Mental health is often referred to as the ”poor cousin” within our healthcare system; this is an accurate descriptor when we consider the relative paucity of services and accessible supports that exist within our public and (albeit to a lesser degree) private healthcare systems for mental health. Over the last decade, however, increasing attention has been placed on heightening knowledge about the prevalence, magnitude and impact of mental health issues, particularly in the workplace. Employers are increasingly recognizing that it makes solid business sense to create psychologically healthy workplaces and to foster the psychological health of their workers. In addition, an emerging legal obligation exists and will, by July 2012, be articulated in a new standard called the National Standard of Canada for Psychological Health and Safety in the Workplace, through a collaborative effort of the Bureau de normalization du Quebec (BNQ) and the Canadian Standards Association (CSA).

Much of the existing attention placed on mental health in the workplace focuses on disorders that fall within the depressive spectrum (primarily major depressive disorder, but also bipolar mood disorder and dysthymia) and, to a lesser degree, anxiety disorders. It is important to remain cognizant that there are high rates of comorbidity between common mental health conditions (depression, anxiety) and substance (particularly alcohol) use and dependence. However, substance use issues are almost completely ignored, becoming the estranged and often altogether forgotten sibling of mental health.

In actual practice, clinicians, researchers and governments often view mental health and substance use as quite separate entities; however, it is important to remain mindful that within psychiatry and psychology, substance use issues are considered a subset of mental health issues.

Defining substance use issues
The term ”addiction” is often used to refer to problems with alcohol and drug use, but these problems should more accurately be referred to as substance use, abuse and/or dependence issues. An understanding of problematic behaviours in the workplace necessitates a broader definition than that seen in medical diagnoses, since within (arguably) all workplace contexts, the use of any non-prescription substance may be inappropriate and cause for reprimand and ineligibility from disability benefits or other programs offered to workers.

Alcohol is the most common non-prescription substance that contributes to workplace impairment. Some estimates suggested that workplace alcohol use and impairment directly affects up to 15% of the workforce, with approximately 2% of workers reporting drinking before work on at least one occasion, 7% reporting they have drank during the workday, 1.5% reporting they have worked under the influence of alcohol and 10% reporting they have worked while hungover (Frone, 2006). These figures are consistent with population prevalence statistics that indicate approximately 17% of the population engages in risky drinking (i.e., alcohol use that poses some health or lifestyle hazard; Adlaf, Begin & Sawka, 2004).

Substance use can have a number of significant impacts in the workplace, including on job performance and productivity, absenteeism rates and the quality of interpersonal relationships with other workers, as well as with clients and customers. Substance use issues are also particularly concerning for those in safety-sensitive jobs, given that they can increase the likelihood of job-related accidents and injuries.

Given the impact that substance use has on the workplace, employers must take proactive action. The following are some recommendations:

  1. Establish clear zero-tolerance written policies on substance use in the workplace, and ensure that workers are informed about these policies.
  2. Provide education to workers on the range of substance use issues, and provide resource information that can direct them to confidential services if they are struggling (e.g., written educational resources on an intranet or internet site; information on in-house supports such as employee and family assistance programs; information on extended benefits coverage for a psychologist).
  3. Ensure that any signs of possible substance use are identified and addressed early on (all too often, coworkers and managers will ignore multiple signs of problematic use/abuse). The goal is to provide non-judgmental support and help.
  4. Have existing protocols in place for how to deal with substance use in the workplace. If at all possible, try to link the worker with treatment supports while maintaining him or her in the position. In some cases (e.g., safety-sensitive positions) this may not be a possibility and a time-limited absence from work may be required.
  5. Identify and take proactive steps to mitigate the impact of any work environment factors that may be contributing to stress for the worker.

Adlaf, E.M., Begin, P., & Sawka, E. (2004). Canadian Addiction Survey (CAS): a national survey of Canadian’s use of alcohol and other drugs: prevalence of use and related harms: detailed report. Canadian Centre on Substance Abuse (CCSA): Ottawa.

Frone, M. R. (2006). Prevalence and distribution of alcohol use and impairment in the workplace: a U.S. national survey. J Stud Alcohol, 67 (1), 147-56.

Dr. Joti Samra is a clinical psychologist and principal in an organizational and media consulting practice. She is president of the BC Psychological Association and chair of the BC Psychologically Healthy Workplace Awards Committee. She is the lead principal in a number of national workplace initiatives, including Guarding Minds @ Work and Managing Emotions.

Copyright © 2020 Transcontinental Media G.P. Originally published on

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The substance abuse issue I feel is wide spread which also causes mood swings which in turn effects all co-workers which could endanger their lives depending on the type of work they do. It seems to be a cool thing to do and no regard for other beings is taken into account. Instead of police officers stopping everyone for a “ride program” they should test for drugs as well instead of letting them go under the influence.

Friday, August 05 at 2:55 pm | Reply

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