130 journal of employment counseling • September 2006 • Volume 43

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© 2006 by the American Counseling Association. All rights reserved.

effects of drugs and alcohol on behavior,job performance, and workplace safetyKaren ElliottKyna Shelley

A study of records for 1 large U.S. company revealed that employees with positivedrug screens were fired, whereas workers who self-disclosed drug/alcohol problemsremained employed. Both groups were offered substance abuse intervention, andsome previously fired workers were rehired after they received treatment. Accidentresults showed that drug-test positive employees, as compared with self-referred workers,had a significantly higher accident rate in all categories. Treatment data revealed thatdrug-test positive workers had significantly higher accident rates before and after treat-ment than self-referred employees. Posttreatment results showed that drug-test posi-tive employees had a significant decrease in accidents after services, whereas the

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self-referred group showed no change.

Drugs are considered to be any substance that alters or interferes with an individual’shealth, personal life, or work (Coshan, 1992). Employee drug and alcohol abuse is a prob-lem for many, if not all, businesses. No one is immune to it; people of all ages, incomes, andprofessions consume drugs and alcohol, and contrary to popular belief, approximately 70%–75% of all substance abusers are employed (Substance Abuse and Mental Health Ser-vices Administration, 1996). Much discussion has occurred about the nation’s drug problemin organizations. Some research has reported that substance abuse in the workforce has anegative impact on society, suggesting that there is a link between substance abuse anddangerous, dysfunctional behaviors (e.g., workplace accidents and injuries; Bass et al.,1996; Hoffman & Larison, 1999). Other researchers found no such relationship (Buchanan,1988; Macdonald, 1995). Despite the conflicting research, one thing is clear—substanceabuse is a societal problem and a legitimate workplace issue.

SUBSTANCE ABUSE AND SAFETY

Substance abuse can create absenteeism, accidents, and security problems, thus damagingthe stability of a company. Dawson (2003) suggested that 5.2 million American workersexperience workplace injuries or illnesses each year. The large number of substance abusersin the workforce increases the likelihood that work-related injuries will occur.

Early research suggested a link between drug/alcohol abuse, workplace accidents,and fatalities. Employees with positive drug tests were 5 times more likely to have avehicle accident than other workers (Crouch, Webb, Buller, & Rollins, 1989), and59% of industrial vehicle fatalities showed that the victims had alcohol in their blood(Fell, 1982). Other studies reported that substance-abusing workers had 4 times asmany work-related accidents as other employees, and 11% of all occupational deathsoccurred in individuals who had high blood alcohol content (Baker, Samkoff, Fisher,

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Karen Elliott, Academic Success Team, Developmental Institutional Research, College of the Mainland;Kyna Shelley, Educational Leadership and Research, University of Southern Mississippi. Corre-spondence concerning this article should be addressed to Karen Elliott, 1200 Amburn Road, TexasCity, TX 77591 (e-mail: kelliott@com.edu).

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& VanBuren, 1982; Campbell & Graham, 1988). Later research reported that substance abusershad 4 times as many work-related accidents as nonusers (Goldstein, 1997), and approxi-mately 65% of all workplace accidents were directly related to drug/alcohol use (Bahls,1998). Recently, 47% of industrial injuries and 40% of workplace deaths were attributed toalcohol use (Atkinson, 2001; Nighswonger, 2000), and the Department of Labor estimatedthat substance abusers were 5 times more likely to be injured as nonusers (Pope, 1990).

SUBSTANCE ABUSE TREATMENT

Dealing with substance abusers tests an organization’s commitment to its workforce. Recog-nizing substance abuse as a potential problem, some businesses have set up treatment pro-grams in an effort to combat it. Early research suggested that substance abuse treatment canreduce accidents and injuries (e.g., vehicle, industrial, personal injury/illness) in the work-place. One study reported a 62% annual reduction in the number of reported injured daysafter individuals received treatment (Campbell & Graham, 1988), and a nearly 50% declinein accidents was found after one company implemented an Employee Assistance Program(EAP; Pope, 1990). Recent research revealed a 49% decline in lost work hours, and a 65%–82% reduction in workplace accidents after employees were offered treatment services(Bernstein, 1992; Thomas, 1996).

EAPS

EAPs in the 1940s and 1950s were focused on alcohol abuse that affected performance (Reddy,1997) and have since been expanded to include drugs and other mental health issues (Beishon,1999). The EAP, which was designed to help identify and aid employees who need assistancewith health, behavioral, and job performance problems, attempts to move an employee towardseeking appropriate help and to provide long-term support in helping the employee recover.

EAP activities and services are clustered in two areas: direct service delivery to cli-ents and service maintenance to organizations (Winegar, 2002). Services to clients in-clude (a) crisis intervention, (b) assessment and referral, (c) counseling and support, (d)follow-up counseling, and (e) treatment monitoring. Services to organizations includemanagement consultation, training services, health promotion and educational activi-ties, policy consultation, program evaluation, and critical incident debriefing.

PURPOSE OF THE STUDY

The present study examined two hypotheses regarding the relationship between drug/alcohol use and workplace accidents. First, we hypothesized that there would be no differ-ence between the accident rates of drug-test positive employees and the accident rates ofself-referred employees. To explore this, accident rates were reviewed for both groups. Oursecond hypothesis was that both groups would have lower posttreatment accident ratesthan pretreatment accident rates. To test this theory, workplace accidents before and aftersubstance abuse intervention were analyzed.

METHOD

Sample

One large U.S. company provided employee records that were used for analyses of randomand postaccident drug test results, treatment information, and workplace accidents for twogroups: drug-test positive employees and self-referred employees. Employees who tested

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positive for an illicit substance were fired. Individuals who wanted to be rehired werereferred to substance abuse treatment through their organization’s EAP and considered forrehire only if such a recommendation was made by their substance abuse counselor. Self-referred employees disclosed a drug or alcohol problem to the organization without havinga positive drug test. These individuals were not fired but were referred for treatment throughthe organization’s EAP as well. A total of 507 employees were analyzed: 334 drug-testpositive workers who completed substance abuse treatment and were rehired and 173self-referred employees who received substance abuse intervention.

Procedure

Drug test results, self-referral information, and work status were obtained through the company’sMedComp database. Accident records for all employees were obtained using the organization’sbusiness objects database. A workplace accident refers to any incident resulting in injury orillness to self or others, or involving an employee who was operating/driving a vehicle ormachinery. The study was based on analysis of records from January 2000 to December 2002.Data were analyzed with a z test to examine the difference between proportions of two inde-pendent samples (i.e., drug-test positive employees, self-referred employees).

RESULTS

Workplace Accidents

Overall, drug-test positive workers had a significantly higher accident rate (z = 4.64, p <.01) than the self-referred group. In addition, drug-test positive employees had signifi-cantly higher vehicle (z = 3.25, p < .01) and injury/illness accident rates (z = 2.78, p < .01)than self-referred workers.

Pre- and Posttreatment Accidents

Results showed that drug-test positive employees had significantly higher rates ofpretreatment (z = 4.11, p < .01) and post-treatment accidents (z = 2.24, p < .05) thanhad self-referred workers. Posttreatment-only data revealed that drug-test positiveworkers had a significant decrease in accidents after treatment (z = 2.00, p < .05),whereas the self-referred group showed no real change in accidents after treatment.

DISCUSSION

Several differences between groups were found. First, a higher number of employees withpositive drug screens were found than employees who self-referred for drug/alcohol treat-ment. This finding suggests that businesses have a small number of people who are willingto self-disclose about drug/alcohol problems. The reluctance to self-disclose is consistentwith previous literature, which suggested that some individuals do not seek help becausethey might be viewed as incompetent (Batson, 1998). In addition, fear of being labeled analcoholic or a drug addict and fear of job loss may prevent some workers from seeking help,which can reduce the number of self-referred employees. Second, an examination of post-treatment workplace accidents revealed that drug-test positive employees had fewer acci-dents following drug/alcohol treatment, whereas self-referred workers had more, suggestingthat employees who refer themselves for substance abuse concerns are more likely to haveaccidents after treatment than are employees who test positive for drugs/alcohol. These

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findings are inconsistent with previous literature, according to which employees who re-ferred themselves for substance abuse treatment were usually more positive and more moti-vated to complete treatment than other substance abusers (Hansen, Stevie, & Warner, 1972;Ritchie, 1986). However, self-referred employees remained on the job and suffered no con-sequences for their drug/alcohol use, which may have contributed to their posttreatmentaccident rate, whereas drug-test positive employees were fired and went through the rehiringprocess, which may have influenced their behavior and reduced accidents after treatment.

In the present study, one similarity among groups was found. Workplace accidents oc-curred in each group before and after treatment, suggesting that substance-abusing em-ployees are likely to have workplace accidents whether they test positive or refer themselvesfor services. Most treatment programs are designed to empower people to help themselves;few will completely eliminate a problem. Most substance abusers do not think they needhelp and will not seek treatment (Halloran, 2003). In addition, if an employee is coercedinto treatment or is threatened with job loss, that individual may be responding only tohidden pressures rather than addressing the substance abuse problem, thereby increas-ing the likelihood of accidents.

Limitations and Future Research

This research is not without limitations. The present study examined only one factor—drug/alcohol use—in analyzing job performance and workplace accidents. Other variables (e.g.,mental illness, physical health) could be linked to on-the-job accidents. Psychologicaland other problems can impair an individual to the extent that they are a threat to safetyand productivity. Working next to or with this type of employee can be unsafe for every-one. Examining all employees and alternative explanations could provide important andaccurate information when assessing performance and work-related accidents.

Another limitation is that various types of treatment were not examined. All employees in thisstudy received substance abuse treatment through their organization’s EAP. Future research shouldexamine various treatment opportunities (e.g., inpatient, outpatient, short-term, long-term) andcompare accident records of employees receiving these types of services. A great deal of variationexists among treatment programs, which can influence results and produce pertinent informationfor an organization regarding the effectiveness of their treatment program.

Finally, this study examined only 3 years of data. Some employees may have a history ofworkplace accidents prior to testing positive or self-disclosing; others may have improvedtheir performance and reduced the number of accidents they were involved in during theyears after treatment. It could be helpful to examine previous work history and then followup several years after treatment to gain a better understanding of the work patterns andbehavior of substance-abusing employees.

Conclusions

Drugs and alcohol can have harmful effects on individuals who take them and have thepotential harm to others around the user. Any addiction may cause serious problems in theworkplace, but substance abuse by just one employee can disrupt an entire organization.The company in the present study decided that employees who referred themselves for sub-stance abuse treatment were not a safety risk and allowed them to remain on the job whilethey received treatment. Results showed that these workers continued to have workplaceaccidents during and after treatment, suggesting that self-referred employees should also be

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considered a safety risk along with workers who test positive for drugs/alcohol. Any amountof alcohol or drugs increases the risk of safety-related problems.

All drugs have multiple effects, and any drug can be addictive and destructive,increasing the potential dangers to everyone. Over time, substance abuse will dam-age an organization and will manifest itself in accidents, injuries, property damage,or death. Employees have the right to expect a safe, hazard-free work environment,and employers have the right to expect quality, unimpaired performances.

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