Work Drug Safe

Recognizing the Signs - Substance Abuse and Other Causes of Workplace Issues

Is Your Screening Program Up to Date?

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Understanding the signs of substance abuse is essential to your workplace safety. In 2020 40% of adults reported struggling with mental health or substance use.1 As a group, nearly one third of Millennials have a behavioral health condition, with nearly one million insured Millennials diagnosed with substance use disorder in 2018.1 With more than one-in-three employees in the U.S. workforce now being Millennials, the makeup of the American workplace, as well as the problems employers face, is swiftly changing.2

In 2020 40% of adults reported struggling with mental health or substance use.1

Many factors contribute to workplace safety, but drugs and alcohol are known to have significant impact. Consider that in 2019 there were over 57 million individuals age 12 and older who used illegal drugs.3

Private employers reported approximately 2.8 million nonfatal workplace injuries and illnesses in 2019, occurring at a rate of 2.8 cases per 100 full-time equivalent workers.4 In 2019 there were 5,333 fatal workplace injuries, a 2% increase over 2018.5 With so much at risk, employers must educate themselves about substance abuse, its impact on workplace safety and productivity, and the best ways to identify it before it contributes to this year’s injury and illness statistics.

Signs and Symptoms of Substance Abuse

Since workplace safety is often regulated by state and federal governments, looking to statutes provides a good starting point.

For example, Illinois’s medical marijuana law provides a laundry list of specific, articulable symptoms that an employer may consider when evaluating whether an employee is impaired. While this law targets medical marijuana, its contents can be used as a model for substance abuse in general:

  • speech,
  • physical dexterity,
  • agility,
  • coordination,
  • demeanor,
  • irrational or unusual behavior,
  • negligence or carelessness in operating equipment or machinery,
  • disregard for the safety of the employee or others,
  • involvement in an accident or other carelessness that results in an injury to the employee or others,
  • disruption of the production of manufacturing process, or
  • carelessness that results in an injury to the employee or others.6  

Laws in other states include broader signs, such as significant deterioration in work performance7, absenteeism8, or an individual’s appearance indicating substance abuse.9

These are, generalities that operate as a rule of thumb, although they apply to most situations, they do not fit in every situation. Some drugs will not fit under these general signs and symptoms. For example, hyperactivity may be a sign of methamphetamine use, but not of marijuana or cocaine use.10 That is why employers should use statutes as a starting point, but also research online sources like National Safety Council Drugs at Work , and start employee education, and supervisor training on the most commonly abused drugs and their unique signs.

Other Explanations for Employee Behavior

Just as our starting list of signs and symptoms cannot cover all types of substance abuse, it also may not provide an immediate and accurate answer for why an employee is exhibiting those signs. Other explanations for abnormal behavior or deteriorating work performance could include but are not limited to: stress, divorce, family demands, financial problems, death in the family, or the job itself. Thus, employers should add to their decision tree questions that aim to identify causes other than substance abuse before ordering drug testing, employee assistance, or disciplinary measures.


Employers should take away these lessons… First, they should look to state laws for guidance. If they are unsure of where to begin or are worried they are missing something, there is a good chance that there is a statute on the topic. While not every state has a law on every issue, neighboring states might. When in doubt, look to the laws of other, similar states to glean an idea of what others may have found reasonable or sensible. Keep in mind that while other state’s laws don’t apply in your state of business, they can be used to guide your policy as long as you comply with all applicable laws in your state of business.

Second, they should educate their workforce, especially their supervisors. With so many possible sources of workplace troubles, supervisors have a monumental task on their hands. They cannot do their job successfully unless they are equipped with accurate information and are refreshed and retrained on it regularly.

Finally, a safe, productive and admired workplace is never out of reach. Nonfatal workplace injuries and illnesses in 2019 occurred at a rate of 2.8 per 100 full-time equivalent employees nationwide1, but that is only the average. Some workplaces had more, some less. A diligent and careful approach to a drug-safe workplace can help move an employer’s workplace to the lower end of that spectrum.

1. Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic - Centers for Disease Control and Prevention 06/24/2020

2. BlueCross BlueShield, Pew Research Center, Millennials are the largest generation in the U.S. labor force, 04/11/2018,, Accessed 03/22/21.

3. Substance Abuse and Mental Health Services Administration, Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health, 09/2020,, Accessed 03/22/21.

4. Bureau of Labor Statistics, Employer-Reported Workplace Injuries and Illnesses, 11/04/2020,, Accessed 03/22/21.

5. Bureau of Labor Statistics, National Census of Fatal Occupational Injuries in 2019, 12/16/2020,, Accessed 03/22/21.

6. 410 Illinois Comp. Stat. 130/50(f).

7. Arkansas Code Ann. 11-14-102.

8. Mississippi Code Ann. 71-7-1.

9. Arizona Rev. Stat. 23-493.

10. Addiction Center, Meth Symptoms and Warning Signs, 07/15/19,, Accessed 03/22/21.