By Dr. Edward A. Selby, Ph.D.

Work-related stress is a major factor in the substance misuse of many adults. Indeed, stress revolving around work is one of the most common and intense forms of stress that can trouble anyone. But for some the interplay between work stress and substance misuse goes beyond use of alcohol or drugs to unwind after work. Work stress and substance use can mutually affect each other, with a stressful work environment promoting the use of substances like alcohol or chemical substances to cope, but then substance use can negatively affect workplace performance. Diminished performance at work can be due to the biological side effects of using drugs or drinking at home (for example, coming to work with a hangover), but some severe cases can involve active use of a substance or alcohol while at work. Not surprisingly, substance use behavior has caused many people to lose their jobs and substance use can be a factor in chronic unemployment (Lee et al., 2017).

Workplace Stress and Substance Use

First off, it is extremely common for people to experience stress due to workplace challenges, and jobs with high stress are more likely to lead to substance use as a way of coping with work-related stress. Workplace stress can affect any job, ranging from traditionally blue-collar work to office-based jobs and professionals (Macdonald, 2018; Giorgi et al., 2017; Vayr et al., 2019). Whether it’s the difficult nature of the work, difficult supervisors, coworkers, or employees, or even just general discontent with the work one’s doing, anyone can experience work stress that leads substance use. Substance use is often used as a short-term but problematic coping method (Selby et al., 2008). However, there are also some professions that are particularly prone to elevated substance use. For example, hospitality employees, such as food service workers and hotel employees, have been noted to be at particularly high risk for substance abuse and heavy alcohol consumption due to high stress and shift work (Belhassen & Shani, 2012; Hight & Park, 2018). So, the type of work one does may specifically increase risk for substance use problems even beyond ordinary workplace stress. Those finding themselves highly stress by their work and using alcohol or other substances to cope should consider the long-term consequences of using substances to cope instead of other healthy stress management activities (e.g., exercise, art and recreational activities).

The Impact of Substance Use on Work Performance

While alcohol and drug use can affect any workplace environment, from offices to field work, some jobs may be more impacted by the residual effects of substance use. Depending on the work done in a particular setting, substance use can cause workplace related problems even if a substance is not actively used at work. One study on the impact of alcohol use in the office indicated that while only 1-2% of employees reported alcohol-related absences over the prior year, 11% of workers reported inefficiency due to hangovers from the day before (Buvik et al., 2018). Relatedly, in the same study managers reported spending substantial time and resources on single cases of employee-related problem alcohol use. So employee substance use behavior can be a challenge for managers to address (and may increase their stress level as well!).

Even more problematic than office workplace absence and inefficiency is when substance use affects behavior in a way that is dangerous or destructive. This is especially true when substances or alcohol are used in combination with dangerous workplace settings, which could include workplaces ranging from those operating heavy machinery to more everyday tasks like driving for deliveries or ridesharing. Construction work, for example, is both dangerous and involves works who endorse higher rates of substance use. In one recent study, one in six construction workers in New Zealand reported workmates being visibly under the influence of alcohol in the workplace (Roche et al., 2020). Another study found that marijuana, cocaine and non-prescription opioid use was elevated in construction workers as compared to other occupations (Ompad et al., 2019). Substance use in dangerous settings isn’t restricted to using dangerous machinery either, and drug use in any setting where people can be hurt is a major concern. Drug use has negatively affected workplace behavior among physicians (Merlo & Gold, 2008), who as a group also have elevated rates of substance use disorders (Vayr et al., 2019) in addition to increased access to addictive non-prescription medications. The key here is that substance use can cause problems in any workplace, and the dangerousness of substance use in the workplace isn’t always obvious.

Workplace Substance Use Warning Signs

Substance use in the workplace can be difficult to identify in some cases, but in many cases there will be signs of substance use and related mental health struggles. For example, Dimoff & Kelloway (2019) published a very useful tool for identifying Signs of Struggle (SOS) in the workplace called the SOS Checklist. Informed by the SOS checklist, I’d expect the following observable signs and behaviors in the workplace that could occur with substance misuse and/or other mental health concerns:

Performance Decline

• Failing to meet goals or deadlines.
• Low customer satisfaction.
• Increased workplace errors, violations, or injuries.
• Increased conflicts with others at work.

Poor Attendance

• Increasingly late arrivals to work.
• Increased absences.
• Taking longer than normal breaks or breaks without permission.
• Increasingly sporadic use of sick leave.

Social Withdrawal

• Participating less in work-related social functions.
• Withdrawing from friendly workplace interactions with colleagues.
• Decreased email engagement, including unusually long response times and/or using short, curt responses.

Expressions of Distress

• Emotional outbursts at work (crying, yelling at others).
• Mentioning need for use of a substance to manage work stress.
• Unusual or inexplicable behavior occurring in the workplace.

Problematic Behaviors

• Using alcohol or a substance at work.
• Excessive focus on alcohol-based work socialization.
• Bringing drugs or alcohol into the workplace.
• Expressing intent to harm self or others.
• Neglecting personal hygiene.
• Violence or aggression toward others.

Recommendations

Knowing the right way to address substance use problems in the workplace can be just about as difficult as identifying the presence of a substance use problem in the workplace, and responses will differ depending on whether you’re a supervisor, coworker, or employee. At the workplace level, having written policies against workplace substance use has been found to decrease employee drug use (Ompad et al., 2019). Fostering a work environment that supports getting help for an employee struggling with substance use is also likely be function better. It’s also important to know that strong employees and supervisors can struggle with substance problems, too, so helping them get access to substance use treatment options is not only more humane than options like termination but is also likely to improve workplace functioning. For example, a supportive workplace environment may also help employees feel comfortable coming forward if they are seeing substance use problems among other co-works or supervisors. Finally, if you or someone you know is having problems with substance use, don’t wait until problems arise at work to get help. Get substance use treatment now, before your employment is disrupted or irreparably damaged.

 

References:

Belhassen, Y., & Shani, A. (2012). Hotel workers’ substance use and abuse. International Journal of Hospitality Management, 31(4), 1292-1302.

Buvik, K., Moan, I. S., & Halkjelsvik, T. (2018). Alcohol-related absence and presenteeism: Beyond productivity loss. International Journal of Drug Policy, 58, 71-77.

Dimoff, J. K., & Kelloway, E. K. (2019). Signs of struggle (SOS): The development and validation of a behavioural mental health checklist for the workplace. Work & Stress, 33(3), 295-313.

Giorgi, G., Arcangeli, G., Perminiene, M., Lorini, C., Ariza-Montes, A., Fiz-Perez, J., … & Mucci, N. (2017). Work-related stress in the banking sector: a review of incidence, correlated factors, and major consequences. Frontiers in Psychology, 8, 2166.

Hight, S. K., & Park, J. Y. (2018). Substance use for restaurant servers: Causes and effects. International Journal of Hospitality Management, 68, 68-79.

Lee, J. O., Jones, T. M., Kosterman, R., Rhew, I. C., Lovasi, G. S., Hill, K. G., … & Hawkins, J. D. (2017). The association of unemployment from age 21 to 33 with substance use disorder symptoms at age 39: the role of childhood neighborhood characteristics. Drug and alcohol dependence, 174, 1-8.

Macdonald, W. A. (2018). Work demands and stress in repetitive blue-collar work. In Work Stress (pp. 139-163). Routledge.

Merlo, L. J., & Gold, M. S. (2008). Prescription opioid abuse and dependence among physicians: hypotheses and treatment. Harvard Review of Psychiatry, 16(3), 181-194.

Roche, A. M., Chapman, J., Duraisingam, V., Phillips, B., Finnane, J., & Pidd, K. (2020). Construction workers’ alcohol use, knowledge, perceptions of risk and workplace norms. Drug and Alcohol Review, 39(7), 941-949.

Selby, E. A., Anestis, M. D., & Joiner, T. E. (2008). Understanding the relationship between emotional and behavioral dysregulation: Emotional cascades. Behaviour Research and Therapy, 46(5), 593-611.

Vayr, F., Herin, F., Jullian, B., Soulat, J. M., & Franchitto, N. (2019). Barriers to seeking help for physicians with substance use disorder: a review. Drug and Alcohol Dependence, 199, 116-121.