Drug Screening and Workers' Compensation: Understanding the Link

Most worksite injury prevention programs focus solely on conditions of the worksite – making sure workers properly use PPE, correct equipment usage and more. But worksite accidents don't happen in a vacuum; often, what workers do outside of work can have a major impact on your worksite's overall safety.

One of the worker behaviors that has the most direct impact on your worksite's safety — and the number and cost of workers' compensation claims and work stoppages — is substance abuse. Creating an effective, compliant, fair drug screening process can help you keep your workers safe while reducing your workers' compensation claims rates and costs.

The Connection Between Substance Abuse and Worksite Accidents

Since 2011, workplace unintentional overdose deaths have increased 619%, according to the National Safety Council. And a 2023 survey by the American Addiction Centers found that 22.5% of respondents admitted to using drugs or alcohol during work hours.

Among construction workers, the American Addiction Centers reports that rates of drug and alcohol use disorders are higher than in the general population. An estimated 12% of construction workers have an alcohol use disorder, compared with 7.5% nationally. When it comes to substance use disorders, 14.3% of construction workers received this diagnosis within the last year — 15% of construction workers vs. 8.6% of the rest of the population.

Construction workers also have a high level of diagnosed opioid use disorder, with 1.3% of construction workers suffering, almost twice the national average. The Centers for Disease Control and Prevention also reports that construction workers are seven times more likely to die of an opioid overdose than workers in other industries, and they represent about 25% of all fatal opioid overdoses in workers.

Whether workers are actively using substances while on the job or they're using off the clock, not taking measures to identify workers who may be struggling and get them help can cost your business a lot of money.

The Impact of Substance Abuse on Worksite Safety

Substance use while on the job slows a worker's reaction times and decision-making capabilities. This can create a dangerous situation for your worksite's safety, especially if the worker must operate heavy machinery or is responsible for the safety of others, for example.

A worker that uses drugs and alcohol frequently at home also can impact worksite safety.

Prolonged substance abuse can lead to many chronic conditions, including live damage, stroke, lung disease, and memory, attention and decision-making problems. Some of these issues, if present in your workers, will directly impact the day-to-day safety of your worksite. However, even a condition that leads to chronic absenteeism can affect worksite safety.

If the worker who routinely misses work is crucial to safe daily operations, their absence could put the rest of your team at risk of accidents. Showing up to work not feeling well also poses a safety risk, with a worker's physical condition easily distracting them from maintaining safety protocols on the job.

How Drug Screening Can Prevent Worksite Accidents

Screening for drug and alcohol use — at the new hire stage, when there's suspicion of use and randomly throughout the year — can help you identify those workers who may be struggling with substance abuse, both on and off the clock.

For those workers who show up to work under the influence, drug screenings can help you quickly confirm their condition. This allows you to take them off the job before they can be involved in a potential accident, keeping themselves and coworkers safer.

Workers for whom an off-the-clock substance abuse issue is a problem can also be found through pre-employment and random testing. They can receive treatment faster, hopefully leading to quicker, more effective sobriety and better overall health.

By testing workers for drugs and alcohol, you can catch use and abuse early on before it causes accidents and injuries.

How Substance Abuse Can Impact Workers' Comp Claims

Substance abuse can have a variety of impacts on workers' compensation claims, affecting both employers and workers.

Those workers who use drugs or alcohol on the job, or who have a substance abuse problem that affects their work, are more likely to be injured at work or involved in an accident that injures someone else. This drives up your injury-related healthcare costs and workers' compensation claims, and greatly impacts your staffing levels and project timelines.

A worker who is injured in an accident resulting from their own drug or alcohol use — or even one who tests positive for substances following a work-related accident — may have their workers' compensation claim denied, depending on your state's workers' compensation laws. This could severely impact the care an injured worker receives, and they will be required to pay for their own medical expenses and they won't receive any pay while they're recuperating.

For workers who are returning to work from an injury, substance abuse is also a concern, especially if they were prescribed opioids in the course of treatment. A 2021 study in Occupational and Environmental Medicine found that workers were 1.79 times more likely than non-injured workers to die from opioid-related causes. Regular screenings for drugs and alcohol could help identify workers who may be at risk of opioid use disorders following an injury and can prevent opioid-related workers' compensation claims, injuries and even premature deaths.

Benefits of Implementing Drug Screening Programs

Worksite drug screening programs provide a variety of benefits to employers and workers. They allow companies to cut down on rates of illness and injury and provide workers with early access to support in their recovery.

Here are some key benefits of worksite drug and alcohol screening programs.

Reducing Worksite Accidents and Injuries

As we've covered earlier in this article, workers who report for duties under the influence of drugs and alcohol, or those for whom a substance abuse problem has caused health issues, are more likely to be involved in accidents on the job. Whether their reaction time is slower and they get into an auto accident, or their addiction causes a change in their decision-making capabilities that leads to a risky climb up a ladder and subsequent fall, workers who are not of a fully clear mind are more accident-prone.

By screening your workers for drug and alcohol use, you can identify those who should not be working due to being under the influence. This allows you to immediately remove them from duties and avoid accidents they may cause.

Workers who may benefit from substance abuse treatment can be identified through onsite screenings, giving you the opportunity to intervene and get them help. The sooner an individual receives treatment for a substance use problem, the more likely they are to stay clean. By getting a worker help earlier, you may also help them avoid some of the more serious health consequences of long-term use, keeping your workers healthier and more productive.

Decreasing Workers' Comp Claims and Costs

Prevention is the best way to decrease accident rates and workers' compensation costs. Screening workers for drug and alcohol use when you suspect they may be at work under the influence, or randomly as part of your regular operations, helps you identify workers who may pose a risk of accidents.

Workers who test positive for drug or alcohol use can be taken off their duties before an accident happens, saving potential workers' compensation claims and costs.

Improving Overall Worksite Safety

When workers aren't at their best on their shifts, mistakes can be made. And sometimes, those mistakes can lead to dangerous conditions for your worksite.

If you can identify those workers who may not be performing at their best due to drug or alcohol use, you improve the safety of the rest of your team. By taking out someone who poses a risk off active duty, your worksite has one less hazard and you prevent any incidents that may involve that individual.

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