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Aims: The aims of this study were to map the amounts and patterns of alcohol & drug (a&d) use among employees, to analyze the relationships between a&d use and the experienced negative and positive effects of such use, and to analyze how conditions of work and structural and cultural factors in the workplace affect the a&d use of employees. Method: A total of 1 245 employees from 74 companies took part in the survey, giving a response rate of 34%. Given this low response rate, the sample was still considered representative, controlling for sex, age, industry, company size and geography. Results: 2.6% of the employees had used illegal drugs and 18% had used prescribed drugs the last year. 3% had used prescribed drugs each week. There were strong connections between illegal drug use and negative consequences for the workplace (absenteeism, accidents and intoxication at work), but it seemed that none of the workplace factors affected the use of illegal drugs. Extensive use of prescribed drugs was strongly connected to experiencing bad working conditions and high absenteeism. 95% of the employees had used alcohol the last year. Based on the answers about the amounts of alcohol consumed the last two weeks, 4% of the women and 5% of the men in the sample could be characterized as heavy drinkers (according to WHO gender-specific limit values). High alcohol consumption is shown to be correlated to negative effects such as absenteeism (only short-term), accidents and intoxication at work. Demographic factors such as sex, age, marital status and caring responsibilities played a lesser role in explaining the variation in drinking among employees in this sample, and especially the variation in work-related drinking. Neither did the conditions of work explain the variation in drinking. Instead, such factors as number of work journeys abroad, hours working outside the permanent worksite, norms and beliefs (especially beliefs about alcohol as a strategy for coping with work strain), offer explanations for the variation in drinking among employees. Conclusions: Alcohol and drugs use among employees is a twofold challenge to the working life. First, it is a challenge to prevent the negative effects of a&d use on the workplaces and the employees. Second, it is a challenge to prevent the many occasions for drinking in relation to work, and the structural and cultural factors in the workplace, from having a major negative impact on the alcohol and drug use of employees.

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