The case for workplace drug and
alcohol tests has no substance

Impaired thinking

Britain’s employers have a big drug and alcohol problem. They are wasting millions on testing and firing workers. Hazards editor Rory O’Neill says providing support and a healthier working environment would provide a cheaper and more effective resolution to the bad working conditions causing worker impairment.

Click on image for the full cartoon: Andy Vine

Taking liberties at work

Construction giant Laing O’Rourke likes testing its employees. In 2007 it tested almost as many for drugs and alcohol use as it provided with occupational health screening. And pushing 10 per cent of those tested – 114 out of 1,271 -were fired as a result.

Drug and alcohol testing is still a minority pursuit in British workplaces. A September 2007 Chartered Institute of Personal and Development (CIPD) survey report (1) indicated almost two-thirds of firms (65 per cent) don’t test now and have no intention of starting. But it is a relatively large and growing minority that is now pushing drug tests. The proportion tested has at least doubled in the last decade and, according to CIPD, has risen from 18 per cent of firms in 2001 to 22 per cent of firms in 2007. A further 9 per cent plan to introduce some form of testing.

Despite a decade of hype, however, the evidence of a workplace drug and alcohol problem – and particularly one that affects safety – is just as flaky as ever. Lack of evidence notwithstanding, the CIPD survey identified a further drug and alcohol problem. Firms are much more willing to take disciplinary action than they are to provide affected workers with support.

In doing so, companies may themselves be on the wrong side of the law, breaking rules on the privacy of workplace health information that say drug and alcohol tests much only be used where they provide “significantly better evidence of impairment than other less intrusive means.”

In almost every case, and particularly when it comes to drugs, there are more effective and less intrusive measures of impairment assessment than demanding hair, urine, saliva or breath samples.

Workers are only human. When they are struggling, often at least in part due to work pressures or exposures, they deserve the same respect for their human rights and compassion they might reasonably expect outside the workplace. This should mean measures to support them, not disciplinary action to punish them. But heavy-handed application of “zero tolerance” approaches to drugs and alcohol are leaving no room for human frailty.

A testing habit

Laing’s random testing programme may be unusually draconian – random testing is rare among the UK firms that do test, found CIPD – but still almost a third (31 per cent) of organisations said they had dismissed employees in the last two years due to alcohol problems. And more than 1 in 7 (15 per cent) had fired a worker for drug misuse.

By contrast, only half of the employers quizzed gave access to counselling for workers fighting dependencies on drink or drugs, with just 38 per cent offering coordinated rehabilitation. CIPD employer relations adviser Ben Willmott said: “Since 2001 the number of organisations with drug and alcohol policies has remained around the same (58 per cent) and where organisations do have policies they are doing very little to actively promote them.”

He added: “Clearly drug and alcohol misuse is an issue which needs to be taken seriously. Yet only a third of employers train managers in how to manage these sorts of issues at work.”

Drugs and alcohol use cannot be ignored, of course. But testing is a singularly inappropriate response. A major review, the Joseph Rowntree Foundation Independent Inquiry into Drug Testing at Work (IIDTW) published in June 2004 (2), noted: “For the majority of businesses, investment in management training and systems is likely to have more impact on safety, performance and productivity than the introduction of drug testing at work. There is a wealth of evidence that good and open management is the most effective method of improving workplace performance and tackling drug and alcohol problems amongst staff.”

Well-intentions companies sometimes just get caught up in the hype without giving too much thought to the purpose and practicalities of testing programmes, which is bad business all round.

Tim Gale, a national organiser with the stage and screen union Equity, told Hazards about the union’s experience at the Millennium Dome, where the union represented both stage management and performing staff. “The management wanted to impose random tests on all employees which we resisted, although we were forced to accept testing in those in ‘safety critical’ jobs in the stage management – operating heavy lifting machinery, in essence.” After protracted negotiations, however, “the management never actually put the policy into practice.”

WHY TESTING IS A BAD IDEA

Unsafe assumptions

Many employers certainly perceive there is a drug and alcohol problem at work. CIPD’s survey found 41 per cent of employers feel that alcohol misuse is a major cause of absenteeism and poor productivity. A third (34 per cent) of firms believe drugs have a similar impact.

In fact, IIDTW found the productivity argument may be as poorly justified as the safety case, with the evidence “inconclusive”.

And a 2007 report from Australian Safety and Compensation Council (ASCC), based on a review of literature, laws and practice worldwide, said “despite the intuitive link, there is little clear evidence on the links between drug use and absenteeism, low productivity, poor performance and accidents at work,”(3) echoing the findings of the UK report. ASCC, an Australia federal government agency, cited an official analysis of coroners’ reports on workplace deaths, either at work or on the roads. It found in that for 95 per cent of deaths at work neither alcohol nor drugs played any part – for drugs, the figure was 98 per cent.

Even where alcohol played a part, for “a third of these deaths alcohol had been consumed at least partly in connection with work, either during normal duties or at work-sponsored events.”

The ASCC report concluded: “The implications of consumption patterns, the timing of the consumption and the effects of withdrawal also need to be considered in any decision to implement an alcohol and illicit drug testing regime. The advantages of implementing testing regimes for the general working population could be quite minimal.”

In 2006, guidance from the Alberta Federation of Labour in Canada called on unions to oppose all types of mandatory tests.(4) AFL president Gil McGowan said the tests were an unwarranted invasion of privacy, adding “quite frankly drug and alcohol testing doesn’t work. It does not make workplace safer” (Hazards 97).

Weapon testing

But some companies find it easier to address their employees’ foibles than their own. And if they are getting it wrong on drug and alcohol tests, this poor practice is likely to be reflected throughout the management process.

In July 2007 Jim McCourt, who runs the Inverclyde Employment Rights Office in Glasgow, complained that random body searches and drug tests were commonplace in an Amazon factory shipping out books, CDs and DVDs across Scotland. He said the situation is spiralling out of control, as his office has received in the region of 50 calls for help from under-fire employees who work for the internet giant.

He told Hazards: “Amazon is unnecessarily heavy-handed with a workforce that is delivering for them. They are harsh and over zealous. I have concerns about the contract of employment which is just within the law.” He said the situation was “particularly brutal” at Amazon, adding: “There is no representation for employees. They feel drug tests are used as a punishment by the company.”

The use of workplace testing as a means of punishment or control is a recurring complaint.

Ronnie Draper, president of the bakers’ union BFAWU told Hazards he was aware of one company that “had tried to enforce random testing on site by line managers. This was rejected on the grounds that random tests would become targeted tests aimed at getting rid of problem people.” The union insisted tests could only occur if they were undertaken by an independent outside body. “This appears to have concentrated the mind of the employer as these services do not come cheap.”

Gil McGowan of Canadian union federation AFL said: “Our believe is that employers are using drug testing as a method of exerting control over their workforce, not to make workplaces safer. Our policy statement is urging our affiliate unions to push back against employers trying to implement invasive and possibly illegal testing programmes.”

Tests don’t work

Testing is not only the wrong way to go about it, there’s little evidence to suggest it even works. The Australian government compensation agency ASCC 2007 report concluded: “Although there is very good evidence to support the efficacy of road side random breath testing, there is little robust evidence on the deterrent effects of drug testing for either illicit drugs or alcohol in the workplace.”

If the testing doesn’t work, then why do firms bother? For one thing, testing is a big money spinner, with some testing firms making unsustainable claims to push their products. Laing O’Rourke’s UK random testing programme came with a £80,000 price tag for the year, according to the company’s Human Capital Report 2007. The deterrent effect wasn’t apparent here. Roughly the same proportion of tests were failed each year since the scheme started.

The UK independent report noted that not only were some of the organisations doing the testing less responsible than you might hope, they “may be making what appear to be inflated claims about the extent and impact of alcohol and drug problems in the workplace and the effectiveness of their own products.”

In the US, the country so far to have demonstrated most enthusiasm for the testing approach, this is attributed in a large part to government mandates, incentives and drug testing industry lobbying. This can include reductions in workers’ compensation insurance fees where testing is introduced (5).

Arguments that companies testing their are motivated by a desire to improve safety – the top reason given for introducing testing in the UK, according to the 2007 CIPD survey – would seem to be disingenuous if the US experience is anything to go by. Studies there have found firms facing recruiting difficulties have been abandoning pre-employment drug testing in a bid to attract staff (6).

GETTING IT WRONG

Illegal tests

Testing workers might not just be undesirable, it could in many instances be illegal.

The UK Information Commissioner’s Office (ICO) data protection code on obtaining and handling information about workers’ health puts strict limits on the health information that can be obtained by employers and says in most instances alcohol and drug testing is an unwarranted intrusion (Hazards 89).

The fourth and final part of the Employment Practices Data Protection Code – ‘Information about Workers’ Health’ (8) - is intended to help employers comply with the Data Protection Act (DPA). ICO says it “addresses the collection and subsequent uses of information about a worker’s physical or mental health or condition.”

On drug and alcohol testing, the code says: “Very few employers will be justified in testing to detect illegal use rather than on safety grounds,” adding: “Even in safety critical businesses such as public transport or heavy industry, workers in different jobs will pose different safety risks. Therefore collecting information though the random testing of all workers will rarely be justified.”

The Code’s good practice recommendations note:

• Only use drug or alcohol testing where it provides significantly better evidence of impairment than other less intrusive means.

• Use the least intrusive forms of testing practicable to deliver the benefits to the business that the testing is intended to bring.

• Tell workers what drugs they are being tested for.

• Base any testing on reliable scientific evidence of the effect of particular substances on workers.

• Limit testing to those substances and the extent of exposure that will have a significant bearing on the purpose(s) for which the testing is conducted.

It will be a rare case where an employer will be able to demonstrate adequately this case for testing. And if they can’t prove the case for testing, they can’t do it. That’s the law. Thinking it’s a good idea, thinking it might make the work safer, or thinking it might result in improved productivity are not good enough reasons. Recommendations supporting the code of practice on workers’ health information say: “Before obtaining information through drug or alcohol testing ensure that the benefits justify any adverse impact, unless the testing is required by law.”

Major recent investigations in the UK and elsewhere and research by the UK Health and Safety Executive (9) could not provide evidence this compelling so it is unlikely information so clearly establishing benefits far in excess of other approaches is available to many individual employers.

Punishing approach

Companies in fact are routinely taking the least responsible actions to deal with drug and alcohol problems at work. CIPD’s 2007 survey found firms were far more likely to take disciplinary action on workplace drugs and alcohol issues than provide support.

Six out of 10 firms responding to the CIPD survey said the use the disciplinary procedure when managing drugs and alcohol misuse at work. In the last two years, half of the respondents had disciplined workers for alcohol misuse at work and about a quarter had taken disciplinary action for drug misuse. Almost a third had dismissed an employee in this period for alcohol related problems, and 15 per cent for drug related problems. Fewer than one in 10 pay for treatments. And over 40 per cent of employers were making these decisions in a vacuum – they had no policy on managing alcohol and drug misuse at work.

Only a third (33 per cent) train managers as part of their efforts to communicate their drug and alcohol policies. And only a fifth (22 per cent) train employees on the organisation’s policy, procedures and approach, a failing would leave those using tests at risk of being in breach of the Information Commission code on workers’ health information.

Assistance was much less apparent than discipline. Just a third of employers had referred employees with alcohol problems for treatment and rehabilitation in the previous two years, with 12 per cent having done so for drug problems.

CIPD employer relations adviser, Ben Willmott, said the firms that helped their staff had a good success rate in getting them back to work - with 60 per cent staying with the company after overcoming problems. “Supporting employees with drug and alcohol problems has a high success rate with many individuals returning to work. But organisations must make employees aware of policies and support in place otherwise they will not have the confidence to hold up their hand and acknowledge they have a problem and need help.”

A March 2006 Australian report from the Victorian Drug and Crime Prevention Committee (10) noted employees, employers and unions are collaborating on strategies to help reduce drug related harms in the workplace. The Committee acknowledged that punitive approaches to alcohol and other drug abuse are generally not productive. It added there is a need to look wider than the individual who may be affected by alcohol and drugs, and place more emphasis on changing workplace culture.

Ronnie Draper, president of the UK bakers’ union BFAWU, told Hazards: “If members are found to have an alcohol or substance problem, then we would expect that they would be entered into a rehabilitation programme or at the very least be directed to help before any action is taken. We would be looking for corrective not punitive action to be taken.”

Work impaired

One key union objection to testing is that it gives a disproportionate emphasis to the unproven impact of drugs and alcohol on safety and productivity, while distracting attention from other factors.

The policy agreed in October 2006 by Canada’s Alberta Federation of Labour (4) notes: “The issue of drug and alcohol impairment detracts important attention from other forms of impairment. Impairment due to fatigue, overwork, stress or work-related neurotoxins (eg. solvents) are more prevalent in workplaces than substance impairment, yet do not attract the focus of employers in the same way. These impairments need to be addressed as seriously as substance impairment.”

Australian unions, in a December 2006 policy document published by the national union federation ACTU, have highlighted “other impairment factors which should also be addressed”, including:

Fatigue Fatigue is tiredness that results from physical and/or mental exertion. The level of fatigue experienced will depend on the workload imposed by a job, the length of shift, previous hours and days worked, and the time of day or night. Signs of fatigue can be similar to impairment from alcohol and/or other drug (AOD) use.

Chemicals Many industrial chemicals, particularly solvents are known to have effects similar to fatigue or alcohol, including dizziness, inability to concentrate, perceptual and mood changes - all of which can be an impairment risk.

Heat Working in hot conditions can result in a number of adverse health effects - ranging from discomfort to serious illness, which are generally grouped together as heat stress. Workers in a variety of occupations may be exposed to heat stress.

Noise Not only is occupational noise a hazard, in terms of hearing loss - noise is a significant impairment hazard. Obviously, excessive noise in the work environment prevents everyone from hearing what is happening around them, which could include instructions and/or warnings. Exposure to noise is also a significant cause of stress.

Stress When people are exposed to chronic, prolonged stress at work, they may experience any of a range of physical and psychological symptoms. Chronic stress can cause or worsen a range of ill-health problems, which can severely affect quality of life, including: cardiovascular disease; asthma; digestive disorders such as peptic ulcers and irritable bowel syndrome; psoriasis; sexual problems; depression; and alcohol and drug use.

Abusing workers

Unresolved hazards of work can be the reason people develop drug and alcohol problems in the first place (Hazards 55).

The European Network for Workplace Health Promotion’s 2002 Barcelona Declaration on Developing Good Workplace Health in Europe (11) links the increase in mental disorders in Europe to increasing psychosocial stressors and strain in the workplace, and declares that smoking and alcohol consumption are also work-related and “can only be tackled through health promoting workplaces.”

In the Australian context, the Tasmanian Workplace Safe agency has prepared guidance material for employers and workers on “hidden hazards,” including explicitly linking job stress with misuse of tobacco, alcohol and other drugs.

A 2004 study confirmed undervalued and overworked UK civil servants were being driven to drink by their bad jobs (13). The findings, published in the journal Occupational and Environmental Medicine, revealed there was a “striking association between adverse psychosocial work conditions in terms of effort-reward imbalance and alcohol dependence in men.”

The authors added the link remained after consideration of possible confounding factors. University College London researcher Jenny Head, who led the study, said: “People who find they put in effort and don't feel they are getting rewards are more at risk of becoming a problem drinker. We have already shown that stressful conditions at work can lead to poorer health for people. This is just another way that stress can impact on health… They are also turning to alcohol because they feel they are not being adequately rewarded for their efforts.”

There should be greater emphasis on psychosocial factors in occupational health research and prevention, the research team concluded.

A 2007 review of interventions to tackle job stress, and which noted the link between workplace stress and substance misuse, concluded “there is great potential for improving worker health through integrated approaches” (14).

Writing in the International Journal of Occupational and Environmental Health, the authors say treating workers for stress – and by inference related substance misuse - without tackling the underlying workplace issues delivers fewer long-term benefits for both the worker and the employer.

A December 2000 US study published in the Journal of Applied Psychology noted where work problems interfered with family life affected workers were twice as likely to have a “substance dependence disorder” (Hazards 77).

None of this is new and all of it should have been directing employers towards primary prevention of the controllable workplace hazards driving people to drink and drugs.

In 1991, the Occupational Health and Safety Commission in the state of Victoria, Australia, noted in enquiry findings: “We can see work-related alcohol and drug use as an outcome of bad job design and poor work environment, rather than viewing it simply as a causal factor in workplace accidents” (Hazards 55).

And in Karasek and Thorell’s seminal 1990 book, ‘Healthy work: Stress, productivity, and the reconstruction of working life’, the authors note that workers with lots of work but with little say over how the work is done resort to substance misuse for temporary relief from the stress. They write: “It is in high-strain populations that drugs are most commonly used, to assuage anxiety and induce some synthetic form of relaxation” (15).

UNIONS TARGET IMPAIRMENT

Tackling impairment

The 2004 report of the UK IIDTW concluded drug testing could not detect levels of impairment – it was as likely to identify occasionally users as serious misusers, particularly as traces of cannabis can be found in samples for months after the last use.

The CIPD survey found just over a quarter of firms used a capability procedure as part of their approach to managing drug and alcohol problems in the workplace. But unions and recent reports have argued it is crucial to address all issues of impairment, the flip side of capability, and provide accessible support.

Australian national union federation ACTU, in its December 2006 policy document concludes drug and alcohol should be impairment based, have an educational component, be non-punitive and supportive, have rehabilitation as a key component and should help provide a safe and productive working environment.

The Building Trade Group Drug and Alcohol Programme (BTGDA), a pioneering scheme introduced in 1989 by construction unions in Australia, was developed “by workers for workers” and “uses peer-education strategies, where fellow-workers (site safety committee or other nominated peers) undertake interventions.”

Providing support to affected members is a crucial role that can be filled by unions, by negotiating employment protection and referral for suitable, expert counselling and rehabilitation services.

In Canada, the autoworkers’ union CAW has long established and company funded ‘Substance/abuse/Employee and family assistance programmes’ to support affected members (Hazards 84).

Recent evidence has highlighted the effectiveness of union-led peer-to-peer prevention and support initiatives. In the US, there are thousands of Member Assistance Programmes, run by unions at workplace or local level for their members (Hazards 84). Cornell University experts say these “peer counsellors” are more accessible than management and achieve better results than more traditional approaches, including employee assistance programmes (16).

FURTHER INFORMATION

Union programmes/approaches

Workplace Drug and Alcohol Testing Policy Statement, Alberta Federation of Labour, 2007. [pdf]

Final Drug and Alcohol Policy, ACTU, endorsed by the ACTU Executive, 5 December 2006. [pdf]

Details of ACTU impairment preliminary assessment programme.

Drug & Alcohol Safety and Rehabilitation Program, Building Trades Group (BTGDA), Australia • Brief description

Recovery: Substance Abuse/Employee and Family Assistance Programs, CAW, Canada [pdf] • CAW substance abuse webpage

UNIONSAFE drug and alcohol webpage, Australia.

New South Wales Labor Council model policy for managing drugs and alcohol in the workplace, Australia.

Smithers Institute for alcohol-related workplace studies, USA. Brief description

References

1 CIPD CIPD Managing drugs and alcohol misuse at work • People Management magazine
CIPD Managing drug and alcohol misuse at work report

2 Drug testing in the workplace: Summary conclusions of the Independent Inquiry into Drug Testing at Work, Joseph Rowntree Foundation, 2004.

3 Work-Related Alcohol and Drug Use - A Fit for Work Issue, Australian Safety and Compensation Council (ASCC), March 2007

4 Workplace Drug and Alcohol Testing Policy Statement, Alberta Federation of Labour, 2007.
Related AFL news release

5 Kenneth D Tunnell. Pissing on Demand: Workplace Drug Testing and the Rise of the Detox Industry, 2004: New York University Press.) Tunnell, K.D. (2004) Cited in Workplace Drug Testing and the Detox Industry accessed on 22 October 2007

6 Francis, Hanley and Wray, 2003. Francis, P., Hanley, N. & Wray, D. (2003) A Literature Review on the International State of Knowledge of Drug Testing at Work with Particular Reference to the US. Joseph Rowntree Foundation and NEF.

7 Final Drug and Alcohol Policy, ACTU, endorsed by the ACTU Executive, 5 December 2006. [pdf]
Details of ACTU impairment preliminary assessment programme

8 ICO - The Employment Practices Code: part 4 - information about workers' health
ICO - The Employment Practices Code: Good Practice Recommendations - Part 4

9 Beswick, J; Health and Safety Laboratory. Review of the literature on illegal drugs in the workplace: WPS/02/01. England: Crown. 2002.

10 Drug and Crime Prevention Committee (2006) Inquiry into Strategies to Reduce Harmful Alcohol Consumption Final Report Volume 2. Parliament of
Victoria No 189 Session 2003-2006, Australia.

11 European Network for Workplace Health Promotion. Barcelona Declaration on Developing Good Workplace Health in Europe: ENWHP, 2002.

12 Workplace Safe Tasmania. Stress, Bullying, Alcohol, & Other Drug Misuse: Hidden Hazards. Hobart, Tasmania: Workplace Standards Tasmania, 2003:47.

13 J Head, S A Stansfeld and J Siegrist. The psychosocial work environment and alcohol dependence: a prospective study, Occupational and Environmental Medicine, vol.61, pages 219-224, 2004 [abstract]

14 Anthony D Lamontagne and others. A Systematic Review of the Job-stress Intervention Evaluation Literature, 1990–2005, INT J OCCUP ENVIRON HEALTH 2007;13:268–280 [pdf]

15 Karasek R and Theorell T. Healthy work: Stress, productivity, and the reconstruction of working life. 1990. Basic Books. ISBN 0 465 02897 7.

16 Member assistance programs in the workplace: The role of labor in the prevention and treatment of substance abuse, ILR Bulletin no.69, Cornell University Press, 1994. ISBN 0 87546 336 3. www.cornellpress.cornell.edu

Other sources

Hazards webpages
- Workplace testing
- Workplace drug and alcohol
- Workplace stress webpages

HSE alcohol and drugs webpages

TUC drugs/alcohol webpages

US National Workrights Institute drug testing in the workplace webpages

ILO Safework webpages: Workplace drug and alcohol abuse prevention programmes.

UNISON drug and alcohol infosheet.

BFAWU guide to the effects of drugs and alcohol in the workplace

GMB briefing on drugs and alcohol at work [pdf]

Drunk or disordered, TUC, December 2001. £15 (£4.75 to union members) from TUC Publications, tel: 020 7467 1294. www.tuc.org.uk/publications

Alcohol and drug problems at work: The shift to prevention, ILO, 2003. ISBN: 92-2-113373-7. £6.95 from ILO publications, tel: 020 7828 6401. Email: pubvente@ilo.org

For details of the Australian, Canadian and US member assistance programmes, see the Hazards drink and drugs webpage