Addictions in the workplace

Consumption, labor factors and effects

• Substances and behaviors. Alcohol, cannabis, cocaine and other drugs, psychoactive medications (anxiolytics, hypnotics, opioid analgesics), tobacco and non-substance addictions such as gambling or compulsive use of technology.
• Occupational risk factors. Stress, excessive or insufficient workload, shift work and night work, precariousness and insecurity, isolation, conflicts and harassment, permissive culture of consumption and availability of substances in certain sectors.
• Effects on safety. Decreased attention, coordination and reflexes, risky behaviors and a higher probability of accidents, especially in safety-critical tasks.
• Health effects. Physical and mental illnesses associated with consumption, worsening of pre-existing conditions, and interaction with other occupational hazards.
• Organizational effects. Absenteeism, presenteeism, sick leave, turnover, conflicts, deterioration of the work environment, and liability for damages to third parties.
• Groups and sectors. Higher prevalence described in sectors such as construction, hospitality, transport, agriculture and certain shift work, although no sector is exempt.

Regulatory framework and limits of action

Law 31/1995 obliges employers to guarantee safety and health, to assess risks, including psychosocial risks that may encourage substance use, to adapt work to the individual, and to protect particularly vulnerable individuals. Article 22 establishes health surveillance as voluntary, except in legally defined circumstances, with respect for privacy and confidentiality of the results. This conditions any substance detection test: it is only permissible with a legal or contractual basis, proportionality, a preventive purpose, prior information, and safeguards, and never as a covert instrument of disciplinary control. Article 54 of the Workers’ Statute classifies habitual drunkenness or drug addiction with negative repercussions on work as a breach that may justify disciplinary dismissal, and Organic Law 3/2018 and the General Data Protection Regulation protect health data.

The International Labour Organization, in its set of practical recommendations on addressing alcohol and drug-related issues in the workplace, recommends company policies developed with worker participation, focused on prevention and support, with confidentiality, non-discrimination, and treatment of substance use problems as health issues. The European Union Agency for Drugs and Drug Addiction notes that policies focused on health rather than punishment are the most effective, that evidence on the effectiveness of drug testing in reducing accidents is limited and that it should be reserved for safety-critical activities, and that employment is a key factor in recovery. The National Strategy on Addictions includes the workplace among the settings for prevention.

Elements of a company policy on addictions

• Commitment and participation. Written policy, agreed upon with the workers’ representatives, with preventive and care objectives and with the involvement of management.
• Prevention. Information and awareness, training of managers to detect warning signs, action on psychosocial factors and health promotion.
• Early detection and guidance. Confidential consultation channels, protocol for action in case of suspicions or risk situations and referral to the medical service of the prevention service or to external resources.
• Assistance and treatment. Support for treatment, temporary job adjustments and coordination with health and social resources, with guaranteed confidentiality.
• Reintegration. Support for the return to work , monitoring and relapse prevention.
• Critical safety. Clear criteria for critical safety tasks, with temporary removal from the task but not from employment, and with legal guarantees for any evidence.

Organizational application: how to address addictions in the workplace

1. To agree with the workers’ representatives on a company policy on addictions with a preventive and assistance focus, objectives, responsibilities and guarantees of confidentiality and non-discrimination.
2. Integrate the psychosocial factors that favor consumption into the risk assessment and act on them (burden, shifts, support, conflicts).
3. Identify critical safety tasks and define appropriate action criteria, with temporary withdrawal from the task and referral to care, and with a legal or conventional basis for any test.
4. Train managers and key personnel in signal detection, communication and referral, and inform and raise awareness among all staff.
5. Establish the guidance and assistance circuit with the medical service of the prevention service and with external resources, guaranteeing the confidentiality of health data.
6. Define the procedure for adapting the job during treatment and for reintegration with follow-up.
7. Periodically evaluate the policy using aggregated and anonymous indicators and review it with the participation of the workers.

Preventive management software allows for documenting policies and protocols, integrating psychosocial factors into assessment and planning, managing management training and awareness, recording monitoring indicators in an aggregated and anonymous manner, and coordinating job adaptations and reintegrations with the required confidentiality guarantees.

Limits and common mistakes

1. Addressing consumption solely through discipline, without preventive policies or assistance, hides the problem and distances people from help.
2. Conducting detection tests without a legal or conventional basis, without proportionality or guarantees, or using them for covert control purposes.
3. Violating the confidentiality of health data or stigmatizing the affected individuals.
4. Ignoring the work-related factors that encourage consumption and shifting all responsibility to the individual.
5. Not training the commanders, who are the ones who detect the signals and need to know how to act.
6. Forgetting about reintegration and follow-up, which are key to preventing relapses.

The specific action must comply with labor and data protection legislation and have medical and legal advice; this sheet is for informational purposes only.

Regulatory and reference framework

• Law 31/1995, of November 8. Law on the Prevention of Occupational Risks; risk assessment, adaptation of work, health surveillance and especially sensitive persons.
• Royal Legislative Decree 2/2015, of October 23. Workers ‘ Statute; Article 54, disciplinary dismissal.
• Organic Law 3/2018, of December 5. Protection of Personal Data and guarantee of digital rights; health data.
• ILO. Addressing alcohol and drug-related issues in the workplace. A guide to practical recommendations . International guidance for company policies.
• EUDA. Workplaces and drugs: health and social responses . Evidence on policies, testing, support and reintegration.
• National Drug Plan. National Strategy on Addictions . Spanish strategic framework, with the workplace among the prevention environments.
• Royal Decree 39/1997, of January 17. Regulation of Prevention Services; risk assessment and health surveillance.

The National Strategy on Addictions 2017-2024 is the latest published on the National Drug Plan portal at the time of this review; collective agreements and company agreements may regulate policies and protocols on addictions.