Identifying & responding to workers’ alcohol &

other drug use Allan Trifonoff & Tania Steenson

ALC & ATA Supply Chain Safety Summit

Workshop presentation

17 September 2019

Sydney

About NCETA

One of 4 national research centres focusing on alcohol & other drugs (AOD)

Works as catalyst for change in the AOD field by enhancing the capacity of workers & organisations to reduce AOD related harm

Located in Adelaide at Flinders University

Funded by Australian Government Department of Health & Flinders University

Workshop topics

• Prevalence of alcohol & drug use amongst Australian workforces o At-risk industries & population groups

• Workplace factors that contribute to alcohol & drug

use

• Effective workplace responses to alcohol- & drug-related health & safety risks

• Drug testing’s efficacy in reducing workplace alcohol- & drug-related health & safety risks

How many workers use alcohol?

• 87% of Australian workers drink alcohol. • Over 1/3 of workers regularly drink

alcohol at risky levels. • 17% of workers drink at short-term risky

levels weekly. That is over 1.7 million Australians.

1 in 5 workers drink at short-term risk levels weekly

1 in 6 workers drink at short-term risk levels monthly

What is short- & long-term risk?

The National Health & Medical Research Council (NHMRC) develops guidelines to help people reduce the harms associated with alcohol use. Short-term risky drinking is consuming 4 or more standard drinks on a single occasion. Long-term risky drinking is consuming more than 2 standard drinks per day.

Australian Guidelines to Reduce Health Risks from Drinking Alcohol 2009 (2009 Alcohol Guidelines)

Age 14-17 18-29 30-59 60-69 Long-term risk 6%* 11% 11% 11% Short-term risk 33%* 62% 47% 31%

1 in 4 males (28%) & 1 in 10 (11%) females drink at long-term risk levels

Long-term risk

Which workers use alcohol?

Male workers more likely than female workers to drink alcohol at short- & long-term risky levels.

1 in 2 males (42%) & 1 in 4 females (23%) drink at short-term risk levels monthly or weekly

Short-term risk

Younger workers more likely to drink alcohol at short-term risky levels. Long-term risky drinking is fairly consistent amongst all age groups.

Risky drinking is unevenly distributed across different industry & occupational groups. Some industries are more likely to have high rates of risky drinking behaviour amongst their workforce. They include:

• hospitality • construction • manufacturing • mining • utilities.

At risk industries

Industries with the highest proportion of short-term risky drinkers:

• construction • mining • utilities.

Industries with the highest proportion of workers who drink at short-term risky levels on a monthly basis include:

• hospitality • arts & recreation • utilities • mining.

Over 1 in 4 workers employed in these industries drink at risky short-term levels.

Over 1 in 5 workers employed in these industries drink at risky short-term levels on a monthly basis.

Risky short-term drinking by industry

The NHMRC defines illicit drugs as: • illegal drugs (e.g., cannabis, ecstasy, heroin, cocaine, hallucinogens,

barbiturates) • pharmaceutical drugs used for non-medical purposes (e.g., painkillers,

tranquilisers, amphetamines, barbiturates, methadone, other opiates, steroids) • other substances used inappropriately (inhalants, ketamine, gamma hydroxy

butyrate (GHB)). Illicit drug use = using one or more of the above substances for non-medical purposes at least once during the past month & past 12 months.

Illicit drugs

Approximately, 18% of Australian workers used an illicit drug during 2015/2016. That is, approximately:

• 1.8 million Australian workers used an illicit drug in 2015/16.

• 1 million (9%) Australian workers used an illicit drug in the past month.

1 in 10 workers also attended work under the influence of drugs during 2015/2016.

How many Australian workers use illicit drugs?

4% of these workers used an illicit drug at work.

Which workers use illicit drugs?

Male workers more likely to use illicit drugs than female workers.

11% 7%

VS

Age 14-17 18-29 30-49 50-69 Past year illicit

drug use 25% 30% 17% 10%

Illicit drug use is more common amongst young workers aged 18-29 than workers aged over 30.

Most common drugs used by workforce

Outside work hours • Alcohol • Cannabis • Ecstasy • Painkillers/analgesics • Meth/amphetamine

During work hours

• Painkillers/analgesics • Alcohol • Meth/amphetamine • Cannabis

Which workers are more likely to use alcohol & drugs?

Any worker may drink alcohol at risky levels or use drugs. But some workers are more likely to than others:

• male • young (aged 18-29 years) • employed in blue collar trades/industries e.g.:

o agriculture o construction o manufacturing o mining o hospitality.

Why are these workers & workforces most at risk?

These workers & workforces are most at risk because they are: 1. male dominated & men are more likely to:

• engage in risk taking behaviours • conform to social norms & expectations

2. more likely to work in physically demanding trades & industries which have: • hot, noisy or harsh conditions • long hours, & • timeframe pressures.

These working conditions increase stress & fatigue & contribute to

alcohol & drug use.

Workplace factors

Workplace customs & practices

• Subcultures • Social networks • IR/safety climate • Behavioral norms at

work • Administrative/

management culture

Workplace conditions • Physical conditions • Type of work • Dangerous work • Shiftwork/hours • Task complexity/stress • Autonomy/decision

making

External factors • Pre-existing attitudes,

beliefs & behaviors • Values, behaviors &

expectations of family & friends

• The social & cultural norms of wider community

Control factors • Physical & social

availability • Alcohol policy &

procedures • Supervision levels • Low visibility of workers

Workplace accidents & fatalities

Cost of time off work

Impaired performance

Low productivity

Poor workplace morale

Consequences of workers’ alcohol & drug use

Over 10% of workplace accidents involve alcohol use. Approximately 12% of workplace fatalities involve alcohol & drug use.

Alcohol- & drug-related absences cost Australian workplaces over $3 billion per year. Australian workers with alcohol & drug use disorders are 2.6 times less productive compared to the total workforce. Alcohol use alone costs Australian businesses an estimated $6 billion per year due to lost productivity.

Workers' alcohol & drug use can reduce their ability to perform tasks safely & exercise sound judgement when assessing risks. This negatively impacts workplace health & safety & exposes employers to legal action. Employers have a legal duty to eliminate or minimise workplace alcohol & drug risks to health & safety as far as reasonably practical.

Workplace morale may be reduced if workers misuse alcohol or drugs. This stems from:

1. co-workers' concerns about health, safety & wellbeing

2. co-workers' anxiety about covering for non-performing team members

3. arguments with managers, supervisors, team leaders, & co-workers because of mood changes

4. the financial & resourcing imposts associated with worker turnover (i.e., dismissal or resignation).

Effective workplace responses

Effective workplace alcohol & drug programs: • improve workers' health, safety, morale & productivity • reduce turnover, time off work, & accidents & injuries • enhance workplace culture by adopting a comprehensive approach

which: • applies to all workers • targets worker & workplace safety, health & wellbeing • provides workers with information about alcohol- & drug-related:

o health, social, & behavioural problems o workplace harm (e.g., co-worker relationships, safety risks) o counselling & treatment services & workplace supports.

1. Formal written documents tailored to organisation/site: • developed in consultation with workers • informed by workplace risk & needs assessment • aimed at improving fitness for work & workplace health &

safety 2. Include:

• management & supervisor training • worker awareness & education initiatives • information about support services • rehabilitative & restorative focus • guidance for identifying & responding appropriately to

vulnerable & at-risk workers • testing procedures if required.

Comprehensive alcohol & drug policies

Need to include information on: • alcohol & drug harm in the workplace • workplace factors that may contribute to increased

risk of harm • general alcohol & drug health effects • access to support & treatment.

Training is critical for those implementing the policy to build knowledge, confidence & communication skills. It needs to be:

• regular • ongoing • across the whole organisation • adaptable to changing circumstances.

Education & training

• Typically provided through: o employee assistance programs (EAP) o community based non-profit services

• Consistent with workplace rehabilitation policies & principles

• Information is easily & confidentially accessible • Access to support & treatment lessens the costs &

loss of morale associated with dismissal.

Access to support & treatment services

Workplace drug testing

Introduced in some Australian industries during the 1990s & has expanded since that time. 4 reasons:

1. meet employers’ general work health & safety obligations & deter use

2. maintain public safety 3. ensure public confidence in integrity-

sensitive occupations 4. comply with industry-specific legislation.

What do alcohol & drug tests detect?

Alcohol & drug testing detects previous use. Alcohol tests can identify impairment. Drug tests can only show previous use, not impairment. Drug tests cannot indicate:

• intoxication or impairment • hangover effects • amount of drug used or pattern of use.

All alcohol & drug tests require a 2 step screening &confirmation method. Workplace alcohol & drug testing programs also have to comply with Australian standards where applicable.

Step 1 Screening

Step 2 Confirmation

What Australian

Standards apply?

How do alcohol & drug tests work?

A sample is collected & screened using a ‘point of collection’ device. The accuracy of these devices may be unreliable & ‘false positive’ readings can be returned.

Drug tests require laboratory screening to confirm their accuracy. For alcohol, a second breathalyser test is given at least 20 minutes after the first positive result to confirm BAC levels.

Several standards have been developed to regulate alcohol & drug testing programs. The standards detail: • procedures for collecting, storing, handling, & transporting

samples (including chain of custody) • qualifications & training required for on-site collectors of

specimens & laboratory staff • quality control management of on-site & laboratory testing

devices & methods • cut-off points for positive on-site screening & confirmation

results. Alcohol breath analysis standards: AS 3547:1997 Breath alcohol testing devices for personal use Urine testing standards: AS/NZS 4308:2008 Oral fluids/saliva testing standards: AS/NZS 4760: 2019

There are various testing methods & approaches. Each method & approach has strengths & weaknesses for:

• deterring use • detecting impairment • improving workplace safety & wellbeing.

Types of alcohol & drug testing programs

Available testing methods Testing approaches 1. breath - alcohol 2. urine - drug 3. saliva - drug 4. hair – drug

1. random testing 2. for cause or targeted testing 3. post-incident testing 4. pre-employment testing

Effectiveness of drug testing

There is little evidence that workplace alcohol & drug testing:

• improves workers’ safety or reduces workplace risk

• is cost-effective • enhances workplace morale.

However, workplace alcohol & drug testing programs can promote workers’:

• knowledge about alcohol & drug risks • compliance with workplace safety standards • access to alcohol & drug support services

when they adhere to principles of good practice.

Systematic review

Pidd & Roche, 2014 Systematic weaknesses in study designs, limited sample representativeness, poor control of confounders

Negative impacts

Testing programs can have negative impacts on workplace health, safety, & morale. For example, workers may try to avoid detection by:

• using drugs with a shorter window of detection • changing their patterns of drug use • not reporting minor incidents, accidents & near miss events • not asking for help and/or attending treatment services.

In addition, positive test results can marginalise & stigmatise workers who may already be experiencing financial, personal, & social hardship & disadvantage.

Urine

Saliva

Hair

Each drug testing method has pros & cons. Some methods are better at detecting certain types of drugs. Other methods have greater privacy concerns, cost more money &/or take more time.

Workplaces should not rely on drug testing alone to improve safety &or deter use.

Urine &saliva are the most common methods used. Hair testing is rarely used.

Drug testing methods

Drug type Urinalysis Saliva Hair

Methamphetamine 2 to 5 days Up to 48 hours Up to 90 days

Benzodiazepines Up to 7 days Up to 36 hours Up to 90 days

Occasional cannabis use Up to 4 days Up to 24 hours Up to 90 days

Frequent cannabis use Up to 30 days Up to 48 hours Up to 90 days

Cocaine Up to 3 days Up to 36 hours Up to 90 days

Methadone Up to 3 days Up to 36 hours Up to 90 days

Opiates (codeine, morphine)

2 to 5 days Up to 48 hours Up to 90 days

Ecstasy (MDMA) Up to 3 days Up to 48 hours Up to 90 days

Window of detection

by drug type & testing method

Table: Detection times for common drugs by test type4

Note: This table should be used as a guide only. Drug detection times are variable & influenced by factors such as strength & amount of drug taken & individual metabolism.

Window of detection

Hair, followed by urine & then saliva, has the longest period of detection.

Saliva testing is more likely to indicate recent drug use, followed by urine & hair testing.

Workplaces aiming to: 1. reduce short-term impairment & improve

safety may opt for saliva testing 2. deter general use may favour urine testing.

Safety sensitive workplaces may choose a combined saliva & urine testing program.

4 common ways to implement drug testing: 1. Random 2. For cause 3. Post-incident 4. Pre-employment.

Each has limitations for detecting &/or deterring use, & no approach is sufficient for proving causation in a workplace incident (see handouts). The limitations of testing approaches should be weighed up against the privacy concerns involved in, & money & time taken to conduct testing.

Drug testing approaches

Deterrent Random testing

Detection

For cause Post-

incident Pre-

employment

Workers involved in development Underpinned by worker awareness, education & training programs Statutory requirement Enhances worker buy in Can occur via team meetings, surveys, debriefs, workshops

Consultative Part of organisation’s broader alcohol & drug or health & safety strategy Wellbeing & safety focus

Evidence-based

Focus is on impairment, fit for work, & workplace safety Based on workplace risk assessment, consultation findings, statutory requirements

Appropriate

Follow procedural fairness & natural justice principles Already part of standard workplace disciplinary processes

Fair

Workplace laws (health & safety, Fair Work, privacy & confidentiality, industry) Australian alcohol & drug testing standards & public safety laws

Compliant

Principles of effective alcohol & drug testing programs

Questions

NCETA resources

Mr Allan Trifonoff Phone: 08 8201 7511 Email: allan.trifonoff@flinders.edu.au

Contact information

www.nceta.flinders.edu.au

nceta@flinders.edu.au

@NCETAFlinders

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