Understanding substance misuse

At its core, substance misuse describes the harmful or hazardous use of psychoactive substances, including alcohol, illegal drugs and misused prescription medications. While many people associate the term with dependency or addiction, misuse can begin long before a person reaches that point. It can involve using substances to cope with stress, taking higher doses of medication than prescribed or regularly drinking more alcohol than is safe. In other words, substance misuse can affect anyone, at any stage of life, and it does not always present in the dramatic ways depicted in films or television.

The substances people commonly misuse

When people hear the term “drug misuse”, their minds often jump to illicit substances. While illegal drugs such as cocaine, cannabis and heroin remain a concern, they are only part of the picture. Alcohol continues to be the most commonly misused substance in the UK, especially among working-age adults, and its effects are often underestimated because it is legal and socially accepted. Alongside alcohol, prescription medications, particularly strong painkillers, sedatives and stimulants are increasingly misused when individuals rely on them beyond their intended medical purpose.

When it comes to illegal drugs, some may use cocaine to sustain energy, social confidence or long working hours, while cannabis might be used to unwind at the end of the day. Others experiment with newer synthetic drugs that can have unpredictable effects. What ties these substances together is not the legal status, but the way they affect our bodies, judgement and behaviour, which can have serious implications for safety and wellbeing in the workplace.

The impact of substance misuse at work

In the context of the workplace, misuse often goes unnoticed. People who are struggling may go to great lengths to hide their difficulties, continuing routines while privately dealing with increasing physical and emotional strain. But over time workers begin to exhibit declining concentration, reduced productivity, uncharacteristic errors or increased conflict with colleagues

Workplaces thrive on reliability, communication and the ability to perform safely. When a worker is misusing substances, even in ways they believe are controlled, this can be disrupted. Some individuals might experience withdrawal symptoms that make daily tasks far more difficult, while others may struggle with sleep, mental health issues or emotional volatility linked to their substance use.

In safety-critical roles, the consequences can be immediate and severe. Substance related impairment increases the risk of accidents, potentially endangering not only the worker but everyone around them. Even in non-physical roles, there are dangers. Poor decision making, missed deadlines or unexplained absences can place strain on teams and ultimately affect the wider organisation. Substance misuse rarely stays contained, it often becomes a workplace issue long before it is openly acknowledged.

What workers should do if they think they have a problem

Admitting you have a problem is an important and often courageous first step. For many workers, the fear of judgement or disciplinary action can feel overwhelming, but early support can make a big difference. Speaking with a GP or another healthcare professional allows individuals to explore what they are experiencing in a confidential space, where appropriate treatment or referral pathways can be discussed.

Employees can also reach out directly to occupational health services that provide impartial assessments and guidance designed to support the individual rather than penalise them. Some workplaces offer employee assistance programmes, counselling or mental health support that can help people address underlying stressors contributing to substance misuse. The key message for anyone who suspects they may be struggling is simple, do not wait. Seeking help early can prevent problems from escalating, both personally and professionally.

What workers should do if they are under the influence at work

If you are under the influence while at work it’s important to try and act responsibly. Continuing to carry out duties, especially in roles involving machinery, driving or decision-making, puts yourself and others at serious risk. The safest course of action is to remove yourself from any work activity immediately and inform a manager or supervisor. Many organisations have clear policies for this exact situation, which focus on safety and support rather than punishment.

It is vital to understand that hiding the issue or attempting to “power through” can have far greater consequences. Transparency allows employers to respond appropriately, whether that involves arranging safe transport home, referring someone to a healthcare service or initiating a pathway to longer-term support. Being honest in such a moment is not a sign of failure, it is a demonstration of responsibility and care for colleagues.

What employers can do to create a preventative workplace

Employers play a central role in creating an environment where substance misuse is less likely to develop and more easily addressed. It begins with creating a culture where substance abuse can be discussed without stigma. Clear policies outlining expectations, support options and procedures for managing incidents provide employees with reassurance and structure.

Education is another essential component. Employers who invest in training sessions, awareness campaigns or wellbeing initiatives give their workforce the tools to recognise early signs of misuse and understand how to seek help. Occupational health services provide invaluable expertise here, offering assessments, advice and tailored interventions that help organisations manage issues safely and sensitively.

Support for mental health is also deeply connected to substance misuse prevention. Stress, burnout and unresolved personal difficulties can all increase the likelihood of turning to alcohol or drugs as coping mechanisms. Workplaces that prioritise mental wellbeing, through workload management, supportive leadership and access to psychiatric support are better positioned to reduce these risks.

In conclusion

Workers who think they may have a problem should seek support early. Knowing that help is available and that taking action is a positive and responsible step. Employers, meanwhile, have the power to shape environments where misuse is less likely to take hold and more easily addressed through effective policies, education and occupational health partnerships. Substance misuse is a complex issue that can touch any workplace and by approaching the topic with compassion, we can protect our teams and create a culture where wellbeing comes first.