Imagine that you’re a supervisor at a construction site, in a state where marijuana is legal. As you begin the day, you notice that one of your employees, Mike, doesn’t look like himself. His eyes are red, and he’s moving more slowly than usual. You think he might be under the influence of marijuana. Mike operates heavy machinery, and you’re worried about his and others’ safety. To play it safe, you follow company policy, have Mike get a urine test, and send him home until the test comes back three days later.

As it turns out, Mike was up all-night taking care of a cranky newborn. There’s no law against that. But even if you explain to Mike that submitting to the test was “just company policy,” more than likely he’ll harbor resentment that you thought he was under the influence. You can hardly blame him. He’s literally been suspended three days being a good father and a conscientious employee. Intended or not, the policy’s narrow focus on substance abuse implies a lack of confidence in Mike without even establishing whether or not he’s actually impaired.

It’s been over thirty years since the US Congress passed the Drug-Free Workplace Act, and today organizations struggle with more than just substance abuse to keep their work environments safe. It isn’t enough to eliminate illegal drugs. For example, fatigue impairs people in a similar way to alcohol or marijuana, presenting the same dangers in loss of awareness, coordination, and judgement that can lead to injury. According to some studies, being awake for 24 hours is the equivalent to having a blood alcohol content of 0.10; you’re legally intoxicated at 0.08. Perfectly legal conditions or other situations can lead to diminished physical, mental, and emotional capacity required to work safely, for reasons as wide-ranging as prescription drug use, shift work, planning a wedding, or experiencing harassment.

Both workers and organizations have trouble understanding the scope of the problem. Only 39% of employers responding to a National Safety Council survey viewed prescription drug use as a threat to safety and just 24% said it was a problem, even though seven in ten reported issues ranging from absenteeism to overdose. Conversely, while over 93% of all employers feel that fatigue is a safety issue, only 72% of employees agree, meaning that many employees tend to overestimate how fatigued, and how safe, they really are.

What can an organization do? Recognize that employees can be impaired for any number of reasons. Educate your employees on the risks and signs of impairment. Set up workplace policies tailored to your needs that address impairment and help people to get support if needed. The organization can craft these policies in collaboration with employees, the health and safety department, unions, and other relevant personnel.

If testing is needed, test for impairment rather than specific substances. New technologies exist that evaluate impairment by measuring coordination and responsiveness. Unlike drug testing, which only checks for specific substances, can take several days, and implies the stigma of substance abuse, results are immediate, and testing evaluates the employee’s fitness for work, detecting impairment regardless of the cause.

What can I do as an employee? Educate yourself. The more you know about risks of impairment, the easier it’ll be to protect yourself, and others. If you have situations in your life that could cause impairment, take action. Some examples include:

• Talk to your doctor if you have trouble sleeping. To avoid feeling fatigued at work, stay hydrated, eat right, and move around periodically if you work sitting down.
• Educate yourself on stress and anger management. Exercise, eat right, rest and take advantage of your support network of friends, family, and coworkers to manage your stress level. Get professional help if necessary.
• Before starting a new prescription, ask your doctor about potential side effects and how it might impact your ability to work or drive. When cannabis is used to manage pain, treat it as seriously as you would treat a medical prescription. Even if cannabis is legal for recreational purposes in your state, educate yourself its impairing effects and your employer’s policies to stay safe.
• Never work under the influence of alcohol or hung over.
• And most importantly, take care of your fellow workers. When you see that someone’s impaired, for any reason, you need to help protect their safety. Talk to them, and if you need more help, stop work, tell your supervisor, and so on.

To shift our focus from substance abuse to impairment, we need to keep our focus on reducing exposure to injury. What we understood as a root cause 30 years ago, is just one of many conditions affecting human performance reliability today. For safer workplaces, we constantly need to look at both our problems and our solutions with fresh eyes.

For a deeper look at the issues surrounding the situation with Mike, read Jim Spigener’s article here.