1. Presented by Lisa Shields March 2016 1

2. Regulation History and Overview 49 CFR Part 655 Key Components Types of Drug Testing allowed by DOT Difference between Reasonable Suspicion vs. Random testing Job Performance Symptoms Drugs of Abuse Who can make a decision to direct employee in for testing Administrative Requirements Best Practices Resources Available March 2016 2

3.  Designated Employer Representatives (DER)  Drug & Alcohol Program Manager (DAPM)  Safety Managers  HR Professionals  Dispatchers  Service Agents March 2016 3

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5.  Starting from the front please tell us your name and where you are from? March 20165

6.  This presentation is intended to inform and empower key decision makers in making “fair”, “reasonable” and “observable referrals.” March 2016 6

7. Why do we drug and alcohol test? March 2016 7

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9.  Do you have to be right without a reasonable doubt?  What if you’re wrong?  How do you face the employee if employee turns out to be negative?  What are the repercussions? The truth is …… March 2016 9

10.  You are not making determinations based on anything other than observable indicators that will be covered today. March 2016 10

11.  Pre Employment  Random  Post Accident  Reasonable Suspicion  Return to Duty  Follow Up March 2016 11

12.  Random Testing vs. Reasonable Suspicion Testing  Un-announced testing  Serves as a deterrent  Serves as form of detection Major difference is what? March 201612

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14.  655.45 Mandatory requirement to test a specific percentage of your DOT employee pool at the minimum annual percentage rate 2016 – 25% Drug and 10% Alcohol March 201614

15.  655.43 The employer shall conduct a drug and/or alcohol test when the employer has reasonable suspicion to believe that a covered employee has used a prohibited drug and or engaged in alcohol misuse. March 201615

16. ◦ A supervisor(s), or other company official(s) who is trained in detecting the signs and symptoms of drug use and alcohol misuse must make the required observations. ◦ Only one trained supervisor or company official is required. March 2016 16

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18.  By performing Reasonable Suspicion testing who are we protecting? a) Transit Agency b) Employee c) Employer d) Traveling Public e) All of the above March 2016 18

19.  Reasonable suspicion testing: 1. You may conduct a drug and/or alcohol test when you have reason to believe that an employee has used a prohibited drug and/or engaged in alcohol misuse. 2. Your decision should be based on: Specific Contemporaneous Articulable Observations March 2016 19

20.  Reasonable Suspicion Checklist  Document occurrence(s) that led to decision to test  Where will you take employee to be tested  The “sit down” be prepared  Let’s get the keys and go March 201620

21.  An employer can only direct a covered employee to undergo reasonable suspicion testing while the employee is performing safety-sensitive functions; just before the employee is to perform safety-sensitive functions; or just after the employee has ceased performing such functions. March 2016 21

22.  If an alcohol test is not administered within two hours following the determination that reasonable suspicion exist, the employer shall prepare and maintain on file a record stating the reasons the alcohol test was not promptly administered.  If an alcohol test is not administered within eight hours following the determination that reasonable suspicion exist the employer shall cease attempts to administer an alcohol test and shall state in the record the reasons for not administering the test. March 2016 22

23.  Documentation is key March 2016 23

24. Cognitive: Pertaining to the mental processes of perception, memory, judgment, and reasoning Contemporaneous: Living or occurring during the same period of time; happening in the here and now Observations: An act or instance of noticing or perceiving. March 2016 24

25.  Peripheral vision: The capacity to see side or fringe areas when one is looking ahead  Visual acuity: Acuteness of the vision as determined by a comparison with the normal March 2016 25

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27.  Addiction March 201627

28.  Society of self medication  Coping mechanisms  Stresses  Poor self esteem  Family Problems  Finances March 201628

29.  Marijuana  Cocaine  Amphetamines  Opiates  PCP  Alcohol March 2016 29

30. Amphetamines & Opiates March 2016 30

31.  Type: Hallucinogen  Method of Use: ○ Smoked ○ Ingested in foods  Duration of High: ○ 30 minutes to several hours ○ “Typical” smoker experiences a high for approximately 2 hours March 2016 31

32.  Reddened, bloodshot eyes  Pungent aroma on clothes and body  Fatigue  Pupils may appear dilated  Slowed speech  Lack of motivation on the job  Irritating cough chronic sore throat  Talkativeness March 2016 32

33.  Normal  Pinpoint  Dilated March 2016 33

34.  Produces a mildly tranquilizing and mood altering effect  Cigarette papers  Roach clips  Small pipes made of bone to smoke  Blunts  Names on Street  Pot  Hash  Weed  Joint  Reefer  Acapulco Gold March 2016 34

35.  Delayed decision-making  Diminished concentration  Impaired short-term memory  Impaired signal detection  Distortions in time and distance estimation  Lengthened glare recovery & blurred double vision  Distorted visual & depth perception March 2016 35

36.  Decreased car handling  Decreased reaction times  Impaired distance estimation  Inability to maintain headway  Subjective sleepiness March 2016 36

37.  Type: Stimulant  Method of Use:  Oral  Snorted  Smoked  Injected  Duration of High:  5 minutes March 2016 37

38.  Runny or irritated nose  Constant sniffing  Broad mood swings  Excessive activity an appearance of excitability  Euphoric feeling, hyper excitability  Long periods without eating or sleeping  Talkative or nervous  Breath odor  Problems concentrating March 2016 38

39.  Energizes the entire central nervous system.  Single edge razor blade and mirror  Rolled up dollar bill  Half straw or metal tube  Folded paper packet  Glass pipes  Names on Street  Coke  Crack  Snow  Blow  Rock  Smoke March 2016 39

40.  Lapses in attention & concentration  Tendency to over react & overcompensate  Paranoia & withdrawal can create violent or aggressive behavior  Impaired motor coordination  False sense of alertness & skill  Wild mood swings create instability  Distorted vision March 2016 40

41.  Type: Stimulant  Method of Use:  Oral  Snorted  Smoked  Injected  Duration of High:  Several hours to 15 hours March 2016 41

42. March 2016 42 Talkativeness Confusion Rapid respiration Heightened aggressiveness Impulsive risk taking Runny/bleeding nose Increased heart rate, blood pressure Restlessness/Hyper excitability Dilated pupils

43.  Effects the central nervous system as a stimulant. Speeds up the mind and body  Counterfeit capsules  White flat  Granular powder or in lumps and packaged in aluminum foil  Names on Street  Meth  Speed  Crank  Black Beauties  Crystal  Ritalin  Rits March 2016 43

44.  Overestimation of performance capabilities  Delayed reaction time  Impaired coordination  Extreme mental & physical fatigue  Over-actions when driving such as: Over-braking Over-acceleration Over-steering March 2016 44

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46.  Type: Narcotic (Analgesic)  Method of Use:  Oral  Snorted  Injection  Duration of High:  Several hours March 2016 46

47.  Impaired alertness and mental function  Constricted pupils  Low raspy voice  Physical fatigue and drowsiness  Impaired coordination  Possible puncture marks (‘tracks”)  Nausea/vomiting  Excessive scratching and itching  Mood swings March 2016 47

48.  Are narcotics typically given by doctor’s to alleviate pain, depress body functions and reactions.  Pill form  Smoked  Injected  Names on Street  Smack  Horse Emma  Dollies  Juice  China White  Big D  Syrup March 2016 48

49. Poor concentration while driving Day dreaming Distorted vision and difficulty focusing on tasks Distorted sense of time and distance False sense of security and ability March 2016 49

50. Over prescribing Opiates  Communities are experiencing huge increase in Heroin usage  Decimating families  Resulting in over dosing across the nation  Death March 2016 50

51.  Type: Hallucinogen  Method of Use: ○ Oral ○ Snorted ○ Smoked ○ Injected  Duration of High: ○ Several hours to 24 hours March 2016 51

52. Impaired coordination, Slowed body movements Severe confusion and agitation Extreme mood swings Muscle rigidity Nystagmus (involuntary jerky eye movement) Profuse sweating Delusions Fearfulness, Anxiety Violent or Bizarre behavior Memory and speech difficulties March 2016 52

53.  Developed as an anesthetic but the adverse side effect found to be a potent tranquilizer in large animals  Clear liquid  Granular powder packaged in aluminum foil  Names on Street  Angel Dust  Hog  Dust March 2016 53

54.  Distortions of size, shape, and distance perception  Visual & auditory hallucinations  Feeling of superiority  Sense of invulnerability & power  Aggressive behavior  Loss of perception of time  Impaired coordination and dulled senses March 2016 54

55.  What are the street names/slang terms?  Bath Salts are sold under a number of different “brand” names: Bliss, Blue Silk, Cloud Nine, Drone, Energy- 1, Ivory Wave, Lunar Wave, Meow Meow, Ocean Burst, Pure Ivory, Purple Wave, Red Dove, Snow Leopard, Stardust, Vanilla Sky, White Dove, White Knight, and White Lightning. March 2016 55

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57.  Use of a Reasonable Suspicion checklist  Where possible second opinion  May take time to document observations  Action should proceed with directing employee in for test  No Excuses March 2016 57

58.  Type: Depressant  Method of Use: Oral  Duration of High: One to several hours March 2016 58

59. Odor of alcohol Slurring of speech Incoherence Unsteady gait Nausea Skin cool to the touch Profuse sweating Euphoria Glassy eyes Poor attention span March 2016 59

60.  Increased reaction time  Increased or erratic speed  Swerving  Unable to make rapid decisions  Distorted sense of time and distance  Distorted vision  Loss of peripheral vision  Impaired visual tracking  Blurred vision March 2016 60

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62. (% One hour after drinking alcohol) Blood Alcohol Levels March 2016 62

63. Face Eye Nose Mouth Hands Arms Body Mood Speech Movement State-of-Mind Physical Symptoms March 2016 63

64.  Flushed or very pale face  Excessive sweating  Blood shot, watery eyes  Unusual movements  Dilated/constricted pupils  Extreme fatigue/falling asleep March 2016 64

65.  Running nose  Sores around nostrils  Dry mouth  Frequent swallowing March 2016 65

66.  Shaking hands  Clamminess  Puncture marks  Tremors  Unusually sedate or calm  Odor or alcohol or marijuana March 2016 66

67.  Slurred or incoherent  Inappropriate verbal response  Verbal abusiveness March 2016 67

68.  Nausea  Vomiting  Hallucinations  Staggering or unsteady gait  Impaired motor coordination  Over-reaction or over-compensation  Physically abusive March 2016 68

69.  Unsteady gait  Impaired motor coordination  Over-reaction  Over-compensation March 2016 69

70.  Euphoric high  Excessive laughter/talkativeness  Highly excited/nervous/irritable  Withdrawal/depression  Extreme aggression/agitation March 2016 70

71.  Confusion  Disorientation  Impaired short-term memory March 2016 71

72.  Costs of Substance Abuse Abuse of tobacco, alcohol, and illicit drugs is costly to our Nation, exacting over $600 billion annually in costs related to crime, lost work productivity and healthcare March 2016 72

73. Increased involvement in accidents Participating in risky behavior Indifference toward safety rules Careless handling and maintenance of safety- sensitive machinery Disregard for the safety of others March 2016 73

74. Absenteeism Overtime pay Insurance claims Increased insurance costs Workers compensation (5x higher) Accidents Workplace crime March 2016 74

75. Diverted supervisory managerial time Friction among workers Waste Damage to equipment Damage to public image Personnel turnover March 2016 75

76.  Identify unusual or inappropriate behavior  Observe the employee  Objectively document behaviors  Determine if testing is required  Have a “sit down” with employee  Transport the employee March 2016 76

77.  Be confident, diplomatic and respectful  Don’t approach employee from a confrontation standpoint  Stick to the salient points – not subjective but objective  Give the employee the opportunity to describe and explain the events from their viewpoint  Send employee in for testing March 2016 77

78.  Your employee does not have to test positive to be correct in sending him or her in for a Reasonable Suspicion test  Even if an employee self discloses that he or she will be hot still send them in for testing  Know what your company protocols are beforehand – in the event you have a positive  Do not let employee drive to testing facility! March 2016 78

79.  Seek confirmation from another supervisor ( Best Practice )  List signs and symptoms.  Be specific and brief.  Be objective.  Include date and time. March 2016 79

80.  FTA regulations require only 1 trained supervisor to make a referral for testing. An employer’s policy cannot contradict this requirement.  Documentation must remain on file for a period of no less than 2 years.  Testing must proceed without delay. Supervisors can allow an employee to contact a union representative, but the testing process must continue immediately. March 2016 80

81.  Escort from the workplace discreetly  Should take place in a private office with supervisor and confirming party  Tell the employee they are being sent for a reasonable suspicion drug and alcohol test  Explain to the employee how they will be transported to testing facility  Respect the employee’s confidentiality March 2016 81

82. Expect an emotional response: Excuses and sympathy Apologies and promises Switching Anger Tears and helplessness Deflecting Self-pity Innocence March 2016 82

83.  Compassion  Guilt  Friendship  Loyalties  Jeopardizing employee’s livelihood  Loss of employee confidence/support  Insecurities  Fear for personal safety  Do not like confrontation  Lack of training on the referral process March 2016 83

84.  Ignoring job performance problems, hoping they will go away or are temporary  Accepting excuses or apologies  Threatening disciplinary action without follow through  Giving advice or pep talks  Doing some of the employee’s work because he is in a bad spot or working around the person  Considering someone a “functional alcoholic” who doesn’t affect you March 2016 84

85.  Substance Abuse Professional (SAP) referral process.  Assessment/Treatment  Return to Duty  Follow Up testing March 2016 85

86.  Must be a local Substance Abuse Professional (SAP) The Substance Abuse Professional (SAP) is a person who evaluates employees who have violated a DOT drug and alcohol program regulation and makes recommendations concerning education, treatment, follow-up testing, and aftercare. March 201686

87.  This can only occur at the advising of the SAP.  There should only be a Return to Duty Drug and Alcohol test after a violation of DOT policy i.e. Positive or Refusal to test  A Return to Duty test should not be used when an employee has been on leave March 201687

88.  Document reason for directing employee(s) in for testing  Escort employee to testing facility  If after hours be sure to have a facility identified where you can send employee(s) after hours  Can you stand down an employee until you receive a result back?  Workplace Drug and Alcohol policy – is key to what your next step will be March 2016 88

89.  If your company has a zero tolerance policy you must give the employee the name of a local SAP to follow up with his or her positive test  No you may not send the employee in for another test hoping he or she will pass this one  Follow the DOT regulations  If you allow for a second chance then you must allow the SAP to do his or her job  Once employee has been cleared by SAP a Return to Duty test is required (Observed) March 2016 89

90.  Retention of records in a secure location with limited access :  Five Years Verified positive drug or alcohol test results. Refusals to take required drug or alcohol tests. Employee referrals to SAP’s. Follow-up testing schedules. March 2016 90

91.  Substance Abuse Treatment Locator www.findtreatment.samhsa.gov The Substance Abuse and Mental Health Services Administration (SAMHSA) web site will help individuals locate drug and alcohol abuse treatments programs in their communi­ties.  AlcoholScreening.org www.alcoholscreening.org This free confidential web site lets individuals privately assess their own drinking habits and receive personalized feedback to help them determine if they need help to change those habits. There is also information about their community drug and alcohol abuse treatments and consultations.  Al-Anon/Alateen www.al-anon.alateen.org Al-anon provides information on the effects of alcohol abuse and refers to nearby support groups. Alateen is the organization’s program for young people whose lives have been affected by someone else’s drinking. March 2016 91

92.  Alcoholics Anonymous (AA) www.aa.org AA offers a way to stop drinking to individuals who feel they have that problem. There are commu­nity programs listed in local phone books.  American Council on Alcoholism www.aca-usa.org The service provides referrals to alcoholism treatment programs nationwide and distributes written materials.  National Council on Alcoholism and Drug Dependence Hopeline www.ncadd.orgwww.ncadd.org- This organization provides written information on alcohol and drug abuse and referrals to treatment and counseling services nationwide.  National Drug and Alcohol Treatment Referral Service www.ncadi.samhsa.gov  Center for Substance Abuse Treatment www.csat.samhsa.gov March 2016 92

93.  (800) 527-5344 Alcohol Helpline  (800) COCAINE Helpline  (877)-A-LIFE-4U Marijuana Helpline  (800) 662-HELP National Drug and Alcohol Treatment March 2016 93

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95. Compliance Oversight Solutions Ideal (“COSI”) 800-948-0294 lshields@complianceoversightsolutions.com All rights reserved and are the property of COSI © March 2016 95