COVID-19 Pandemic Stress Heightens Need for Drug and Alcohol Testing

Michelle Hopkins

Recognizing the signs and knowing how to handle substance abuse in the workplace have long been important and difficult responsibilities for supervisors. That’s why the Substance Abuse and Mental Health Services Administration (SAMHSA) provides guidelines for supervisor training.1 Workplace drug and alcohol misuse, like many aspects of life, is affected by the COVID-19 pandemic. Human resources professionals and researchers are discovering that the COVID-19 pandemic and its associated stresses underscore a need for increased vigilance to identify substance abuse and potentially implement more drug and alcohol testing, as well. This article explores some of the connections found between COVID-19-related stress and substance abuse and offers suggestions for supervisors in providing an effective and compassionate response.

Substance misuse: What’s COVID-19 got to do with it?

The Society for Human Resource Management (SHRM) is warning managers that substance addiction is a genuine threat as companies emerge from COVID-19 lockdowns and strive to return to normal operations. While widely recognized for effects on physical health, COVID-19 also “intensifies the threat of mental health distress in several ways, including stress caused by financial, employment [and] child/family care instabilities, as well as fear [for] themselves or loved ones being exposed to or infected by COVID-19.”2 These concerns, along with reports of sharp increases in fatal opioid overdoses, are spreading across at least 30 states, according to the National Safety Council (NSC).3

“Employers must prepare for an increase in substance misuse – one that could be a serious threat to worker safety and cost tens of thousands in productivity losses, absenteeism and presenteeism, and workers’ compensation claims if employers do not plan ahead,” the NSC said in a statement. “Employers are in a unique position to spot signs and symptoms of misuse early.”4

Cori Repp, MD, director of medical operations for Concentra in central Florida and medical review officer (MRO), provides employers valuable guidance on recognizing those signs and symptoms, as well as handling substance abuse in the workplace in her recent webinar, “Mitigating Substance Misuse During the COVID-19 Pandemic.”5

The NSC statement on COVID-19-related substance misuse specifically called out the need for employers “to implement opioid policies and procedures as part of their return-to-work strategy” because “drug overdose – primarily from opioids – is the leading cause of preventable death for American adults. In fact, a person is more likely to die from an accidental opioid overdose than a car crash,” the NSC statement said.

Concentra has addressed the significance and drivers of opioid abuse in the workplace (also called opioid use disorder), recognizing that “treatment initiatives have helped reduce the fatal effects of the opioid epidemic across the country.”6 However, access to treatment has been difficult for many people during COVID-19 lockdowns, exacerbating stress for employees seeking to recover from substance abuse and dependency.

Nearly 1 in every 2 adults acknowledges COVID-19 mental health effects

Approximately 45 percent of American adults in a poll conducted by the Kaiser Family Foundation (KFF) said the COVID-19 pandemic has negatively affected their mental health due to worry and stress. When isolated by shelter-in-place orders, adults reported a 10 percent higher number of negative mental health effects. The impact of job loss on mental health was on par with the effects of isolation. Ironically, older Americans expressed fewer COVID-19-related mental health effects than younger, working-age adults; however, KFF acknowledged that older adults “are already at risk of poor mental health due to experiences such as loneliness and bereavement.”7

COVID-19 isolation may be the first dramatic environmental change some employees have experienced and lack of familiarity with the potential effects can itself become a stress. “Being confined and isolated affects the human physiology as a whole,” said Alexander Chouker, a physician-researcher who commented on simulations of spaceflight missions. Participants who were isolated for three months “experienced changes to their sleep, changes to their immune, endocrine, and neurocognitive systems, and alterations in their metabolisms,” he said.8

Widespread concern about a potential rise in drug and alcohol misuse and the prevalence of COVID-19-related stress should put to rest the myth that there is a stereotype of people who misuse substances. “There is a misconception that people who use drugs fit a certain stereotype, and it really is not correct,” says Michael Berneking, MD, Concentra physician and certified medical review officer. “Most people who are using illicit drugs are currently employed. They are productive members of your business and productive members of society.”9

This fact, coupled with the unprecedented nature of COVID-19 in modern times, are good reasons for employers to show compassion to employees who test positive for drugs and/or alcohol in the current high-stress environment. “Everyone reacts differently to stressful situations. How you respond to stress during the COVID-19 pandemic can depend on your background, your social support from family or friends, your financial situation, your health and emotional background, the community you live in and many other factors,” states the Centers for Disease Control and Prevention in introducing a list of people who may respond more strongly to the stress of a crisis.10

Maja Jurisic, MD, CPE, Concentra vice president and medical director of strategic accounts, addressed the impact of different emotional backgrounds (“adverse childhood experiences”) on drug use in the Concentra article, “A Drug Testing Trap You Need to Avoid.”11

Three tips for employers’ response to COVID-19-related substance misuse

Get a consultation with an occupational health expert. Concentra serves employers in 44 states – from small businesses to large national and global companies – and can help you customize a drug and alcohol testing program that fits the needs of your workforce. Concentra is also a trailblazer in workers’ compensation telemedicine and expanded telemedicine in response to the COVID-19 pandemic, as well as rolled out a variety of COVID-19 testing and screening services to protect your workforce in these challenging times.

Encourage employee self-care. Most employees probably know this advice but a reminder from a concerned employer can be a powerful motivator for employees to find positive ways to handle stress. Tips include making sure to keep a regular routine that includes time for relaxation and exercise. Proper nutrition, restful sleep away from electronic devices and news coverage, time in the outdoors, fresh air and engaging in activities that are personally uplifting are also beneficial suggestions. Remind employees that smoking, alcohol, and drugs will not provide the relief they seek.

Reinvigorate your employee assistance program (EAP) or start one. While a majority of companies across all workforce sizes offer employee assistance programs, research has found that often these services are underutilized by employees who don’t understand how to access the program or worry that their personal issues will become known.12 Create a silver lining in the COVID-19 experience by addressing these concerns and instilling in your employees the knowledge they can turn to their employer in times of stress.

And you can turn to Concentra for help with drug and alcohol testing programs and all your occupational health needs. Talk to a Concentra expert for more information on our drug and alcohol testing services.


  1. Drug-free Workplace Programs, Supervisor Training. Substance Abuse and Mental Health Services Administration (SAMHSA). April 16, 2020.
  2. Post-COVID-19 Nightmare: Substance Abuse on the Job,” Society for Human Resource Management. July 7, 2020.
  3. National Safety Council news release, “Employers Must Brace for Increased Employee Substance Misuse Due to Pandemic’s Impact on Mental Health.” Released by CISION/PR Newswire, Jun 9, 2020.
  4. Concentra webinar, “Mitigating Substance Misuse During the COVID-19 Pandemic,” featuring Dr. Cori Repp. August 26, 2020.
  5. The Dangers of Opioid Use Disorder in the Workplace,” by Eliana Yamouni. May 1, 2020.
  6. The Implications of COVID-19 for Mental Health and Substance Use. Kaiser Family Foundation. April 21, 2020.
  7. What Coronavirus Isolation Could Do to Your Mind (and Body),” Wired magazine. March 25, 2020.
  8. Concentra webinar, “What Employers Need to Know About Drug Testing,” featuring Dr. Michael Berneking. November 18, 2019.
  9. Coronavirus Disease 2019 (COVID-19) | Coping with Stress. Centers for Disease Control and Prevention. Last updated July 1, 2020.
  10. A Drug Testing Trap You Need to Avoid.” March 24, 2020.