Workers for Ethical Substance Use Policy (WESUP)
July 28, 2021
WESUP: A Grassroots Organization
Workers for Ethical Substance Use Policy (WESUP) was established as a non-profit organization in 2021. Our purpose is to improve workplace substance use policy, using education and advocacy.
For far too long, many workplaces have stigmatized and marginalized workers who are suspected of having a “substance use problem”. Workers are improperly branded as being an inherent danger to workplace safety and are often removed from the workplace or coerced into outdated, invasive, harmful, profit driven treatment & monitoring programs; and denied access to evidence-based health care.
In Vancouver, 2015, a small group formed, sharing stories of being harmed by workplace substance use policy. Some group members had been removed from the workplace on the mere suspicion of a substance use issue, without any evidence of being impaired at, or even outside of, the workplace. Some workers had voluntarily reached out to their employers asking for help to address substance use challenges, or for help with other physical or mental health conditions.
After being singled out by their employer, workers were required to undergo addiction assessments from one of a small group of addiction physicians chosen by their employer. The approach used by these few physicians is based on outdated beliefs and stereotypes about people who use psychoactive substances.
Information about workers’ substance use was often taken out of context and any use of a psychoactive substance, even outside of the workplace, was seen as a threat to workplace safety. Any use of illicit substances was automatically considered a “substance use disorder” regardless of the individual circumstances of the worker.
Based solely on the diagnosis of “substance use disorder,” workers were stripped of their autonomy to make their own health care decisions, and coerced into strict “one-size-fits-all” treatment & monitoring programs that do not meet the minimum standards of services available to the general public.
Workers were coerced into signing contracts (typically 3-5 years long) that mandate 24 hours a day, 7 days a week abstinence, with the threat of job loss if they did not comply. Workers were prohibited from using any “psychoactive substances” except for caffeine, nicotine, and select prescribed medications. Even anti-nauseant, cold, and other over-the-counter medications were banned.
Because of the ban on psychoactive substances, workers with Opioid Use Disorder were prohibited from using Opioid Agonist Treatment medications, workers with mental illness were prohibited from using certain psychiatric medications, and workers in pain were prohibited from using most pain medications. This blanket prohibition of medications (which can be used safely in the workplace) had devastating effects on workers’ health.
Abstinence was enforced through random testing of the workers urine, blood, breath, hair follicles and liver enzymes. A worker could be subjected to a test at any time, including when the worker was on vacation. A single positive test could result in the treatment and monitoring contract being extended by multiple years, or even job loss.
Significant conflicts of interest existed between the physicians making the treatment recommendations, and their ownership of the medical monitoring / drug testing companies that workers were required to use.
Workers had to pay exorbitant costs (up to $1000/month out of pocket, typically for 3-5 years) to these private companies, which were often owned by the referring physicians.
Drug testing services are available through the public health care system at a considerably lower cost. However, workers were not permitted to access those services. Workers were mandated to use the private drug testing companies; referring physicians directly profited from this arrangement.
Despite their personal and cultural beliefs, workers were required to attend inpatient addiction treatment centers that are based on the 12-step philosophy, and to attend daily 12-step peer support meetings. Many workers objected to the religious and moralistic nature of these programs which are based on Christian doctrine. However, workers were not offered or permitted to access non-religious psychosocial treatments that are available to the general public.
Workers’ compliance to these mandates was strictly enforced. If workers did not follow all of the conditions of the “treatment and monitoring agreement” outlined by their employer, and based on the physician’s recommendations, the worker would be deemed “non-compliant,” risking their careers.
Workers had no choice in the physician that assessed them, and no choice as to their treatment goals or treatment plan. They were not offered any harm reduction services, withdrawal management, trauma-informed care, anti-craving medication, or mental health services. They were not allowed to access services through the publicly funded health care system, were not allowed to get a second medical opinion, and there was no appeal process for them to challenge the assessment, diagnosis, or conditions to which they were subjected.
Workers reported that the workplace substance use policies took a huge toll on their mental health. Some workers were bankrupted by the medical monitoring costs. Some workers were forced to abandon their careers.
As more and more workers began sharing similar stories of being harmed by workplace substance use policy, we established a nonprofit organization that would allow workers to support each other. Peers could exchange information about worker’s rights, advocating for themselves, mounting legal challenges and fighting for policy change.
We’re demanding a new and humane approach to addressing employees’ substance use. Employees should be offered voluntary, confidential, culturally appropriate, trauma-informed health care services that are based on current harm reduction / health promotion principles.
Only as a last resort, should conditions be placed on an employee remaining in the workplace. When that is necessary, employees must be allowed an individualized & evidence-based risk assessment, and employees’ self-determination and human-rights must be placed at the forefront.
As our membership reflects, workers from many different occupations are subjected to harmful workplace substance use policy.
If you have been harmed by a workplace substance use policy and want more information about advocating for your rights, or just want someone to talk to, we are here.