The Elephant in

the Room:

Addressing substance

use/abuse in South

African workplaces

19 July 2016

Roger Weimann

SANCA Central Eastern Cape

WHO ARE WE?

SANCA stands for the South African Council on

Alcoholism and Drug Dependence.

We are an non-profit organisation that strives to

prevent and treat substance abuse on all levels.

SANCA National consists of 28 clinics with 190

service points throughout South Africa.

Substance use = drug/substance used for correct purposes, correct dosage under

correct controls

Substance abuse = using legal substances for wrong reasons, past the

prescribed period or dosage, without controls AND

Using any illegal substance

Addiction = any activity, substance or behaviour that has become the major focus

of a person’s life to the exclusion of other activities or has begun to harm the

individual or others physically, mentally or socially

Definitions

We think mostly of drugs being used by

people living on the streets or living in

poverty.

The Reality: 67% of substance abusers

and addicts are part of the workforce

The Reality: There are employees not being

productive because they are worried about

someone being a substance abuser in their

family or friendship circle

TRENDS AND INTERESTING FACTS

20 Million South Africans are estimated to abuse substances OR are

developing a dependency to a substance;

That one addict affects a minimum of 16 people directly or indirectly around them;

Children as young as 7 are starting to use alcohol and drugs, but the

average age to experiment with drugs has dropped to 12 from 19;

The most affected age group is adolescents and young adults, our future

workforce;

That most serious addictions are still with socially acceptable drugs like

alcohol and dagga;

That 85% of all crimes are committed under the influence of a drug

Alcohol consumption in South Africa ranks 10th in the World

Drug and Alcohol related crimes in South Africa have consistently

increased (according to Police Crime Statistics) from 212.9 per 100000

or the population in 1994 to 430.5 per 100000 of the population in

2010

South Africa also has the highest incidence rate of Foetal Alcohol

Syndrome in the world – a very dubious distinction indeed

Coupled with all of this is the ever increasing unemployment levels

within the country, with the Eastern Cape having approximately a

45% unemployment rate

According to the Medical Research Council, there is a registered

liquor outlet for every 190 persons in South Africa (this number only indicates registered liquor outlets)

HOW BIG AND BAD IS SUBSTANCE ABUSE?

The average South African consumes 20 litre’s of alcohol

per year - one of the highest rates in the world

Over 50% of admissions for dagga are under 20 years of

age;

There is an increase of cocaine and heroin admissions

especially in Gauteng and KZN;

In the Eastern Cape Alcohol and Dagga remain the

most commonly abused substances

Whitepipe (Dagga and Mandrax) abuse is on the increase

Sharp rise in Crystal Meth (TIK) abuse in Eastern Cape.

An increase in the abuse of Over-The-Counter (OTC) and

Prescription Medications (PRE) is evidenced throughout

the country

Zirrup (a mix of Soda and cough mixture) is gaining popularity

particularly amongst teens and college students

South Africa has one of the highest rates of Codeine abuse

(according to WHO South Africa ranks in the top 50 countries

abusing codeine)

In a study conducted by the Medical Research Council in

2014 - A total of 17 260 admissions were recorded, with 435

people admitted for codeine misuse or dependence as a

primary or secondary substance of abuse (approximately

2,5%). HOWEVER, this study was conducted on admissions into

treatment and not all active users.

Codeine is part of the opiate family which includes heroin

and opium – all highly addictive

TYPES OF DRUGS USED & EFFECTS

Category Examples Examples of General Effects

Alcohol beer, wine, spirits impaired judgement, slowed reflexes, impaired motor

function, sleepiness or drowsiness, coma, overdose

may be fatal

Cannabis marijuana, hashish distorted sense of time, impaired memory, impaired

coordination

Depressants sleeping medicines, sedatives,

some tranquilizers

inattention, slowed reflexes, depression, impaired

balance, drowsiness, coma, overdose may be fatal

Hallucinogens LSD (lysergic acid

diethylamide), PCP

(phencyclidine), mescaline

inattention, sensory illusions, hallucinations,

disorientation, psychosis

Inhalants hydrocarbons, solvents,

gasoline

intoxication similar to alcohol, dizziness, headache

Nicotine cigarettes, chewing tobacco,

snuff

initial stimulant, later depressant effects

Opiates morphine, heroin, codeine,

some prescription pain

medications

loss of interest, "nodding", overdose may be fatal. If

used by injection, the sharing of needles may spread

Hepatitis B, or C and HIV/AIDS.

Stimulants cocaine, amphetamines elevated mood, overactivity, tension/anxiety, rapid

heartbeat, constriction of blood vessels

(Source: Blume, S.B., Alcohol and Drug Abuse in the Encyclopaedia of Occupational Health and

Safety 4th edition, International Labour Office, 1998)

CAUSES OF SUBSTANCE ABUSE IN THE

WORKPLACE

Work-related factors contributing to

Substance use/abuse

High stress,

Low job satisfaction,

Long hours or irregular shifts,

Fatigue,

Repetitious duties/ monotonous work,

Periods of inactivity or boredom,

Isolation,

Remote or irregular supervision and,

Easy access to substances

Work requiring relocation and the frequent changes in co-workers and supervisors

Other Personal and social causes/

factors

Peer temptation and social pressure

Personal problems and influences

Addictive personality and personality type

Genetic predisposition

Availability and affordability

Dysfunctional relationships

Physical pain/ discomfort due to illness or disease

Emotional escapism due to traumatic events

Coping with life changes

IMPACT OF SUBSTANCE ABUSE ON THE

WORKPLACE

DID YOU KNOW?

According to studies conducted by the International Labour Organisation

(ILO) on the abuse of alcohol and drugs in the workplace, the following was

found:

Absenteeism of employees with alcohol and drug problems was three

times higher than for other employees,

Employees with chemical dependence problems claimed sick benefits

three times more than other employees and also made compensation

claims five times more than other employees,

20% to 25% of injuries in the workplace involved employees under the

influence of alcohol, and

Drugs and alcohol supplied at work amounts to 15% to 30% of all accidents

at work.

(Source: Sarah Modise, CCMA, 2015)

COST TO BUSINESS

DIRECT COSTS

productivity losses,

direct health care,

Premature death/fatal accidents

Injuries/accident rates

Absenteeism/extra sick leave, and

Loss of production.

ADDITIONAL COSTS tardiness/sleeping on the job

theft

poor decision making

loss of efficiency

lower morale of co-workers

increased likelihood of having trouble with co-workers/supervisors or tasks

higher turnover

training of new employees

disciplinary procedures

drug testing programs

medical/ rehabilitation/ employee assistance programs

It’s estimated that Drug

abuse costs employers $81

billion annually in the USA

It is estimated that in South Africa the abuse of alcohol and other drugs

costs the economy at least R9 billion a year.

Overall, an undetected drug abuser costs his employer 25% of his wages.

In one study alcoholics were found to have lost 86 working days a year

due to absence.

Over 50% of accidents in the workplace are drug-related, and theft at work

and other criminal activities are trebled.

Steinman et al (2003) interviewed a sample of male alcoholics of which 67%

were in employment. He found that each lost 86 working days a year due

to absence. Sixty six percent of the sample was often late for work, 61%

reported Monday morning absenteeism, and 62% sometimes took alcohol

at work, with 12% doing so regularly.

Steinman,S & Senekal,A (2003) Solving psychosocial problems in the workplace: The Work Trauma Foundation and the ILO,

Department of Sociology; RAU. Referred to at www.interaction.nu.ac.za/sasa 2003

SIGNS & SYMPTOMS TO LOOK OUT FOR

IN THE WORKPLACE

Physical Signs & Symptoms

Physical signs such as fluctuating weight, complexion, pupils of eyes don’t react to light, etc.

Deterioration in appearance and/or personal hygiene

Unexplained bruises

Sweating

Complaints of headaches

Tremors

Diarrhoea and vomiting

Abdominal/muscle cramps

Restlessness

Frequent use of breath mints/gum or mouthwash

Odour of alcohol on breath

Slurred speech

Unsteady gait

Psychosocial Impacts

Family disharmony (how the colleagues speaks of family members)

Mood fluctuations (e.g., swinging from being extremely fatigued to

‘perkiness’ in a short period of time)

Inappropriate verbal or emotional response

Irritability

Confusion or memory lapses

Inappropriate responses/behaviours

Isolation from colleagues

Lack of focus/concentration and forgetfulness

Lying and/or providing implausible excuses for behaviour

Workplace Performance & Professional

Image

Calling in sick frequently (may work overtime)

Moving to a position where there is less visibility or supervision

Arriving late for work, leaving early

Extended breaks; sometimes without telling colleagues they are leaving

Forgetfulness

Errors in judgment

Deterioration in performance

Excessive number of incidents/mistakes

Non-compliance with policies

Doing enough work to just ‘get by’

Sloppy, illegible or incorrect work (e.g., writing, reports, etc.)

Changes in work quality

SUBSTANCE ABUSE IN THE WORKPLACE

AND THE LAW

SUBSTANCE ABUSE AND THE LAW:

Employee Equity Act No. 55 of 1998

The Act seeks to promote equal opportunity in the workplace

and fair treatment in employment through the elimination of

unfair discrimination.

To the extent that the Act relates to medical testing, it applies to

all employees and employers. However, it does not apply to:

Members of the National Defence Force;

The National Intelligence Agency;

The South African Secret Service;

The South African National Academy of Intelligence; or

To the directors and staff of Comsec.

SUBSTANCE ABUSE AND THE LAW: Employee

Equity Act No. 55 of 1998 Section 7 Medical

Testing

Other criteria that should be taken into account are whether:

The test is relevant and appropriate to the job;

The test is unbiased in how or when it is applied, assessed or interpreted;

Tests to establish the health of the employee are distinguished from tests

that assess the employee’s ability to perform essential job functions or

duties;

Employees have been adequately informed as to the nature and purpose

of the test; and

Employees have been informed of the fact that results will be confidential.

Special conditions for HIV/Aids testing

The South African courts have found that the prevention of alcohol abuse at work is a

management responsibility and that it is the employer who should ensure that employees

may not commence with work if drunk.

This would also apply toemployees under the influence of drugs or other

potentiallyharmful substances.

Substance Abuse & the Law:

Occupational Health and Safety Act Occupational health and safety legislation requires employers to provide

and maintain a working environment that is safe and without risk to the health or welfare of its employees.

Employees affected by alcohol, drugs and other potentially harmful substances in the workplace are a risk to themselves and to others around them.

The penalties for an employer not complying with its health and safety obligations are significant. Directors and senior managers may in some instances be held personally liable for such non-compliance.

In many industries, the employer is not considered to have discharged its legal obligations in relation to occupational health and safety unless it implements policies and procedures to address the risks associated with substance abuse in the workplace.

In addition, specific industry legislation, such as rail and mine safety legislation, requires employers to ensure that drugs or alcohol does not affect employees while they are at work.

DRUG SCREENING IS A LEGAL

MINEFIELD

Urine screenings are not accepted in South African courts and only blood tests stands up in court

Blood samples tested at forensic laboratory will stand up in Labour court and in criminal cases

All other tests are purely for screening purposes using a urine specimen

Pre-employment prohibited unless the employee’s job description requires that the employee must be alcohol and drug free. Example: drivers, working dangerous machinery, pilots, etc.

Regular random drug screening is allowed if so stated in the company’s alcohol and drug policy.

Types of drug tests available to test hair follicles, saliva, urine and blood as well as breathalyser tests for alcohol.

WORKPLACE STRATEGIES TO DEAL WITH

SUBSTANCE ABUSE

Summary of the Workplace Strategies

to deal with Substance abuse

Implementing drug-free workplace and other written substance abuse policies;

Offering health benefits that provide comprehensive coverage for substance use

disorders, including aftercare and counselling;

Educating employees about the health and productivity hazards of substance abuse

through company wellness programs, Employee Assistance Programs (EAPs) and

Work/Life programs;

Utilizing EAP services to help employees with substance abuse;

Respecting employees’ privacy; and

Reducing stigma in the workplace.

ALCOHOL & DRUG WORKPLACE

POLICIES A company substance abuse policy should emphasize that the program is

confidential and be jointly created by both labour and management.

Statement of the purpose and objectives of the program

Definition of substance abuse and other terminology

Statement of who is covered by the policy and/or program

Statement of the employee's rights to confidentiality

Pro-active strategies such as employee education (e.g., a substance-free awareness program) and training employees, supervisors, and others in identifying impaired behaviour and substance abuse.

Reactive strategies such as:

Provision for assisting chronic substance abusers

Outline of how to deal with impaired workers

If necessary, statement of under what circumstances drug or alcohol testing will be conducted

Provision for disciplinary actions.

The policy should outline:

A list of prohibited substances in the workplace

The assistance that the employer is prepared to provide to employees who

voluntarily disclose a substance abuse problem

The consequences of working under the influence of a prohibited

substance

The consequences of not disclosing a substance abuse problem

TESTING SHOULD BE CLEARLY STATED AND LISTED WITHIN THE ORGANISATION’S

SUBSTANCE ABUSE POLICY AND PROCEDURE

Testing MUST be voluntary, but it can be done if the test is random or if it is

not motivated by victimization or unfair discrimination

If there is legitimate cause to suspect substance abuse/use, the employee

can be obliged to comply with the employer’s request.

Debates and Decisions

The stance of the company: zero tolerance or a understanding that

addiction is a disease and treatable to reduce stigma

The availability of alcohol at work functions on or off work premises

Should the policy apply to all contractors, visitors and guests or only

employees?

Policy will be enforced with all levels of management

Relapse is part of recovery, so how many relapses will be allowed?

Company resources available to financially and emotionally support the

employee in treatment as well as budget allocation for pro-active

strategies.

Violations of the policy and disciplinary consequences

What would be a safe legal alcohol limit for employees?

Pre-employment testing or any random drug screening?

WHAT IS A SAFE LEVEL OF ALCOHOL

CONSUMPTION?It is not only heavy drinking that might result in incidents at work, but even low quantities of alcohol consumption have resulted in incidents.

A study conducted in the 1990's has shown that even though alcohol is consumed in small quantities the effects can be costly for the employer. The study was conducted amongst airline pilots performing routine tasks in a simulator under three alcohol conditions. The outcome was that, before the pilots could drink any alcohol, 100% of them could not perform all tasks correctly. After a blood alcohol concentration of 0.01/100ml, 89% could not perform all the operations correctly and after all the alcohol had left their system, 68% could not perform all the operations.

Clearly this reveals that substance abuse should not be seen as only affecting heavy users as incidents can result from the consumption of low quantities of alcohol as well.

Thus, it becomes important for employers to implement preventative measures and management programmes rather than just concentrating on the identification and rehabilitation of heavy users.

The Legal Limit in SA is : 0,05% Blood Alcohol

0,024% Breath Alcohol

Equates to 1 unit of 10ml Alcohol content taken in a hour

PRO-ACTIVE STRATEGIES: EDUCATION,

AWARENESS & EDUCATION

Wellness Days with exhibitions: focus on employee health (EWP)

Campaigns during the month of June as part of the HR Calendar as 26 of June is International Day against substance use and illicit drug trafficking.

Training of peer educators, supervisors, union representatives, line management to identifying the signs and symptoms and constructively deal with incapacitated employees timeously.

Breakfast or Lunch time awareness talks

Industrial plays with substance abuse as a theme

Displaying posters and having interesting articles on the intranet of the company.

Events to be carefully planned especially where alcohol with be available, e.g. transport service

Regular random Drug screenings (if policy clearly states and is signed by employees)

WHEN AM I A RESPONSIBLE

DRINKER?

One beer One glass of wine

One tot of spirits

= =

• One unit per hour and not more than 6 units for men over 18 years of age and over 68kgs• Women to drink slower and less than men (3 to 4 units).• Don’t drive at all even after having one unit.• One drink, one cool-drink (soda) rule• Drink after you have eaten and don’t mix your drinks.

RE-ACTIVE STRATEGIES: EAP

Encourage employee for a self-referral if work standard has not

been compromised due to their behaviour

Manager referrals to the EAP service provider for any signs & symptoms of substance abuse where productivity has been negatively affected. This is not a substitute for disciplinary or

remedial action, but it might be used together with disciplinary

action. This referral is a suggestion by the manager but completely

voluntary. No disciplinary or remedial procedures have been

instated.

Mandatory referrals are used as part of remedial action or

disciplinary process to avoid termination of an employee’s

employment.

Absolute confidentiality and privacy of employees to be respected

Support and follow up during and after return from rehabilitation

Most Frequently Asked Questions

Where do I go?

How much will it cost?

How long will it take?

What can I expect to happen at a rehab?

Are there not more drugs inside than outside?

Do they give me my drugs to detoxify?

What do I do if someone refuses help?

What is your success rate?

“Courage is not the absence of

fear — it’s inspiring others to move

beyond it.”

― Nelson Mandela

It will take teamwork and unity to

address substance abuse in the

workplace.

It starts with you!

THANK YOU!!!

Contact Details:

SANCA Central Eastern Cape

043 7221210

info@sancacec.co.za

www.sancacec.co.za

Sanca East London