Photo of the day: Cannabis and Impairment in the Workplace

We often think of impairment as a result of substance use or addiction or dependence on alcohol or drugs, whether legal or illegal. However, impairment can be the result of any number of issues, from fatigue to medical conditions, to traumatic shock and life events. Regardless of the source, impairment at work can affect our ability to do our jobs safely.

Table of Contents

The legalization of recreational cannabis on October 17, 2018, has heightened the focus on issues regarding impairment in the workplace. This infographic and photo of the day outline its effects, what employers and workers need to know, and the key elements of an impairment policy.

Workplace impairment

Someone who is impaired may have difficulty completing their work tasks safely and may put themselves, their coworkers, and the public in danger.

There are many potential causes of impairment. In addition to factors such as fatigue and certain medical conditions, these include the use of legal and illegal substances such as:

alcohol
cannabis, including foods that contain cannabis known as “edibles”
street drugs
certain medications

A shared responsibility

Everyone has a role to play in workplace health and safety. Employers and employees alike should be prepared to prevent the risk of cannabis impairment at work and should note the following employer and employee responsibilities in federally regulated workplaces. For businesses or industries regulated by the province or territory, please refer to provincial and territorial governments.

Employers’ responsibilities

Employers should:

ensure the health and safety of all employees at work
address physical and/or psychological hazards in their workplace, including when impaired.
work with employee representatives to develop, implement and evaluate a hazard prevention program to monitor and prevent hazards
include policies on substance use and impairment in hazard prevention programs when the use of cannabis and other causes of impairment represents a hazard.

Employees’ duties

Employees must:

work safely
understand the impact that using substances (medical/therapeutic or non-medical) can have on their safety and that of others
report to their employer anything or circumstance that is likely to be hazardous to the employees or any other person in the workplace
inform their employer if a medical condition or treatment may cause impairment and impact their ability to perform their job safely
follow all instructions provided by the employer concerning the health and safety of employees

What can be considered impairment at work?

We often think of impairment as a result of substance use or in terms of addiction or dependence on alcohol or drugs (used legally or illegally). While not formally defined by the Canadian Human Rights Commission describes the appearance of impairment at work as: “e.g. odor [sic] of alcohol or drugs, glassy or red eyes, unsteady gait, slurring, poor coordination.”

However, impairment can be the result of various situations, including many that are temporary or short-term. Issues that may distract a person from focusing on their tasks include those that are related to family or relationship problems, fatigue (mental or physical), traumatic shock, or medical conditions or treatments. Examples include:

experiencing the effects of substance use, including alcohol or other drugs (legal or illegal)
treating illness or using medication(s) with side effects (such as radiotherapy causing tiredness, or antibiotics causing nausea)
having fatigue
being tired due to long work periods, or working more than one job
experiencing the disruption to body circadian rhythm caused by shiftwork
having a crisis in the person’s family
assisting a child or a family member or having a young infant
preparing for an external activity such as an exam or wedding
experiencing shock or insecurity after a workplace incident, fire, or robbery
having unresolved conflict with the employer or among employees
experiencing sexual harassment or bullying
being exposed to extreme cold (results in lower mental alertness, less dexterity in hands, etc.) or heat (results in increased irritability, loss of concentration, loss of ability to do skilled tasks or heavy work, etc.)

When should a workplace respond to impairment?

In general, employers should consider if there is a risk to the individual’s safety or the safety of others. For example, while impaired:

Does the person have the ability to perform the job or task safely (e.g., driving, operating machinery, use of sharp objects)?
Is there an impact on cognitive ability or judgment?

Part of this evaluation would be to consider if there are other side effects of a medical condition or treatment that need to be considered.

Each situation should be assessed on a case-by-case basis.

What elements should be in a policy about impairment?

Elements of the policy about impairment should include:

Statement of the purpose and objectives of the policy and program
Definition of impairment
Statement of who is covered by the policy and program
Statement of the employee’s rights to confidentiality
A mechanism for employees to confidentially report when they have been prescribed a medication that may cause impairment or when they feel they might be otherwise impaired
Statement regarding if either medical/therapeutic or non-medical substances are allowed on the premises, or under what situation they would be allowed
That arrangements have been made for employee education (e.g., general awareness)
That arrangements have been made for educating and training employees, supervisors, and others in identifying impaired behavior and what steps will be taken if the impairment is suspected
Provisions for assisting those with disabilities due to substance dependence
Processes for accommodation and return to work/remain at work
If applicable, a statement of under what circumstances substance testing will be conducted, as well as the criteria for testing and interpretation of test results
Provision for a hierarchy of disciplinary actions

Employers should collaborate with employees, health and safety committee/representative, and union (if present) to design a policy that outlines what is an acceptable code of behavior, and an acceptable level of safety performance. The main goal is that workplaces are encouraged to establish a policy and procedure so that safety is maintained, and where necessary, help can be provided in a professional and consistent manner. The policy may also need to state how discussions will take place, what options are available if the ability to work safely is a concern (e.g., assigned less safety-critical work, sent home, etc.), and actions that may be taken. If an employee may be sent home, it should be clear if this action is taken, under what circumstances is it appropriate and whether it is done via sick time or how payment will be affected, if relevant.

Supervisors should be educated and trained regarding how to recognize impairment. In most cases, when assessing an individual for impairment, it is suggested that a second trained person be present to help make sure that there is an unbiased assessment.

Note: it is not the role of the supervisor or employer to diagnose a medical issue, or possible substance use or dependency problem. Their role is to identify if an employee is impaired and to take the appropriate steps as per the organization’s policy.

What can impairment look like?

Because impairment may be the result of various circumstances, the employer should develop a clear statement of what is considered to be impaired behavior within their workplace. The Canadian Human Rights Commission uses the following characteristics as they relate to changes in an employee’s attendance, performance, or behavior:

personality changes or erratic behavior (e.g. increased interpersonal conflicts; overreaction to criticism)
the appearance of impairment at work (e.g., odor of alcohol or drugs, glassy or red eyes, unsteady gait, slurring, poor coordination)
working in an unsafe manner or involvement in an incident
failing a drug or alcohol test
consistent lateness, absenteeism, or reduced productivity or quality of work

Sometimes there are immediate signs and symptoms present. Other times, it is a pattern of behavior that may be a concern. The following table is from “A Toolkit to Address Problematic Substance Use that Impacts the Workplace” as published by the Atlantic Canada Council on Addiction (ACCA) which can be used to help determine impairment in general.

ACCA notes the following about using signs and symptoms:

They may be different from person to person.
When used alone or in combination, they do not necessarily mean that somebody has a substance use problem. However, they may be indicators that your employee is in trouble or in need of some help (regardless of if the issue stems from problematic substance use or another cause).


Table 1 Signs and Symptoms of Problematic Substance Use (not specific to any causal agent)
	Indicators
Physical	deterioration in appearance and/or personal hygieneunexplained bruisessweatingcomplaints of headachestremorsdiarrhea and vomitingabdominal/muscle crampsrestlessnessfrequent use of breath mints/gum or mouthwashodour of alcohol on breathslurred speechunsteady gait
Psychosocial impacts	family disharmony (e.g., how the colleagues speak of family members)mood fluctuations (e.g., swinging from being extremely fatigued to ‘perkiness’ in a short period of time)inappropriate verbal or emotional responseirritabilityconfusing or memory lapsesinappropriate responses/behavioursisolation from colleagueslack of focus/concentration and forgetfulnesslying and/or providing implausible excuses for behaviour
Workplace performance and professional image	calling in sick frequently (may work overtime)moving to a position where there is less visibility or supervisionarriving late for work, leaving earlyextended breaks; sometimes without telling colleagues they are leavingforgetfulnesserrors in judgementdeterioration in performanceexcessive number of incidents/mistakesnon-compliance with policiesdoing enough work to just ‘get by’sloppy, illegible or incorrect work (e.g., writing, reports, etc.)changes in work quality

Duty to accommodate

Under the Human Rights Act, employers have the obligation to accommodate to the point of undue hardship an employee who has identified as having a disease, injury, or disability, including substance dependence and medical authorizations to use cannabis for medical purposes.

(Learn more:is-fatigue-a-hidden-but-deadly-workplace-epidemic/)