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Just Say Yes to Preventing Substance Abuse

Safety remains a key reason to keep up the fight against workplace drug and alcohol abuse.

A booming economy, resulting in low unemployment, and a six-year decline in injury and illness rates have resulted in prosperous and safe workplaces across the country.

Despite this optimistic scenario, substance abuse experts say this is not the time for U.S. businesses to let down their guard against the use of dangerous drugs and alcohol by employees. Drug and alcohol abuse is a societal problem that never will go away completely in the workplace, no matter how comprehensive a company's substance abuse program.

Even though these programs have existed for years, government studies reveal that 70 percent of illicit drug users age 18 to 49 work full time, more than 60 percent of adults know people who have gone to work under the influence of drugs or alcohol, and drug-using employees are 3.6 times more likely to be involved in a workplace accident and five times more likely to file a workers' compensation claim.

Yet, because it has become more difficult to fill job openings in many industries, there have been rumblings that some companies are considering eliminating drug testing as part of their substance abuse program. The reason: They fear they will not be able to keep or find enough workers otherwise.

Moreover, attempts to use adulterants, designed to alter drug test results, have increased in the last few years. For example, clean urine samples can be purchased through Web sites. As a result, drug testing companies have had to develop new ways of detecting adulterated samples.

Put Safety First

While the vast majority of workers are not substance abusers, it still is a significant enough problem -- nearly 14 million Americans are illicit drug users -- that employers should have a substance abuse program, said Garen Dodge, assistant director of the Institute for a Drug-Free Workplace. More employers are not only establishing these programs, he added, but are doing so for safety reasons.

"One of the trends I'm seeing is companies being proactive, realizing that the abuse of drugs and alcohol is a safety concern and, on that basis, establishing comprehensive substance abuse programs," said Dodge, who regularly assists companies in developing such programs. "Co-workers are recognizing that working next to somebody who's high on drugs or under the influence of alcohol is unsafe for that person and, potentially, for themselves."

The symptom that concerns Elena Carr the most is reports that some employers may abandon drug testing. Carr, substance abuse coordinator for the Department of Labor's Working Partners for an Alcohol- and Drug-Free Workplace, worries that employers will take this route instead of increasing treatment efforts.

"It is an employer's choice that probably is affected by the state of the economy," said Carr, formerly director of AFL-CIO's Substance Abuse Institute. "In the early 1990s, when there were lots of workers to choose from, testing and firing people was definitely the route of choice for many employers."

Now, the testing pendulum may begin swinging the other way. Dodge, who is a partner with the Washington, D.C., law firm of Littler Mendelson, also has heard the argument that testing should be relaxed if companies cannot fill their job openings.

"The counterargument is that a company will spend more money on a bad employee than if a position is not filled," Dodge said. "Is it cost-effective to relax drug testing and take on the chronic drug abuser who is more likely to be sick, late, unproductive, use drugs on the job and introduce drugs to co-workers?"

Numerous studies, reports and surveys suggest that substance abuse is having a profoundly negative effect on the workplace in terms of decreased productivity and increased accidents, absenteeism, turnover and medical costs. One accident costs a business an average of $12,000 to $16,000, according to the National Safety Council. Accidents caused by substance abuse also represent an area of high liability. In 80 percent of serious accidents caused by substance abuse, the injured party is not the abuser.

Yet, it is up to companies to decide whether to do drug testing because there are few federal workplace substance abuse rules. Apart from industries regulated by the Department of Transportation and federal contractors subject to the Drug-Free Workplace Act of 1988, employers mostly are left on their own to determine what type of substance abuse program to have or whether to have one at all.

While OSHA embraces the idea that having a drug-free workplace contributes to the safety of workers, Carr said, the agency has issued no standards for substance abuse programs and only provides information and assistance to employers and employees. "The impact of drugs in the workplace affects a small population of workers," she said. "It pales in comparison to other issues that OSHA traditionally deals with."

Despite a lack of regulations, most employers address substance abuse in some fashion. In a study released last year by the Substance Abuse and Mental Health Services Administration (SAMHSA), 70 percent of full-time workers age 18 to 49 reported that their workplaces had a written policy concerning drug or alcohol use. The study indicated that smaller companies were much less likely to provide information or have a written policy.

The percentage of full-time workers age 18 to 49 who indicated that their employer conducted any type of drug testing programs, whether at hiring, randomly, upon suspicion or post-accident, was 48.5 percent in 1997, according to the SAMHSA study. Drug tests, typically of urine, detect stimulants (such as amphetamines, cocaine), hallucinogens (marijuana, LSD), opiates and morphine derivatives, and depressants (alcohol, barbiturates).

No-nonsense Approach

Many companies not only have substance abuse programs for safety reasons but are avoiding the urge to soften their stance on drug testing in a low-unemployment job market.

Two companies -- United States Gypsum (USG) of Chicago and BE&K Construction of Birmingham, Ala. -- have a no-tolerance policy toward substance abuse in the workplace. Employees who test positive for drug or alcohol use are fired, while job applicants who test positive are not hired.

Both companies, members of the Institute for a Drug-Free Workplace, established substance abuse programs in the mid-1980s.

"We didn't start this program because we necessarily had a big drug problem," said Jeffrey Rodewald, director of employer relations for 13,000-employee USG. "We just felt it was necessary to do for safety reasons. Our drug and substance abuse policy is not based on a moral issue. That's not the concern. The concern is that we don't want people hurt on the job."

In the past three years at USG, a maker of wallboard and ceiling products, management has seen an increase in employees requesting assistance for substance abuse. "Part of the reason might be who's left to hire," Rodewald said.

Rodewald has seen job applicants stay off drugs long enough to pass a mandatory pre-employment drug test, then use drugs once they have been hired. That may be one reason why USG's positive rate for post-incident test results (almost 10 percent) is about double that of its pre-employment positive rate (5 percent), said Donald Schaefer, USG's director of occupational safety.

"With a full-employment economy, even though we're being selective and not seeing a real big change in our (pre-employment) rates, once they're in the work force, that may be part of what's driving up that post-incident number," Schaefer said.

The best way to combat the increase in post-incident positive test results, Rodewald contends, is through random drug testing, which is not allowed in some states. USG's employees have asked for, and received, increased random testing. "We had to find a way to deal with this problem from a safety standpoint and not wait for an accident to occur," he said.

USG employs drug testing at several stages as one element of a workplace substance abuse program (see "Five Steps to a Substance Abuse Program"). The company's multistage testing is representative of workplaces across the country. The SAMHSA study revealed that 38.6 percent of respondents reported drug testing was part of their hiring process, 25.4 percent were subject to random testing, and 28.7 percent worked at companies that tested after accidents.

As with a positive test result at any stage, someone with an adulterated sample is subject to dismissal. "We're not giving the person another opportunity to be re-tested," Rodewald said. The same goes for anyone who refuses to take a test. Any positive results are rechecked and confirmed before action is taken against an employee.

At BE&K Construction, the goal of its substance abuse policy is to provide and maintain a work environment free from the effects of substance abuse for all employees. That can be easier said than done, especially in an industry that has one of the U.S. work force's highest rates of illicit drug use at 14.1 percent and heavy alcohol use at 12.4 percent, according to the SAMHSA study. The core age group of substance users, 18 to 34, constitutes the bulk of construction workers.

Even so, BE&K does not back down from its goal of being 100 percent drug-free at its sites in more than 15 states, said Bill Harris, personnel manager for the company's 3,000 construction workers. "We have a very strict program," Harris said. "There are no exceptions. From our chairman of the board down to the newest laborer, we're all subject to drug testing."

Like USG, BE&K does pre-employment, random, post-accident and for-cause testing to the tune of 1,200 to 1,500 samples per year. Each month, random sampling involves 10 percent of a project's work force.

A worker cannot be rehired for 90 days after the first confirmed, positive test result and for a year after the second offense. During that time, and before, the company's employee assistance program offers counseling. A worker will not be rehired if tested positive a third time.

Because marijuana is the most prevalent illicit drug, BE&K sets its cutoff level at 20 nanograms per milliliter. Most companies' policies set a threshold of 50 or 100 nanograms.

"I think we're the trendsetter and go above and beyond what's normal," Harris said, adding that BE&K's overall positive test results have dropped from 14 percent in the program's beginning to less than 5 percent today. "Other companies have modeled their policy after ours."

Alcohol Abuse

Not to be forgotten in any substance abuse policy is alcohol consumption. More than 11 million employed Americans are self-admitted heavy drinkers, the SAMHSA study revealed. Heavy drinking was defined as five or more drinks on five or more days in the past 30 days. In fact, 59 percent of U.S. workers believe that alcohol abuse is a major problem in the workplace.

Up to 40 percent of industrial fatalities and 47 percent of industrial injuries can be linked to alcohol consumption and alcoholism, according to the 1989 Occupational Medicine article "Management Perspectives on Alcoholism: The Employer's Stake in Alcoholism Treatment."

USG's policy allows for temporary suspension and testing of a worker who has a "detectable presence" of alcohol, Rodewald said. If a test is positive, the worker's job status depends on the blood alcohol content from a test. If the test result is at or above 0.08 percent, the employee is dismissed. If below 0.08 or there is no detectable presence, the worker is returned to work with back pay.

If a presence is repeatedly detectable, but always measures less than 0.08, it becomes a performance issue. "Just because you're under the legal limit doesn't mean you can keep coming in to work in that condition," Rodewald said, adding an employee is subject to discipline for repeated measurable presences of alcohol below the legal limit.

Employers who do not have a substance abuse program or may be thinking of doing away with drug testing should reconsider, Working Partners' Carr said. "Drug and alcohol use and abuse is something you can't afford to ignore," she said. "Even though it may not be required, having a drug-free workplace program is the right and the smart thing to do."

For more information on workplace substance abuse programs, contact the Institute for a Drug-Free Workplace, a business coalition formed in 1989 to serve the common interests of employers and employees in preventing drug abuse and its impact on the workplace, at (202) 842-7400 or on the Internet at

SAMHSA supports a workplace helpline at (800) 967-5752, which provides assistance to employers developing and implementing substance abuse prevention programs. SAMHSA's Web site is

Five Steps to a Substance Abuse Program

A comprehensive substance abuse program typically includes five components: a written policy, supervisor training, employee education and awareness, an employee assistance program, and drug and alcohol testing.

Step 1: Write a Substance Abuse Policy

Before writing the policy, Working Partners for an Alcohol- and Drug-Free Workplace suggests conducting a needs assessment to better understand your company's situation and determine what you want the program to accomplish. Remember, workers should be your allies in this process.

A written policy has three basic parts: an explanation of why you are implementing a program, a description of substance abuse-related behaviors that are prohibited and an explanation of consequences for policy violators. The policy should identify all elements of the substance abuse program.

Step 2: Train Supervisors

Supervisors are responsible for identifying and addressing performance problems that may be the result of substance abuse. While not expected to diagnose conditions, supervisors should be able to identify the signs of poor job performance.

Train supervisors to understand the company's substance abuse policy and procedures, to identify and help resolve employee performance problems, and to know how to refer employees to available assistance.

Step 3: Educate Employees

Educating workers is considered a critical step in achieving the program's objectives. A basic program should achieve several objectives:

  • Provide information about the dangers of alcohol and illicit drugs.
  • Describe the impact that substance abuse can have on workplace safety, accident rates, health care costs, absenteeism, productivity, product quality and the bottom line.
  • Explain, in detail, how the policy applies to every employee and consequences for policy violations.
  • Describe how the basic components of the program work. Components might include an employee assistance program (EAP) and drug and alcohol testing.
  • Explain how employees and their dependents, if included, can get help for their substance abuse problems.

Step 4: Provide Employee Assistance

Many companies use EAPs to assist workers whose job performance is negatively affected by personal problems, including substance abuse. Employers have found that EAPs are cost-effective because they help reduce accidents, workers' compensation claims, absenteeism and employee theft.

EAPs, if they are to be successful, should be viewed as a confidential source of help. Workers, though, should understand that it will not shield them from disciplinary action for continued poor performance or policy violations.

Step 5: Drug and Alcohol Testing

By itself, testing is not a substance abuse program, but it can be an effective deterrent to drug use and an important tool to help employers identify workers who need help. Consider who will be tested, when testing will take place, what substances will be tested, what consequences workers will face who test positive and who will administer the testing.

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