Indg91 - drug misuse at work : a guide for employers
a guide for employers Produced by HSE in partnership with the Home Office, the Department of Health, the Scottish Executive, the Health Education Board for Scotland, the National Assembly for Wales and the Health and Safety Executive Northern Ireland. WORKING TOGETHER FOR A HEALTHIER NATION INTRODUCTION
This booklet has been developed by the Health and Safety Executive (HSE), theHome Office, the Department of Health, the Scottish Executive, the HealthEducation Board for Scotland, the National Assembly for Wales, the Health andSafety Executive Northern Ireland and other organisations. It will help owners andmanagers of businesses and other organisations, particularly small and medium-sized enterprises, deal with drug-related problems at work.
It provides a basic understanding of the signs, effects and risks of drug misuse. It also sets out a best practice approach to dealing with drug-related problems atwork. DRUG MISUSE AT WORK a guide for employers WHAT IS DRUG MISUSE?
In this booklet, ‘drug misuse’ refers to the use of illegal drugs and the misuse, whether deliberate or unintentional, of prescribed drugs and substances such as solvents. Drug misuse can harm the misuser both physically and mentally and, through the misuser’s actions, other people and the environment. Historically, society regards alcohol, tobacco and caffeine differently from other drugs and the problems associated with their use are well documented. They are therefore not considered further in this booklet. However, remember that simultaneous use of alcohol and drugs is particularly dangerous.
The joint HSE/Department of Health booklet Don’t mix it: A guide foremployers on alcohol at work (Leaflet INDG240 HSE Books 1996(single copy free or priced packs of 10 ISBN 0 7176 1291 0)) offersseparate guidance. The Health Education Board for Scotland’s guideAlcohol in the workplace: A simple guide (Health Education Board forScotland 2001) is available to employers in Scotland. IS IT MY CONCERN?
Yes. Drug misuse can be a serious problem not only for the misuserbut also for the business where they work and, sometimes, for theirco-workers. The possession of some drugs is illegal, exposing themisuser to the risk of criminal charges as well as causing harmfuleffects to their health. You could be breaking the law if you knowinglyallow drug-related activities in your workplace and you fail to act. It isjust as important to know the implications to both your employees andbusiness of not tackling drug misuse, particularly where safety isinvolved.
Successfully tackling drug misuse can benefit both your business andyour employees. For example by:
saving on the cost of recruiting and training new employees to replace those whose employment might be terminated becauseof untreated drug misuse;
DRUG MISUSE AT WORK a guide for employers
reducing the cost of absenteeism or impaired productivity;
creating a more productive environment by offering support to
those employees who declare a drug-related problem,improving employee morale;
reducing the risk of accidents caused by impaired judgement;
enhancing the public perception of your organisation as a responsible employer;
contributing to society’s efforts to combat drug misuse. WHO IS AT RISK?
All kinds of people are involved in drug misuse - they do not conformto any stereotype. A lot of people who are involved in drug misuse arein work. TAKING DRUGS - WHAT ARE THE SIGNS?
If you are going to tackle drug misuse at work effectively, you maywant to start by examining your own knowledge about the types ofdrugs available and the harmful effects they can have on the misuserand your business. So your first task will probably be to gatherinformation to raise your awareness and that of your managers orsupervisors. This booklet can be a starting point but you may alsowant to approach some of the organisations listed at the end foruseful reading material, educational videos and other information.
Drugs can affect the brain and the body in a number of ways. Theycan alter the way a person thinks, perceives and feels, and this canlead to either impaired judgement or concentration. Drug misuse canalso bring about the neglect of general health and well-being. Thismay adversely influence performance at work, even when the misusetakes place outside the workplace.
DRUG MISUSE AT WORK a guide for employers
Signs of drug misuse which you might look for include:
abnormal fluctuations in concentration and energy;
a deterioration in relationships with colleagues, customers or management;
dishonesty and theft (arising from the need to maintain an expensive habit). Remember: all the signs shown above may be caused by other factors, such as stress, and should be regarded only as indications that an employee may be misusing drugs. DRUG MISUSE AT WORK a guide for employers THE LEGAL POSITION
You have a general duty under the Health and Safety at Work etc Act 1974 (HSW Act) to ensure, as far as is reasonably practicable, the health, safety and welfare at work of your employees. You also have a duty under the Management of Health and Safety at Work Regulations 1999, to assess the risks to the health and safety of your employees. If you knowingly allow an employee under the influence of drug misuse to continue working and his or her behaviour places the employee or others at risk, you could be prosecuted. Your employees are also required to take reasonable care of themselves and others who could be affected by what they do at work.
The Transport and Works Act 1992 makes it a criminal offence for certain workers to be unfit through drugs and/or drink while working on railways, tramways and other guided transport systems. The operators of the transport system would also be guilty of an offence unless they had shown all due diligence in trying to prevent such an offence being committed.
The Road Traffic Act 1988 states that any person who, when driving or attempting to drive a motor vehicle on a road or other public place, is unfit to drive through drink or drugs shall be guilty of an offence. An offence is also committed if a person unfit through drink or drugs is in charge of a motor vehicle in the same circumstances.
The principal legislation in the UK for controlling the misuse of drugs is the Misuse of Drugs Act 1971. Nearly all drugs with misuse and/or dependence liability are covered by it. The Act makes the production, supply and possession of these controlled drugs unlawful except in certain specified circumstances (for example, when they have been prescribed by a doctor). If you knowingly permit the production or supply of any controlled drugs, the smoking of cannabis or certain other activities to take place on your premises you could be committing an offence. DRUG MISUSE AT WORK a guide for employers
The Act lists the drugs that are subject to control and classifies themin three categories according to their relative harmfulness whenmisused.
includes ecstasy, cocaine, heroin, LSD, mescaline, methadone, morphine, opium and injectable forms of Class B drugs.
includes oral preparations of amphetamines, barbiturates, cannabis, cannabis resin, codeine and methaqualone (Mandrax).
includes most benzodiazepines (eg Temazepam, Valium), other less harmful drugs of the amphetamine group, and anabolic steroids.
The penalties for offences involving controlled drugs depend on theclassification of the drug. Penalties for misuse of Class A drugs aremore severe than those for Class B drugs which in turn are moresevere than the penalties for Class C drugs. The Act alsodistinguishes, in terms of the penalties that may be imposed, betweenthe offences of possession and drug trafficking or supplying, with thelatter attracting higher penalties.
It is possible that in certain circumstances charges may be broughtagainst an employer or an employee under either this Act or theHealth and Safety at Work Act or both. It would be up to the courts todecide on the circumstances of each case.
A table showing the most commonly misused substances by adults inthe UK appears on pages 16-19.
DRUG MISUSE AT WORK a guide for employers WHAT CAN I DO? A policy on drug misuse
All organisations - large and small - can benefit from an agreed policy, applying to all staff, on drug misuse.
As with alcohol, such a policy should form part of your organisation’soverall health and safety policy. Many large organisations havepolicies that describe their position on drug misuse. A written drugspolicy has many advantages, for example leaving less room formisunderstanding than an informal ‘understanding’. The key elementsof a policy on drug misuse are described in Box 3.
A straightforward four-step process to establish and implement apolicy for dealing with drug misuse at work is set out below.
Remember: it is good practice to have a policy even if you do not find any evidence of current drug misuse. A policy which is in place will enable you to deal with any future problems which may arise. Follow the complete four-step process. Step 1 - Find out if there is a problem
You may want to explore carefully some key areas of your business:
sickness record - are there any periods of unexplained or frequently taken absence?
behavioural changes - what behavioural changes have you noticed in any employee (see Box 1)?
productivity - are there any unexplained dips in productivity?
accident records/near misses - have the number of accidents ornear misses increased or involved particular employees?
disciplinary problems - have you noticed particular performanceor conduct problems with any employees?
These may help you to find out if drug misuse is harming your business.
DRUG MISUSE AT WORK a guide for employers Step 2 - Decide what to do
Following Step 1 allows for a better understanding of the manyaspects of drug misuse at work. It will provide you with a clearerpicture of how drug misuse affects your business. But how do youmake this work in practice?
You may want to think about the following:
A programme of awareness for all your staff using the same information described in Step 1. There are many ways to provide such training: group sessions, seminars etc. This programme may also cover an explanation of your drugs policy (see Step 3) so you may want to incorporate it into your induction process for new employees.
A programme of training for managers or supervisors on recognising the signs of drug misuse. This could be the most crucial part of managing drug misuse at work as they will need to be clear about the business’ rules about drug misuse. They will need to know what to do if they suspect an employee is misusing drugs or if they are approached by an employee who declares a drugs problem. Local drug or health advisory services may be able to help train managers to recognise the signs of misuse and how to handle the situation. The service may charge for training.
Encouraging those with a drugs problem to seek help (some useful organisations are listed at the end of this booklet).
The need for confidentiality if an employee admits to a drugs
problem. People with a drugs problem may be persuaded to come forward if they are assured that their problems will be dealt with discreetly. However, you will also have to consideryour own legal position, if evidence or information supplied toyou suggests that an employee’s drug problem has involvedbreaking the law at work (see ‘The Legal Position’, page 6)
The nature of the work you do. Are there any aspects of the work that are safety-critical, eg: using machinery, electrical
DRUG MISUSE AT WORK a guide for employers
equipment or ladders, as well as driving or operating heavy lifting equipment, where instances of drug misuse could have serious consequences?
In deciding what to do, you will almost certainly need to consult others,particularly your employees. You should consult safety representativesappointed by recognised trade unions under the Safety Representativesand Safety Committees Regulations 1977. If your employees are notcovered by such representatives, you should consult them eitherdirectly, or indirectly through elected representatives of employeesafety, according to the Health and Safety (Consultation withEmployees) Regulations 1996.
In larger organisations, good practice would be to set up a working partyled by a senior manager to look at the issue of drug misuse as it affectsthe business. You need to involve the occupational health physician ornurse and personnel managers also where available, as well asworkers’ representatives.
This may not be feasible for smaller businesses, but you may find ituseful to talk to:
national or local drug misuse agencies (some of them are listed at the end of this booklet) for advice;
the local business forum or health promotion unit to get an idea of what other businesses have done in your area. Remember, getting the support of your workforce for any change in company rules will be much easier if staff or their representatives have been involved.
Some useful contacts appear at the end of this booklet. DRUG MISUSE AT WORK a guide for employers WHAT CAN I DO IF I SUSPECT AN EMPLOYEE HAS A DRUG PROBLEM?
Employees with a drug problem should have the same rights toconfidentiality and support as they would if they had any othermedical or psychological condition. What if they won’t admit that they have a problem? It may be very difficult for people to admit to themselves or others that they have a drug problem. They may feel there is a stigma attached to drug misuse and they may well fear reprisals if they admit to taking illegal drugs. Whilst your freedom to act may be limited if it becomes clear that an employee has broken the law at work, you should let staff know that you will, as far as possible, treat drug misuse as a health issue rather than an immediate cause for dismissal or disciplinary action. Should I dismiss them? Disciplinary action may be taken as a last resort. You could be judged (by an industrial tribunal) to have unfairly dismissed employees whose work problems are related to drug misuse if you have made no attempt to help them. However, you may need to temporarily move them to another job if their normal work is safety-critical. See ‘disciplinary action’ in Box 3. Should I allow them time off to get help? The cost of recruiting and training a replacement may be greater than the cost of allowing someone time off to get expert help. Who else can help them? If one of your employees is misusing drugs, you should encourage them to seek help from your organisation’s occupational physician or nurse (if you have one), their GP or a specialist drug agency.
In taking action, you need to ensure that you have the support ofother managers and gain the support of your employees. Whenyou have gathered together your information and consultedrelevant people you will be ready to take action. DRUG MISUSE AT WORK a guide for employers Step 3 - Taking Action
Implement your agreed policy on drug misuse.
KEY ELEMENTS OF A POLICY ON DRUG MISUSE
A model workplace policy on drug misuse may cover thefollowing:
Aims A statement on why the policy exists and who it applies to. (Note: the policy must be seen to apply equally to all staff, including managers, and types of work.) Responsibility Who is responsible for carrying out the policy. (Note: all managers and supervisors will be responsible in some way, but it will be more effective if a senior employee is named as having overall responsibility.) Definition A definition of drug/substance* misuse. The rules How your organisation expects employees to behave to ensure that drug misuse does not have a detrimental effect on their work. DRUG MISUSE AT WORK a guide for employers Safeguards Statements which make it clear that:
absence for treatment and rehabilitation will be regarded as normal sickness;
the policy will be monitored and reviewed regularly in consultation with workplace representatives. Confidentiality A statement assuring employees that a drug problem will be treated in strict confidence, subject to the provisions of the law. Help A description of the support available to employees who have a drug problem. (Note: this might include local advisory services.)
A statement encouraging those with a drug problem to seek helpvoluntarily. Information A commitment to providing employees with general information about the effects of drugs on health and safety. Disciplinary action The circumstances in which disciplinary action will be taken. You m i g h t :
explain that if help is refused and/or impaired performance continues disciplinary action is likely;
explain that dismissal action may be taken in cases of gross misconduct;
state that possession/dealing will be reported immediately to the police and that there is no alternative to this procedure. DRUG MISUSE AT WORK a guide for employers Step 4 - Checking what you have done
You should regularly check to see if the policy is working and whetherany changes need to be made. You may need to look again at theaspects set out in Step 1 and see if the situation has changed, eg hassickness absence or the number of accidents altered? You might alsowant to check whether your employees are still sufficiently aware of theissue of drug misuse and its consequences. DRUG SCREENING AND TESTING
Drug screening or testing is a sensitive issue because of the manyemployment implications involved. Securing the agreement of theworkforce to the principle of screening is essential (except in cases ofpre-employment testing), partly because of the practical and legalissues involved. These might include:
How will test samples be kept secure to ensure they cannot be tampered with?
What action will be taken if a positive result is given?
Screening can be used in various ways, for example:
as part of a selection process for job applicants;
testing all or part of the workforce routinely, occasionally or on a random basis;
in specific circumstances, such as after an accident or incident or as part of an aftercare rehabilitation programme.
More organisations - particularly those in safety-sensitive industries - are using screening and testing as a way of controlling drug
DRUG MISUSE AT WORK a guide for employers
problems. There may be a case for considering the introduction of screening, particularly in certain critical jobs (eg staff who have responsibility for making safety-critical decisions such asdrivers, pilots and some machinery operators) in which impairment due to drugs could have disastrous effects for the individual, colleagues, members of the public and the environment.
Screening is only likely to be acceptable if it can be seen to be part ofan organisation’s occupational health policy and is clearly designed toprevent risks to the misuser and others.
Screening by itself will never be the complete answer to problemscaused by drug misuse and its results must always be supplementedby a professional assessment of the employee. Prevention is just asimportant and the guidance set out earlier in the booklet is relevant toall businesses, whether screening is introduced or not.
Laboratories that are accredited by the United Kingdom AccreditationService (UKAS) will have satisfied assessors that they provide aservice that meets all testing criteria. UKAS contact details appear atthe end of this booklet. DRUG MISUSE AT WORK a guide for employers MOST COMMONLY MISUSED SUBSTANCES IN THE UK See page 4 for the Misuse of Drugs Act 1971.
cocaine but initial feelings aremuch more intense.
Heightened sense of soundand colour.
of vision, hearing and time. An LSD trip can last as longas 8-12 hours. Magic mushrooms
LSD but the trip is oftenmilder and shorter. Cannabis DRUG MISUSE AT WORK a guide for employers
can lead to coma and even death. Sharinginjecting equipment brings risk of HIV orhepatitis infection.
Dependence, restlessness, paranoia, damage
As for cocaine but, because of the intensity
of its effects, crack use can be extremely hardto control, damage to lungs.
Possible nausea and panic, overheating and
dehydration if dancing, which can be fatal. Use has been linked to liver and kidneyproblems. Long-term effects not clear butmay include mental illness and depression.
There is no way of stopping a bad trip which
may be a very frightening experience. Increased risk of accidents can trigger offlong-term mental problems.
Impaired co-ordination and increased risk of
accidents, poor concentration, anxiety,depression, increased risk ofrespiratory diseases including lung cancer. DRUG MISUSE AT WORK a guide for employers MOST COMMONLY MISUSED SUBSTANCES IN THE UK (continued) See page 4 for the Misuse of Drugs Act 1971. Barbiturates Amphetamines Tranquillizers Anabolic steroids
up muscle. However, there issome debate about whetherdrug improves muscle powerand athletic performance. Solvents DRUG MISUSE AT WORK a guide for employers
lead to coma or even death. Severewithdrawal symptoms.
Insomnia, mood swings, irritability, panic.
The comedown (hangover) can be severe andlast for several days.
Dependency and tolerance, increased risk of
Supply is illegal but, apart fromTemazepam, not illegal to possesswithout a prescription. (Misuse ofDrugs Act 1971 and associatedRegulations).
For men: erection problems, risk of heart
attack or liver problems. For women:development of male characteristics. Injectingequipment brings risk of HIV or hepatitisinfection.
and nose, particularly dangerous for those
with glaucoma, anaemia, breathing or heartproblems.
accidents. Fatal heart problems can cause
solvents to anyone under 18, ifthey suspect they are intendedfor misuse
DRUG MISUSE AT WORK a guide for employers USEFUL ORGANISATIONS AND PUBLICATIONS Scotland
The Scottish Drugs ForumShaftesbury House
Free, confidential, 24 hours a dayNational workplace organisations
Caerphilly Business ParkCaerphilly CF83 3GG
The SDF can provide advice on drug agenciesand local drug services in Scotland and details
Tel: 08701 545500 (HSE’s Infoline) or contact
your nearest HSE office (see the telephonedirectory). The Employment Medical Advisory Service ofHSE can advise on all aspects of occupational illDrug Action Teams
Over one hundred Drug Action Teams have been
The Board aims to promote good health by
established across England to implement the
providing information on health and factors
strategy at a local level. They are made up of
which affect it; helping people to develop the
senior personnel from health, local authorities
motivation and skills they need to live a healthy
and the criminal justice agencies. Their role is to
life; encouraging healthy environments. HEBS
agree local priorities and resources for all
works closely with the 15 Scottish Area Health
relevant agencies, both statutory and voluntary. Boards. The Area Health Boards’ healthpromotion departments should be the first point
Reference Groups which are made up of people
who have professional expertise and/or localknowledge. Drug Reference Groups can includerepresentatives from the business community.
For details of your nearest Drug Action Teamcontact:
Drugs Strategy Directorate50 Queen Anne's GateLondonSW1H 9ATTel: 020 7273 3765Website: drugs.gov.uk
20 DRUG MISUSE AT WORK a guide for employers Wales
Responsibility for planning and implementing
actions to tackle substance misuse rests with the
responsible authorities and their partners whichcome together in 22 Community Safety
Partnerships based on local authority boundaries.
A strategic level of support has been established
in the four Welsh police areas and delivered by
Welsh Assembly Government staff - SubstanceMisuse Advisory Regional Teams (SMARTs).
responsible authorities and their partners on the
development and implementation of their Local
Substance Misuse Action Plans. For details ofyour Community Safety Partnership please
contact the nearest Substance Misuse AdvisoryRegional Team.
Health and Safety Executive Northern Ireland83 Ladas Drive
Other work-related organisations An independent association of unions, itrepresents virtually every sort of worker acrossa whole range of industries and services. Itsmain job is to help unions achieve thingstogether which they could not do alone, throughrepresentation, research and campaigning. TheTUC is represented on the Health and SafetyCommission.DRUG MISUSE AT WORK a guide for employers The employers’ organisation, covering large andsmall firms and trade associations, aims toOffers online teaching and learning in theprovide the means of formulating, makingaddictions; research and consultancy servicesknown and influencing general policy in regardand online provision of information andto industrial questions and to act as a nationalpoint of reference for industry’s views. The CBIis represented on the Health and SafetyThe IPD has over 80 000 members and is theworld’s largest institute for those involved in themanagement and development of people.Specialist organisations
Health Protection Agency: Chemical Hazards
Provides specialist advice on local drug servicesand best practice information on drug treatmentand care, prevention and education.Advice on analytical facilities and procedures.DRUG MISUSE AT WORK a guide for employers Publications
Toxicology UnitSt George’s Hospital Medical School
Drugs and the workplace: Face it together
The guide is under revision. Enquiries to:
Offers a computerised tablet identificationservice (TIC-TAC) which includes illicit drugstablets. Useful to employers who discovertablets or capsules on work premises.
6 St Anne’s PassageKing StreetManchesterM2 6ADTel: 0161 836 6850Fax: 0161 836 6859Website: www.tacade.com
Advice, resources, training, consultation andresearch on alcohol and drugs.
United Kingdom Accreditation Service 21-47 High StFelthamMiddlesexTW13 4UNTel: 020 8917 8555
A laboratory accredited by UKAS will havesatisfied assessors that it meets all criteria forproviding drug screening test results.
Advisory, Conciliation and Arbitration Service(ACAS) (contact your local office - see thetelephone directory)
Advice on good employment practice includingprocedures to deal with drug misuse.DRUG MISUSE AT WORK a guide for employers 23
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For information about health and safety ring HSE’s Infoline Tel: 08701 545500 Fax: 02920 859260e-mail: [email protected] or write to HSE Information Services, CaerphillyBusiness Park, Caerphilly CF83 3GG.
This leaflet contains notes on good practice which are not compulsory but which you mayfind helpful in considering what you need to do.
This leaflet is available in priced packs of 10 from HSE Books, ISBN 0 7176 2402 1. Single free copies are also available from HSE Books. Crown copyright This publication may be freely reproduced, except for advertising, endorsementor commercial purposes. First published 1/98. Please acknowledge the source as HSE.
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