What to Do When You Suspect an Employee is Impaired at Work

Recognizing and Addressing Workplace Impairment

Introduction

One of the more stressful calls we receive from business owners and managers is: “I think my employee is impaired. What do I do?”

It’s a challenging situation. You want to be fair and avoid making incorrect assumptions, but you also have a duty to protect your patients, your team, and your business.

Workplace impairment isn’t always about illegal drugs or alcohol. Medical conditions, prescription medications, and even exhaustion can mimic the signs of substance use. So, what’s your next move when you suspect impairment?

This article will walk you through handling these situations effectively—without overstepping or underreacting.

We frequently receive calls from employers asking, “What do I do if I suspect an employee is under the influence?” The answer depends on the situation, but a few key principles apply in every case:

• Stay objective – Focus on observable behavior, not assumptions.
• Act quickly – If impairment is suspected, do not allow the employee to work.
• Follow proper procedures – Document your observations and apply company policies consistently.
• Ensure safety – Make sure the employee doesn’t drive or endanger others.

This guide will walk you through what to do when an employee shows signs of impairment, how to distinguish between substance use and medical issues, and the steps to protect your practice while being fair to your employees.

Step 1: Recognizing Workplace Impairment

Objective Observations Matter

Impairment is impairment—whether from alcohol, drugs, or an undiagnosed medical issue. The key is to document objective observations that anyone could agree indicate something is wrong. These may include:

• Slurred speech
• Bloodshot or glassy eyes
• Unsteady movements or stumbling
• Confusion or difficulty following instructions
• Falling asleep or appearing overly drowsy
• Smelling like alcohol or marijuana

When you notice signs like these, do not let the employee start or continue working. At this stage, you don’t need to determine the cause—only that something is affecting their ability to perform their job safely.

Common Scenarios

• Scenario 1: An employee arrives disheveled, with slurred speech and an odor of alcohol.
  Immediate action: Do not let them work. Escort them to a private area and discuss your concerns. If they admit to drinking, arrange safe transportation home.
• Scenario 2: A team member reports that an associate doctor is slurring words, forgetting details, and showing hand tremors after lunch.
  Consideration: This could be a sign of a serious medical issue rather than substance use. The employee should see a doctor before returning to work.
  
• Scenario 3: An employee appears groggy and disoriented.
  Further evaluation: If they have recently changed medications, they may be experiencing side effects. Document your observations, and a doctor’s clearance is required before they resume work.
• Scenario 4: An employee smells like marijuana but shows no signs of impairment.
  Policy-based response: While they are not impaired, your company likely has a policy regarding professional appearance and odor. If the smell is disruptive, ask them to change clothes before returning to work.

Step 2: Immediate Action – Stopping Work and Ensuring Safety

If you suspect impairment, do not let the employee continue working. Their safety—and the safety of those around them—is your top priority.

• Escort them to a private area to discuss your observations.
• Avoid letting them drive – If they seem impaired, offer to call a taxi, rideshare, or a family member. If necessary, inform them that you will call the police if they attempt to drive.
• Document everything – Record your observations factually and in order.

Example: Instead of writing, “John seemed drunk,” document, “John had slurred speech, smelled of alcohol, and struggled to keep his balance while walking.”

If the employee denies impairment, remind them that your concern is workplace safety—not accusations. If necessary, follow your company’s reasonable suspicion testing policy (if applicable and legal in your state).

Step 3: Deciding Next Steps

Medical vs. Substance-Related Impairment

Not all impairment is due to drugs or alcohol. Some medical conditions—including diabetes, neurological disorders, or reactions to prescribed medication—can mimic intoxication.

If an employee’s symptoms raise medical concerns:

1. Send them to their doctor for evaluation.
2. Require a return-to-work note that confirms they are fit to perform their job.
3. Ensure compliance with ADA and medical privacy laws when discussing their condition.

Applying Corrective Action or Termination

If impairment is due to drug or alcohol use, review your company’s policies and past precedent before deciding on corrective action.

• For a first-time offense (and if your policies allow), you may issue a formal warning, require substance testing, or offer support resources.
• For repeat offenses or severe impairment, termination may be warranted, especially if safety risks were involved.

In all cases, your actions should be consistent, documented, and aligned with your workplace policies.

Step 4: Strengthening Workplace Policies on Impairment

Key Policies to Have in Place

To handle workplace impairment effectively, your employee handbook should include:

• Reasonable suspicion procedures – Clear guidelines for when and how to act on suspected impairment.
• Substance-free workplace policy – Expectations around alcohol and drug use during work hours.
• Hygiene & odor policy – Guidelines on professional appearance and strong odors, including cannabis.
• Fitness-for-duty requirements – How employees should handle medical conditions that affect job performance.

Need help strengthening your policies? CEDR can create a custom employee handbook to ensure compliance and consistency in your workplace.

Final Thoughts: Your Role as a Manager

Dealing with workplace impairment is challenging, but having clear policies and a fair, consistent approach will help you navigate these situations confidently.

• Stay objective – Document behaviors, not assumptions.
• Act quickly – If impairment is suspected, remove the employee from work immediately.
• Ensure safety – Prevent impaired employees from driving or putting others at risk.
• Follow policy – Apply your company’s handbook procedures consistently.
• Support employees when appropriate – When medical issues are involved, allow employees to get clearance from their medical provider so they can return to work ASAP.

Bottom Line: Impairment is impairment—whether from alcohol, drugs, or medical conditions. The key is knowing how to respond appropriately while protecting your business, employees, and patients.

Need help ensuring compliance with workplace policies? CEDR members have access to expert guidance and customized handbooks. Contact us today to learn more!