Alcohol Is Still the Number One Threat to Workplace Safety

Alcohol Is Still the Number One Threat to Workplace Safety

Alcohol remains the most common substance abused by workers.

The legalization of marijuana and its direct impact on the workplace garners a lot of attention, and rightfully so. According to the 2022 Quest Diagnostic Drug Testing Index, more workers are testing positive for marijuana than ever before. 

“Positivity rates for marijuana in the general U.S. workforce, based on more than 6 million urine tests, continued an upward climb, increasing 8.3 percent (3.6 percent in 2020 versus 3.9 percent in 2021), the highest positivity rate ever reported in the DTI. Over five years, positivity for marijuana in the general U.S. workforce increased 50 percent (2.6 percent in 2017 versus 3.9 percent in 2021).” 

Yet, according to the federal government, there are many more alcohol users and abusers in the U.S. than marijuana users. The 2021 National Survey on Drug Use and Health found that nearly 60 million Americans 12 and older admit to using illicit drugs and that more than 138 million people admit to being current alcohol users. 

According to the survey, of those 138 million alcohol users, 61.6 million admit to being “binge” drinkers (five or more drinks on at least one occasion in the past month) and 17.7 million being “heavy” drinkers (five or more drinks on at least five occasions in the past month). Alcohol is clearly the single most used and abused drug in America making it the number one threat to workplace safety.  

Alcohol Abuse and the Workplace 

Many employed Americans with a drinking problem consume alcohol on the job. A survey of employees conducted by the American Addiction Centers found that 14.7 percent of at-home workers and 3.3 percent of other employees admit to being impaired on the job every week. 

Workplace alcohol abuse has a direct impact on safety and injuries. According to the National Council on Alcohol and Drug Dependence (NCADD): 

  • Workers with alcohol problems are 2.7 times more likely than workers without drinking problems to have injury-related absences. 
  • A hospital emergency department study found that 35 percent of patients with an occupational injury were at-risk drinkers. 
  • [Breath] alcohol tests detected alcohol in 16 percent of emergency room patients injured at work.
  • Analyses of workplace fatalities showed that at least 11 percent of the victims had been drinking. 
  • Large federal surveys show that 24 percent of workers report drinking during the workday at least once in the past year. 
  • 20 percent of workers and managers across a wide range of industries and company sizes report that a coworker’s on- or off-the-job drinking jeopardized their own productivity and safety. 

The Pandemic’s Impact 

Numerous reports indicate that the COVID-19 pandemic has made the problem of substance abuse and its impact on the workplace worse. One year into the pandemic, an annual report revealed a significant increase in alcohol and other substance use affecting 49 percent of American workers. 

Of the 49 percent of workers who reported struggling with some level of addiction, the number of workers reporting lower productivity or missed work because of substance abuse or addiction has nearly doubled since 2019. Further, 36 percent report that it has affected their work more since the pandemic began. Nearly half of full-time workers now report problem use of alcohol, drugs or prescription medication, and 19 percent report at least weekly usage.

Alcohol remains the most common substance abused by workers. According to a 2022 report by LifeWorks and the Hazelden Betty Ford Foundation, 31 percent who drink alcohol have increased their consumption since the pandemic began and 29 percent who use drugs reported an increase in drug use.

What Workplace Alcohol Abuse Looks Like 

Many sources highlight the outward signs and symptoms of alcohol abuse at work, including: 

  • Sleeping while working 
  • Being tardy or not showing up 
  • Poor decision making 
  • Confrontational behavior with supervisors and coworkers 
  • Unintentional injuries to oneself or others 
  • Appears hungover or is still intoxicated 
  • Lack of coordination 
  • Has bloodshot or glossy-looking eyes 
  • Slow pupil response 
  • Inability to complete work assignments 
  • Starts to sweat heavily 
  • Slurs speech 
  • Becomes nauseous and pale

Alcohol Testing 

Because of the direct effects of alcohol abuse on the workplace, employers have a right and an obligation to take steps to address the problem. This can include screening employees for alcohol following accidents and when reasonable suspicion exists that an employee is on the job under the influence of alcohol. It is important for employers to understand

  • No state prohibits employers from conducting alcohol testing when such testing is conducted in accordance with state or federal laws or to comply with government-mandated alcohol testing. 
  • Some states require alcohol testing under certain circumstances and may limit or restrict it under other circumstances. A careful review of applicable state laws is advised. 
  • Some states require workplace alcohol tests to be conducted in accordance with specific guidelines, which often mirror federal guidelines (See 49 CFR Part 40, Subparts J, K, L, M and N). 
  • The U.S. Department of Transportation (DOT) drug and alcohol testing regulations require alcohol testing in specific situations and always pre-empt any state law restrictions. 

While the Americans with Disabilities Act (ADA) considers a current alcohol abuser to have a disability and is thus protected under the ADA, employers still have the right in all 50 states to: 

  • Prohibit employees from consuming alcohol while on the job, and  
  • Prohibit employees from being under the influence of alcohol at work.

An employer may be required under the ADA to make some accommodations for an alcoholic to attend counseling appointments, but the ADA allows employers to “discipline, discharge or deny employment to an alcoholic whose use of alcohol adversely affects job performance or conduct.”

The Equal Employment Opportunity Commission (EEOC) has issued directives relative to alcohol testing for employees and job applicants and employers should review these policies very carefully to ensure complete compliance. The agency also provides numerous examples or scenarios to illustrate under what circumstances alcohol testing may be permitted and/or when accommodations must be granted. 

Alcohol Testing Methods 

Today there are several accurate and scientifically sound alcohol testing methods, which include: 

Evidential breath testing (EBT). Evidential breath testing is permitted by the DOT as an alcohol screen and required for a confirmation test. Most states also permit EBT outside of DOT testing while some jurisdictions may only permit the use of devices approved by DOT’s Office of Drug & Alcohol Policy & Compliance (ODAPC). (See “Approved Screening Devices to Measure Alcohol in Bodily Fluids” and “Approved Evidential Breath Measurement Devices”)

Non-evidential breath tests. Non-evidential breath tests are permitted for an alcohol screen and any positive results must be confirmed with an EBT device for DOT purposes. You should check individual state laws as some states have specific conditions for the use of breath alcohol screening devices. Some jurisdictions only permit the use of devices approved by ODAPC. 

Saliva alcohol screens. Saliva alcohol screens are permitted only as a screen under the DOT regulations. Most states also permit saliva alcohol screens, though some conditions may apply. Keep in mind that some jurisdictions only permit the use of devices approved by ODAPC. 

Blood. Blood tests may be permitted under limited circumstances, though not in all states. In some circumstances, employers may rely on a blood alcohol test conducted by medical personnel at the scene of an accident and/or in a hospital 


A 2015 study found that marijuana users commonly drink alcohol while they are consuming cannabis. According to the study, “The prevalence of simultaneous use was almost twice as high as concurrent use, implying that individuals who use both cannabis and alcohol tend to use them at the same time. Furthermore, simultaneous use was associated with increased frequency and quantity of alcohol use. Simultaneous use was also the most detrimental: compared to alcohol only, simultaneous use approximately doubled the odds of drunk driving, social consequences, and harms to self. The magnitudes of differences in problems remained when comparing drunk driving among simultaneous users to concurrent users.” 

What’s the point? As marijuana legalization continues to spread across the country resulting in many more people using marijuana, a simultaneous increase in alcohol abuse can be expected. As such, employers have a vested interest in ensuring that their workers are alcohol-free while on the job. Alcohol screening when and how permitted is one of the most effective ways for employers to deter workers from using alcohol on the job or being at work while under its influence.  

This article originally appeared in the October 1, 2022 issue of Occupational Health & Safety.

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