For the past 2 decades, the construction industry has experienced a steady decline in both recordable injuries and lost workday cases. Yet, the rate of serious injuries and fatalities (SIFs) has remained steady without an associated decrease. Many company owners, operational leaders and safety professionals wonder aloud at why and how these SIFs continue to occur in their companies despite the expansion of their safety training efforts.

What’s Under the Hard Hat

A factor that needs to be evaluated in looking at safety incidents is whether the employees involved were mentally distracted at the time of the incident. It has been reported that approximately 20% of the adult population has an underlying mental health condition. However, many more workers are distracted by the pressures of daily living.

The reality is that employees bring these worries to the workplace, and this can lead to breaks in focus. It is important for construction leaders to consider the invisible crisis in construction: the mental health and well-being of the workforce.

Company leaders are admonished to rethink the possible effect of alcohol and substance use as a major source of distraction that increases the risk of incidents and injuries. Before COVID-19, construction had issues with mental health, alcohol and substance use and suicide. The aftermath of the pandemic has multiplied the pressures on workers and their families. Many turn to alcohol and other substances when times are tough.

Signs of Substance Misuse

There are many challenges with substance misuse in construction, but four substances in particular lead the way: alcohol, opioids, marijuana and cocaine. It is important to understand how these substances impact workers’ coordination, judgement and ability to perform their jobs, increasing their risk of an accident or injury by four times. The following examples are representative issues of the prevalence of substance misuse in construction:

• Alcohol—Alcohol in moderation is not the problem; binge drinking into the late hours at night without enough time for the alcohol to be eliminated from the system before work the next day is the problem. The industry rates the second highest in heavy drinking, with 16.5% of workers reporting heavy drinking of more than five to seven drinks in a single setting.
• Opioids—Opioids are one of the most misused substances in construction, leading to dependency and addiction. This has been partly due to the physical demands of construction, which has led to a higher rate of musculoskeletal injuries and long-term chronic pain in workers. Opioids have been highly prescribed for pain management to help workers deal with injuries and chronic pain issues.
• Marijuana—Marijuana is fast becoming a more acceptable drug. Much of this is attributed to the decriminalization and legalization of personal use in many states with many more considering legalizing it. The challenge with marijuana is two-fold:
  • The tetrahydrocannabinol (THC) potency in today’s marijuana (30% THC versus 10% THC) is much stronger than it was even 5 years ago. This stronger THC content has the potential to cause significant impairment of workers and increase their dependency upon it.
  • Marijuana is no longer a drug that is just smoked; manufacturers are now extracting the THC from the plant and creating drinks and edibles. This makes it virtually impossible to detect use by a worker on a jobsite.
• Cocaine—Cocaine is a readily used substance on jobsites for its ability to be easily concealed and used virtually undetected during the day. Also, stimulants like cocaine can only be detected in the system for a short time frame of up to 72 hours.

How Company Leaders Excuse Substance Misuse

There are many ways that companies have “excused” substance misuse as being normal. As the industry struggles to find workers to fill open positions, an interesting trend is emerging related to drug testing.

Some companies have either suspended or contemplated stopping pre-employment testing requirements just to fill open positions. The simple question contractors should ask themselves before thinking about this approach is, “Are the risks of this questionable practice are worth the reward?”

Effects of Substance Misuse

Generally, individuals who are misusing substances are more unreliable, with higher absenteeism or tardiness. Employees with substance use disorders have poor work performance and unprofessional conduct. These factors can create resentment among the rest of the crew, which affects jobsite morale, productivity, quality and safety.

Substance misuse by workers poses serious risk for workplace accidents and injuries to themselves, other workers on the site or the general public. These injuries can adversely affect workers’ compensation experience modification rates, Occupational Safety and Health Administration statistics, and medical costs, which can have adverse impacts on prequalification requirements on projects.

With these accidents there is increased risk of third-party liability, defense and settlement costs, increased insurance premiums and reputational risk. It is imperative for companies to remain vigilant with their detection.

Now is the time for companies to take a fresh look at their alcohol and substance use policies and testing procedures. Many employers have found that substance use testing is no longer a deterrent against substance misuse by a small percentage of workers. Below are six key steps for companies to move into proactive prevention steps: