Health problem or disciplinary issue?

    • Drug and Alcohol misuse is a significant health problem in any workplace setting.

      It is estimated that up to 17 million working days are lost each year because of alcohol-related sickness and the cost to employers of sick days due to drink is estimated at £1.7bn.*

      So why aren’t we doing more to prevent substance misuse?

      What’s the problem?

      Identifying the issue. A lot of absence or poor performance issues aren’t seen to be related to drugs or alcohol and a significant part of the problem is recognition and effective management of the problem by the employer.

      There’s a lot of fear and uncertainty about what to do if an employer knows or suspects that someone has a problem which leads to a reluctance to speak out until the situation spirals in to a disciplinary issue and the business miss the opportunity to address it as an illness.

      The employee is also likely to find it difficult to disclose the problem, for fear of repercussion on their employment.

      Without the issue being identified and managed effectively the business can experience an impact on productivity as well as any health and safety implications if the employee is allowed to continue at work inappropriately. It can leave the business open and exposed to discrimination claims by dismissed employees, often under disability discrimination legislation.

      How can businesses address the issue before the problem becomes too severe?

      Making sure there’s a clear, accessible and fit for purpose Drug and Alcohol Policy should ensure that the employee is aware of what to expect should a misuse be suspected throughout the course of their employment - leaving little uncertainty in their mind on how the situation will be handled.

      A clear policy defining what is meant by substance abuse, why the policy exists, to whom it applies, and the rules regarding alcohol and illicit drugs, will also help the employer if defending cases of discrimination under disability legislation.

      Raising manager’s awareness of the common behaviours of this type of issue can also help. Looking out for: frequent, unexplained short-term absences, unexplained changes in mood, erratic performance, even withdrawal tremors.

      Employers of workers who hold ’Safety Critical’ roles; i.e. roles which if not performed correctly may have health and safety implications on the individual and those around them, are expected to implement measures to ensure that problems are identified at an early stage, through testing before the start of their employment and then randomly or ‘for purpose’ if a problem is suspected.

      However, testing for Drug and Alcohol is a very contentious matter, and best practice guidance advises that it should only be introduced after careful consideration and alongside a detailed policy that sets out the reasons for testing, the procedures to be followed, and any role for health professionals.**

      What support should businesses provide to employees?

      There should be a clear explanation of the level of support that the employee could be offered if they declare such a problem within the businesses Drug and Alcohol Policy. By providing clear guidance the employee may be encouraged to come forward and seek help.

      Support can be provided through a GP, who can direct them to available support from the local Drug and Alcohol Unit and support groups such as Alcoholic Anonymous (The AA).

      The employee can also be referred to the Community Mental Health Team, for support with mental health problems which are often concurrent with substance misuse.

      Employers with access to an Occupational Health Service are expected to highlight the role of Occupational Health in their policy. Occupational Health can offer guidance to the employee on available avenues of support and liaise with their GP to ensure that they are aware of the problem, in addition to providing guidance to the employer on practical measures to help them when managing these cases.

      Employee Assistance Programmes can also help with mental health issues or similar causes associated with substance misuse.

      *National Institute for Health and Clinical Excellence (June 2010), 'Business case: Alcohol-use disorders: preventing harmful drinking', p. 13

      **Faculty of Occupational Medicine, Royal College of Physicians (2012) Ethics guidance for occupational health practice. London: Faculty of Occupational Medicine.

    • Dr Yousef Habbab

      Viewpoint by Dr Yousef Habbab, Consultant Occupational Physician AXA PPP healthcare, Health Services division.

      Yousef trained in Occupational Medicine at the National Health Service, after starting his postgraduate medical career in surgery. His interests include stress and mental health in the workplace. Yousef has passed the Membership exams for the Royal College of Surgeons of Edinburgh and is a Member of the Faculty of Occupational Medicine of the Royal College of Physicians in London.