Alcohol and Drug Use in the Workplace

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2 2 Prepared by, Jacqui Cameron, Linda Jenner, Nicole Lee, Angela Harney and Lewis Burnside. With thanks to Gary Wright, Tony Papa, Jack Owens and Jason Jennings for their assistance April 2015 This project received funding from the Australian Government

3 3 Contents Contents 3 Introduction 9 Alcohol and drug use among the Australian workforce 10 How common is alcohol and drug use by workers? 10 What are the workplace-related factors that increase alcohol and drug use among the workforce? 11 Which industries have higher levels of alcohol and drug use among workers? 12 What are the impacts of alcohol and drug use on the workplace? 12 Alcohol and drug use in the building and construction industry 14 How common is alcohol and drug use by workers in the building and construction industry? 14 Implications of alcohol and drug use for the building and construction industry 15 Initiatives for prevention and the reduction of risk 15 Legislation and the current policy environment 21 Why develop an alcohol and drug policy? 23 Elements of effective alcohol and drug policy Developing an effective policy 24 A focus on worker wellbeing, safety and fitness for work 24 Consultation and communication Policy content 26 The role of culture Education and training Access to counselling and treatment Policy evaluation 31 Interventions in the workplace: an overview of models 32 Alcohol and drug testing 32 Health promotion 34 Using the Internet to access information and treatment 35 Utilising peers and co-workers 36 Brief interventions 36 Accessing professional help 37 References 38

4 4 Executive Summary Alcohol and drug use can have a significant effect on Australian workplaces, and is associated with accidents and injuries, disrupted work relationships, and decreased productivity. Work-related stress and working conditions such as long hours, dangerous work, and job insecurity may contribute to the problem. On the other hand, workplaces can do a great deal to help workers by implementing health promotion activities that focus on workers health, wellbeing, safety and productivity. This guide describes the steps in addressing safety and promoting worker wellbeing in regard to alcohol and drug-related issues. It outlines key evidence supporting best practice alcohol and drug policy development in the workplace and provides guidance on developing and implementing a broad and effective workplace policy. The guide is intended for a wide audience including employers, policy makers, unions and workers in the building and construction industry across Australia. Alcohol and drug use among the Australian workforce How common is alcohol and drug use by workers? The most recent results from the 2013 National Drug Household Survey showed that employed people s lifetime risk for alcohol consumption was about 23 per cent, while 34 per cent of workers surveyed were at risk of alcohol-related injury on a single drinking occasion at least monthly 1. The use of any illicit drug by workers in the previous 12 months was around 17 per cent, which was lower than approximately 25 per cent reported by the unemployed and those unable to work. What are the workplace-related factors that increase alcohol and drug use among the workforce? A large number of factors have been identified as contributing to increased risk of alcohol and drug use in the workplace. These include shift-work and working long hours; difficult or dangerous work; poor industrial relations; low pay; boredom; and lack of job security. Work-related stress has been found to be a factor in increased use of alcohol and drugs by some workers (1). Which industries have higher levels of alcohol and drug use among workers? For more information about alcohol and other drug use among the Australian workforce, see page 10 of this guide. In Australia, workers in male-dominated industries were more likely to drink alcohol at levels associated with risk of harm, and workers in the hospitality industry and those employed as tradespersons were most likely to report drinking alcohol at levels that posed risk of harm (2). Workers in hospitality, construction and retail were at greater risk of using drugs than workers in industries such as education (3). 1 Weekly risk was not reported.

5 5 What are the impacts of alcohol and drug use on the workplace? The impacts on the workplace of employees alcohol and drug use are wide ranging. Impacts include being unproductive while at work; poor decision-making abilities; increased rates of illness, injury and accidents; increased workers compensation claims and need for rehabilitation of workers (4-7). It has been estimated that up to five per cent of all workplace deaths in Australia may be associated with alcohol use (6). In summary, the impacts on the workplace may include (6) : Accidents Absenteeism Lower productivity Staff turnover Adverse consequences for individual workers such as accidents and injury For more information about impacts of alcohol and drug use on workplaces, see page 12 of this guide. Adverse consequences for other workers such as reduced morale and poor working relationships Alcohol and drug use in the building and construction industry How common is alcohol and drug use in the building and construction industry? Recent studies show that around fifty per cent of adult workers (8) and greater than sixty per cent of apprentices surveyed in the building and construction industry (9) were drinking alcohol at levels that put them at risk of harm. In 2004, about five per cent of adults employed in the building and construction industry reported use of methamphetamine in the previous 12 months, and around twenty per cent reported recent use of cannabis (3). Implications of alcohol and drug use for the building and construction industry A number of factors related to alcohol and drug use are of particular relevance for the construction industry. For example, in , 88 per cent of people employed in the construction industry were male 2, and evidence shows that male dominated industries have higher levels of alcohol use. For more information about alcohol and drug use by workers in the building and construction industry, see page 14 of this guide The risk for accident and injury in the construction industry is high, with environmental factors, site conditions, materials and equipment, organisational profiles and individual characteristics playing a part (10). Alcohol and drug use has been associated with accident and injury (11) which is likely to compound existing industry-related risk factors. 2

6 6 Construction is also considered to be an industry of high-stress and there is some evidence to suggest that alcohol and drugs may be used by some people as a means to cope (12). Initiatives for prevention and the reduction of risk Australian experts see the workplace as an ideal setting for preventing alcohol and drug-related harms and addressing issues that do arise in a way that integrates workplace cultural and environmental factors with external (family and community) factors (2). For more information about the legislation and current policy environment, see page 21 of this guide. For over 20 years, the commercial construction industry has been active in the delivery of alcohol and drug programs across Australia. These include: Incolink, a company established by unions and employers in the Victorian building industry in ; the Construction and Other Industries Drug and Alcohol Program (COIDAP) 4, auspiced by the South Australian Building Industry Redundancy Scheme Trust (BIRST); the Construction Industry Drug and Alcohol Foundation Treatment Centre Foundation House 5 ; and Construction Charitable Works (CCW) 6. To see case studies of these initiatives in the building and construction industry, see page 15 of this guide. Legislation and the current policy environment Workplace health and safety is of paramount importance to workplaces nationally. Until recently, every state and territory in Australia had its own legislation in place to prevent workplace injury, morbidity and mortality. While these laws shared common elements, variations in content and application existed. In 2008, the states and territories took action under the Inter-Governmental Agreement for Regulatory and Operational Reform in Occupational Health and Safety to: work cooperatively to harmonise OHS legislation. The Parties have endorsed the development of this Agreement to strengthen and formalise jurisdictional commitment in implementing [Occupational Health and Safety] OHS reforms 7 Other laws that influence the development and application of workplace alcohol and drug policy include (6) : Workers rehabilitation and compensation legislation Inter-Governmental Agreement for Regulatory and Operational Reform in Occupational Health and Safety (2008), Recital C.

7 7 Unfair dismissal legislation Anti-discrimination legislation Drink and drug driving Criminal legislation concerning illicit Common law obligations Why develop an alcohol and drug policy? There is a broad range of work-related stressors and work conditions that increase risk for alcohol and drug use among the workforce, and workplaces are seen as the ideal setting to prevent harms and address risk. Organisations from diverse sectors and industries are now introducing policy and procedures for a range of reasons including to: minimise hazards, risks and injuries in the workplace as a result of alcohol and/or other drug use; meet duty of care obligations and those stipulated by workplace health and safety legislation to provide a safe workplace free from hazards; demonstrate an employer s commitment to a safe and hazard-free workplace in regard to alcohol and/or other drug use; make clear the obligations of all workers (including management) in respect to ensuring a workplace that is free from risks associated with alcohol or drug use; prevent uncertainty if situations do arise that involve the use of alcohol and drugs; promote a workplace culture that is intolerant of drinking and drug use that puts workplaces at risk of harms; and to facilitate a culture of peer support and encouragement to offer and seek help when it s needed. Elements of effective alcohol and drug policy Organisations should consider the following elements when developing an effective alcohol and drug policy. 1. During the development stage, the focus should be on worker wellbeing, safety and fitness for work. Meaningful consultation and communication in the workplace is essential to effective policy. 2. The policy content should be based on practices for managing risks and hazards in the workplace; patterns of consumption of alcohol and drugs by workers; workplace culture; availability of alcohol and other drugs to workers; and environmental working conditions that might increase risk of alcohol and drug-related harms. Effective policy is applied universally across the workplace and at every level. 3. Implementation of effective policy is accompanied by education and training of the entire workforce, For more information about the elements of effective alcohol and drug policy, see page 23 of this guide.

8 8 and includes general health and wellbeing sessions for workers. 4. Effective policy embeds access to counselling and treatment for workers who are affected by the use of alcohol and other drugs. 5. Effective policies are living documents and are reviewed or evaluated at regular intervals. Interventions in the workplace: an overview of models A recent review of workplace interventions for alcohol (13) found that brief interventions, interventions delivered within health and life-style programs, psychosocial skills training and peer referral had the most beneficial results. A multilevel approach that provides a menu of options for supporting the workforce is most effective (14). Interventions are feasible in the workplace setting, even within a culture that is typically ambivalent about addressing risky drinking. Alcohol screening, secondary prevention, and low- intensity intervention activities may be effective for those identified as risky drinkers. Health and well-being promotion activities and alcohol testing alone, which were examined in a number of studies, do not appear to have an impact on drinking rates (5). Increasingly, there is a move towards a broad primary prevention based approach to managing alcohol and drug use in each workplace rather than simply relying on alcohol and drug testing alone (1, 15). For more information about interventions, see page 32 of this guide. This guide provides an overview of the following intervention approaches: Alcohol and drug testing Health promotion Using the Internet for support Utilising peers and co-workers for support Brief interventions Accessing professional help

9 9 Introduction The use of alcohol and other drugs is an important issue for all communities. According to the latest National Drug Strategy Household Survey, 78 per cent of Australians drank alcohol in the last 12 months, and 15 per cent of the population had tried an illicit drug in the last 12 months, with the majority of those using cannabis. People use alcohol and other drugs for a range of different reasons and use is not synonymous with impairment or dependence. As many Australians are members of the workforce, issues related to alcohol and drug use by workers and the implications for workplaces have been of long-standing interest to employers, policy makers, governments, researchers, unions and the media. Legislation now exists that outlines the responsibilities of both Australian employers and employees to maintain safe workplaces, making alcohol and drug policies an important part of workplace health and safety. Workplace alcohol and drug policies have the potential to benefit both employers and employees by promoting workers health and well-being and discouraging alcohol and drug use that places employees, their colleagues and workplaces at risk of harms. Policies should cover a range of key areas if they are to be effective and meet best practice standards. Workplaces present a potential opportunity to address alcohol and drug related issues. However, as systematic and methodologically sound research into this area has been conducted relatively recently, many existing practices are not consistent with the current evidence (16). The purpose of this guide is to outline the key evidence supporting best practice alcohol and drug policy development in the workplace. It provides guidance on developing and implementing a broad and effective workplace policy. The guide is intended for a wide audience including employers, policy makers, unions and workers in the building and construction industry across Australia.

10 10 Alcohol and drug use among the Australian workforce How common is alcohol and drug use by workers? Estimates of alcohol and drug use by workers are drawn from a number of sources including surveys of workers in specific industries or workplaces, and population level studies. The use of alcohol and drugs by the Australian workforce is a relatively recent area of enquiry and gaps in knowledge remain, particularly in regard to specific industries and occupational groups, and cohorts of workers within industries. Every three years, the National Drug Strategy Household Survey collects information about the use of alcohol, tobacco and illicit drugs (including pharmaceuticals) from a representative sample of Australians aged 14 years and over. Secondary analyses of the 2001 and 2004 surveys conducted by researchers at the National Centre on Training and Addiction (NCETA) showed that (2) : nearly half of those surveyed that were in the workforce (47.8%) reported drinking alcohol at levels that put them at risk for short-term harm at least occasionally, and eleven per cent did so at least weekly 8 six per cent of employed respondents reported attending work at least once in the previous 12 months while under the influence of alcohol and nine per cent reported drinking alcohol at work Employed people were more likely than unemployed people or those not in the workforce to drink at levels that placed them at risk of lifetime harm 9 (24.8%) and were at risk of alcohol-related injury on a single drinking occasion (30% at least yearly but not weekly, and 20% at least weekly). Conversely, about 16 per cent of employed people surveyed reported the use of illicit drugs in the year prior to the survey compared with about 25 per cent of unemployed respondents. The most recent results from 2013 (17), showed that employed people s lifetime risk for alcohol consumption was about 23 per cent, while 34 per cent of workers surveyed were at risk of alcoholrelated injury on a single drinking occasion at least monthly 10. The use of any illicit drug by workers 8 The National Medical Health and Research Council (NHMRC) Alcohol Guidelines in effect at the time indicated that males consuming 7-10 standard drinks in one day was risky for short-term harm and 11 or more drinks was high risk ; for females consuming 5-6 drinks in one day was risky and 7 or more was high risk. 9 The current NHMRC Alcohol guidelines indicate that for healthy men and women, drinking no more than four standard drinks on a single occasion reduces the risk of alcohol-related injury arising from that occasion and drinking no more than two standard drinks on any day reduces the lifetime risk of harm from alcohol-related disease or injury. 10 Weekly risk was not reported.

11 11 in the previous 12 months remained stable across time at around 17 per cent, a rate lower than that reported by the unemployed and those unable to work at approximately 25 per cent. What are the workplace-related factors that increase alcohol and drug use among the workforce? A large number of factors have been identified as contributing to increased risk of alcohol and drug use in the workplace and they are summarised here. However, as Cercarelli and colleagues point out there is no single reason for risky alcohol use, no single alcohol problem and no single effective response ; therefore, workplace responses must be tailored to the needs, circumstances and environments of each particular setting (4). Work stress has been found to have an effect on workers use of alcohol and drugs (1). For example: working in difficult or dangerous conditions; shift work and long and/or irregular hours; poor industrial relations; low pay; boredom in job roles; lack of job security; low job satisfaction; and difficult workplace events such as industrial disputes or downsizing. There is no single reason for risky alcohol use, no single alcohol problem and no single effective response. Cercarelli et al., 2012 A recent systematic review of the research literature also found that individuals, men and women included, who work long hours were more likely to drink alcohol at levels that put their health at risk (18). More recent research (19) identified a number of additional risk factor that may contribute to alcohol use among workers in male-dominated industries including building and construction. These included: work conditions such as high job demands and low collegial support; socioeconomic factors as indicated by occupational category (i.e. blue collar, manual work); inadequate supervision; work pressures; lack of control over daily work tasks or roles; and ease of access to alcohol and drugs (4, 20, 21). These work-related stressors can all lead to the use of alcohol and drugs by workers outside and/or during work hours (1).

12 12 Which industries have higher levels of alcohol and drug use among workers? Large-scale population studies of alcohol and drug use by Australians consistently show that there is a higher prevalence of drinking and use of illicit drugs among men than women. Similarly, those in younger age groups are more likely to report drinking and drug use than those in later life. It is not surprising then that alcohol use is higher among workers in male-dominated industries (5, 22). Australian research suggests that workers in the hospitality industry and those employed as tradespersons were more likely to be risky drinkers (2) and those in hospitality, construction and retail were at greater risk of using drugs than workers in industries such as education (3). Internationally, there is a higher than average prevalence of alcoholrelated problems among workers in construction, utilities, manufacturing, agricultural, and transportation (5). Other international studies have found that the building, manufacturing and hairdressing industry employees have high levels of harmful drinking (4). What are the impacts of alcohol and drug use on the workplace? The impacts on the workplace of employees alcohol and drug use are wide ranging, and it is not only workers with significant problems that contribute to these effects. While a higher frequency of substance use is generally associated with increased risk of experiencing harms, problems can also occur from episodic use. For example, when Roche and colleagues examined data from about 13,500 workers collected by the 2001 National Drug Strategy Household Survey, they found that drinkers who drank at risky levels for short-term harms infrequently (less than monthly or yearly), were significantly more likely than non-risky drinkers to report alcohol-related absenteeism (23). Risk of absenteeism increased with frequency of risky drinking. Given these results, the suggestion by Australian researchers that the adverse effects of alcohol and drug use on workplaces be considered in relation to three broad problem areas, is highly appropriate (20) : 1. Intoxication acute effects (accidents, reduced productivity, poor work relations, drink-driving, and hangover effects). 2. Regular use ill health, absenteeism, lowered capacity for work. About impairment Although much of the literature concerning impairment in the workplace focuses on the use of alcohol and other drugs, there are many other ways that a worker can be impaired. Physical illness or injury, mental health problems, stress, effects of prescribed medicines, and fatigue may all negatively impact on a worker s performance in either the short- or long-term and potentially affect his or her fitness for work. As many of these difficulties appear similar in presentation, it is extremely difficult to identify the cause of a person s apparent impairment in the absence of sensitive and careful inquiry. Therefore policies and practices that target alcohol and drug use in the workplace are best implemented in the context of promoting the overall health, wellbeing and safety of the workforce.

13 13 3. Dependence ill health, absenteeism, lowered capacity for work, withdrawal symptoms, importance of using substances becomes a priority. Other impacts include being unproductive while at work, poor decision making, increased morbidity, increased rates of injury and accidents, increased workers compensation claims and need for rehabilitation of workers (4-7). It has been estimated that up to five per cent of all workplace deaths in Australia may be associated with alcohol use (6). In summary, the impacts on the workplace may include (6) : Accidents Accidents that may result in injury or death Loss of work time or production time Damage to the workplace or tools, machinery etc. Increased costs for employers e.g. WorkCover Potential industrial relations or other hearing Absenteeism Loss of time Loss of production Covering costs of absent workers Lower productivity Lower quality and quantity of outputs Potential loss of customers Loss of skilled workers (if workers are terminated) Other workers covering for their work mates Staff turnover Costs of dismissal Replacement costs of workers Training of new workers Loss of experience and expertise in workforce Consequences for individual workers Potential injury to self or other workmates Possible discipline procedures resulting in demotion, dismissal etc. Interpersonal problems with workmates Loss of earnings Loss of reputation, experiences Consequences for other workers An unsafe or risky workplace Covering for work mates Disputes between workers Reduced morale

14 14 Alcohol and drug use in the building and construction industry How common is alcohol and drug use by workers in the building and construction industry? Australian research into the use of alcohol and drugs by workers in the construction industry specifically is limited; however existing literature is suggestive. A recent study was conducted into the extent of alcohol and drug use in the construction industry across three states in sites such as high density CBD construction, roadway development, tunnelling, railway extensions, and extensions to a casino complex. A survey containing a brief alcohol screen the Alcohol Use Disorders Identification Test (AUDIT) - and questions related to the use of other drugs was distributed to 500 workers. Interviews with management staff and employees were also conducted to explore issues related to workplace culture and alcohol and drug policy (8). Of 494 respondents, 286 (58%) scored above the cut-off for risky or hazardous alcohol use; fourteen per cent reported it would be difficult to cut down or stop drinking; and seven per cent reported that they possibly or definitely had a problem with drinking (8). Another recent Australian study of alcohol use among Australian male construction industry apprentices was conducted by researchers at Incolink (9). The study examined harmful alcohol use and alcohol-related violence in a sample of 108 carpentry and plumbing apprentices, most of who were in their second year. The AUDIT scale was used to measure apprentices alcohol use. Results showed that nearly 66 per cent of apprentices were drinking at hazardous or harmful levels; about one third (36%) indicated that they drank 10 or more drinks on any one occasion, while 22 per cent drank between seven and nine drinks on any one occasion. Less is known about the prevalence of drug use by workers in the construction industry, however an analysis of the National Drug Strategy Household Survey of 2004 found that about 5 per cent of respondents who worked in the construction industry reported using amphetamine in the previous year and around twenty per cent had used cannabis 11 (3). 11 Of respondents in the hospitality industry, 25 per cent had used cannabis and nine percent had used amphetamine in the previous year. Of the population sample, about eleven per cent had used cannabis and about three per cent had used methamphetamine in the previous year (Australian Institute of Health and Welfare, 2004 National Drug Strategy Household Survey).

15 15 Implications of alcohol and drug use for the building and construction industry A number of factors related to alcohol and drug use are of particular relevance for the construction industry. For example, in , 88 per cent of people employed in the construction industry were male 12, and evidence shows that male dominated industries have higher levels of alcohol use. The risk for accident and injury in the construction industry is high, with environmental factors, site conditions, materials and equipment, organisational profiles and individual characteristics playing a part (10). With 28 fatalities recorded by Safe Work Australia as at mid-december , the construction industry had the third highest industry rate of fatal injury of nineteen industry workplaces listed 14. Alcohol and drug use has been associated with accident and injury (11) which is likely to compound existing industry-related risk factors. Construction is also considered to be an industry of high-stress and there is some evidence to suggest that alcohol and drugs may be used by some people as a means to cope (12). Worker age is also a factor to be considered. Young male construction workers transition into the workforce during a period in which they are vulnerable to alcohol and drug use, which may be further influenced by entry into an industry where there is potential for harmful alcohol use (9). A recent study conducted by researchers from Incolink into harmful alcohol use among a sample of 108 apprentices found a positive correlation between harmful alcohol consumption and other alcohol related harms. Notably, and as a self-reported result of drinking, one quarter reported poor performance while at work and 15 per cent reported poor performance at college; 21 per cent reported drink driving and 29 per cent had verbally abused someone (24). Initiatives for prevention and the reduction of risk Only a few studies have looked at results of interventions for alcohol and drug use in the construction industry specifically. One large scale study conducted in Washington, USA examined outcomes from a drug-free workplace program comprising a written policy; access to an employee assistance program; supervisor training in an alcohol and drug policy and related procedures; worker training in the effects of substance use and an introduction to the program; and drug testing on a controlled and carefully monitored basis (25). A total of 261 companies from a range of industries (including construction) enrolled in the program. The investigators used data obtained from workers compensation claims from the Washington State Department of Labor and Industries covering the period 1994 through 2000, and work-hours data The Agriculture, forestry and fishing; and Transport, postal and warehousing sectors both recorded 43 fatalities as at 10 December 2014.

16 16 reported by employers pre- and post-intervention. The 261 intervention workplaces were compared with 20,500 non-intervention workplaces. The analysis showed a reduction in the incidence rate of more serious injuries for both the construction and services industries. Based on the results of their research in the Australian construction industry and what is known about effective workplace approaches more generally, Biggs and Williamson (8) recommended a number of education strategies for improving safety in respect to alcohol and drug use and promoting cultural change. These included disseminating findings from their research via tool box talks, safety posters etc. and using different forms of informal and formal communication to raise awareness about alcohol and drug issues; continuing industry-supported campaigns; and promoting how to access confidential alcohol and drug use support or treatment providers externally or internally through the Employee Assistance Program (EAP). For over 20 years, the commercial construction industry has been active in the delivery of alcohol and drug programs across Australia. These include: Incolink, a company established by unions and employers in the Victorian building industry in ; the Construction and Other Industries Drug and Alcohol Program (COIDAP) 16, auspiced by the South Australian Building Industry Redundancy Scheme Trust (BIRST); the Construction Industry Drug and Alcohol Foundation Treatment Centre Foundation House 17 ; and Construction Charitable Works (CCW) 18. These programs are described in case studies 1-4 on the following pages

17 17 Case study 1: Incolink Victoria: An industry-wide peer intervention approach Incolink is a joint enterprise of trade unions and employer associations in the Victorian commercial building and construction industry. The organisation has approximately 50,000 active members and close to 100,000 members who are eligible for support. Along with its primary role as a redundancy fund, Incolink has been delivering a suite of social support services to construction workers for over two decades. This includes a comprehensive alcohol and other drugs education and support program that has been operating with the bipartisan support of unions and employers since In line with recommended good workplace practice, the program operates under an industry wide drug and alcohol policy called the Victorian Building and Construction Industry Alcohol and other Drugs Policy. This policy sits within major enterprise bargaining agreements in the industry. The key principles of the policy are that safety is paramount on building sites, and that people experiencing problems with alcohol or drugs will be provided with assistance and support without jeopardising their employment. It also contains provisions for respectfully dealing with someone who may be unable to work safely due to being affected by alcohol or drugs, or any other reason that may cause impairment. Incolink delivers education and prevention sessions in TAFE, union training courses and at workplaces state wide across the industry. In 2014, Incolink won the Victorian Health Promotion Foundation Award and the Victorian Public Healthcare Award for its Drink Safe Mate prevention program in TAFE. Incolink also delivers a suicide prevention program called Life Care, to every first year building and construction apprentice in Victoria. As one of the risk factors to suicide, the important issue of alcohol and drug use is also covered in these sessions. The full range of education and prevention topics delivered by Incolink includes: Suicide Awareness, Stress, Critical Incident Stress, Gambling, QUIT Smoking and Financial Awareness. In partnership with the CFMEU National Office, Incolink has delivered a three year National Construction Industry Drug & Alcohol Preventative Education Campaign between 2012 and Incolink provides state wide counselling and support for members experiencing difficulties associated with their substance use. We provide outreach and after hours support to improve access to help and to reduce barriers to accessing treatment. Incolink also provides specialist counselling across Victoria to support members in relation to issues such as relationship problems, mental health concerns, anger, suicidation and financial troubles. Incolink recognises the complexities of people s lives and that they often present with co-occurring issues, hence Incolink responds in a person-centered holistic manner. The Incolink Drug and Alcohol Program works to achieve safe and healthy workplaces through a holistic, evidence-based approach that is informed by internal and external research. For more information go to:

18 18 Case study 2: The Construction and Other Industries Drug and Alcohol Program Based in Adelaide, South Australia, the Construction and Other Industries Drug and Alcohol Program (COIDAP) was established by employers and workers in the construction industry to address the issue of unsafe work practices caused by the use of drugs and alcohol in the workplace. COIDAP is run by a committee of worker and employer representatives, together with experts from the drug and alcohol field. In conjunction with site safety committees, COIDAP provides onsite education to workers as well as training to those responsible for workplace safety. The education sessions are designed to inform workers of their responsibilities for their own safety in the workplace and that of others in accordance with WHS legislation. Beliefs concerning culture and attitudes to workplace safety are also explored to encourage collective responsibility in taking action to reduce risk. Education and prevention sessions are also delivered to apprentices at group training centres and in TAFE. In addition to education and training, COIDAP provides follow up counselling and support to people in the industry who require advice or intervention for issues related to the use of alcohol or other drugs. Consistent with that described elsewhere in this guide, COIDAP recognises that there are many issues in the workplace that contribute to employee drug and alcohol use including high-demand lowautonomy work, long working hours, poor workplace culture and a male dominated industry. These risk factors can also manifest in poor mental health and increased risk of suicide. To provide a holistic response to the industry, COIDAP works closely with its sister organisation, the Mates in Construction suicide prevention program. Cross referral between COIDAP and the Mates in Construction program ensures that experts in the construction industry provide a tight safety net for workers, as well as eliminating issues related to the sharing of information between external counselling practitioners, which can act as a barrier to effective interventions. The close working relationship between COIDAP and Mates in Construction has resulted in significantly improved outcomes for workers and their families. COIDAP is also involved in the policy arena and works with employers in the development of new, or the review of existing AOD/Impairment policies; drawing on the experience and knowledge accumulated over the two decades since the program began. COIDAP has been officially recognised for its contribution to Occupational Health and Safety in South Australia.

19 19 Case study 3: The Construction Industry Drug and Alcohol Foundation Based in Sydney, New South Wales, the Construction Industry Drug and Alcohol Foundation (the Foundation) was established in 1994 to address the lack of available and effective alcohol, drug and problem gambling treatment options; limited places in existing facilities; and unrealistic waiting periods in an already overcrowded public health system. The Foundation is a non-profit organisation that aims to raise funds to provide adequate, effective and readily accessible alcohol, drug and problem gambling treatment services and support to construction industry workers, members of their families and the general public. In what can be a difficult industrial relations setting on occasion, the Foundation skilfully brings together all stakeholders in the building and construction industry in an atmosphere of cooperation and harmony. Membership of the Foundation is open to construction industry employees and union officials, construction industry employers or employer groups, and representatives from the drug and alcohol, medical, legal, or other appropriate fields. The Committee of Management consists of union official representatives, employer group representatives, and a representative from the drug and alcohol medical field and the broader community. Whilst the Foundation operates independently and autonomously, it is linked through similar goals to the Building Trades Group (BTG) Drug and Alcohol Program. The BTG provides alcohol and other drugs education programs to the building and construction industry in NSW. The education program informs workers of the pitfalls of AOD use in the workplace where safety may be seriously compromised, and also explores risks that may affect health, livelihood and relationships with family and friends. Evaluation shows that the BTG education program has had a positive impact upon those building workers and apprentices exposed to the education sessions. The program continues to be well received and supported not only by the building industry but also by municipal councils, TAFE institutions and other industries that have been made aware of the program. Foundation House Foundation House is an alcohol, drug and gambling treatment centre run by the Construction Industry Drug and Alcohol Foundation. As a result of a successful fundraising campaign and high levels of recognition and support within the community and the construction industry, the Foundation achieved a long-term objective in June 2000 when the then NSW Premier, the Honourable Bob Carr officially opened Foundation House, located in a tranquil waterfront setting within the grounds of Callan Park in Sydney s inner west. Foundation House has a capacity of 28 beds and is staffed 24 hours per day, seven days per week. It provides a 28 day program. Foundation House originally provided drug and alcohol services exclusively, however in recent years it has expanded its operations and now provides residential and outpatient alcohol, drug and problem gambling services to a broad target group, including construction industry personnel, members of their families and members of the general public. In addition to the residential programs, Foundation House offers a broad range of services specifically designed around the needs of the individual client. These services include an outpatient Gambling Program, outpatient counselling, family support, and relapse prevention groups for clients with problems related to the use of alcohol and drugs and gambling.

20 20 Case study 4: Construction Charitable Works Based in Canberra in the Australian Capital Territory, Construction Charitable works (CCW) is a charitable organisation established to support building and construction workers during their time of need. CCW provides counselling and support to the industry for all alcohol and other drug use related issues including supported referral to detoxification and rehabilitation services. CCW works closely with Foundation House in Sydney and community services in Canberra to develop client focussed treatment plans for inpatient care. CCW also provide support for a range of issues that may affect workers such as critical incident response, generalist counselling, case management and apprentice support. CCW complements its partner organisation, Creative Safety Initiatives, which provides a range of social and industry related education and training activities. These include the delivery of a full day of training to construction apprentices in TAFE that covers topics such as drugs and alcohol, impairment, problem gambling, bullying and suicide awareness. This is a holistic approach that address s a range of risk factors that are relevant for a young apprentice during an important life transition period. As part of a negotiated Enterprise Bargaining Agreement process, the CCW drug and alcohol program is also embedded into building and construction workplaces in the ACT. This includes a policy, the delivery of alcohol and other drug awareness sessions onsite and the provision of access to support for workers.

21 21 Legislation and the current policy environment Workplace health and safety is of paramount importance to workplaces nationally. Until recently, every state and territory in Australia had its own legislation in place to prevent workplace injury, morbidity and mortality. While these laws shared common elements, variations in content and application existed. In 2008, the states and territories took action under the Inter-Governmental Agreement for Regulatory and Operational Reform in Occupational Health and Safety to: work cooperatively to harmonise OHS legislation. The Parties have endorsed the development of this Agreement to strengthen and formalise jurisdictional commitment in implementing [Occupational Health and Safety] OHS reforms 19 Central to these reforms were the development of the new national Model Work Health and Safety Act 20 and the accompanying Model Work Health and Safety Regulations 21 that were designed to replace existing state- and territory-based laws. Adoption of the new national regulations by all states and territories will ensure that the protection of workplace safety and penalties for safety offences will be applied consistently across the whole of Australia. The responsibilities for ensuring workplace health and safety remain incumbent on all parties and workplace alcohol and or drug testing is not mandated. Another important document is the Australian Work Health and Safety Strategy that provides a framework for a range of national activities to promote the health, wellbeing, safety and productivity of the Australian workforce. The construction industry is one of seven industry groups identified as national priorities for workplace risk prevention activities. The strategy emphasises the important role of research in developing evidence-based policy, programs and practice. Other laws that influence the development and application of workplace alcohol and drug policy include (6) : Workers rehabilitation and compensation legislation (WorkCover) accidents that occur when workers are intoxicated with alcohol or other drugs may not attract compensation. Unfair dismissal legislation workers are entitled to challenge an employer s decision to terminate their employment, therefore policies and procedures in regard to alcohol and 19 Inter-Governmental Agreement for Regulatory and Operational Reform in Occupational Health and Safety (2008), Recital C Model Work Health and Safety Bill, 23/06/ Model Work Health and Safety Regulations, Revised as at 9 January Australian Work Health and Safety Strategy

22 22 other drug use (including grounds for termination) must be well considered and applied consistently. Anti-discrimination legislation such as the Australian Human Rights Commission Act 1986 and the Disability Discrimination Act 1992, as well as the various state- and territory-based anti-discrimination laws, may prohibit discrimination against employees on the basis of having an alcohol or drug use disorder. Drink and drug driving legislation under the various state- and territory-based laws, it is illegal to drive (and in some states attempt to drive) if a person s blood alcohol level exceeds 0.05g/100 ml. Certain drivers may be required to have a zero blood alcohol content such as holders of provisional licenses; and drivers of trucks, heavy vehicles, passenger vehicles and those containing hazardous goods. It is also an offence to drive whilst intoxicated with illicit drugs such as amphetamine type stimulants and cannabis. Criminal legislation concerning illicit drugs employers may be held accountable for activities in the workplace involving illegal drugs such as sale, manufacture, use or supply. Common law obligations employers have a duty of care to ensure employees are not exposed to unnecessary risks to their health or safety.

23 23 Why develop an alcohol and drug policy? As described in earlier sections, there are multiple work-related stressors and working conditions that increase risk for alcohol and drug use among the workforce. Australian experts see the workplace as an ideal setting for preventing alcohol and drug-related harms and addressing issues that do arise in a way that integrates workplace cultural and environmental factors with external (family and community) factors (2). Workplace policy has a key role in any effective workplace response. Increasingly, organisations from a wide range of different sectors and industries such as small business, education, retail, hospitality and high-risk industries, such as construction, are introducing policy and procedures relating to the use of alcohol and drugs as it pertains to the workplace. There are a number of compelling reasons to introduce policy and procedures. These include: Taking steps to ensure that hazards, risks and injuries do not occur in the workplace as a result of alcohol and/or other drug use. The workplace offers potential as a unique and cost-effective setting for prevention and intervention strategies to reduce alcohol-related harm. Pidd and Roche, 2009 Meeting duty of care obligations and those stipulated by workplace health and safety legislation to provide a safe workplace free from hazards. Demonstrating an employer s commitment to a safe and hazard-free workplace in regard to alcohol and/or other drug use. Making clear the obligations of all workers (including management) in respect to ensuring a workplace that is free from risks associated with alcohol or drug use. Preventing uncertainty if situations do arise that involve alcohol and drug use. Promoting a workplace culture that is intolerant of drinking and drug use that puts workplaces at risk of harms. Facilitating a culture of peer support and encouragement to offer and seek help when it s needed.

24 24 Elements of effective alcohol and drug policy 1. Developing an effective policy A focus on worker wellbeing, safety and fitness for work Increasingly, there is a move towards a broad primary prevention based approach to managing alcohol and drug use in each workplace rather than simply relying on alcohol and drug testing alone (1, 15). This can include an approach of testing and measuring impairment and 'fitness for work' which focuses on evaluating worker s capacity to work without risk to their own or others health and safety, rather than being focused only on the presence of alcohol or drugs in the system (26, 27). This assessment is most commonly used at recruitment stage or when changes of work or health conditions occur to ensure workers physical and psychological capabilities match the requirements of the job, with an aim to prevent health and safety risk for the worker, their co-workers and the public (27). The types of tests used to evaluate fitness for work vary widely but can include physical assessments such as testing of reaction times on a computer and eye reaction to light (26). Criteria usually used to determine impairment includes assessment of the worker s capacity and the worker s risk in relation to his or her specific workplace, together with ethical, economic and legal considerations (27). The effectiveness of fitness to work and impairment testing is still limited but is successfully used by some employers in Australia as an alternative to, or in conjunction with workplace alcohol and other drug testing. It is recommended to be applied as part of a wider and more comprehensive workplace alcohol and other drugs policy (26). Consultation and communication The important role that meaningful consultation plays in the development of effective policy is well established and the new Model Work Health and Safety Regulations stresses the importance of workplace consultation. According to Australian experts: A key component of an effective policy is consultation with stakeholders such as management, unions, employees, supervisors and occupational health and safety staff. This consultation process allows for the development of mutually acceptable goals and procedures. Successful consultation with stakeholders during the policy development stage is often crucial for policy credibility and acceptance. Pidd and Roche (2013) p. 5