACTS AND STATISTICS

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), illegal and illicit drug use is increasing and becoming a growing workplace hazard to worker safety. SAMHSA conducts an annual National Survey on Drug Use and Health (NSDUH).[1] This survey is a major source of information on substance use, abuse, and dependence among Americans 12 years and older. Survey respondents report whether they have used specific substances ever in their lives (lifetime), over the past year, and over the past month (also referred to as current use). Most analyses focus on past-month use. SAMHSA ’s 2022 NSDUH survey found:   

Alcohol Use

  1. Among the 137.4 million current alcohol users aged 12 or older, 61.2 million people (or 44.5%) were past-month binge drinkers. The percentage of people who were past-month binge drinkers was highest among young adults aged 18 to 25 (29.5% or 10.3 million people), followed by adults aged 26 or older (22.6% or 50.1 million people), then by adolescents aged 12 to 17 (3.2% or 834,000 people).
  2. Among people aged 12 to 20, 15.1% (or 5.8 million people) were past-month alcohol users. Estimates of binge alcohol use and heavy alcohol use in the past month among underage people were 8.2% (or 3.2 million people) and 1.7% (or 646,000 people), respectively.

Illicit Drug Use

  1. Marijuana was the most commonly used illicit drug, with 22.0% of people aged 12 or older (or 61.9 million people) using it in the past year. The percentage was highest among young adults aged 18 to 25 (38.2% or 13.3 million people), followed by adults aged 26 or older (20.6% or 45.7 million people), then by adolescents aged 12 to 17 (11.5% or 2.9 million people).
  2. Among people aged 12 or older, 3.2% (or 8.9 million people) misused opioids (heroin or prescription pain relievers) in the past year. Among the 8.9 million people who misused opioids in the past year, 8.5 million people misused prescription pain relievers compared with 1.0 million people who used heroin. These numbers include 587,000 people who misused prescription pain relievers and used heroin in the past year.

Fentanyl Misuse

  1. 991,000 people aged 12 or older (or 0.4%) misused prescription fentanyl or used illegally made fentanyl (IMF) in the past year, including 686,000 people (or 0.2%) who used IMF in the past year.
  2. IMF may be present in products sold as heroin or fake prescription drugs without people’s knowledge. Caution must be taken to avoid misinterpretation of estimates of fentanyl misuse and IMF use.

Substance Use Disorders

  1. 48.7 million people aged 12 or older (or 17.3%) had a substance-use disorder (SUD) in the past year, including 29.5 million who had an alcohol-use disorder (AUD), 27.2 million who had a drug-use disorder (DUD), and 8.0 million people who had an AUD and a DUD.
  2. The percentage of people aged 12 or older with an SUD in the past year was highest among young adults aged 18 to 25 (27.8% or 9.7 million people), followed by adults aged 26 or older (16.6% or 36.8 million people), then by adolescents aged 12 to 17 (8.7% or 2.2 million people).
  3. Among the 29.5 million people aged 12 or older in 2022 with a past-year AUD, most (59.1%) had a mild disorder compared with about 1 in 5 (20.7%) who had a severe disorder.
  4. Among the 19.0 million people aged 12 or older in 2022 with a past-year marijuana use disorder, most (55.1%) had a mild disorder compared with only 17.3% who had a severe disorder.

A SAFETY ISSUE

Impaired workers can cause serious injury or damage to themselves, fellow employees, or expensive components or equipment. Developing a comprehensive workplace drug and alcohol policy, along with an effective testing procedure, is essential for any workplace that has people working in hazardous environments or on equipment that requires elevated safety sensitivity. Resources like SAMHSA[2] can help workplace policymakers develop such a program. Once such a program is developed, notification and training of all employees is essential.  Contracting with a third-party company can help with random selections as well as testing and analysis. These companies can buffer a workplace from potential lawsuits that may occur should an employee be terminated from employment for a positive drug or alcohol test.

Managers who will be responsible for administering any program should go through additional training on how to manage it. This may include training on reasonable suspicion or post-accident drug and alcohol testing or how to give proper notice to an employee should they be selected for a random test.

Employees should be reminded regularly to be aware that some prescription or even over-the-counter drugs could affect their performance. Certain cough medicines, pain medications, and many others can have detrimental effects. The company should appoint a designated employee representative (DER) to not only maintain drug testing records, which must be kept confidential but also to be a point of resource when it comes to questions regarding these drugs.

CONCLUSION: FIT FOR WORK VS. THE HANGOVER EFFECT

Statistics show that when it comes to alcohol and other drugs, we cannot underestimate the influence of our behavior while off the job. Many incidents occur the morning after when blood alcohol levels can still be high.  When a worker experiences a hangover, their impaired senses due to excessive alcohol or drug consumption can significantly increase the likelihood of workplace incidents, especially in safety-sensitive industries like ours where operating machinery or equipment is crucial.

Research has found a correlation between the frequency of being hungover at work and other workplace events such as feeling sick at work, sleeping on the job, and having problems with tasks or co-workers. Studies show that employees with substance abuse issues may be frequently tardy or have more missed days of work (sick, vacation, or just never clocked in). It can become an operational issue for managers to continue backfilling positions to ensure work is completed in the time allotted. 

One study published in the American Journal of Psychiatry investigated the hangover effect as demonstrated by pilots tested in flight simulators. The study found there was still “evidence of impairment 14 hours after pilots reached blood alcohol concentrations (BACs) of between 0.10% and 0.12%”…and that pilots were still significantly impaired eight hours after reaching a BAC of 0.10%. This study effectively illustrates not only how performance is decreased long after use has concluded, but how it also contributes to an employee’s potential missed time off work.

Every individual in a workplace has a personal responsibility to ensure the safety of themselves and others. Part of that responsibility is to encourage and help someone with an alcohol or drug problem seek assistance through an employee assistance service or a supervisor. If that individual is putting themselves or others in danger, you have a responsibility to report that individual to a supervisor or leader. The adage “You are your brother’s keeper” is accurate in this case. The employee may not only prevent injury to their brother worker but also potential injury to themselves or others. 

Based on usage statistics and constantly evolving legislation, the guiding principles of alcohol and drug policies continue to include shared responsibility for safety, an understanding of how behavior on and off the job affects safety, and balancing safety and privacy interests. 

REFERENCES

[1] DISA Global Solutions. Marijuana Legality by State, November 20, 2023. Accessed with permission at https://disa.com/marijuana-legality-by-state.

[2] SAMHSA. National Survey on Drug Use and Health (NSDUH). Accessed at www.samhsa.gov/data/sites/default/files/reports/rpt42731/2022-nsduh-main-highlights.pdf.

[3] SAMHSA. Drug-Free Workplace Programs. Accessed at https://www.samhsa.gov/workplace.

[4] Yesavage JA, Leirer VO. “Hangover Effects on Aircraft Pilots 14 Hours after Alcohol Ingestion: A Preliminary Report,” American Journal of Psychiatry, December 1986, Vol. 143(12), pp 1546–50. doi: 10.1176/ajp.143.12.1546. PMID: 3789207.

Paul Chamberlain has been the Safety Manager for Asplundh Electrical Testing, LLC (formerly American Electrical Testing Co., LLC), a subsidiary of Asplundh Engineering Services, LLC, since 2009. He has been in the safety field since 1998, working for various companies and in various industries. Paul received a BS from the Massachusetts Maritime Academy.