Preventing Substance Use in the Workforce

There are a number of steps employers can take to prevent substance use among employees. Employee assistance programs (EAPs), health and well-being programs, and unions can be allies in preventing substance use by supporting employee education on substance use and providing information on how to access help for a potential substance use disorder. Changes to work processes or conditions that reduce the risk of injury can also help by reducing the number of employees who may receive opioids for the treatment of injury-related pain. Efforts to reduce workplace stressors and to eliminate or reduce alcohol consumption at company social events may also be helpful in reducing substance use in the workforce

Under the Drug-Free Workplace Act of 1988, federal workplaces and non-federal workplaces with a federal contract of $100,000 or more or a federal grant in any amount must implement a Drug-Free Workplace Program. Drug testing can help reduce substance use among employees and can help identify employees who may have a substance use disorder. In a recovery-ready workplace, positive drug tests are first and foremost an opportunity to engage employees and support them in stopping drug use whenever possible.

In 2020, the American Public Health Association released a policy statement entitled A Public Health Approach to Protecting Workers from Opioid Use Disorder and Overdose Related to Occupational Exposure, Injury, and Stress. The statement recommended that employers take a number of steps, including the following:

1. Improve occupational injury and illness prevention programs by assessing injury and illness risk factors and taking corrective actions.
2. Address ergonomic hazards that may lead to musculoskeletal injuries, which affect productivity, contribute to workplace absences, and cause pain that may be treated inappropriately with opioids, putting workers at risk of opioid use disorder.
3. Provide training and information on opioid misuse, including employees training and timely targeted information for injured employees.
4. Offer or facilitate access to peer support in the workplace to reduce the risk of a return to substance use disorder and to help workers in need access substance use disorder treatment.
5. Reduce opioid and other controlled substance prescribing through workers’ compensation prescribing guidelines.
6. Offer alternatives to discipline programs (also known as second chance programs) in relation to positive drug tests or other evidence of substance use

APH noted that punitive workplace substance use policies, including zero-tolerance and last chance policies represent a major obstacle to employees reaching out for help with substance use.

NEW NORC at the University of Chicago and the National Safety Council jointly developed Substance Use: Prevention, Screening Tools and Workplace Policies, a resource that provides prevention and early identification recommendations for employers. The National Safety Council Opioids at Work Employer Toolkit provides additional prevention resources.