It’s nothing new for some people to misuse substances such as alcohol or illicit drugs or abuse prescription drugs. Nonetheless, there has been an increasing acceptance that substance abuse and substance use can affect the workplace and vice versa. There are many aspects of the workplace that require alertness, accuracy, and quick reactions.

Impaired performance of these skills can lead to errors and hinder efficiency and accuracy.

There are several ways problematic substance use can impact the workplace:

• Any impairment of judgment, alertness, perception, motor coordination, or emotional state that also affects someone’s capability to work safely or make safety-sensitive decisions
• Addiction and its after-effects (hangovers, withdrawals) affect job performance.
• Reduced productivity due to absences, illness, or other reasons
• While at work, excessive interest in obtaining and using substances hinders concentration and attention.
• Engaging in illegal activities at work, such as selling illicit drugs,
• Substance-related psychological or stress-related effects on another person are caused by a family member, friend, or coworker.

In addition to often being classified as an addiction or dependency, substance use can be recreational, frequent, or problematic. As a result, people’s lives and their work are affected differently. 

NCADI statistics indicate that alcohol and drug users:

• Have a poorer level of productivity.
• Increase sick days by three times.
• Possess a greater likelihood of injuring themselves or another person.
• The possibility of filing a worker’s compensation claim is five times higher.

Among heavy drinkers and drug users, nine percent missed work due to a hangover, ten percent went to work drunk or high in the past year, and eleven percent missed work recently due to heavy drinking or drug use.

Substance use screening in the workplace is important due to these costly consequences. 

Screening is the process of determining if a patient has a particular condition through applying a simple test. During a primary care visit, it is essential to determine the specific problem. 

For the screening to be valid, these conditions must be fulfilled. They are: 

• The population at large must be affected by the disease.
• It must reduce the quality or duration of life.
• Treatments should be available that reduce mortality and morbidity when given during asymptomatic stages of the disease.
• It should be detectable through a cost-effective screening service earlier than without screening and avoid false positives or false negatives in large numbers.
• It must be diagnosed and treated early enough to delay or halt disease progression.

Screening for substance abuse is intended to identify individuals who suffer from or are at risk of suffering from alcohol or drug abuse. Based on these findings, we identify those patients who need further testing to diagnose their substance abuse disorder and develop plans to treat it.

The benefit of conducting substance abuse screenings at regular intervals in primary care is that you can follow up positive screens at later visits. Clinicians often conduct preliminary assessments, also known as brief assessments, due to their long-standing relationships with patients.

Suppose the clinician has the experience and training required and resources available within the community. In that case, he may devise a treatment plan or refer the patient to a drug specialist for assessment. 

When provider-patient relationships are not as close in larger practices or clinics, clear documentation of screening results can help ensure appropriate follow-up.

It is also important to discuss negative screenings for substance abuse. As clinicians, they enable them to reinforce the wisdom of abstaining from drugs and maintaining safe levels of alcohol consumption by strengthening the knowledge of abstinence.

In addition, the clinician can give patients written information on alcohol or the effects of the drug if she does not have the time (or the expertise) to talk face-to-face.