6

After an Alcohol, Other Substance Misuse, or Sexual Misconduct Incident

The previous two chapters in this report examined steps to be taken before setting sail to prevent alcohol and other substance misuse and sexual misconduct, as well as policies and programs that are applicable while onboard. This chapter focuses on policies and programs needed after an incident has taken place.

The committee defined an incident as an occurrence of alcohol or other substance misuse or sexual misconduct. When considering substance misuse, an incident would involve any use that is not in line with laws or company policies and does not require any specific consequences (e.g., property damage, physical injuries) to have occurred to be counted. Near misses involve situations in which sexual misconduct or substance misuse was likely to occur but did not (e.g., a bystander intervened).

When operational incidents or other adverse events occur in high hazard industries, it is crucial that response efforts after the incident are timely and systems-oriented. Investigations, reviews, and resultant corrective and preventive action plans ought to reflect several fundamental objectives: (a) to understand what happened and how it happened; (b) to identify what active and latent conditions, including relevant socio-technical hazards, may have contributed to the undesirable outcome; (c) to identify the systemic changes required to prevent recurrence; and (d) to empower, support, and/or hold accountable (as appropriate) the people involved in the incident during the response process and following their return to work.

This chapter will review several elements of effective response: reporting (including confidentiality and amnesty), prevention of retaliation,

investigation, accountability, and support for mariners identified during an investigation to have a substance use disorder.

REPORTING: CONFIDENTIALITY

Evidence and Best Practices

Across some community samples, disclosure of incidents of sexual misconduct to formal support entities—including police and educational or occupational personnel who can investigate or take action to address the incident—is significantly less common than disclosure to informal supports (e.g., family, friends, significant others; Dardis et al., 2018; Ullman, 2023). Among women veterans who experienced military sexual trauma, a wide range of barriers to disclosure to formal military supports were identified, including the reporting system being too complex, not having adequate training or knowledge of how to make a report, not having access to women to report to, the recipient of the report being too close to the survivor’s chain of command, concerns about negative impacts on their career, concerns about being treated differently by peers, and concerns that reporting would not result in any positive benefits (Dardis et al., 2018). Many of these barriers are, at least in part, related to concerns about confidentiality of the report (Dardis et al., 2018). As a result, considerations related to confidentiality are particularly relevant to reporting likelihood in any system.

Mariners have two reporting options to the U.S. Coast Guard for sexual assault (U.S. Coast Guard, n.d.). One option is to file an unrestricted report, which means that the individual is not requesting that the allegation remain confidential. When an unrestricted report is made, the individual who experienced the sexual assault can receive “medical treatment, advocacy services, legal support, and eligibility for expedited transfer” (U.S. Department of Homeland Security & U.S. Coast Guard, 2019).

Furthermore, if the victim experiences retaliation related to making a report, the retaliation can also be reported. The second option is for a victim to file a restricted report, which allows confidentiality of reporting and does not trigger an investigation. Victims who file a restricted report can receive “legal advice, medical treatment, and advocacy services.” Having multiple reporting options allows survivors to have some level of control over the reporting process, which is in line with recommendations for sexual misconduct reporting and a trauma-informed approach.

Title IX (Education Amendments Act of 1972, 2018), which prohibits sex-based discrimination in federally funded educational programs, has been clarified to require educational institutions to take action when they are informed of sex discrimination, including sexual assault (Ali, 2011;

Lhamon & Gupta, 2014). As a result, many colleges and universities have implemented compelled disclosure policies, which require most or all university employees to report knowledge of sexual misconduct to university officials (Holland et al., 2018). Assumptions underlying these policies include that more sexual violence will be reported and identified and that these policies benefit survivors, employees, and institutions. However, to date, research on mandatory reporting to police has resulted in mixed findings regarding whether more sexual violence is identified, and research has yet to demonstrate that compelled disclosure policies result in “more (or less) successful investigation and adjudication of sexual assault” on college campuses (Holland et al., 2018, p. 261). Furthermore, there is little evidence to support assertions that survivors, employees, and even institutions benefit from these compelled disclosure policies (see Holland et al., 2018, for a review). Importantly, concerns exist that these policies do not allow university employees who are told about sexual misconduct to comply with survivors’ preferences regarding further disclosure of the sexual misconduct, meaning even if a survivor does not want the incident reported to the Title IX office, the employee has to report the incident (Holland et al., 2018), limiting confidentiality for survivors. Survivors of sexual misconduct experience a significant loss of control due to these incidents. Therefore, giving them control over reporting can be particularly important and aligns with a trauma-informed approach.

Current Policy and Practice

According to 46 U.S.C. § 10104(a) (2023), responsible entities (i.e., “an owner, master, or managing operator of a documented vessel engaged in commercial service or the employer of a mariner on such a vessel”; 46 U.S.C. § 10104(g), 2023) must report any complaints or known incidents of sexual misconduct to the U.S. Coast Guard. Additionally, the U.S. Coast Guard will accept reports of sexual misconduct on U.S.-flagged ships from any individual. Furthermore, 46 U.S.C. § 11101 (2023) requires that company policies on sexual misconduct, reporting options for sexual misconduct incidents, and response steps for such incidents are posted in crew berthing areas.

Beyond these universal requirements, the Every Mariner Builds A Respectful Culture (EMBARC) standards require that Cadets meet with the vessel’s sexual misconduct contact¹ before or within 48 hours of embarkation and

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¹ Each vessel operator is required to designate a primary contact for all sexual misconduct cases (SASH Contact). “The SASH Contact must have completed the free 40-hour Victim Assistance Training Online provided by the Office for Victims of Crime Training & Technical Assistance Center, and received the Certificate of Completion, or have completed an equivalent training program” (MARAD, n.d.).

confirm that Cadets are able to communicate with the sexual misconduct contact while on the vessel to facilitate reporting. Furthermore, EMBARC standards require vessel operators to report incidents of sexual misconduct to the U.S. Merchant Marine Academy (USMMA) that occur when Cadets are onboard, even if the incident does not involve the Cadet.

Similar to Title IX compelled disclosure requirements, reporting requirements in the maritime industry do not give the survivor control over whether a report moves forward to the U.S. Coast Guard. As a result, some individuals may be hesitant to report sexual misconduct to anyone who would need to make a report to the U.S. Coast Guard or any other entity (e.g., shipping company owner) that is not permitted to keep the report confidential. This lack of reporting limits access to an understanding of the prevalence of the problem and the development of resources to support survivors.

Organizations such as Seamen’s Church Institute and Women Offshore help provide mariners with access to chaplains, mentorship, and a helpline, all of which can receive confidential disclosures of sexual misconduct. Furthermore, national resources available to the broader community, such as the Rape, Abuse and Incest National Network,² the Crisis Text Line,³ and the National Sexual Violence Resource Center,⁴ are other avenues from which mariners can seek help confidentially. While access to these agencies and resources may be relatively easy when ashore, access to these resources while at sea requires reliable phone and internet connections.

Analysis

The U.S. Coast Guard has a restricted report option that protects confidentiality and allows survivors to choose not to have the incident investigated, which may encourage reporting, provide access to certain services, and allow for better tracking of the prevalence of sexual misconduct.

Conclusion 6-1: There is a tension between the desire to investigate all cases of sexual misconduct and respect for the preferences of survivors. The best way to appropriately balance these issues is still to be determined in multiple contexts, including military and higher education.

REPORTING: AMNESTY

One barrier to reporting addressed on college and university campuses is the concern that the victim may be sanctioned for violations of campus

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² https://rainn.org/

³ https://www.crisistextline.org/

⁴ https://www.nsvrc.org/

substance use policies if they report a sexual misconduct incident (Karjane et al., 2002). In order to address these concerns, some campuses have implemented amnesty policies in which reporters of sexual misconduct (including victims and witnesses/bystanders) will not be sanctioned for substance use violations that occurred during the incident (e.g., Virginia Tech, n.d.). Research has shown that campuses with these types of policies have created a culture in which the reporting of sexual misconduct incidents is more common than on campuses without these policies (Ellyson et al., 2023).

The Safer Seas Act (2022; 10 U.S.C. § 101) includes a provision that grants immunity from civil liability to individuals who report sexual misconduct from alcohol policy violations. In addition, as described in Chapter 2, the USMMA provides amnesty for Cadets reporting sexual misconduct during their Sea Year. However, there is no consistent amnesty approach across the industry. The U.S. Coast Guard itself initiated in 2024 a Safe to Report Policy that provides a level of amnesty for U.S. Coast Guard service members who report sexual misconduct.⁵ While complete amnesty may not always be possible, without some form of amnesty, reports of sexual misconduct will be hampered by concerns for the individual reporting and bystanders in the situation.

Conclusion 6-2: The approach to amnesty for reporting sexual misconduct is inconsistent across the maritime industry, even though this type of policy appears to increase reports of sexual misconduct. By virtue of its investigatory role, the U.S. Coast Guard is best placed to remedy this situation.

Recommendation 6-1: The U.S. Coast Guard should develop a model amnesty policy for individuals reporting alcohol and other drug use and sexual misconduct, which should be considered for broad adoption in the maritime industry.

PREVENTION OF RETALIATION

Retaliation occurs when disparate treatment or negative actions occur after the report of an incident (Honorée et al., 2024), such as sexual misconduct or alcohol and other substance misuse. Employees who voice opposition to harassment often experience both social- and work-related retaliation, which in turn exacerbates negative professional and psychological outcomes (Cortina & Magley, 2003). Among women who experienced military sexual trauma, concerns about negative impacts on their career and

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⁵ https://content.govdelivery.com/accounts/USDHSCG/bulletins/38828d2, and https://www.mycg.uscg.mil/News/Article/3691069/take-a-closer-look-at-the-coast-guards-safe-to-report-policy/

concerns about being treated differently by peers were noted as barriers to reporting their military sexual trauma (Dardis et al., 2018). Furthermore, a review of research on harassment and fears of retaliation against surgical residents revealed that concerns about retaliation impede reporting (Gianakos et al., 2022). Experiences of retaliation reduced willingness to report future maltreatment in a sample of mandated reporters (Sippel et al., 2023). Together, these studies underscore the importance of addressing concerns about retaliation and preventing retaliation behaviors to encourage reporting of incidents, including sexual misconduct and alcohol and other substance misuse.

Current approaches to reducing both actual and feared retaliation have been implementing non-retaliation policies that reflect legal requirements along with individualized anti-retaliation plans when reports are filed—to help the reporter experience agency in their subsequent experiences and to help the accused have a concrete understanding of their expected behavior; however, institutions also have the capacity to move beyond minimal compliance by broadening definitions of adverse actions and protected activities and by explicitly communicating these policies to foster trust and encourage reporting (National Academies, 2023a).

Laws that prohibit discrimination based on various factors (e.g., sex, gender, race, ability status) in the workplace (e.g., Title VII of the Civil Rights Act of 1964) also prohibit retaliation (Honorée et al., 2024). However, these laws focus on employer actions, and therefore, concerns about retaliation or disparate treatment from supervisors or other co-workers are not adequately addressed by these laws. The Safer Seas Act (46 U.S.C. § 11101, 2023) and CVC Policy Letter 23-04 (U.S. Coast Guard, 2023a) require that vessels post a policy prohibiting retaliation, but specifics regarding what may be included in these policies is not provided.

Conclusion 6-3: In order to increase the likelihood of reporting incidents of sexual misconduct and alcohol and other substance misuse, mariners need to know that they are protected from retaliation.

Recommendation 6-2: The U.S. Coast Guard should provide model policy language and require reporting from vessel companies about their retaliation policies.

INVESTIGATION

Evidence and Best Practices

A trauma-informed approach to investigation is recognized as a best practice response to the misuse of alcohol and other substances and incidents of sexual misconduct. Most adults will have experienced some kind of potentially traumatic event in their lifetime (Benjet et al., 2016), and it is well documented that people who have experienced trauma use substances at higher rates than the general population. For example, people who have experienced four or more adverse childhood experiences (ACEs)⁶ are 2.2 times more likely to smoke, 7.4 times more likely to have an alcohol use disorder, 4.7 times more likely to use drugs, and 10.3 times more likely to inject drugs (Felitti et al., 1998). People with post-traumatic stress disorder (PTSD) are two to three times more likely to have a substance use disorder than people without PTSD (Dell’Aquila & Berle, 2023; Kessler et al., 1995). Box 6-1 highlights the Substance Abuse and Mental Health Services Administration’s (SAMHSA) definition of trauma.

The maritime industry is a high-risk work environment that introduces an increased likelihood that workers will experience traumatic events including accidents and incidents of sexual misconduct. One study reported that nearly 36% of the mariners interviewed experienced a shipwreck or serious accident, 17% experienced serious robbery or piracy, and 39% reported experiences with stowaways (Jensen & Oldenburg, 2019). Another study found that the mortality rate in the maritime workplace was 27.8 times higher than other workplaces in Great Britain (Roberts & Marlow, 2005). While these numbers may not be generalizable to the entire maritime industry given its heterogeneity, many individuals exposed to trauma experience short-term impacts (e.g., sleep difficulties, fear/anxiety, sadness, irritability; Bonanno & Mancini, 2012; Galatzer-Levy et al., 2018), which may impact a mariner’s ability to perform their work duties. In more severe cases, people may develop PTSD or meet criteria for other formal mental or physical health diagnoses (Norris et al., 2009).

In addition to traumatic events, other stressors can also impact mental health. Toxic work cultures (e.g., long work hours, bullying and harassment, lacking trust in colleagues and/or supervisors, discrimination) and ACEs can also result in the development of symptoms consistent with trauma (Chang et al., 2019; Kampling et al., 2022; Maguen et al., 2009).

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⁶ ACEs are traumatic events that happen before age 18 including physical, sexual, or emotional abuse, neglect, parental separation and divorce, domestic violence, and substance use and mental illness in the home.

Given this, it is essential that investigations throughout the maritime industry (e.g., major safety incidents, incidents of sexual misconduct, the misuse of alcohol and other substances) are trauma informed.

SAMHSA introduced the Trauma-Informed Approach in 2014 (Substance Abuse and Mental Health Services Administration, 2014). In their Concept of Trauma and Guidance for a Trauma-Informed Approach, SAMHSA defined trauma, introduced the three Es of trauma (event, experience, and effects), the key assumptions (the four Rs), and six key principles of a trauma-informed approach.

For a response, program, organization, or system to be trauma-informed, an organization and the people involved with incident investigation must (a) realize the widespread impact of trauma and understand potential paths for recovery; (b) recognize the signs and symptoms of trauma in the people involved within the system; (c) respond by fully integrating knowledge about trauma into policies, procedures, and practices; and (d) seek to actively resist re-traumatization (Substance Abuse and Mental Health Services Administration, 2014, p. 9). A trauma-informed system builds on the best available evidence to support recovery and resilience and integrates the six key principles: (a) safety; (b) trustworthiness and transparency; (c) peer support; (d) collaboration and mutuality; (e) empowerment, voice and choice; and (f) cultural, historical, and gender issues.

These principles have been translated to the maritime industry in the Ship Operations Cooperative Program in a Best Practices Guide on the Prevention of and Response to Sexual Harassment & Sexual Assault in the U.S. Merchant Marines. This guide discusses the creation of a trauma-informed sexual misconduct policy and response plan as one of the top management/company best practices (Ship Operations Cooperative Program, 2024).

This document defines a trauma-informed approach: “Using methods that consider the feelings and difficult experiences of people who have been through trauma, such as understanding how common trauma is and how it can affect a person’s body, relationships, behaviors and emotions” (Ship Operations Cooperative Program, 2024, p. 75). It further notes that “shifting the culture within maritime workplaces means recognizing that these workplaces need to be sensitive to the needs of those who have experienced trauma” (Ship Operations Cooperative Program, 2024, p. 92). The document defines that “trauma-informed approaches describe approaches delivered with an understanding of the vulnerabilities and experiences of trauma victims, including the physical, social, and emotional impact of trauma” (Ship Operations Cooperative Program, 2024, p. 93).

Specific to the guiding principle of empowerment, voice, and choice, the Ship Operations Cooperative Program Best Practices Guide highlights the importance of “placing a survivor’s needs and interests at the center of the response and accountability processes. Survivor-centered approaches

seek to avoid retraumatizing victims/survivors and place a systemic focus on their safety, well-being, choices, needs, and rights. On an organizational level, a survivor-centered approach centers on those most impacted by the harm and ensures they are considered at every stage of the prevention, response, and accountability processes. It is also meant to empower those who may feel they have lost power, with information and choices” (p. 93).

Predictability is crucial to providing a trauma-informed investigation process, which “means providing as much information about the reporting and investigation process as possible” (Ship Operations Cooperative Program, n.d., p. 99). Another way to be trauma-informed is to have a clear policy that outlines for everyone what can be expected during the investigation process. Executing these policies with consistency is important to support the trauma-informed principles of safety, trustworthiness, and transparency.

The integration of trauma-informed principles also helps prevent institutional betrayal and promote institutional courage. Institutional betrayal refers to “institutional action and inaction that exacerbate the impact of traumatic experiences” (Smith & Freyd, 2014, p. 577). While institutional betrayal can occur prior to an incident (e.g., not taking actions to minimize the risk of sexual misconduct and the misuse of alcohol and other substances in our context), it also includes responses to reports of sexual misconduct and the management of chronic health concerns, including the misuse of alcohol and other substances (Smith & Freyd, 2014).

Responding in a punitive manner to reports of sexual misconduct or substance misuse (e.g., reprimanding and blaming the survivor of sexual misconduct or the person struggling with the misuse of alcohol or other substances), not adequately responding to a report of sexual misconduct (e.g., not investigating, trying to cover up the incident, not implementing protections for the survivor), and company policies or leadership that encourage the use of alcohol or other substances are all examples of institutional betrayal (Smith & Freyd, 2014). Experiences of institutional betrayal are associated with poorer psychological and physical health among trauma survivors (see Christl et al., 2024, for a review).

In contrast, “[i]nstitutional courage is the opposite of institutional betrayal—it is accountability, transparency, actively seeking justice, and making reparations where needed” (Smidt & Freyd, 2018, p. 494). Experiences of institutional courage have been shown to reduce negative outcomes of workplace sexual harassment (Smidt et al., 2023). Therefore, it is important that companies and the broader industry implement policies and procedures that are supportive of survivors when they receive reports of sexual misconduct or the misuse of alcohol and other substances.

Colleges and universities offer a reference point for investigating

incidents involving alcohol and other substance misuse and sexual misconduct. In the United States, these academic institutions are required to have policies and procedures in place to guide investigations of sexual misconduct under Title IX of the Education Amendments of 1972 (2023). Under these requirements, schools are assigned the burden of gathering evidence and the burden of proof for complaints of sexual misconduct (U.S. Department of Education, n.d.). By placing this burden on the school, survivors can contribute evidence but are not assigned responsibility for gathering all evidence, which is consistent with a trauma-informed approach.

Finally, under Title IX, both survivors and accused individuals are allowed to have an “advisor,” who can, but does not have to, be an attorney who can accompany them to interviews, meetings, and hearings. The presence of an advisor is consistent with a trauma-informed approach, as it provides access to support, which may increase the survivor’s sense of safety during the investigation and resulting processes.

Current Policy and Practice

After a marine casualty or other safety incident, the U.S. Coast Guard’s Marine Investigation Board conducts an investigation to gather facts, evaluate evidence, determine causal and contributory factors, and identify safety recommendations such as policy adjustment, regulatory changes and/or other corrective actions. As part of this effort, investigators assess whether there is evidence:

Marine casualty investigations are conducted in cooperation with the National Transportation Safety Board, as applicable. There is no specific provision in this process for a trauma-informed approach.

With respect to reports of sexual misconduct, the investigation is led by the U.S. Coast Guard Investigative Service (CGIS). While the U.S. Coast Guard notes a commitment to “investigating and pursuing appropriate enforcement actions for all reports” (U.S. Coast Guard, 2023b) and the Safer Seas Act details specific information that must be made available for investigations when requested, specifics about what these investigations involve and how they are conducted is limited. The U.S. Coast Guard may refer cases on to the Department of Justice for further investigation (U.S. Coast Guard, 2023b). Furthermore, based on the available information, it

does not appear that the U.S. Coast Guard provides recommendations to companies about whether or how to conduct their own investigations of sexual misconduct alongside the CGIS investigation.

With respect to trauma-informed approaches in the investigation, the EMBARC program requires that “interviews be conducted using trauma-informed interview methods, which includes asking questions of an individual who has survived sexual assault, sexual harassment, relationship violence, or stalking in a manner that is focused on the experience of the victim-survivor, does not judge, or blame the victim-survivor, and is informed by evidence-based research on the neurobiology of trauma” (U.S. Department of Transportation, n.d.). There are no requirements for adoption of a trauma-informed approach beyond ships required to participate in the EMBARC program.

Analysis

Investigation procedures in line with a trauma-informed approach, such as allowing survivors control over the investigation process when possible and allowing individuals access to an “advisor,” are best practice for conducting these investigations. However, aside from EMBARC’s requirements on interviews for survivors of trauma, there is little required or understood about their use in the maritime field. The recently released best practices guide from Ship Operations Cooperative Program is an excellent starting place for deeper engagement with these approaches.

Conclusion 6-4: The maritime industry has high rates of trauma exposure due to the nature of the work and the inherent workplace stressors. A trauma-informed approach to incident response has been identified as best practice; its application would reflect the unique context of the mariner’s workplace system and would facilitate improved trust and openness to future reporting, enhance evidence gathering, and support system safety and operational readiness.

Recommendation 6-3: The U.S. Coast Guard should require training for Service personnel responsible for responding to alcohol and other substance misuse, or sexual assault maritime incidents, from initial investigation and reporting through administrative or other subsequent mariner proceedings. Training should cover how to apply a trauma-informed approach to investigations and the entire response process.

ACCOUNTABILITY

Evidence and Best Practices

Proper investigation of incidents will reveal events, behaviors, human factors, and organizational factors in need of adjustment. Related to human factors, the best practice is for policy violators to be pointed toward rehabilitative support, as discussed in more detail below. Accountability is necessary alongside rehabilitative support; both need to happen simultaneously for best outcomes related to mariner well-being and workplace culture.

Accountability should be based on the seriousness of the incident and, when it is progressive in nature, proportionate with the nature of the violation. In cases of the most serious policy violations (e.g., sexual assault, criminal prosecution, alcohol or other substance-related incidents that cause injury) termination must be considered and adjudicated through the proper legal systems; when alcohol or another substance is part of the violation, referral to support is still warranted.

It is recommended that companies establish a clear and proactive reporting policy for even minor safety incidents (National Maritime Occupational Health and Safety Committee, 2025). Whether a mariner self-discloses an alcohol or other substance-related challenge must also be taken into consideration. For example, a first violation may result in a written warning and review of the policy with a referral to the employee assistance program (EAP). However, if a person self-discloses recognition of the policy violation, a referral to the EAP alone may be appropriate. Any additional violations must also be documented and likely result in a referral to a credentialed Substance Abuse Professional (SAP) for assessment with further accountability aligning with the recommendations of the SAP’s evaluation. When these behaviors impact the mariner’s ability to perform their duties or put themselves or others in danger, a period of leave to focus on treatment and recovery or termination may be appropriate.

Accountability for leaders as well as perpetrators is crucial to promoting a positive reporting culture. Responsibility for vessel conduct falls on the vessel’s owners and operators who must be held to a higher standard Vessel Captains have an obligation to recognize that incidents that happen on their watch reflect poorly on their leadership. Their ability to lead vessels without such incidents need to, at a minimum, factor into their evaluations and consideration for promotion.

Current Policy and Practice

Mariners who violate regulations on alcohol and other substance use or sexual misconduct are subject to penalties from their companies, the U.S.

Coast Guard, and law enforcement. Companies can choose to fire mariners in violation of policy related to alcohol and other substance use or sexual misconduct, but without action by the U.S. Coast Guard, these mariners may still be able to find alternate employment in the industry.

The U.S. Coast Guard applies a range of administrative actions to those who have violated maritime regulations following the investigation of a safety incident. The administrative actions, which “are remedial and not penal in nature” (see 46 C.F.R. § 5.5, 1985⁷), include suspensions or revocations of mariner credentials. As outlined in Chapter 3, penalties vary according to the severity of the incident, and investigators can arrest suspects and refer matters to the U.S. Attorney’s Office for prosecution in federal district court.

As outlined in Chapter 2, some penalties apply to a vessel’s owners and operators. For example, an owner who knowingly fails to make a report about sexual misconduct to the U.S. Coast Guard or subsequently submit a required report can face civil penalties, with the U.S. Coast Guard having subpoena and audit authority to enforce this requirement. More generally, the U.S. Coast Guard can also levy fines and even impound a vessel if in violation of regulations, including regulations on alcohol or other substance testing.

However, there are questions about the status of enforcement. As of April 2, 2025, no Safety Management System audits had been initiated by the U.S. Coast Guard related to alcohol and other substance use, and only one Safety Management System audit for sexual misconduct was initiated after a company improperly handled a report of sexual misconduct and an internal investigation.⁸

Analysis

In contrast to the penalties available for mariners and owners and operators, the committee is not aware of specific penalties for vessel Captains, who play an important role in setting the safety environment for the vessel.

Conclusion 6-5: Accountability is important for violations of standards for alcohol and other substance use and sexual misconduct.

Recommendation 6-4: The U.S. Coast Guard should strengthen the system of accountability, particularly for vessel Captains and senior

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⁷ https://www.ecfr.gov/current/title-46/chapter-I/subchapter-A/part-5

⁸ U.S. Coast Guard, Personal Communication, April 21, 2025. https://www8.nationalacademies.org/pa/managerequest.aspx?key=DBASSE-BBCSS-23-02

shipboard and shoreside leadership, regarding alcohol and other substance misuse and sexual misconduct safety incidents.

SUPPORT FOR PEOPLE WITH SUBSTANCE USE DISORDERS

Evidence and Best Practices

Workplace alcohol and other substance policy violations in safety-sensitive industries can be indicative of a significant substance use disorder. If untreated, these chronic conditions can have severe and even fatal consequences. As a result, a best practice for responding to a violation for substance use is referring the individual to an assessment and, as appropriate, effective treatment.

Treatment in this context can include interventions to address underlying causes of substance use. These may include learning strategies for coping with pain, managing lasting impacts of trauma or other high-stress experiences, working through insomnia or fatigue, and managing symptoms of depression and anxiety that commonly co-occur with substance use disorders (Koob et al., 2023). In occupational settings, this can also involve strategies for addressing pain from workplace injuries, processing workplace trauma and its psychological effects, or managing stress related to job demands and the living environment.

One approach is to refer individuals to a U.S. Department of Transportation (DOT)-certified SAP for evaluation and recommendations. This referral can be through the EAP discussed in Chapter 5 or directly to a SAP, which is a credential provided by the DOT to someone appropriately trained and prepared to “function as to protect the public interest” (U.S. Department of Transportation, 2024).

A more comprehensive approach, found in other safety-sensitive industries—including aviation, health care, railroad, and law—is to utilize a professional health program (National Academies, 2023b). Professional health programs encourage their participants to seek evidence-based addiction treatment at approved treatment facilities, expect total abstinence from alcohol and other substances, regularly monitor participants through formal alcohol and other drug testing for a period of 1–5 years, encourage participation in peer fellowship support, and work with the participant and often their employer to get people safely back to work. Professional health programs function best when the participants’ confidentiality is maintained in treatment. In some cases, these programs can serve as an alternative to disciplinary action.

People in recovery returning to the workplace face challenges; however, companies and industries can make this transition easier by working with addiction professionals to structure the return to work in a way that will allow the individual to continue to prioritize their needs in recovery and

safely do their job. This return-to-work process can be part of a “recovery ready workplace” which is a more comprehensive set of policies to support people with chronic substance use disorders (Substance Abuse and Mental Health Services Administration, 2024).

Current Policy and Practice

At least one oil and gas company has policies that encourage self-reporting and support rehabilitation. Suncor offers a Care and Concern Program. As described to the committee by Sylvie Tran on September 12, 2024,⁹ Suncor rarely has positive tests results due to the combination of its Detection and Deterrence Program and Care and Concern Program. For mariners working in its offshore program, Suncor has designed a system that allows for a single point of entry. Its check-in personnel are trained to identify signs of concealment, impairment due to substances, and mental health concerns. A canine team is also present, and ion scans are used to detect the presence of substances. Supply vessels introduce greater vulnerability, but Suncor maintains random canine searches of these vessels and a single point of entry. Suncor’s Care and Concern Program can be accessed in two ways: through self-report and in response to a positive drug test. Mariners in the Care and Concern Program are encouraged to participate in an inpatient treatment program that addresses co-occurring substance use disorders and other mental health disorders. Participation in the Care and Concern Program lasts two to three years, based on how the employee entered the program; those who self-report can complete this program more quickly. This approach was implemented to help encourage self-reporting. As stated by Suncor’s Vice President of Operational Risk Management, “In the era of labor shortages we lose viable workers if we go straight to termination or banning. And, really, it’s around how do we support our employees.”

Some industries will also use what is called A Last Chance Agreement as part of the return-to-work process. It is a provision within the Americans with Disabilities Act that can only be used for people with alcohol and other substance use disorders (Harrison, 2020). Essentially, it is an agreement between the employee and the employer that outlines the expectations for continued employment—these agreements commonly include that the employee will complete treatment and comply with alcohol and other drug testing to maintain their employment.

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⁹ To watch the recording of the discussion, see https://www.nationalacademies.org/event/43129_09-2024_prevention-mitigation-and-response-to-alcohol-misuse-and-related-incidents-in-the-commercial-maritime-industry

This rehabilitative approach is especially relevant in the maritime industry, given the critical shortage of mariners and the strong evidence base that people with substance use disorders can often safely return to work with proper treatment and support. Furthermore, being gainfully employed is a protective factor for people in recovery.

Analysis

The number of specialized assessment and addiction treatment programs for mariners is limited, but mariners identified as having a potential substance use disorder would benefit greatly from evidence-based addiction treatment. As discussed in Chapter 5, while companies are required to have basic EAP, there are no requirements for referral to treatment following identification of substance misuse.

Conclusion 6-6: The maritime industry faces persistent challenges with inconsistent substance use policies despite being a safety-sensitive environment. Unlike other industries that have long adopted evidence-based support programs recognizing addiction as a treatable condition, maritime has yet to fully embrace this approach. Acknowledging substance use disorders as chronic, relapsing brain conditions—and integrating support alongside accountability—can reduce stigma, enhance safety, and improve mariner well-being.

Recommendation 6-5: The U.S. Maritime Administration, working with the U.S. Coast Guard, maritime employers, and mariner unions, should support the establishment of a support and response network, which would provide resources, independent expert advice, support and referrals to professional services for mariners impacted by sexual misconduct, alcohol and other substance misuse, and other mental health conditions. This network should also include a formal professional health program, a Mariner Assistance Program for all mariners modeled on best practices from other safety-sensitive industries.

REFERENCES