Issues

A significant proportion of workers in Europe are likely to have problems associated with alcohol or drug use; for example, it is estimated that between 5 % and 20 % of the working population in Europe have serious problems related to their use of alcohol. In addition to the general public health and social implications, substance use problems are highly relevant in industries where safety issues exist or where individual performance failings can have a significant impact. This includes, but is not limited to, the construction, farming, transport, power, ICT and financial services sectors.

Alcohol use and drug use are important issues in workplaces because:

  • they can increase accidents and injuries, absenteeism, and, inappropriate behaviour;
  • they can impose an economic burden on employers, governments and society;
  • employers have a duty under health and safety laws to protect, as far as reasonable, the health, safety and welfare of employees and others affected by their activities;
  • workplaces also provide an opportunity for health education about alcohol and drugs and opportunities to identify individuals who have problems with alcohol and drug use or have family members with drug or alcohol problems.

The workplace also has a potential role in supporting the social reintegration of people with a history of serious drug problems.

Response options

  • Workplace policies on the consumption of alcohol and drugs in the workplace.
  • Prevention through information, education and training programmes addressing alcohol and drugs issues, preferably as part of wider health promotion programmes.
  • Workplace screening and testing to identify substance use problems, which may arise informally through discussions around performance issues or as a result of formal assessments, which may include testing in safety-critical industries.
  • Interventions to address problems that have been identified, including assistance, treatment and rehabilitation programmes.
  • Providing employment opportunities for people with a history of serious drug problems.

European picture

Most European countries have some kind of general legislation or agreements to prohibit or regulate the consumption of alcohol and drugs in the workplace. However, the type of legislation in force and nature of occupational safety and health legislation varies considerably depending on the national culture and the awareness of and priority given to the issue.

There is no up-to-date, comprehensive information on the extent and nature of different types of interventions in workplaces in Europe. There is also very little European evidence regarding effectiveness of different interventions.

Looking to the future, the use of performance-enhancing drugs, such as modafinil for cognitive enhancement, may become a growing issue in the workplace.

Summary of the available evidence

Key principles for the management of drug-related issues in the workplace identified by the UN International Labour Organization

  • Drug policies and programmes should promote the prevention, reduction and management of alcohol- and drug-related problems in the workplace.
  • Drug-related problems should be considered as health problems, and dealt with like any other health problem at work and covered by the health care systems (public or private) as appropriate.
  • Employers and workers and their representatives should jointly assess the effects of alcohol and drug use in the workplace, and cooperate in developing a written policy for the enterprise.
  • Employers should cooperate with workers and their representatives to do what is reasonably practicable to identify job situations that contribute to drug-related problems, and take appropriate preventive or remedial action.
  • The same restrictions or prohibitions with respect to alcohol should apply to both management personnel and workers to ensure a clear and unambiguous policy.
  • Information, education and training programmes about alcohol and drugs should be undertaken in order to promote safety and health in the workplace as part of broad-based health programmes.
  • Employers should establish a system to ensure the confidentiality of all information communicated to them concerning alcohol- and drug-related problems.
  • Testing of bodily samples for alcohol and drugs in the context of employment involves moral, ethical and legal issues of fundamental importance that require a determination of what is fair and appropriate testing.
  • Holding a job is an important factor in facilitating recovery from alcohol- and drug-related problems. Therefore the workplace has a special role to play in assisting individuals with these problems.
  • Workers who seek treatment and rehabilitation for alcohol- or drug-related problems should not be discriminated against by the employer and should enjoy normal job security and the same opportunities for transfer and advancement as their colleagues.
  • The employer has authority to discipline workers for employment-related misconduct associated with alcohol and drugs, but counselling, treatment and rehabilitation should be preferred to disciplinary action. Should a worker fail to cooperate fully with the treatment programme, the employer may take disciplinary action as appropriate.
  • The employer should adopt the principle of non-discrimination in employment based on previous or current use of alcohol or drugs, in accordance with national law and regulations.

Adapted from: Management of alcohol- and drug-related issues in the workplace. An ILO code of practice. Geneva, International Labour Office, 1996.

Implications for policy and practice

Basics

  • It recommended that employers have an alcohol and drug use policy as a component of their health and welfare policies rather than as a disciplinary matter.
  • The key principles for the management of drug-related issues in the workplace identified by the UN International Labour Organization, and highlighted above, should also be promoted.

Opportunities

  • Gaining employment is an important component of reintegration, therefore it is important that people with a past or current alcohol or drug problem are supported back into work. Working with employers to overcome barriers to employing people with a history of drug problems offers benefits to employers, to those trying to overcome their drug problems and to society as a whole.

Gaps

  • There is a need for an overview or mapping of existing data sources, current responses and interventions addressing drugs in the workplace as well as evaluation of existing interventions in Europe.
  • Research is needed into the extent and nature of the use of performance-enhancing drugs in the workplace and on the effects of their use in that setting.

Explore all resources in the Best practice portal

Collaborations and partnerships in best practice

logo of the cochrane collaboration  grade logo   grade logo  Health Evidence Network, WHO Europe