Approximately 60% of people struggling with a substance use disorder are currently employed1. Employees who report to work under the influence, hungover, or going through withdrawal can be responsible for a loss of productivity, decline in employee morale, and are more likely to be involved in workplace accidents. Additionally, employers are assuming a significant portion of the $400 billion annual cost of substance use, ultimately covering costs related to absenteeism, workplace injuries, employee turnover, and health care1. Understanding the signs and symptoms of substance use and adopting workplace policies to address substance use in the workplace have the potential to relieve the burden on employers and offer assistance to individuals struggling with the illness.

Spotting the Signs

Workplace substance use can go unnoticed for a variety of reasons. An employer may choose not to perform pre-employment, random, or post-accident drug testing or there might not be a clear policy for supervisors to follow when suspicions arise. Finally, many employees and employers assume that they would just know if someone at work was struggling with substance use. 

In most cases, signs of a substance use disorder are easily identifiable, if you know what to look for. Signs of use can vary depending on the substances being used and on how they are being used. Common physical signs of substance use are2

  • Pinpoint or dilated pupils
  • Bloodshot eyes
  • Runny nose
  • Abrupt changes in weight
  • Disheveled appearance or decline in personal hygiene
  • Pronounced dental issues
  • Slurred speech
  • Hyperactivity or lethargy

There often behavioral issues and performance issues that accompany the physical signs of substance use. These include2,3:

  • Sleeping on the job
  • Patterned absences
  • Frequent tardiness
  • Slurred speech
  • Hyperactivity or lethargy
  • Increased aggression or irritability
  • Mood swings
  • Decreased productivity
  • Frequently disappearing from the work area
  • Frequent and careless mistakes
  • Customer service complaints
  • Unnecessary risk-taking
Addressing Substance Use in the Workplace

Employers are in a unique position to identify and help staff members who may be struggling with a substance use disorder1. Knowing where to start or how to improve existing workplace policies can be tricky. The Substance Abuse and Mental Health Services Administration (SAMHSA) identifies five elements of effective employer led interventions for substance use4. These are4:

  1. A clearly written workplace policy on substance use.
  2. Employee education and training on the substance misuse and the adopted workplace policy.
  3. Tailored training for supervisors enabling them to implement the workplace policy, appropriately document any issues, and handle other legally sensitive areas related to substance use in the workplace.
  4. Secure an Employee Assistance Program (EAP) to provide confidential support and treatment options.
  5. Implement a drug testing policy.

Efforts to address substance use in the workplace help not only the company’s bottom line, but also have the opportunity to offer life-saving care to individuals suffering from a substance use disorder. If you or a coworker are struggling with substance use, contact Greenbriar Treatment Center at 1-800-637-4673 today.


  1. Akanbi, M. O., Iroz, C. B., O’Dwyer, L. C., Rivera, A. S., & McHugh, M. C. (2020). A systematic review of the effectiveness of employer-led interventions for drug misuse. Journal of occupational health, 62(1), e12133. https://doi.org/10.1002/1348-9585.12133(opens in a new tab)
  2. New York State Department of Health and the Office of Alcoholism and Substance Abuse Service. (n.d.). How do I Know? I think My Child is Using Alcohol and/or Drugs.
  3. National Institute on Drug Abuse. (2007, January). Bringing the Power of Science to Bear on Drug Abuse and Addiction: Drugs Have Long0-term Consequences.
  4. Substance Abuse and Mental Health Services Administration US Department of Health and Human Services. Drug-Free Workplace Toolkit. 2019; https://www.samhsa.gov/workplace/toolkit(opens in a new tab). Accessed 11/3/2021
  5. Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicatorsin the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No.PEP20-07-01-001, NSDUH Series H-55). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/(opens in a new tab)