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VALLEY HEALTH EMPLOYER SUMMIT 2014 Is my Employee Impaired? What Do I Do Now? Pamela Reiman, JD, MSW, CADC, CSAC Executive Director Bridging the Gaps,

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Presentation on theme: "VALLEY HEALTH EMPLOYER SUMMIT 2014 Is my Employee Impaired? What Do I Do Now? Pamela Reiman, JD, MSW, CADC, CSAC Executive Director Bridging the Gaps,"— Presentation transcript:

1 VALLEY HEALTH EMPLOYER SUMMIT 2014 Is my Employee Impaired? What Do I Do Now? Pamela Reiman, JD, MSW, CADC, CSAC Executive Director Bridging the Gaps, Inc. 423 West Cork Street Winchester, Virginia (540)

2 But, He Used to Be Such a Good Employee… Identifying Changes in Workplace Behavior that Signify a Potential Substance Use Disorder. Early Intervention is Key – Identify a problem before it can cause harm.  The earlier the intervention, the better the prognosis  Most often, the workplace is the last place that addiction manifests  ANYONE who uses substances in the workplace is of concern  The high cost of doing nothing – Action or inaction directly impacts the course of the illness  No one is immune – Addiction affects all walks of life and at all levels of the workforce o Construction, hospitality, warehousing and sales rank highest in incidence of substance abuse Avoid making any assumptions or judgments; keep it concrete and factual 2

3 Signs & Symptoms in the Workplace Physical Appearance Deterioration of hygiene, grooming, or dress Sudden weight gain or loss Bloodshot or glassy eyes Trembling or shaking Slurred speech Running nose, frequent sniffing Dilated or pinpoint pupils Behavioral Changes Shifts in personality (normally reserved, becomes talkative) Mood Swings  unusual irritability, withdrawn, depressed or particularly energetic Temper Outbursts Frequent text messaging or phone calls made in private Nervousness, fidgeting, paranoia Inconsistent energy levels ( energetic, then sluggish) 3

4 Signs & Symptoms in the Workplace Work Performance Increasing frequency of tardiness or calling in sick Inconsistent quality of job performance Increased incidence of mistakes in work or injuries on the job Loss of focus and concentration Conflicts with colleagues or customers – argumentative, uncooperative, accusative Money or property missing from the workplace Projects or tasks taking longer time to complete; extensions being requested more often Request for pay advances BE CAREFUL – Suspicion of Substance Use should NOT be presumed by a single event, sign, or symptom; But rather by a pattern confirming a significant change in behavior. 4

5 How Bad is Bad? What Does a Positive Urine Screen Mean? Substance Use Disorders – A Progressive Continuum Terminology – Variations with a Difference  Recreational/Social use ---  Abuse – Unreasonable use that causes harm or injury  Dependence – Compulsive or chronic need or active addiction to substance – New Diagnostic Manual -- “Small”, “Medium” or “Large” 5

6 Where do Urine Screens Fit In? Positive screen only indicates that an individual has the metabolites of a substance in their system Does NOT provide any indication of present impairment or when the substance was used Point of Care Testing – subject to false positives (10-30% depending upon manufacturer)  Consider confirmatory testing if using screen results as basis for adverse employment action 6

7 An Employer’s Choice - Reaction or Response Reaction: “Zero Tolerance” -- Positive Screen = Termination from Employment Punitive Model inconsistent with Disease Model “Bad employee” versus individual suffering from a treatable disease Risks to Work Force – Loss of Quality Employees, Morale, Productivity OR Response: Intervention towards Treatment and Rehabilitation The “Firm Choice” --Treatment as a Condition of Continued Employment Treatment does work and can be cost-effective  $1.00 spent on treatment saves $ o Improved quality of life, higher productivity, loyalty, morale 7

8 Beware of Common, but Unhealthy Reactions Denial & minimization Fear Lack of Knowledge and bias Enabling  “Turning a blind eye”  Making excuses, covering, trying to protect  Doing nothing – “Not my problem” 8

9 Any Employer Can React or Respond In Either Way; BUT Have a Plan Ensure you have a written policy to this effect  Stated Purpose of promoting workplace safety, health, and productive environment  Consider all applicable laws (consult with an attorney/union rep)  Clear statement of expectations, prohibitions and consequences Educate and inform the employees of the policy  Provide copy of policy  Obtain signature acknowledging employee has read and understood and received a copy Train the supervisors and managers as to the policy Document, document, document Maintain confidentiality and privacy Fair, Even-handed and Equitable Use confirmatory testing for positive screens, strict chain of custory, accredited labs, and certified medical review officers. Always make it about performance – OBJECTIVE, CONCRETE, & FACTUAL 9

10 When Concerned Enough to Consider Addressing Employee Substance Use – Seek Professional Help – Leave Diagnosing to the Experts Employee Assistance Programs & Mental Health Professionals  Starting Point – Bio-Psycho-Social Assessment for accurate diagnostic and treatment recommendations  Treatment Continuum o Individualized treatment plan based on least restrictive level of care o Proper client-treatment matching enhances success of outcome  Treatment Resources o EAP o Health Insurance with comprehensive SA treatment benefits o Community Resources o 12-Step/Self-Help programs Employer Safeguards if Employee is Retained  Return to Work Agreements  Routine Monitoring/Contract for Abstinence as condition of retention  Continuing Care Responsibilities  Performance Standards and Evaluations  Reasonable Accommodations 10

11 Legal Concerns Americans with Disabilities Act Discrimination and the Definition of Disability –  “In recovery” versus “current” user of “illegal substances” o What’s illegal? o What about alcoholics? o Limited protections against discrimination specific to those in “recovery”  Can you ask? Yes, to questions of use No, to abuse, addiction or previous treatment o It’s all in the timing  Definition of “current” is “recently enough” to reasonably believe that drug use is an ongoing problem  What if employee decides to seek treatment prior to adverse employment action? 11

12 Legal Concerns (continued) Prescription Medication  Can you ask? o Only if employee is acting in a way that compromises safety or suggests they cannot perform job for a medical reason. o “Reasonable belief”  Medically Prescribed medications may have the potential for impairing performance  Slippery slope -- When a drug test of an applicant may become a “medical examination” 12

13 Legal Concerns (continued) Family Medical Leave Act Up to 12 weeks unpaid leave in a 12-month period for conditions defined as “serious health condition” Leave must be taken in order to receive treatment by a health care provider Does not prohibit employer from taking adverse employment action for violations of stated policies Does not require employer to allow opportunity for treatment and reinstatement 13

14 It is an Employer’s Choice. But Through Simple Steps and a Sense of Compassion, the Course of an Individual’s Addiction can be Positively Altered and Health and Productivity Restored. What We Cannot Afford, Is the Cost of Doing Nothing 14

15 RESOURCES Regional Resources Alcoholics Anonymous (540) – Blue Ridge AA Hotline A 12-Step mutual support group for alcoholics. Call for meetings in the Blue Ridge area. Alanon/Alateen A 12-Step mutual support group for family and friends of alcoholics. Blue Ridge Counseling Center (540) Private counseling on range of issues. One counselor specializes in alcoholism. Boxwood Treatment Center (540) ext Boxwood Recovery Center is a residential alcohol and other drug treatment program. *Must first be prescreened by the Community Services Board in the area of residence. The CSB will refer the client to Boxwood for admission. 15

16 RESOURCES Regional Resources (continued) Bridging the Gaps (540) or (866) Integrative alcohol and drug addiction treatment program. Residential, outpatient, and support group programs. Provide licensed substance abuse treatment. Celebrate Recovery (Support Group) (540) A Christian-based recovery program using 12-steps to help with all kinds of addictions. Meetings are held at Winchester Church of God. Council on Alcoholism (540) (24/7) Residential 30+ day Halfway House program for recovering substance abusers that have completed a treatment program. Eastridge Health Systems (304) Outpatient substance abuse treatment including Suboxone and Adult Outpatient Services. Martinsburg, West Virginia. 16

17 RESOURCES Regional Resources (continued) Edgehill Recovery Retreat Center (540) Residential Recovery Retreat Center – provides supportive housing and facilitated introduction into the 12-Step recovery program. Northwestern Community Services Board (800) Offers an array of outpatient, case management, day support, residential and emergency programs that are designed to enhance the quality of life for both children and adults affected by emotional/behavioral disorders, mental illness, and substance use. Old Dominion ASAP – Alcohol Safety Action Program (540) Provides probation, education, and rehabilitation of those charged with or convicted of driving under the influence of alcohol and/or drugs, and/or first offense drug possession. Shenandoah Community Health (304) Outpatient substance abuse and mental health services in Martinsburg, West Virginia. 17

18 RESOURCES National Helplines The Workplace Helpline of the Center for Substance Abuse Prevention (CSAP) U.S. Department of Health and Human Services WORKPLACE Free consultation and advisory service for employers and union representatives wishing to learn about workplace substance abuse programs. Provides sample policies, lists of certified laboratories, and other materials, including a free kit for employers, “Making Your Workplace Drug Free” National Clearinghouse for Alcohol and Drug Information (English and Spanish) (TDD) Clearinghouse offers free of charge or at very low cost more than 10,000 educational and informational items on alcohol and other drug abuse, including pamphlets, books, posters, videotapes for both employers and employees, and a computer disk version of the U.S. Department of Labor’s Substance Abuse Information Data Base, giving information on workplace programs. Drug information, Treatment and Referral Hotline of the Center for Substance Abuse Treatment (CSAT) U.S. Department of Health and Human Services HELP This hotline provides free information, advice, and local referrals for substance abuse treatment nationwide. 18

19 RESOURCES National Organizations Employee Assistance Professionals Association 101 Wilson Boulevard, Suite 500 Arlington, VA (703) Can provide referrals to employee assistance professionals and information on EAPs and substance abuse. National Drugs Don’t Work Partnership/Community Anti-Drug Coalitions of America 901 North Pitt Street, Suite 300 Alexandria, VA (703) This public-private coalition of business, labor, and national, state and local prevention groups helps businesses seeking EAP and drug-testing consortia and provides other services. U.S. Department of Transportation Office of the Secretary Drug Enforcement Program and Program Compliance 400 Seventh Street, SW, Room Washington, DC DRUG or (202) 366-DRUG Provides information about Department of Transportation regulations on drug abuse. 19


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