1. Reasonable Suspicion Training for Drug and Alcohol Use

2. What we will talk about today
Facts about drugs and alcohol
Drugs of abuse
Alcohol basics
Signs and symptoms of use/abuse
Making a decision about reasonable suspicion testing
General guidelines and procedures

3. Under this policy… All members are subject to testing
A member with a positive test will be removed from the worksite
The member with a positive will then be contacted by TEAM for evaluation / help
The member will return to work only after successful completion of treatment
Second positive = discipline / discharge

4. A supervisor should: Know and understand the policy / rules
Regularly document performance issues
Be able to answer questions about it
Be responsible for enforcing the policy
Convey an attitude of confidentiality
Be supportive of the policy
Identify possible use, and take action

5. Testing situations Pre-employment (drug test only) Post-accident
Reasonable suspicion
Work opportunity
Random (20% annually)
Treatment program (return-to-duty, and then follow-up testing for two years)

6. Lab procedures Initial screen (urine)
If negative, reported to TEAM as negative
If positive, lab conducts a confirmatory test
Confirmatory test (on the same sample)
If negative, it is reported to TEAM as negative
If positive it is reported to TEAM as positive
Positive specimens will be stored in the lab for 6 months

7. You will be tested for: Alcohol Marijuana Cocaine
Amphetamine (and methamphetamines)
Opiates
Phencyclidine (PCP, angel dust)
Barbiturates
Methaqualone
Benzodiazepines
Methadone
Propoxyphene

8. Testing levels (gates) for positive
Initial Confirm
Alcohol
Marijuana
Cocaine
Opiates 2,000 2,000
Amphetamines 1,
PCP
[DHHS Standards]

9. Workplace drug testing positives
Marijuana 53%
Cocaine 15%
Opiates 7%
Amphetamines 11%
PCP 1%
Benzos, barbs 8%
(2005 statistics)

10. Termination / discharge for:
Refusing to be evaluated
Not going to the treatment program that was recommended by your EPA
Not finishing the treatment program
Testing positive a second time, at any time in the future

11. Members’ rights and protections
A member who does not consent will not be tested. No one will be forced to test
A member can get a copy of the results
A member can speak to a Medical Review Office about medications
A member can request that the sample be retested (at the member’s expense)

12. Refusal to submit to testing
A refusal to be tested has consequences
A refusal is considered insubordination
Grounds for disciplinary action, up to and including termination of employment
Not cooperating with the process could be considered refusal to be tested

13. Drugs make us feel better…
Socially acceptable drugs
Illegal drugs
Prescription medications
“Over-the-counter “ drugs and meds

14. Drug use is a progression…
Tolerance
Adaptation of increased intake
Psychological dependence
Physical dependence
Addiction

15. Facts About Chemical Use
97% of chemical abusers in work place
Substance abusers 3 times more likely to use sick benefits and have attendance and tardiness problems
Substance abusers 5 times more likely to file worker’s comp claims
47% of work accidents related to abuse

16. Facts About Substance Abuse
Alcohol and marijuana are the most common drugs used in workplace
Marijuana users have 85% more injuries
US businesses lose $ billion a year to substance abuse
Drugs and alcohol use result in increased premiums for health insurance and Workers’ Compensation claims

17. Marijuana (3-4 hours) Euphoria and animation (loud talking)
Reddened eyes
Dilated pupils
Loss of coordination
Frequent hunger
Increased heart rate

18. Cocaine (5-20 minutes) Feeling of exhilaration / energy
Rapid or irregular heart beat
Reduced appetite, eventual weight loss
Increased body temperature
Could result in heart failure, chest pain, respiratory failure, nausea, strokes, seizures, headaches, abdominal pain

19. Amphetamines (2-4 hours)
Irritability
Aggressive or violent behavior
Anxiety, restlessness, panic
Auditory hallucinations, delirium
Rapid breathing
Tremor
Loss of coordination

20. Opiates (3-6 hours) Euphoria followed by drowsiness Pin-point pupils
Slow, shallow breathing
Restlessness and irritability
Watery eyes, clammy skin, runny nose
Nausea, stomach cramps
Staggering gait

21. Phencyclidine (8-12 hours)
Increased heart rate and blood pressure
Impaired motor function
Memory loss
Numbness
Nausea, vomiting , loss of appetite
Panic, aggression, violence
Depression

22. Effects of alcohol 0.02-.03 Slight euphoria, loss of shyness
Relaxed, lowered inhibitions, minor impairment of reasoning
Affected balance, speech, vision, reaction time, hearing
Significant impairment
Gross impairment, lack of control
0.30 Loss of consciousness
0.40 Coma, possible death

23. Alcohol affects the body
Stomach: irritated lining, ulcers
Liver: damaged from processing alcohol
Immune system: illness, colds, coughs
Reproductive system: serious birth defects
Heart: enlarged heart, irregular heartbeat
Brain: memory loss, judgment,coordination

24. Definition of “alcohol use”
“The consumption of any beverage, mixture or preparation containing alcohol, including medications that contain alcohol.”

25. What is 0.02 level of alcohol?
One 12 oz. can of beer
One 4 oz. glass of wine
One 1 oz. shot of booze
IN ONE HOUR...

26. The body processes alcohol
Generally, 1 ounce in 1 hour
Depending on:
body size
eating habits
amount of food consumed
type of food consumed
an individual’s metabolism rate

27. Myths about “sobering up”
Caffeine
Jittery, wide-eyed, but still drunk
Take a cold shower
Cold, dripping wet, but still drunk
Get some physical activity
Tired, worn out, sweating, but still drunk

28. A supervisor’s role (the 4 R’s)
RECOGNIZE . . .
RECORD . . .
RESPOND . . .
REFER . . .
the worker who used
by documenting facts
because it’s your job !
for required testing

29. Why I don’t want to do this…
I want members to like me
Maybe the problem will just go away
Maybe the member will decide to quit
I’m not sure management will support me
This just isn’t my job
I was never trained to do this stuff
Some members are even worse than this one

30. Definition: reasonable suspicion
You have “reason to believe” that
a member has used alcohol or drugs in the workplace, OR
a member is not able to perform his/her job safely, possibly because of being under the influence of drugs or alcohol, regardless of when that use occurred

31. Reasonable Suspicion Testing
A continuum of “knowing”
Proof beyond reasonable doubt
Preponderance of evidence
Probable cause / reasonable suspicion
Having a “hunch”

32. Definition: safety-sensitive job
A job in which impairment caused by drug or alcohol usage would threaten the health or safety of any person

33. Alcohol signs and symptoms
Odor on breath or body
Flushed skin
Eyes glazed or bloodshot
Slowed reaction time
Impaired motor skills
Stumbling, swaying, loss of balance
Speech is slurred, loud, thick
Moody, irritable

34. Drug signs and symptoms
Eyes red, pupils dilated
Mouth dry
Slowed reactions
Impaired motor skills
Sleepy
Skin cold, moist, blush in color
Heart rate, blood pressure, perspiration
Dizziness

35. When you document the incident
DO’S
Observable
Objective
Measurable
Time specific
DON’Ts
Assume
Judge
Mention USE
Trust your memory
Ignore the reality
Deny that it’s happening
Be defensive

36. A checklist for supervisors
When possible, involve a second supervisor
Document the incident (behaviors/performance)
Explain your concern to the member
Ask: is there a need for medical attention?
Call the collection site: location, name
Stay until the collection is done; be available
Arrange for the member to get home
Return to the workplace and finish the documentation

37. If the member responds with:
DENIAL
THREATS
ANGER
EXCUSES
Stay calm
Use documentation
Uphold the policy
Maintain productivity
Don’t react
Focus on the issues
Take a break
Focus on performance

38. If a member decides to run…
Tell the member that you’ll call the cops
Call 911
Give 911 your name and location
Give circumstances (member was suspected to be under the influence)
Explain that you warned him/her not to leave
Give a description of the car, license, etc.

39. BOTTOM LINE: THIS IS ABOUT WORKPLACE SAFETY
Keep in mind:
Get your questions and concerns clarified
You aren’t accusing a personof using
Be confidential and discreet
Testing is only a tool to rule out use
Be thorough with your documentation
BOTTOM LINE: THIS IS ABOUT WORKPLACE SAFETY

40. Always remember … Use Your Employee Assistance Program (EPA)
Early intervention may eliminate the need for a reasonable suspicion test
Watch for a member’s declining job performance.
Document, document, document.
Make an informal referral so that a member can address a drug problem before it becomes a work problem.

41. CALL FOR HELP if you need it!!!