Lifestyle Factors and RTW: Drugs

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Lifestyle Factors and RTW: Drugs

According to NDSHS data, workers are more likely to have used illicit drugs in the past 12 months (17%) compared to people not in the paid workforce (12%).

Written by A. Richey


The most common drug was cannabis, followed by ecstasy, amphetamines, painkillers and cocaine.

Hospitality workers were the most likely to have used an illicit drug, with 31% consuming in the previous twelve months. This was followed by construction (24%) and retail (21%). The lowest levels were in education, mining, and administration. Tradespeople were at 27% and unskilled workers at 22%.

2.5% of the people surveyed reported going to work while under the influence of illicit substances.  This was most prevalent in the younger age group, particularly 18 to 29.

Only 1% reported having time off work due to the consumption of illicit substances, however people who consume illicit substances were more likely to have time off work for illness or injury (47% of workers over a three month period). This compares with 38% who had not used drugs.

Around 2% of deaths in the workplace appeared to have illicit drugs as a contributing factor. According to Smith et al (2004) there was also a correlation between cannabis use and road accidents, as well as drug use and non-work accidents.

According to USA’s NCADD, workers who reported having over three changes of job in the previous five years were found to be twice as likely to be current of past users of illicit drugs, compared to those who had two or less jobs in the same timeframe.

They also found that workers with alcohol problems were 2.7 times more likely to have injury-related absences than workers without drinking problems. An emergency ward study found that 35% of patients with an occupational injury were at-risk drinkers.

Illegal drugs

It can take several days for the impact of illicit drugs to wear off, so if taken on the weekend they can easily have an impact in the workplace. This includes recreational drugs such as ice, ecstasy and amphetamines.

Additional problem areas may include poor decision-making, tiredness, lower attention span, and possibly illegal activities such as selling drugs to other employees of engaging in theft. There may also be equipment damage, a deterioration in workplace relationships and a lowering of staff morale.

Different drugs have different impacts on different individuals, and these may be exacerbated when taken in combination with other legal drugs or illegal drugs.

Bear in mind that impairment can be caused by a variety of factors, and may not necessarily be drug related. Impairment factors might include fatigue, medical conditions, chemicals, heat, noise and symptoms of work-related stress.

Surgical concerns

If taken in the lead-up to surgery (and even if there is no surgery involved), illegal drugs can lead to a wide range of medical problems. A patient using drugs requires special attention from the surgeon and anaesthetist to avoid complications or adverse chemical reactions between the medications and illegal drugs. Patients are well advised to let the medical staff know of any recent drugs use as it can result in longer hospital stays, discomfort due to withdrawal or inadequate pain management post-operatively.

In addition to the risks associated with the use of illegal drugs, skin infections are common in users of illegal drugs so wound healing may be delayed.

Recovery may result in further injuries to the person when they are recovering as their reaction time is slower, they may engage in risk-taking behaviour or they may make poor decisions. There may also be challenges with movement.

The health and wellbeing of staff and patients in the medical facility may also be impacted by illegal drug use.

Legal drugs

Prescription or over-the-counter drugs can have side effects, so it’s always wise for employees to speak to a doctor or pharmacist to find out what they are, and how they might impact on work. The impact may vary from person to person, however some legal drugs may cause clumsiness, memory problems or tiredness for example.

The impact of medication used by injured workers returning to work should be borne in mind when developing appropriate duties. Pain medication could also mask the pain symptoms, with workers over-extending leading to the possibility of re-injury.

Employers may enquire via the physician as to the worker’s functional capacity, such as concentration and coordination limits, related to both the injury and the worker’s medication. Employees are also under obligation to advise employers if there is a potential WHS risk.

Some workers returning to work may overuse pain medication. They take the medication to cope, but the medication may make it difficult for them to function and may present a safety hazard. Employers may actively discourage this through their drug and alcohol policies, along with a discouragement of taking legal drugs without a prescription or for reasons other than as intended.

Should surgery be required, it’s important for the patient to let the treating practitioner know what drugs are being taken, legal or otherwise.

Drug dependence

Drug dependence has been shown to have an impact on accident rates, absenteeism and lower productivity. It also has an impact on workplace rates regarding premature death and fatal accidents.

Drug use may also lead to an increase in mental, physical and social problems, and people suffering from a drug addiction can take longer to recover following an accident or illness.

Employer responsibilities

Employers have a duty of care around the heath of their employees. They need to take all reasonable and practicable steps to ensure the health and safety of their workers, and others which may be affected by the actions of the employer, such as contractors or clients.

Employers could look at developing a drug and alcohol policy, including definitions, task allocation, and a disciplinary policy (including warning process prior to dismissal), as well as providing training for staff regarding alcohol and drug usage. When parties are organised for the workplace, it is the employer’s responsibility to ensure that staff are safe. The Australian Drug Foundation can provide advice on these matters.

Programs promoting workplace health can also have an impact on employee behaviours. This could include efforts to destigmatise addiction. Providing EAPs could also be effective. EAPs provide counselling services for a broad range of issues including referrals for employees with drug and other problems. Staff should be reassured that the service is confidential.

Elements of the workplace may have an impact on people’s decision to take drugs, in addition to social and personal factors. These include:

  • High stress
  • Low job satisfaction
  • Fatigue
  • Repetitious duties
  • Long hours or irregular shifts
  • Irregular supervision
  • Access to substances
  • Isolation
  • Inactivity or boredom

Action can be taken by employers to counteract these factors.

Drug testing in the workplace

Where there are risks in the workplace, often regarding road use or heavy machinery, some employers implement a drug testing systems. WorkCover recommends that this only be implemented as part of a comprehensive alcohol and drug program, including clear procedures and provision of counselling. It is advisable to consider drug testing a deterrent rather than a method of catching people out.

The decision to conduct drug testing should be made in consultation with employees, OHS representatives and union representatives, aiming to reach agreement regarding the workplace activities where drug use could impact safety.

Employers also need to be aware of the existing legislative provisions, such as those relating to rail workers, passenger transport, aviation, mining and heavy vehicle drivers.

Employers need to bear in mind that a positive test may not necessarily indicate impairment. A worker also has the right to refuse testing, unless legislation, contracts or employment agreements state otherwise. A refusal does not indicate that that an employee is under the influence of drugs or alcohol.

The reliability of drug testing may also be subject to legal challenge as there may be varying accuracy rates. Employers need to ensure that all testing is conducted by an accredited laboratory.


*This article is supplied by Return to Work Matters an industry leading in claims management strategies; this article was written by A. Richey.  All views, opinions and conclusions expressed are those of the authors and/or speakers and do not necessarily reflect the view, opinion, conclusion and/or policy of ExamWorks and its affiliates.

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