The role of the occupational physician in substance abuse

Occupational physicians are in a unique position to intervene early in substance abuse in the workplace. Despite the complexities of and the barriers to identifying and approaching the troubled worker, there are a number of effective methods available to enable a successful intervention and an appropriate referral to the substance abuse treatment system. Motivational interviewing is one effective way to increase motivation, in a short span of time, in a worker facing needed change. Drug testing in the workplace abounds with potential conflict. Guidelines set forth by the ADA and ACOEM can help the occupational physician balance the need to advocate and protect the rights and confidentiality of patients with the need to uphold the well being and safety of the workplace and of the general public.