Managing Impairment Risks, Emerging Challenges & Supportive Policies

Why Substance Use Matters for Workplace Safety

Substance use in the workplace isn’t a new issue, but the way it shows up today is shifting rapidly. UK employers are dealing with hybrid working, rising stress levels, and changes in how people use alcohol, prescription medication and recreational drugs. Add fatigue, burnout and the ongoing mental health crisis, and “impairment” becomes far broader than the stereotype of someone turning up visibly under the influence.

Impairment at work is anything that affects someone’s ability to work safely and effectively: a hangover, misused or sedating medication, untreated anxiety, a late-night gambling session or simple exhaustion. The signs are subtle, but the consequences can be serious, especially in safety-critical roles or fast-paced environments where decisions need to be sharp.

For organisations, this is about far more than compliance. Yes, the legal duties exist, but a proactive stance protects your people, reduces accidents, supports productivity and fosters a culture where concerns can be raised early. When staff feel safe, supported and well, performance follows.

Understanding Impairment: It’s More Than “Turning Up Drunk”

Impairment isn’t usually dramatic. More often, it’s quiet, complex and easy to miss. It can show up in many ways:

• Alcohol – a leading contributor to reduced alertness and workplace incidents.
• Recreational drugs, including:
  • Cannabis as attitudes shift and use becomes more common
  • Cocaine, linked to high-pressure roles and urban nightlife
• Prescription medication – painkillers, sedatives and anti-anxiety medication that can impair concentration or coordination.
• Over-the-counter remedies – sleep aids or cold medicine misused or combined with alcohol.
• Fatigue, burnout and stress – often as impairing as substances themselves.
• Pressures at home and financial strain – relationship issues, money worries or gambling harm affecting focus and decision-making.
  

Because impairment often looks like everyday behaviour, the signs can be subtle:

• Slower responses
• Lack of concentration
• Performance dips
• Changes in behaviour
• Difficulty following instructions

None of these automatically point to substance misuse,which is why employers must approach concerns sensitively.

The real challenge is balancing risk with compassion. Identifying concerns without making assumptions. Raising issues without stigma. Creating space for honest conversation rather than fear or shame.

A supportive culture enables earlier intervention, protects safety and ensures people feel able to ask for help.

Current UK Landscape: What Employers Are Facing

While impairment has always been a workplace issue, the UK context has shifted dramatically.

• Alcohol-related harm remains high, with recent UK surveys indicating that around 1 in 4 adults drink at risky levels, and alcohol continues to play a role in workplace absence and performance issues.
• Drug use is rising, particularly among working-age adults. Cannabis remains the most commonly used drug, while cocaine use has grown steadily in metropolitan and high-pressure sectors.
• The HSE consistently identifies human factors, including fatigue, stress and impairment, as major contributors to workplace accidents across multiple industries.
  
  

Hybrid and Remote Working

The move to hybrid working has created new visibility challenges. With fewer in-person interactions, signs of impairment are easier to mask. Some employees report increased alcohol use at home, and performance issues may be hidden behind screens or flexible hours.

Post-Pandemic Strain and Cost-of-Living Pressures

The wider social and economic climate has also influenced behaviour:

• Higher rates of anxiety, loneliness and burnout
• Growing reliance on alcohol or medication as coping mechanisms
• Increase in gambling harm due to 24/7 online access
• Greater strain on employees managing debt, caring roles or financial uncertainty

These stressors impact vigilance, judgement and wellbeing long before they appear as performance issues.

Legal Duties for Employers

Employers must navigate impairment within clear legal frameworks:

• Health and Safety at Work etc. Act 1974 – requiring employers to ensure, as far as reasonably practicable, the health, safety and welfare of employees and others.
• Misuse of Drugs Act 1971 – setting out legal obligations around controlled substances and their possession or supply.
• Management of Health & Safety at Work Regulations 1999 – building on the H&S act 1974, requiring risk assessments and appropriate control measures for any workplace hazard, including impairment.
• Equality Act 2010 – important where substance misuse is linked to a disability, long-term health condition, or where an employee is in recovery.
  

Managing impairment properly is both a compliance requirement and a moral responsibility.

Drug & Alcohol screening: Emerging Challenges for Employers

screening can support workplace safety, but the landscape is becoming more complex. Employers are seeing new patterns of use and evolving products, and must apply screening policies with fairness and respect for privacy.

Key Trends

• Cannabis detection is rising, but THC can remain in the system long after impairment, complicating interpretation.
• Synthetic drugs (NPS) are becoming more common and may not show on standard tests.
• Edibles, vapes and CBD products blur the boundaries:
  • Edibles may hit later or harder
  • Vapes vary widely in THC content
  • CBD products can contain trace THC
• Prescription medication often sits in a grey area—legitimate use may still impair safety.
  

Legal and Ethical Considerations

Employers must ensure screening is:

• Reasonable – backed by clear risk-based justification
• Proportionate – targeted, not blanket
• Transparent – employees know what’s tested and why
• Respectful of privacy – with clear handling of sensitive data
  

Best Practice

A defensible approach includes:

• Clear policies outlining when and why screening occurs
• Focus on safety-critical tasks or reasonable suspicion
• Informed consent and clear employee communication
• Accredited laboratories and reliable methods
• A fair appeals process
• Strong links with support routes such as OH and wellbeing services
  

screening is not a solution by itself, but it can play a meaningful role as part of a wider safety strategy.

Gambling in the Workplace: The Often-Ignored Impairment Risk

Gambling harm is one of the most overlooked workplace risks, yet its impact can be substantial. It affects focus, judgement and emotional stability—often without obvious signs.

How Gambling Harm Shows Up at Work

• Errors and near-misses
• Absenteeism or presenteeism
• Financial misconduct or fraud linked to desperation
• Heightened stress and emotional volatility
  

No sector is immune, gambling harm can arise in finance roles, customer service, safety-critical environments and office settings.

The 24/7 Digital Shift

With smartphones and online betting platforms, gambling is accessible at any moment. Employees can gamble during breaks, commutes or remote-working hours, allowing issues to escalate quickly and quietly.

Warning Signs

• Requests for salary advances or loans
• Secretive behaviour
• Excessive phone use
• Performance decline
• Increased anxiety or irritability
• Unexplained absences or lateness

These signs should always be approached sensitively. Shame and fear often prevent individuals from seeking help.

More Than a “Personal Choice”

Gambling harm is a health and wellbeing issue, not a moral failing. It intersects with equality, financial vulnerability and mental health. Recognising this enables employers to create supportive policies, encourage early disclosure and signpost specialist help before problems escalate.

Role of Occupational Health in Managing Impairment

Occupational Health (OH) plays a crucial role in helping organisations manage impairment safely and compassionately. While managers often notice the first signs of concern, it’s OH that provides the clinical insight, risk assessment and structured support needed to guide decisions.

Assessing fitness for work

When there are concerns about impairment, whether related to substance use, medication, mental health or fatigue, an OH assessment can help determine an employee’s fitness for work. This may include:

• Evaluating whether the individual can perform their role safely
• Identifying any risks to themselves or others
• Recommending temporary adjustments or phased duties
• Highlighting if further clinical support is needed

The aim is not to diagnose or judge, but to ensure safety and support appropriate next steps.

Reviewing medications and potential side effects

For employees taking prescription or over-the-counter medication, OH can help clarify:

• Whether the medication may cause drowsiness, reduced concentration or delayed reaction times
• How these side effects may interact with specific job tasks
• Whether timing adjustments or alternative duties could help reduce risk

This helps managers make informed, fair decisions without breaching confidentiality.

Supporting return-to-work after addiction treatment

When an employee has engaged in treatment for substance misuse or gambling harm, OH plays a pivotal role in planning a safe and sustainable return to work. This may involve:

• Assessing readiness to return
• Recommending a graded plan or modified duties
• Liaising with treatment providers (with consent)
• Monitoring progress and adjusting support as needed

A structured return-to-work process reduces relapse risk and supports long-term recovery.

Guiding managers on reasonable adjustments and boundaries

OH also helps managers navigate the “grey areas” with clarity and confidence. This includes advising on:

• Reasonable adjustments under the Equality Act
• Safety measures for safety-critical roles
• When to escalate concerns
• How to maintain appropriate boundaries while still offering support

By grounding decisions in clinical insight and legal frameworks, OH ensures fairness for employees and reassurance for employers.

Practical Steps for Employers: What to Do Tomorrow

A few focused actions can make an immediate difference:

• Review your policies – ensure they’re current and clear.
• Train managers – on early signs, conversations and escalation.
• Identify high-risk roles – and update risk assessments accordingly.
• Create confidential support routes – via OH, HR, EAPs or external services.
• Review regularly – trends, incidents and policy effectiveness.
• Communicate expectations clearly across your workforce.
• Know when to involve OH – especially for fitness concerns, medication queries or return-to-work following treatment.
  

Small steps strengthen culture, safety and trust.

Conclusion: A Safer, More Supportive Workplace

Workplace impairment is rarely straightforward. It often reflects the real pressures people are facing – stress, health concerns, financial strain or personal challenges. By taking a broader, more human view, employers can move away from reactive or punitive approaches and towards safety, clarity and compassion.

A proactive strategy reduces incidents, improves wellbeing, supports performance and builds trust. With strong policies, confident managers and timely OH involvement, organisations can navigate emerging impairment risks while supporting their workforce.

The landscape may be changing, but the principle remains constant: when you invest in wellbeing and safety, your people, and your business, thrive.