Employee Substance Use: A Guide for Coworkers and Supervisors

Employees with a substance use disorder who work under the influence of drugs or alcohol can present risks to themselves, their coworkers, and the company.

Substance use in the workplace has been linked to:1

  • Risk of physical and mental illness.
  • Reduced performance and productivity at work.
  • Missed time from work.
  • Safety risks, especially in jobs requiring driving or operating machinery.
  • Accidents.
  • Injuries.
  • More disability and workers’ compensation claims.
  • Higher health care costs.

In the workplace, there are certain approaches to offering help that are more appropriate than others. As a complicated health condition, addiction in the workplace is best addressed by management who should adhere to proper procedures when doing so to preclude against their actions being viewed as discriminatory.

Addiction is a disease that must be addressed appropriately by management, or it can be viewed as discrimination.

In this guide, you’ll learn about the signs that your coworker could be abusing substances, what to do if your coworker is using, what supervisors can do, treatment options, and why it’s important to take action.

Signs a Coworker May Be Abusing Drugs or Alcohol

You can’t always tell if someone is actively intoxicated at work or if he or she is struggling with the consequences of problematic drug or alcohol use. Although some physical or mental health conditions can mimic signs of intoxication or substance use, certain patterns of behavior can indicate that your coworker or employee might have an issue with substance use. These include:2, 3, 4

  • Absences that aren’t approved or explained.
  • Acting confrontational, particularly early in the day or after the weekend or holidays.
  • Frequently needing time off for emergencies.
  • Being late often.
  • Difficulty paying attention or remembering things.
  • Disappearing for long periods of time.
  • Frequent absences from work after payday and on Mondays or Fridays.
  • Isolating behavior.
  • Issues with coworkers.
  • Lack of attention to personal hygiene.
  • Making excuses for why work is not complete or late or blaming others for mistakes.
  • Frequent or abnormally long bathroom breaks.
  • Turning in work that’s late, substandard, or not finished.
  • Uncharacteristic or unpredictable mood swings.
  • Using more sick time than would be expected.
  • Wearing long sleeves even in hot weather.
  • Appearing to be under the influence during work hours.


Those in the healthcare field may recognize additional signs that could point to coworker substance abuse, such as:3, 4

  • Wanting to participate more than usual in tasks that involve drugs, i.e. counting medication.
  • Mistakes dealing with medication.
  • Losing or spilling medications.
  • Asking for favors from physicians not in the confines of an appointment, including prescribing them something.
  • Increased complaints from patients regarding poorly controlled pain.

Enabling Happens in the Workplace, Too

Pharmacist stealing medicationPeople who abuse substances often surround themselves or preferentially interact with people who enable them, allowing them to avoid being held accountable for their behavior. Enablers may have good intentions but allow the person’s addiction to worsen by helping them escape consequences and minimizing their issue. Coworkers or supervisors may enable by:2,3

  • Informally counseling the employee on their own (rather than urging more formal recourse for addiction issues).
  • Assigning work to someone else.
  • Ignoring lateness, absences, or disappearance.
  • Accepting calls from the employee’s significant other to explain the employee’s absence.
  • Making excuses for the employee.
  • Switching their schedule to accommodate attendance problems.
  • Trying to talk to the employee rather than reporting concerns to management.

It will ultimately be more helpful to avoid making excuses for them and hold them accountable for their actions.1 Listed below are tips for peers and supervisors to do so.

Tips for Peers

There are a handful of effective ways to help your coworker if you are concerned about their substance use. Most importantly, though, remember that only trained professionals can diagnose a substance use disorder. Because other conditions can cause symptoms that present similarly, avoid trying to diagnose problems you observe in others.

Document Everything in Detail

If you notice any problematic behavior, write down the date, time, names of witnesses, and specific details. Note what action was taken and what the person’s reaction was. Stick to the facts.4

Talk About Your Concerns Privately With Your Supervisor

Bring any documentation that you may have. If your coworker is placing people at risk or behaving in an erratic or belligerent manner, discuss it with whoever is in charge at the moment. This allows management to assess the matter and figure out what to do.4

Bring up Your Company’s Employee Assistance Program (EAP)

If you are comfortable doing so, discuss your company’s Employee Assistance Program (EAP) with your coworker. Many companies have an EAP available, which could provide confidential assessment, diagnostic services, brief counseling, and referrals to further treatment. Some people may not be aware that employers offer these services; giving your coworker a pamphlet may be helpful.2, 4

Tips for Supervisors

Supervisors should undergo training to help identify specific signs that someone is under the influence of alcohol or drugs.5 This allows supervisors to determine reasonable suspicion of employees who should be drug tested or referred to treatment if necessary.

These tips can guide you in effective ways to help your employees.

Keep the Conversations Professional

Talking to an employee who has a substance use issue use isn’t the same as speaking to a loved one. Keep the conversation professional and only address the employee’s performance at work.5 If anyone has observed suspicious behavior, make sure you have thorough documentation including the date, time, any witnesses, and specific details.4

Don’t Diagnose

You’re (most likely) not a mental health professional, so avoid trying to diagnose your employee’s problem. If they disclose a diagnosis to you, don’t share your personal feelings about their diagnosis.5

Don’t Wait

If you suspect that an employee has a problem, address it right away. Substance use disorders won’t go away if you ignore them. If your employee is in danger or putting others at risk, take action immediately. Focus on how their performance can affect their own safety and that of others.

Discuss in Private

Conduct your meeting privately. Addiction is considered a mental health condition and should be afforded the same privacy as any other health condition.5

Use the Company’s EAP

It could be helpful to meet with the EAP manager or representative before discussing the issue with the employee. EAP staff is trained to assess, diagnose, provide brief treatment, and refer to treatment services, and can be a great resource.1

Conduct an Appropriate Intervention

It’s possible to conduct a workplace intervention, but have a plan.4 Make sure to have specific documentation available and ask for help from professionals, such as an EAP counselor who can lead the session.2, 4 Manage your expectations and avoid reacting, attempting to intervene on your own, or using negative labels.4

Your employee may deny that they have an issue with substance use. If you bring up specific, documented issues and they deny such issues and refuse assistance, document this too.2 You should continue to document any further issues and take disciplinary action as needed.2

Employee Leave for Addiction Treatment

Group therapy for employees on leave for addiction treatmentLeave from work to attend substance use treatment is covered under the Americans with Disabilities Act of 1990 and the Family and Medical Leave Act, allowing an employee to seek treatment for up to 12 weeks with no risk of losing their job.1, 6

If addiction treatment is required, an employer can draft a Return to Work agreement that outlines what an employer and the EAP and/or treatment program expect from the employee. This document will also clearly list what will happen if the employee fails to meet these expectations.1

Creating this document involves collaboration between the employee, company, EAP, and any involved treatment professionals, and prior notice to the employee that the agreement would be a condition of ongoing employment.1

Since addiction is a recognized disease, there may be barriers to abrupt dismissal of an employee who is abusing drugs or alcohol. Documenting performance and/or behavioral issues and offering assistance should always be your first step, along with reviewing your company’s policies.6

If your employee is caught using illegal drugs or alcohol on the job and refuses to accept treatment, or if they are driving under the influence while working, termination may be permissable.5

When in doubt, check with your company’s policies, your human resources department, and/or legal department, since each company and state may have different criteria for termination.

Options for Treatment

Most insurance plans are legally required to cover at least some level of substance use treatment.1, 7 If your place of employment offers health benefits, there’s a good chance your coworker or employee can use these benefits for addiction treatment.

There are several different treatment settings that may provide a coworker in need with appropriate recovery help. Below are a few of the common steps or offerings for substance use disorder treatment:1


During supervised detox, the body can be cleared of the drug safely and medications are often provided to relieve some of the more unpleasant or even dangerous symptoms of withdrawal. It must be noted that detox doesn’t treat the addiction, but rather safely helps a person get the drugs or alcohol out of their system.

Inpatient, also known as Residential, Treatment

A stay at an inpatient treatment facility includes a range of intensive treatment sessions daily from addiction professionals. This can be a good option for your employee or coworker if he or she is experiencing severe withdrawal, has co-occurring medical or mental health diagnoses, has unsuccessfully tried treatment before, doesn’t have a strong support system, or could be a danger to themselves or others.

Outpatient Treatment

For employees or coworkers whose responsibilities at home don’t allow them to attend inpatient treatment, or for those who have already completed inpatient care, outpatient treatment allows a person to live at home and go to work while receiving ongoing treatment several times a week at a facility.


  1. National Business Group on Health. (2009). An employer’s guide to workplace substance abuse: strategies and treatment recommendations.
  2. S. Office of Personnel Management. Alcoholism in the workplace: A handbook for supervisors.
  3. S Department of Justice, Drug Enforcement Administration. Drug addiction in health care professionals.
  4. Washington State Department of Health. (2016). A guide for assisting colleagues who demonstrate impairment in the workplace.
  5. Dietchler, D.L., & Dilger, J.E. (2018). When can you intervene in an employee substance abuse issue?
  6. Substance Abuse and Mental Health Services Administration. (2015). Federal laws and regulations.
  7. Substance Abuse and Mental Health Services Administration. Know your rights: Parity for mental health and substance use disorder benefits.
  8. National Business Group on Health  Substance use in the workplace has been linked to:1
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