Substance misuse at work crisis shows need for HR and H&S collaboration

Substance misuse in the workplace is emerging as one of the most difficult challenges for employers to manage. It affects safety, performance, and well-being, and yet it’s often misunderstood or dealt with solely as a disciplinary matter. As the boundaries between health, safety and HR continue to blur, it’s an area that demands a joined-up response – and t’s a challenge brought sharply into focus in the latest edition of IOSH Magazine, with two articles examining the issue from different angles.

The latest edition of IOSH Magazine carries two useful articles highlighting the key issues in terms of understanding the problem and then dealing with it effectively. It’s a topic that definitely cuts across the worlds of HR and H&S – we’ll hear from a health and safety expert on the need for a joined-up approach. 

Katie Smith’s article, ‘A Matter of Substance,’ highlights the scale of the problem, with one in three UK employees admitting to using or witnessing substance misuse at work. She explores the link between drug use, stress, and pain from work-related injuries, and warns that zero-tolerance policies can backfire — driving the issue underground. Her message is that employers should create a culture of openness and support, allowing staff to seek help without fear of reprisal, while still maintaining clear safety standards.

Anna Scott’s piece, ‘How to Implement Drug Testing’ looks at what fair and lawful testing looks like in practice. She explains that drug and alcohol testing should only take place where it’s justified, and must sit within a broader health, safety, and well-being framework. Testing without consent or proper safeguards risks breaching privacy and trust, so policies need to be clear, proportionate, and transparent. Above all, she stresses that testing is not a substitute for culture: communication, fairness and consistency are what make it work.

So let’s get a view on this. Earlier I caught up with Zoe Betts, who joined me by video link to discuss it. So is this a serious the problem and are employers are underestimating it?

Zoe Betts: “Well, yes and yes in answer to those questions, Joe, I do think it's a serious problem and I do think many employers are underestimating the issue, possibly because it's one of those ones that's quite difficult to grapple with. It is a health and safety risk in the workplace, and yet it is perhaps more sensitive and more nuanced than some of the traditional safety risks that many employers will be quite familiar with tackling. My understanding and many, many studies have been done in the UK, in Canada, Australia, in the US, but just to give some sort of context, In the UK, it's reported that one in three workers have either taken substances at work or witnessed that in colleagues’ behaviour. So one in three is really quite staggering to me. That is a high number and, of course, that can be across a range of different substances. This could be cocaine, cannabis, it can be prescription drugs, it can be opioids, it could be performance enhancing drugs and, in fact, they can be over the counter medication which in certain people can create apparent signs of substance misuse when in fact they've done nothing wrong, they're just reacting to something relatively innocuous. So the problem is quite widespread and I think employers are going to have to grapple with this issue because as society evolves, my feeling is that laws around the decriminalisation of drugs will become looser and more prevalent and therefore it's an issue that employers need to be thinking about now.”

Joe Glavina: “A point that’s made in both articles is it can be a mistake to adopt a punitive approach to this issue because it can turn out to be counterproductive and that a more supportive approach workers better. Would you agree with that?”

Zoe Betts: “Yes very much. So I think this is the sort of thing that I would tell my clients, make sure you're not operating in silos, health and safety teams, occupational safety and health professionals have a real role to play in looking after people's health, safety and welfare and considering drug and alcohol abuse, but so do HR professionals. So work together, pool your resources, make sure that policies are fully aligned, and do try to take a managerial approach which is supportive and is encouraging a culture of openness and transparency rather than being, as you say, punitive and driving the problem underground because that simply won't help, it won't cure the problem, it'll simply mean the product the problem is harder to identify and then, of course, it's harder to deal with. So if there's a culture of support and people are encouraged to be open about any issues they may have with substance use, that is then the opportunity for HR and H&S professionals to work together to try to signpost that person to the right support, make sure that they don't feel stigmatized, that they haven't been penalized but, equally, they're not putting themselves or others at risk because the issue here, really, with substance abuse in the workplace is if that person has a safety critical role, if they are then suffering from some sort of lack of concentration, or impaired perception, for example, drowsiness, fatigue, that could place themselves or others, whether it's fellow employees, visitors, contractors, members of the public, at serious risk, and the employer has a legal duty to prevent that. They have to take reasonable steps to safeguard each employee's health, safety, and welfare. So that's trying to prevent somebody from developing a substance misuse problem in the first place but equally well, there is a duty on the employer to make sure that if that person has a substance problem, they themselves are not putting other people at risk as a result of their impaired behaviour or the way in which they've reacted to taking that substance. So it's a serious issue, but very much one that I believe HR and H&S can work on together, but not really in a punitive fashion, rather in a way which encourages people to seek help and be directed to the right resources.”

Joe Glavina: “You mentioned HR and health and safety working together. Is that around managing training to spot the signs of a problem in the first place?”

Zoe Betts: “It’s exactly that. So it is maybe health and safety professionals giving some training to their HR professionals so they fully understand the legal framework around drugs and alcohol in the workplace, but then making sure that the HR professionals are able to provide their expertise when it comes to policies supporting employees in the workplace and, of course, and this does have a role, the disciplinary process. There will be certain occasions where disciplinary is absolutely appropriate, and that's where the HR professionals are experts and they would lead on that, but they can perhaps educate health and safety professionals as to when that is most appropriate, and somebody would need to stop work, and may need to be taken down that route. But I think really, this is an opportunity for employers to assess the policies that they've got in place from both a health and safety and a HR perspective, make sure that they're fully aligned, make sure they're speaking to each other, make sure that communication is being shared and that the messages that are going to the workplace are consistent and are being put across in as positive a fashion as possible, but with a deterrent being provided as well because, ultimately, we do need workers to understand that this is an important issue. It does go to safety, it does go to the culture of an organisation, and the expectation on them is that they won't be using illegal substances in the workplace and I think if HR and health and safety professionals are joined up on that there will be a real force in that message and people will understand how critical it is and why that message is being promoted so strongly.” 

Those two articles on substance misuse appear in the latest edition of IOSH magazine which can be accessed online for free. We have included a link to it in the transcript of this programme for you.

- Link to IOSH magazine September/October 2025 issue