Substance Abuse Policy

Policy Statement

Substance abuse is detrimental to an individual’s health and may jeopardize safety in the workplace. For these and other reasons, the unauthorized use, possession, storage, manufacture, distribution and sale of alcohol, controlled substances, and illegal drugs is prohibited on Duke’s premises or during any business conducted in Duke-supplied vehicles or during working hours.

The “Drug-Free Workplace Act” and the “Drug-Free Schools and Campuses Regulation” require Duke – as a federal contractor and grant recipient – to certify that it will provide a drug-free workplace/campus. As a condition of employment on such contracts and grants, staff will abide by the terms of this statement and notify Duke of any criminal drug statute convictions not later than five days after such convictions for violations occurring on Duke premises. This includes convictions for the unlawful use, possession (including the storage in a desk, locker, or other repository), manufacture, distribution, dispensation, or sale of illegal drugs, drug paraphernalia, or controlled substances on Duke premises or while conducting business in Duke supplied vehicles or during working hours.

Duke will not condone criminal activity on its property (or on property under its direct control) and will take appropriate corrective actions up to and including termination or required participation in drug abuse assistance or rehabilitation programs.

Policy Details


This policy pertains to all staff of Duke University at all sites from their first day of employment or appointment. Nothing in this policy should be construed to supersede procedures governing grant renewal or maintenance of clinical privileges as defined in the by-laws of the medical staff of Duke.

Any disciplinary action to be taken against a staff member for a violation of this policy should be discussed with Staff and Labor Relations.

Substance Possession

The unlawful possession, manufacture, distribution or sale of illegal drugs or alcohol on Duke premises or vehicles is prohibited and will result in corrective action up to and including termination.

Staff are responsible for knowing about and complying with the provisions of state and federal law that make it a crime to possess, sell, deliver or manufacture controlled substances. Any member of the Duke community who violates the law is subject to prosecution by civil authorities as well as to disciplinary proceedings by Duke.

Substance Use

The use of illegal drugs on Duke premises or vehicles is prohibited and will result in corrective action up to and including termination. Staff are discouraged from the use of illegal substances at any time. Use of illegal substances or abuse of legal substances off work time which results in impairment at work will result in action as described in the Impairment Section.

The use of alcohol at work is not permitted and alcohol consumption off work which results in impairment at work will result in action as described in the Impairment Section.

Staff who are taking legally prescribed and/or over-the-counter medications and report to work impaired which affect job performance, safety or the efficient operation of work will be subject to action as described in the Impairment Section.


Alcohol on the breath raises questions concerning a staff member's competence and will not be tolerated for any staff member with patient care responsibilities or for those who work in patient care areas. Select other work areas may prohibit alcohol on the breath. Staff should check with a supervisor regarding the application of this policy in their work areas.


The supervisor is responsible for taking appropriate action when a staff member demonstrates impairment.

The supervisor is requested to utilize the Impairment Checklist in determining evidence of impairment.

Upon evidence of impairment, the supervisor:

  1. Should DOCUMENT the observed behavior, preferably with another supervisor present. The Impairment Checklist can serve as documentation.
  2. Should CONFRONT the staff member in private about the observed behavior and tell the staff member that in the supervisor's judgment he/she appears impaired.
  3. Should not allow the staff member to continue to work or return to work until cleared by Employee Occupational Health and Wellness (EOHW) or designated facilities and should DIRECT the staff member as soon as possible to EOHW or the designated facility for assessment.
  4. Should CONTACT Staff and Labor Relations if the staff member is not cleared to return to work.
NOTE: Falls, slips or injuries could be an indication of impairment. Supervisors who have concern about staff should consult with EOHW for direction in managing their staff safely.


Voluntary Intervention
Duke maintains employee assistance programs, (Personal Assistance Services [PAS] and BHS) which provide confidential, no cost to the employee assistance to help resolve alcohol or drug abuse and other personal/emotional problems. Use of employee assistance does not jeopardize an individual's employment or opportunities for promotion.

Staff are encouraged to seek assistance from employee assistance before alcohol and drug problems lead to impairment.

Mandatory Intervention
If a staff member demonstrates impairment, EOHW will intervene on a mandatory basis.

EOHW/designated facility will determine whether the staff member is impaired and inform the supervisor of such status. Diagnosis of substance abuse by EOHW/designated facility during a mandatory intervention will result in the staff member's restriction from work until the abuse is in remission. No specific health information will be released without the staff member's permission. If the staff member is impaired, EOHW/Emergency Room will initiate any further medical or safety procedures, including treatment recommendations, and a return to work assessment if the staff member is eligible to return.

An assessment of the health status of a staff member will be conducted by EOHW in those situations which constitute reasonable cause. The assessment will include historical and physical examination information. Laboratory assessment may include evaluation of body fluids for substances including illegal drugs. The data will be analyzed based on customary medical criteria. Assessment for illegal drugs and alcohol will be based on federal and state agency guidelines.

Staff who refuse to be assessed will not be allowed to return to work until cleared by EOHW. Refusal to be assessed or to follow recommendations for rehabilitation once abuse is confirmed may be grounds for termination.


Duke recognizes substance abuse as a treatable condition. Staff with this problem will normally be encouraged to participate in rehabilitation. However, there are positions that are of such a critical nature that substance abuse may be grounds for immediate termination. These positions include but are not limited to those positions which involve the public safety of the community such as Public Safety Officers or Communication Officers; positions involving patient contact or support and those positions which require the possession of a driver's license.

Staff involved in PAS on a voluntary basis will develop a rehabilitation plan in conjunction with PAS and mandatory follow-up will not occur.

If rehabilitation has been as a result of a mandatory referral, the staff member will participate in follow-up by EOHW for one year minimum. Should a staff member who has been in mandatory rehabilitation and follow-up fail an assessment by EOHW within that year, he/she may have a second opportunity for rehabilitation if not in a safety sensitive position. Refusal of a second rehabilitation will result in termination. Failure of any assessment during mandatory follow-up after the second mandatory rehabilitation shall be grounds for termination.

Drug Testing

Drug testing after initial hire will be conducted only where Duke determines that reasonable cause exists to do so.

Under certain circumstances, Federal or State Agencies request or require staff to submit to drug testing. Duke will cooperate to a reasonable extent with such agencies in these instances.

Involvement of Law Enforcement Agencies/Licensing Agencies

The use, sale, purchase, transfer, theft or possession of an illegal drug is a violation of the law. Duke will refer such illegal drug activities to law enforcement, licensing and credentialing agencies when appropriate, and as authorized by law.

As a condition of employment, a staff member must notify Duke if he or she is convicted of a criminal drug offense, including a plea of nolo contendre (no contest), occurring in the work place within five days after the conviction. Duke must notify the granting agency of a staff member conviction within 10 days after learning of the conviction.

Drug Awareness Program

Periodically Duke will inform staff about the dangers of drug and alcohol abuse in the workplace, its policy of maintaining a drug-free workplace, available drug counseling, rehabilitation and employee assistance programs, and the penalties that may be imposed upon staff for drug or alcohol abuse violations.


Impairment - Behavior which indicates having a diminished capacity or inability to perform duties.

Illegal Drug - Any drug which is not legally obtained.

Legal Drug - Includes prescribed drugs, over-the-counter drugs or alcohol which have been legally obtained.

Reasonable Cause - A belief, based on an observance of performance/behavior, that a staff member is impaired.

Voluntary Intervention - Use of employee assistance by a staff member to resolve a personal or work performance problem before such a problem results in impairment or management involvement.

Mandatory Intervention - Action taken by Employee Occupational Health and Wellness (EOHW) or designated facility requiring a staff member to be assessed for fitness of duty when impairment indicates a potential health or safety risk to the staff member or to others.

Substance Abuse - Use of legal or illegal drugs in an inappropriate manner; substance misuse; substance dependence; use of any illegal substance.

Policy Number: 10.03

Issued Date

July 1, 2006

Last Revised

June 14, 2010


Workplace Health & Safety Policy