Substance Misuse Guidance

Purpose of Notes

The purpose of this guidance is to provide assistance and advice for managers in dealing with employees affected by alcohol, drug or substance misuse. These guidance notes should be read along with the University policy on Substance Misuse.

In addition to the information provided there are contact details for organisations that provide specialist help and advice.

It is understood that many people who start to take substances will do so because of difficult times in their lives such as bereavement, financial troubles, relationship difficulties or many other social problems. It is also accepted that it is easier and cheaper to intervene early with an effective employee assistance programme than ignore it and have to rely on the disciplinary process later on.

Recognising a problem with substance misuse

In most cases, it is the behaviour associated with alcohol and drug misuse that will be most obvious to managers and colleagues. Possible indicators are listed below. It is essential to bear in mind that other factors, such as illness or stress, can also produce these signs – so thoroughly examine each situation before acting.

Possible indicators of misuse:

Patterns of depression or fatigue (often after the weekend)
Absenteeism – short term/frequent patterns
Poor timekeeping
Erratic performance
Lack of discipline
Unusual irritability or aggression
Over-confidence
Sudden mood swings
Inappropriate behaviour
Reduced response times
Becoming easily confused
Reduced productivity
Deterioration in relationships with colleagues, customers or managers
Financial irregularities
Dishonesty and theft

Remember: These are only signs – they can all be caused by other factors.

Relevant legislation

As with many legal issues, managers are advised to seek expert advice on their specific circumstances. Substance misuse may involve both employment law and criminal law. HR can provide advice.

Outside certain industries, such as public transport, there is little legislation directly related to drugs and alcohol in the workplace. However, there is legislation on substance abuse that can affect an employer and an employee.

Misuse of Drugs Act 1971: this is the key UK legislation relating to the control and classification of drugs. This act and its subsequent amendments set out the penalties for possession and supply of various illegal drugs.

Section 8 Misuse of Drugs Act 1971: A person commits an offence, if being the occupier or concerned in the management of any premises, he knowingly permits or suffers any of the following activities to take place on those premises, that is to say:

Producing or attempting to produce a controlled drug;
Supplying or attempting to supply a controlled drug to another;
Preparing opium for smoking;
Smoking cannabis, cannabis resin or prepared opium.

This is a criminal offence with individual liability.

Not taking reasonable action to prevent this has been legally found to constitute “permitting”.

Health & Safety at Work Act 1974: sets out the duty of care of employers to employees in the workplace. Section 2 places a duty on employers to provide a safe place of work and competent employees. Failure to deal with an employee who is under the influence of alcohol or drugs, who may constitute a risk to other employees, could leave an organisation open to prosecution. Managers should complete a risk assessment for their area.

Management of Health & Safety at Work Regulations 1999: regulation 3 places a duty on the employer to make a suitable and sufficient assessment of the risks to health and safety of employees and others affected by their undertaking.

Common Law: places a duty on the employer to take reasonable care of the health and safety of employees.

Provision and Use of Work Equipment Regulations 1998: requires employers to assess any additional risk as a result of using work equipment in the conditions that exist in their business and particularly any special needs of young workers.

Data Protection Act 1998: all health and medical information is sensitive personal data under the terms of the Data Protection Act. All information surrounding possible drug or alcohol misuse must be handled securely and confidentially.

Road Traffic Act 1988: sets out the offence of driving or attempting to drive a motor vehicle while unfit through drink or drugs. Employers may be liable unless they can show ‘all due diligence’.

Confidentiality

An employee with a substance or alcohol abuse problem has the same rights to confidentiality as they would for any other health related condition.

All self-referrals to the Occupational Health Unit have to be made via HR. They will be treated in strict confidence and no details will be given to an employee’s manager without the express consent of the employee. The only exception is where an Occupational Health professional considers it necessary in defence of public interest.

Any help or treatment given will be treated confidentially between the employee, Occupational Health and where necessary, any external agency involved.

Managing employees with substance misuse issues

When faced with a situation where an employee has been under-performing because of, or if there has been an incident that may be linked to a drug or alcohol problem, it is important to act promptly, taking advice where necessary.

Initially, it will be necessary to raise the matter with the employee concerned, following the advice set out in these guidance notes. Usually, a referral to Occupational Health will be required, via HR.

With support, substance and alcohol misuse problems can be successfully dealt with. Consider the full costs of recruiting and training to replace employees; supporting an employee’s recovery may be more cost effective.

Handling conversations about substance misuse

When there is a reasonable suspicion of substance misuse, it is important to act promptly. Formal evidence may not always be available, but there is a duty to safeguard the health and safety of the employee, students and other University employees.

Ensure that the meeting can be conducted in private.
Advise the employee of the concerns, including observations or examples of relevant behaviour, or impact on performance. Take any relevant supporting documents or information where applicable.
Enquire after the employee’s health.
Give the employee the chance to explain their version of events and encourage them to discuss the issue.
Explain the University’s position on substance misuse and provide a copy of the policy. Ensure that the employee is aware that whilst support will be provided, they must not attend work under the influence of substances under any circumstances.
Offer help in confidence, including sources of support and advice (see Appendix).
Propose a referral to Occupational Health. Seek employee approval for this. If approval is not forthcoming, explore why the employee is reluctant to do so.
If the employee admits to a problem, ask what support they need, particularly around time for treatment or any temporary amendment to duties.
Agree a course of action, including scheduling a review meeting.

Misconduct and Performance

Every support will be provided to employees who have acknowledged that they have a problem with substance misuse, and are engaging with treatment and Occupational Health. However, there may be occasions where it is necessary to invoke the disciplinary procedure in relation to substance misuse.

The University Disciplinary or Capability procedure will apply in these circumstances, depending on the nature of the issue. Advice is available from HR.

The University’s Disciplinary procedure makes it clear that incapability due to substance misuse maybe a disciplinary matter. Examples include; where an employee has failed to engage with Occupational Health, when an employee attends work under the influence of alcohol or drugs, where the matter is affecting their ability to effectively perform their duties, or having a negative impact on students, colleagues or the University.

As with all disciplinary matters, employers are obliged to conduct reasonable investigations into misconduct matters and take into account mitigating factors. Even if the police or other law enforcement agencies have been involved, managers will still need to consider whether dismissal is an effective option. Pending charges will not necessarily be legitimate grounds for dismissal, so always seek advice from HR.

In the event that an employee engaged with treatment, the manager may exercise their discretion to suspend disciplinary proceedings. Realistic outcomes and timescales will need to be agreed. Employees must be advised that that failure to show improvement in the area identified will result in the formal processes recommencing.

Dealing with incidents

In the event that an employee appears to be suffering from an excessive consumption of alcohol or drugs in the workplace, urgent action may be required depending on the person’s condition. In a real emergency, action may be necessary before calling an ambulance; in other situations, an ambulance may not be necessary. If a first aider is available, ask them to attend.

If for any reason a first-aider is not available, use the following as a guide.

If a person appears half-asleep or drunk, keep them awake. Do not allow them to lie down; if they fall asleep and vomit there is a risk of choking, with potentially fatal results; they may be dehydrated without realising it, so encourage them to drink small amounts of water if they are conscious. Do not offer coffee or other caffeine rich drinks – these could worsen the situation; if you have concerns over safety you should call an ambulance or doctor. To assist medical personnel in treating the person you may wish to hand over any tablets, packets, or any other materials that you believe to be connected with their condition.
If a person faints or appears unconscious: if a first-aider is not available, check to see if the person is breathing. If not, summon immediate emergency assistance. If they are breathing, loosen their clothing and ensure their airways are clear; do not attempt to give mouth-to-mouth resuscitation, or other first aid if you are not trained to do so; place them in the recovery position (on their side, with one leg straight and one leg bent).
If a person appears agitated, anxious or tense: keep calm – they’re more likely to relax; speak quietly and softly; reassure them that you will make sure they are okay; try to create as quiet an atmosphere as possible (e.g. turning off loud equipment). Turn down bright lights; try to regulate their breathing. They may be dehydrated without realising it; encourage them to drink small amounts of water – do not give them coffee.

In the event that medical assistance is not required, the employee should be sent home. If necessary, ensure that they get home safely.

Attending work under the influence of alcohol or drugs may amount to a disciplinary matter. Consider the appropriate action following the incident. This may include an investigation under the Disciplinary Procedure.

Frequently Asked Questions

I suspect one of my employees has a problem with drugs or alcohol. What should I do?

If you suspect an employee may have a drug or alcohol misuse problem you should arrange to ensure that the employee’s work (or continued attendance at work) does not pose a health and safety risk to themselves or others, and then hold an informal discussion with the individual, following the guidance set out in this document.

If the employee is in a safety critical role, hold the conversation immediately. Depending on the outcome of the conversation, it may be necessary to transfer the employee to alternative duties until advice can be taken, or the University can be confident that the substance misuse issues are no longer ongoing.

If having spoken to the employee there is still reasonable suspicion of substance misuse refer the employee to Occupational Health via HR.

One of my team has told me in confidence that they have a problem. What should I do?

Whilst employees sometimes ask for matters to be kept confidential, and whilst we have duties under the Data Protection Act to ensure this confidentiality, we must meet our duties of care as an organisation. Advise the employee that it is essential you refer them to Occupation Health, and ensure that they are aware of the University’s position on substance misuse (provide them with a copy of the policy). Clearly outline the standards that must be maintained.

It has been reported to me by a third party that one of my employees is misusing alcohol or drugs but I have no real evidence. What should I do?

As we have a duty of care towards all of our employees, even if there is no evidence as such, it is still important to discuss the matter with the employee concerned. Follow the guidance in this document around having a conversation with employees about concerns about potential substance misuse.

Can we test someone that we believe is under the influence of drugs or alcohol?

We do not normally engage in drug or alcohol testing for our employees. However, if you believe that there are particular circumstances that apply that mean this should be considered, please discuss it with HR.

One of my team is receiving support via the University for a substance problem. What should I be doing as the manager?

It is important to keep a regular and open dialogue with any employee who is receiving support for substance misuse, whether or not they are at work during this time. Agree a regular meeting, and check in regularly about whether any specific support is required. Document your discussions with them.

One of my team is away from work due to substance misuse. Is this treated as sickness absence?

Yes. Normal sickness procedures and contractual sick pay will apply. For the avoidance of doubt, substance misuse is not considered a disability (although conditions arising from a dependence on drugs or alcohol may be).

I have talked to an employee I am concerned about, but they deny that there is a problem. What are my next steps?

If you still believe that the employee may be misusing substances, advise them that you wish to refer them to Occupational Health.

One of my team has been receiving treatment for a substance misuse problem, but they are also underperforming. What should I do?

It is not unusual for someone to experience difficulties at work whilst dealing with substance misuse. Ensure that you keep a record of the performance issues, and discuss them with the employee. Also ensure that they are aware of the necessary performance standards required of them and their role. Whilst the University wishes to support employees with a substance misuse problem who are seeking treatment, this has to be balanced against the needs of students, colleagues and the University itself. It may become appropriate at some point to invoke the Capability procedure. Each situation is different, so take advice from HR before commencing any formal action.

Appendix One - Information on substances

Substances can be broadly categorised in a way that helps with understanding how a person might be affected when using them:

Depressants

Such as alcohol, tranquillisers, heroin, methadone and solvents slow down the central nervous system, affecting co-ordination and reaction times. Alcohol, for instance, used to create feelings of relaxation and disinhibition in social settings, can be inappropriate and cause problems in the workplace. Due to slow reactions, depressant use is particularly dangerous whilst driving or operating machinery.

Stimulants

Such as amphetamines (‘speed’), ecstasy, cocaine, mephedrone, tobacco and caffeine increase the heart rate and give the user a sense of increased alertness and energy. People using some stimulants can become aggressive. Illicit stimulants might be used recreationally but the following day at work, a user can feel tired or depressed. Employees may also use stimulants to enable them to work long shifts but repeated and regular use could lead to problems or dependence.

Hallucinogens

Such as cannabis, ketamine and ‘magic mushrooms’ change the way people think, feel and perceive their surroundings. They can enhance appreciation of surroundings but can also cause anxiety or paranoia. As they can distort the user’s sense of time and perception, these drugs would again be dangerous in ‘safety critical’ jobs. Whilst none of the hallucinogens mentioned cause physical dependence, a user may become psychologically dependent on their effects. Cannabis is the most commonly used illegal drug in the UK.

When it comes to illegal drugs, the most commonly tried drugs are:

•Cannabis

•Cocaine

•Ecstasy

•Amyl Nitrites (Poppers)

•Amphetamines

•Ketamine

Appendix Two - Sources of advice and help

Types of service

Across the UK there is a huge range of services offering differing types of assistance to those suffering from substance misuse. One way of defining services is by breaking them down into:

statutory sector (part of the National Health Service)

– GPs and community alcohol/drug teams;

voluntary sector (may provide many of the same services as the statutory sector, but often with a focus on counselling and advice services);
private sector – there are a wide range of services provided by the private sector – everything from counselling to residential treatment. Details on these services can be found on the FRANK website.

Here is a brief guide to the services:

General Practitioners: the majority of referrals to specialist services are made via GPs or mainstream NHS services. This has a number of advantages, as the GP will be aware of the individual’s medical history and is normally well placed to monitor the situation.
Hospital-based inpatient and outpatient care: for those who require medical care for detoxification or for those receiving substitute prescriptions. (See below). Unusual for inpatient care to be prolonged (see residential services).
Residential services: due to their association with the rich and famous, some of these are household names. Residential treatment programmes are normally intended for heavily dependent users – though individual practises vary widely. Residents must be drug-free, normally meaning they have undergone detox prior to admission. Some may provide this themselves prior to the main programme.
Self-help groups: Alcoholics Anonymous and Narcotics Anonymous are two well-known organisations of this type. Different organisations may have differing philosophies.
Substitute prescribing: for substances such as heroin there are substitutes that may be prescribed by either a GP or a specialist service. The substitute, normally methadone, can be prescribed either on a gradually reducing basis to wean the user off drugs (reduction programme) or at a steady rate to stabilise the user (maintenance programme). An organisation needs to consider its response to individuals in this position. There are many cases where individuals on methadone are able effectively to hold down a job, often without colleagues’ awareness.

Employee Assistance Programme (EAP)