Impact of the Use and Abuse of Prescription and Illegal Drugs in the Workplace

By Brigitte Tubbs-Jones

Despite all of the employment-related issues that Human Resource professionals contend with on a daily basis in the workplace, there is one issue that has become increasingly challenging to address: the rapid rise of substance use and abuse in the workplace. Substance use and abuse in this context refers to both illegal and prescription drugs. In regard to the rise of illegal drugs in the workplace, a recent report sponsored by the U.S. Department of Labor and the Office of National Drug Control Policy states that the United States consumes sixty percent (60%) of the world’s production of illegal drugs and that nearly seventy percent (70%) of current illegal drug users are employed. This means that whether employers want to admit it, it is highly likely that they have employees who are dealing with substance use and abuse in their organization. It is startling to think that nearly one third (1/3) of employees have personal knowledge of the sale of illegal drugs in their workplace. Also, as marijuana, which is one of the most widely used drugs, becomes decriminalized or legalized in many states, employers have seen an increase in its use in the workplace.

The prescription drug use and abuse epidemic has significantly impacted the workplace as well due to medical advancements which have provided people with access to better prescription drugs so they can have a better quality of life. The use and abuse of prescription drugs in the workplace, especially opioids and central nervous system depressants, has skyrocketed. Although a risk of an unfavorable reaction or addiction always exists through use of a prescription drug based on the particular individual, when employees are not taking their medications as prescribed, or are taking someone else’s prescriptions, the results can be catastrophic. Medical professionals have now deemed prescription drugs to be just as addictive and potent as drugs such as heroin and cocaine.

In recent years, employers have experienced the impact of this rapidly-increasing challenge on all aspects of their organization, including: workplace safety, employee morale, financial health of the organization, as well as organizational image.

Before we cover the impact in each of the mentioned areas, below is a list of some of the typical signs and symptoms than an employee may exhibit when they have a substance abuse problem:

  • Frequent tardiness or absenteeism
  • Abrupt changes in mood or attitude
  • Poor relationships with co-workers
  • Changes in personal appearance and hygiene
  • Uncharacteristic errors in judgment
  • Poor concentration
  • Repeated or unusual work-related accidents
  • Unusual temper flare-ups
  • Frequent complaints of feeling ill
  • Borrowing money from co-workers on a frequent basis or requesting paycheck advances
  • Questionable extended lunch or breaks

Impact of Substance Use and Abuse on Workplace Safety

The increase in use and abuse of illegal and prescription drugs in the workplace has resulted in an increase in work-related accidents, emergency room visits, workers’ compensation claims, and deaths. According to the Bureau of Labor Statistics, organizations who utilize EAPs (Employee Assistance Programs) have far fewer work-related injuries than those without them.

Impact of Substance Use and Abuse on an organization’s financial health

According to the ‘Working Partners’ National Conference Proceedings Report, substance abuse wipes out more than $100 billion dollars annually from American businesses due to costs associated with: workers’ compensation claims, medical costs, theft, decreased productivity, absenteeism, and employee turnover. Nearly half of all workers’ compensation claims are able to be traced back to workplace substance abuse. Additionally, employees who are substance abusers typically file up to five (5) times as many claims as those who are not. Multiple claims being filed usually results in additional medical costs for the employer. Replacing employees can also be a great expense, ranging from more than $7,000 for a salaried worker to potentially $40,000 for a senior executive.

Drug-Free Workplace Programs may provide organizations with some financial relief. Although the Drug-Free Workplace Act of 1988 only applies to federal contractors, organizations who are federal grantees or individuals who receive a contract or grant from the federal government, many states have implemented Drug- Free Workplace programs as well in an effort to promote worksites where employees can operate in an enhanced competitive position and avoid the expenses that come along with substance abuse. Typically, once an organization submits an application as well as any additional requested information and agrees to abide by the program requirements, they will receive an Implementation Guide along with materials to display in their common areas. Some of the requirements for participation in the program may include: a signed acknowledgment form by every employee stating they have read and understand the policy, an agreement by the employee to comply with drug testing, and awareness by the employee of discipline that may be issued as result of a positive drug test.

Many Drug-Free Workplace programs offer financial incentives to employers for their participation, usually in the form of a premium credit on their workers’ compensation insurance policy. Many organizations who participate in such programs have reported that the financial investment they make via education, prevention, and assistance programs pays off by having fewer substance abuse related accidents and therefore, positively impacting their bottom line. Use of EAPs have also been shown to yield financial results. Recent data on the cost-effectiveness of EAPs indicate that a savings to investment ratio may be as high as 15:1.

Impact of Substance Use and Abuse on Employee Morale

Another result of increased use and abuse of both prescription and illegal drugs in the workplace is a decrease in employee morale. According to recent data, employees who abuse substances in the workplace are 1/3 less productive than other employees. Substance abusers are also 2.5 times more likely to be absent eight (8) or more days a year. Oftentimes, employers are faced with the following actions by substance abusers: habitual tardiness or sleeping on the job, hangover/withdrawal which negatively affects the employee’s job performance, and poor decision making. Over the past few years, the sale of illegal drugs to other employees on the organization’s property has also risen, which has led to a further impact on employee morale.

Impact of Substance Use and Abuse on Organizational Brand/Image

Employee substance use and abuse can also have a negative impact on the organization’s brand/image as a result of poor customer service, including failure to timely respond to emails and phone calls, failure to meet internal and external deadlines, and cancelling meetings with clients, customers, or business partners. In a manufacturing environment, substance use and abuse could have a significant impact on the quality of products made which could potentially subject the organization to a products liability claim or other legal action. The impact on an organization’s brand/image could very well affect their bottom line.

What mitigating factors are available to employers to reduce the impact of prescription and illegal substance abuse on their organization?


Organizations should ensure that all supervisors and employees are educated about the signs and symptoms of substance use and abuse in the workplace. They should also be educated regarding the effects of the abuse on the workplace, family and community. In an effort to ensure timely and proper training, it can be incorporated as a part of employee onboarding and made available as a refresher on an annual or semi-annual basis. Supervisors and employees should also be informed of available resources provided by the organization as well as those provided on a local, county, or state level for counseling, prevention, and treatment. Training for supervisors should equip them with additional tools to properly respond to employee substance use and abuse.

If the organization is involved in a Drug-Free Workplace Program, they will likely be required to post information in common areas, such as restrooms and break rooms, and cafeterias. However, even if an organization is not part of such a program, educating employees through the use of posters and pamphlets, company-wide emails, EAPs, and other methods is recommended.


As the landscape on drug use continues to change, organizations need to be more mindful than ever of their policies regarding the matter. An annual review should be conducted of all relevant policies and any necessary revisions made at that time. Many employers currently maintain policies which prohibit the use, sale, and possession of illegal drugs. However, most policies don’t address the use of prescription drugs obtained by an employee without a prescription or an employee’s use of legally prescribed drugs that may affect his/her ability to perform assigned job duties or potentially expose an employee or others to harm.

In response to the growing need for guidance in this area, the U.S. Department of Labor developed the following model language for employers to consider using in their drug and alcohol policies:

Prescription and over-the-counter drugs are not prohibited when taken in standard dosage and/or according to a physician’s prescription. Any employee taking prescribed or over-the-counter medications will be responsible for consulting the prescribing physician and/or pharmacist to ascertain whether the medication may interfere with safe performance of his/her job. If the use of a medication could compromise the safety of the employee, fellow employees, or the public, it is the employee’s responsibility to use appropriate personnel procedures (e.g. call in sick, use leave, request change of duty, notify supervisor, notify company doctor) to avoid unsafe workplace practices.

The illegal or unauthorized use of prescription drugs is prohibited. It is a violation of our drug-free workplace policy to intentionally misuse and/or abuse prescription medications. Appropriate disciplinary action will be taken if job performance deterioration and/or other accidents occur.

In addition to the items mentioned above, comprehensive policies should also address under what circumstances is drug testing conducted, employee responsibility to notify supervisor of prescription drug usage (safety-sensitive positions), and return to work policies for employees undergoing substance abuse treatment. Employers should be cautious when making adverse employment decisions based on assumptions about an applicant or employee’s use and/or abuse of prescription drugs. Recent rulings have shown that the Equal Employment Opportunity Commission has been successful against employers who have utilized ineffective drug policies.

Brigitte Tubbs-Jones, Esq., PHR, SHRM-CP Director of Legal Services Tennessee Department of Human Resources

Brigitte Tubbs-Jones, Esq., PHR, SHRM-CP
Director of Legal Services
Tennessee Department of Human Resources