Written by National Director, Substance Use Policy and Programs, Alexandra Perry.

Safety-sensitive work has become a much bigger conversation lately, especially as workplaces continue navigating substance use, psychological safety, and increasingly complex return-to-work situations.

During a recent webinar Dr. Rahim Haji and I facilitated, one of the strongest themes that emerged was that many organizations are genuinely trying to do the right thing but are struggling with how to practically respond when substance use concerns arise within safety-sensitive roles.

I also think there is a great deal of confusion right now around the intersection between safety-sensitive work, substance use, and return to work. These conversations often become overly simplified, as though someone is either “safe” or “unsafe,” “fit” or “unfit,” when in reality recovery and workplace functioning are far more dynamic than that.

Why These Situations Escalate So Quickly

What continues to stand out to me is how quickly situations involving substance use can move into fear and escalation because they are genuinely difficult and sometimes worrisome situations to navigate, especially within safety-sensitive environments where the responsibility to protect people is very real. Organizations often feel pressure to respond quickly, sometimes before we get a full understanding of what is happening functionally.

Substance Use Rarely Exists in Isolation

The reality is that substance use rarely exists in isolation. Many people are trying to cope with chronic stress, burnout, trauma, psychological injuries, grief, pain, or environments where they have simply been carrying too much for too long. Particularly within safety-sensitive environments, many individuals become highly skilled at compensating and continuing to perform externally while struggling internally. By the time concerns become visible, things are often much more complex than they initially appear.

Moving From “Is Someone Safe?” to “What Is Happening Over Time?”

I would really like to see safety-sensitive conversations move beyond simply asking whether someone is “safe,” because pragmatically we can only control so many variables. Instead, I think the focus needs to shift toward understanding what is happening over time. That opens up more options, more understanding, and ultimately better planning.

We can ask questions, like, what patterns are emerging? Is functioning changing? Is the workplace environment contributing? Are there already supports in place? A role may absolutely be safety-sensitive, but that does not automatically mean every situation carries the same level of concern or requires the same response.

The Cost of Fragmentation

One of the biggest challenges across workplaces right now is fragmentation. Employers, treatment providers, disability teams, unions, assessors, and workers themselves are often all operating separately, each holding different pieces of information and different expectations around recovery and return to work.

When systems become fragmented, responses become reactive as well. People receive conflicting messaging, unrealistic RTW expectations, or recommendations that may sound good on paper but become difficult to sustain in real life. This is not safety planning.

That is why I keep coming back to the idea that our response to safety sensitive roles should almost automatically mean coordinated care. The higher the level of risk, the more important communication, alignment, and preparedness become. In many ways, the safest thing organizations can do is slow down enough to better understand what is happening before responding, a hard thing to manage when again, safety concerns are very real.

The Safest Thing We Can Do Is Focus on Our Response

Years ago, while working frontline in shelters and inpatient treatment, I used to say that in complex situations, the safest thing we can do is focus on our response. If we react, ignore, avoid, or move too quickly into discipline, situations tend to escalate, especially when someone is already in a state of crisis. In many ways, our response can either help stabilize a situation or unintentionally intensify it.

I honestly think the same principle applies within workplace substance use conversations. The more organizations understand what is happening, prepare together, and coordinate their response, the safer everyone becomes. It’s like they say, the more we know, the more we know how to fix the issue.

Rethinking How We Talk About “Accommodations”

I also think we need to challenge how we talk about “accommodations” within safety-sensitive work. Somewhere along the way, accommodations started becoming associated with lowering standards or creating exceptions. In some environments, the word itself almost carries a negative undertone.

But when used properly, accommodations are not about reducing safety expectations. If anything, they are often part of a larger safety strategy, very important. They are structured ways of supporting stability and recovery while also acknowledging the realities of stress, trauma, coping, fatigue, and workplace pressure.

Accommodations as Coordinated Safety Planning

In many ways, I think accommodations are really coordinated safety planning, perhaps this language better reflects the intention of our goals. When someone in the community is struggling with mental health challenges, trauma, or crisis, safety planning is rarely about assuming everything will go perfectly. It is about understanding risks, building supports, identifying warning signs, and having backup plans if things become more difficult.

Workplace risk management is not all that different. Organizations already anticipate risk every day. They assess likelihood, understand impact, and create response plans to improve safety outcomes. I think substance use and recovery conversations need the same mindset. Not fear-based reactions, but thoughtful preparation, communication, and coordinated planning that supports both safety and recovery over time.

Redefining Successful Return to Work

The same shift is needed in how successful return to work is defined. Too often success is measured simply by whether someone came back to work. But successful RTW should really be defined by whether recovery can continue to hold over time within the realities of that work environment. That requires planning, support, pacing, and a realistic understanding of what recovery looks like outside of treatment settings.

Slowing Down to Build Safer, More Supportive Workplaces

At the end of the day, I know most organizations genuinely want to create safer workplaces and support their people well, especially when situations become complex. Part of the work I hope to continue supporting organizations with is slowing these conversations down enough to create more understanding, better coordination, and more realistic planning. Because when we move too quickly into fear or reaction, we can lose the opportunity to fully understand what is happening and what may help.

I also want to reassure organizations that there is rarely one perfect response to these situations. But I do think we can create workplaces that are more prepared, more coordinated, and more supportive in how they respond. And when we do that, there is far more opportunity for both safety and recovery to hold over time.