Alcohol and other drug use, psychological distress, and occupational functioning in Australian public safety personnel

Purpose This study aims to examine rates of severity of alcohol and other drug (AOD) use risk and psychological distress and their association with occupational functioning (absenteeism and presenteeism) among Australian public safety personnel (PSP). Design/methodology/approach An online self-assessment of AOD use risk was completed by 238 PSP between March 2024 and March 2025 as part of a pilot implementation trial of a PSP-tailored AOD use intervention. This study analysed cross-sectional baseline data from that trial. Rates and severity of AOD use risk (Alcohol, Smoking and Substance Involvement Screening Test) and psychological distress (K10+) were examined and a series of hurdle negative binomial regressions were used to examine their associations with absenteeism and presenteeism. Findings Moderate-to-high levels of alcohol use risk, other drug use risk and psychological distress were prevalent in the sample. Higher alcohol use risk [odds ratio (OR) = 1.03], other drug use risk (OR = 1.09) and psychological distress (OR = 1.14) were associated with increased odds of absenteeism. However, only psychological distress was associated with the frequency of absenteeism [incidence rate ratios (IRR) = 1.10]. For presenteeism, psychological distress was associated with both increased odds (OR = 1.11) and frequency (IRR = 1.06). Other drug use risk was associated with increased odds of presenteeism, particularly at lower levels of psychological distress. Neither alcohol nor other drug use risk was significantly associated with the frequency of presenteeism. Originality/value Findings show that psychological distress is the most consistent correlate of occupational impairment, while AOD use risk is associated with occupational impairment in ways that differ across contexts and substance classes.