Illicit Drug and Alcohol Use: The Underlying Causes of Unsafe Behavior

Lack of worker focus, common human factors at work, blame culture, the list goes on... Organizations are challenged daily by one of the most common causes of workplace incidents; the unsafe behavior of people. Behavior-Based Safety (BSS) is a widely known scientific approach that aims to identify and change workers' unsafe behavior. Although its methods and models have been criticized, and may seem outdated in the 21st century, its main idea remains true: human behavior (unsafe behavior) is the cause of many incidents.

The reasons behind unsafe behavior vary, however, there are some factors, such as alcohol and drug use, that are proven to alter human behavior.

“The overwhelming cause of most industrial accident and injuries can be contributed to the unsafe acts of employees." (Unsafe Acts - Human Behavior)

To decrease the occurrence of unsafe acts, employers must address the immediate and root causes behind them. This is not a one-off project. What is needed is a long-term plan to address the “catalysts” that make workers behave in an unsafe manner.

There are ways organizations can tackle unsafe behavior originating from outside of work. Whether it’s side-effects from substance use, fatigue from pulling all-nighters with small babies or stress caused by financial problems, action should be taken so that they don’t have the chance to cause damage in the first place.

Opioid epidemic

Unsafe Behavior Caused by Opioid EpidemicThe opioid epidemic in the US has brought a new series of hazards to the workplace. Drugs and alcohol alter human behavior, and even when not used onsite they cause side-effects that can jeopardize workers’ safety.

In low risk jobs these side effects have less of an effect; however, when it comes to high risk jobs, all possible dangers must be evaluated. Unfortunately, employees are not likely to approach superiors about their personal issues, especially when it’s something as sensitive as illicit drug use - therefore a more systematic approach is needed.

Misuse of opioids, drugs and other substances should not be taken lightly by anyone. Opioids killed more than 42,000 people in 2016, and 70% of the estimated 14.8 million Americans using illegal drugs are currently employed. According to an analysis by Quest Diagnostics, employee drug use is at its highest for a decade.

“Three-quarters of those struggling with addiction to alcohol, pain medication, marijuana and other substances are employed. Workers with substance use disorders miss nearly 50% more work days than their peers – up to six weeks annually – and absenteeism leads to losses in productivity." (National Safety Council)

Safety, Illicit Drugs and Alcohol

The opioid epidemic in the US and the legalization of Marijuana (2015) in 26 US states have raised questions about the impact drugs can have on workplaces and their safety.

MarijuanaThis increasing substance use has proven to reduce safety. Marijuana, opioids and non-alcoholic drugs are already a far more common cause for traffic incidents than alcohol.

According to a study released by the Governors Highway Safety Association (2016), 44% of fatally-injured drivers tested positive for drugs, whereas in 36% of the cases the impairing substance was alcohol. More than half of the drug-affected drivers had marijuana, opioids or a combination of the two in their system. These numbers reflect the nationwide increase in drug use and the risks they pose to our safety (Forbes).

According to OSHA,

“Overdoses from the non-medical use of drugs or alcohol while on the job increased from 165 in 2015 to 217 in 2016, a 32-percent increase. Overdose fatalities have increased by at least 25 percent annually since 2012.

Side-effects & After-effects

Drug side-effectsEven when not under the influence of drugs, the use of different substances causes severe side-and after-effects and alters worker behavior.

Alcohol and drug use increase the risk of problems in the workplace such as absenteeism, presenteeism, low productivity and inappropriate behavior." (BMA)

In addition to these, fatigue, poor decision-making and needless risk-taking are some of the most common symptoms of both drug and alcohol use.

Some facts about workplace accidents related to alcohol use:

  • “Workers with alcohol problems were 2.7 times more likely than workers without drinking problems to have injury-related absences
  • A hospital emergency department study showed that 35 percent of patients with an occupational injury were at-risk drinkers
  • Breathalyzer tests detected alcohol in 16% of emergency room patients injured at work
  • Analyses of workplace fatalities showed that at least 11% of the victims had been drinking

Drugs and alcohol cause workers to be less aware. They cause them to be less concerned for their and others’ safety. Drugs and alcohol slow reaction time. They put co-workers and careers at risk.

If a worker is under the influence of an impairing substance at work, their inhibitions get lower and the tendency of violent behavior rises. Even if a worker is not intoxicated during work, after-effects of substance use (hangover, withdrawal) will have an impact on their job performance.

Family members and friends of an alcohol or drug user may also suffer from lower job performance.

In addition to safety issues, alcohol and drug use can make organizations lose time and may have a negative impact on the workplace culture and safety.

Prescription medication

The problem with drug use doesn’t limit itself to illicit drugs. People react differently to prescription medication which can be easily misused. Prescription opioids (used to treat moderate-to-severe pain) have created a nationwide addiction spiral. According to the National Safety Council, four out of five new heroin users started out by misusing prescription opioids. It is therefore essential to make sure workers are aware of the risks involved with opioid painkillers and that they know better than to share their personal opioid prescriptions with their colleagues, for example.

Many users are unaware of the fact that opioids are as addictive as heroin and can cause dependence in a matter of days.

DependenceEHS professionals can help fight the opioid crisis. Opioid painkillers are being prescribed for workplace injuries. This means that in addition to absence from work, occupational injuries are one of the reason workers get exposed to the highly addictive medication. OHS also holds the responsibility to protect their workforce from occupational exposure to the substances at work (Mark Ames).


Addiction is not the only risk. Like other substances, prescription opioids have strong side effects:

“Some of the hidden side-effects of opioid painkillers include rapidly developing addiction, withdrawal, constipation, permanent changes to brain chemistry, nausea, respiratory depression, increased sensitivity to pain, driving impairment and decreased sex drive." (National Safety Council)

By addressing opioid, illicit drug and alcohol use, organizations will not only be alleviating the national crisis, but will also benefit themselves. By eliminating substance use, employers can expect to see improvements in incident rates, productivity and the overall workplace culture.

How to approach drug and alcohol use at work?

There are ways employers can reduce the use of intoxicating substances. Educating employees about the risks of substance abuse and the risks they pose to our safety is essential. Implementing drug-testing, providing professional support services and wellness programs, and encouraging safe behavior across departments are good ways to tackle the problem.

Employers can offer services and programs to support those suffering from alcohol/drug abuse, or other health and/or personal problems. One such program is  the Employee Assistance Program (EAP). According to NCADD, this program should offer:

“…short-term counselling, assessment, and referral of employees with alcohol and drug abuse problems, emotional and mental health problems, marital and family problems, financial problems, dependent care concerns, and other personal problems that can affect the employee’s work."

Having counsellors come in from outside the workplace makes it easier for employees to approach and get help for their problems.

In addition to providing professional support, organizations can implement drug-free workplace and other written substance abuse policies.

Small companies may find it more difficult to establish such programs and policies. However, according to NCADD:

  • “alcohol and drug treatment has been proven to reduce healthcare costs,
  • EAPs and drug-free workplace policies improve workplace productivity and morale, and decrease accidents, absenteeism, downtime and turnover, and
  • Organizations with long-term programs have better health status and lower use of medical benefits amongst their workforce. “

Implementing such strategies will reduce costs related to worker wellbeing, injuries, absences and productivity.

Drug/alcohol testing

Drug testing is an efficient way to establish a drug-free workplace. However, employees may feel that their privacy is being invaded and that they’re not being trusted by their employer. This is a valid point; however, if it’s made clear what the policy is, why it’s been implemented and in what circumstances testing is to be done, employees may accept it better. There are many law cases where such issues are being solved. The court may therefore both “reinforce and sometimes … limit drug testing." (Andrew Current)

Both government and private sector employers can legally test their employees. Job applicants may be required to go through drug testing prior to receiving a job offer, and for some industries drug testing is a requirement; such as transportation, aviation and industries that require the operation of heavy machinery or a motor vehicle.

There is no federal law that regulates drug testing in the private sector; however, it depends on the state law and the company policy whether this is a contingency for an offer ( When it comes to high-risk jobs, the state law is already likely to require drug testing.

Federal and state laws in the US provide guidelines on the policies workplaces are allowed to set for substance abuse.

Addressing the cause of unsafe behavior

Changing human behavior is difficult, and there are aspects that cannot be controlled. However, in the case of impairing substances the reason for behavioral change is something that can be taken out of the picture to begin with. Now, if we can eliminate the use of drugs and alcohol at work, we have a better chance of reducing the unsafe behaviors rooted in their use.

Stop DrugsPrescription opioids, illicit drugs and alcohol are all traceable causes of unsafe behavior. Employee drug use is at its 10-year high, and opioid painkillers have exposed many workers to the dangerous addiction spiral.

Employers can, by establishing drug-free workplace programs, send a clear message that the safety of the workforce comes first. Even if drugs were used outside of work hours, they have severe side-effects that can at worst endanger other people’s lives in the workplace. Employers should therefore invest in supporting programs and take the measures to eliminate the known (controllable) root cause for work incidents and injuries.

The action taken by workplaces could make a significant difference nationwide and help many of those struggling with addiction. If organizations say no to drugs, then employees (70% out of the 14.8 million employed drug users) would have to say no too. It goes without saying then that OHS professionals play an important role, and their actions can make a significant difference in tackling the opioid crisis.

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A Copenhagen Business School graduate with a MA in International Business Communication, Tytti joined the Pro-Sapien marketing department in 2017 and brings a wide range of experience to the team – not to mention the ability to fluently speak three languages, Finnish (native), English and Spanish. Outside of business Tytti is an avid gymnast having competed at international level in the Aesthetic Group Gymnastics Championships, and has lived in Finland, France, Argentina, Spain, Denmark and now the United Kingdom. As the Graduate Marketing Executive Tytti coordinates Pro-Sapien’s social outreach and blog content, and can be reached at