Workplace Alcohol and Other Drug Policy and Support Services in the United States, 2015-2019

Background/Purpose: Substance use among employed individuals is a critical social problem. It poses unique threats to their and their families’ health and well-being (via increased work injuries, turnovers, and absenteeism) and the larger community (via lost productivity and greater health costs). Workplace can be an important avenue for substance use prevention and reduction among employed individuals for its easier access and broader approachability. However, our understanding is limited about the availability of the most commonly used workplace measures (i.e., alcohol and other drug [AOD] policy and support services for substance use problems [e.g., Employment Assistance Program, Counseling services]) and its contributions to substance use prevention and reduction. Therefore, this study aims to examine the extent of working individuals’ access to workplace AOD policy and support services and identify effective workplace strategies to alleviate their substance use risks in the US.

Methods: Data came from the 2015-2019 National Survey on Drug Use and Health, a nationally representative cross-sectional study of noninstitutionalized US civilians. This study’s analytic sample was restricted to 131,787 employed individuals aged 18+, reporting availability of AOD policies and support services at their workplaces as well as their current substance use/misuse, separately for alcohol, marijuana, other illicit drugs, and prescription drugs. For statistical analyses, I first estimated the prevalence of workplace AOD policy and support services among those whose workplaces have an AOD policy for all employed individuals and their subpopulations. Then, multinomial logistic regression analyses were conducted to assess the associations between workplace AOD policy/support services and current substance use, separately for each substance type. Lastly, the predicted probabilities of each substance use/misuse behavior were estimated for different combinations of workplace substance use intervention strategies based on the multinomial logistic regression estimates.

Results: Over 77% of individuals reported having a written AOD policy in their workplaces, but only 64.8% of them had access to EAP or other counseling services for substance use problems. In particular, traditionally vulnerable workers (i.e., females, Hispanics, part-time workers, individuals with limited English proficiency) showed 15%-66% lower odds of having support services at their workplaces. While having a workplace AOD policy is associated with lower odds of current substance use/misuse for all substance categories, the predicted probabilities of current marijuana (6.6% [95% CI=6.3-6.9]) and other illicit drug (0.7% [95% CI=0.6-0.8]) use as well as prescription drug misuse (5.4% [95% CI=5.1-5.6]) were lowest when both the AOD policy and support services were available at workplaces than having either of them alone.

Conclusions and Implications: Findings suggest that workplace AOD policies are widely implemented in the US, but limited availability of support services for substance use problems, especially among disadvantaged workers, raises concerns. Potential synergetic benefits of having both AOD policies and support services at workplaces pose opportunities to promote comprehensive workplace strategies for substance use prevention and reduction. While experimental evidence is needed to determine the effectiveness of such comprehensive approaches, it is also important to disseminate the knowledge about great risks of substance use/misuse among working individuals and workplace prevention efforts’ large-scale benefits.