Substance abuse in the workplace and how it’s identified

1. Substance abuse in the workplace and how it’s identified Immediate Past PresidentThe Substance Abuse Program Administrators Association Jeff Sims, C-SAPA, C-SI

2. How did we get to this point? • Most aggressive actions occurred since the late 1980’s:- The Anti-Drug Abuse Act of 1986 (directed U.S. Secretary of Labor to initiate efforts to address the issue)- President Reagan’s Executive Order 12564, Drug-Free Federal Workplace (made it a condition of employment to refrain from using illegal drugs)- Drug-Free Workplace Act of 1988 (required federal contractors and grantees to have drug-free workplaces)- Drug-Free Workplace Act of 1998 (establish grant programs that assist small businesses in developing drug-free workplaces)- Omnibus Employee Testing Act of 1991 (required transportation industry employers to conduct alcohol and drug testing for employees in “safety sensitive” positions) It created a model for non-regulated employers now follow.

3. The U.S. drug and alcohol problem • In 2006, estimated 20.4 million Americans were current illicit drug users, which is a rate of 8% among all Americans. No significant changes in recent years. • About 57 million people, or more than one-fifth (23.0 %) of the population age 12 and over, participated in binge drinking (having five or more drinks one the same occasion at least once in the past 30 days).

4. The U.S. Drug and Alcohol Problem in the Workplace • In 2006, of the 17.9 million current illicit drug users age 18 and over, 13.4 million (74.9 percent) were employed. • Similarly, among 54.0 million adult binge drinkers, 42.9 million (79.4 percent) were employed. • Of the 20.6 million adults classified with substance dependence or abuse, 12.7 million (61.5 percent) were employed full-time. Data provided by the Substance Abuse and Mental Health Services Administration, (2007). Results from the 2006 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H-32, DHHS Publication No. SMA 07-4293). Rockville, MD.

5. Small Businesses Most Vulnerable • While about half of all U.S. workers work for a small and medium sized businesses (those with fewer than 500 employees), and nine in ten employed current illicit drug users. • Almost nine in ten workers with alcohol abuse dependences work for small medium employers. • However, smaller firms do not perform testing.

6. Drug Abusers as Employees • More likely to be involved in an accident and file a workers’ compensation claim • More likely to quit or get fired • More likely to steal from workplace • More likely to miss work • More likely to be in a confrontation • Less productive

7. The Impact on Safety Substance abusers are: • 3.6 times more likely to be involved in a workplace accident • 5 times more likely to file a workers’ compensation claim • As many as 50% of all workers’ compensation claims involve substance abuse

8. The Impact on Safety 80% of those injured in “serious” drug-related accidents at work are not the drug abusing employees… but innocent co-workers and others.

9. “ROI” Return On Investment How much does s/a cost per drug user? • $7,000 (national average) How many drug users do you have? • 17% of workforce (national average) • Use their figure How many employees do you have?

10. “ROI” Do the Math! • 250 employees • multiplied by % of drug users in their workplace (5%) • multiplied by $7000 • equals cost of s/a • compare to cost of drug testing • (300 tests at $45 per test average)

11. “ROI” 250 x 5% =13 13 x $7,000 =$91,000 300 (drug tests/year) x $45 (cost per test) =$13,500 $ 91,000 -13,500 =$ 77,500 SAVINGS!

12. 5 Key Components A comprehensive drug-free workplace program includes: • Policy • Supervisor training • Employee education • Employee assistance • Drug testing (Alcohol testing)

13. Who to Test? Employees • All employees • Safety-sensitive employees • All employees under certain circumstances • Temps, contract workers, seasonal hires • Union workers

14. When to Test? Traditionally… • pre-employment • post-accident • reasonable suspicion • Random • Return to duty • Follow up

15. Federally Mandated Test • Marijuana • Cocaine • Opiates10/1/2010 w/ separate confirm for heroin • Amphetamines10/1/2010 w/separate confirm for MDMA • Phencyclidine (PCP) The primary drugs of abuse

16. SUPERVISORY TRAINING • Observe • Document • Confront • Refer • Follow through

17. OBSERVE Watch For These Signs • Absenteeism • “On the job” absenteeism • Accidents • Difficulty in concentration • Confusion • Spasmodic job performance • Lowered efficiency • Physical behaviors • Relationship issues at work

18. DOCUMENT • Only observable and verifiable facts allowed - not rumors • Record all actions and behaviors • Include statements or pertinent facts • State time, date, location • List witnesses

19. CONFRONT Use documentation to outline job performance issues • Avoid being manipulated by accepting excuses • Be firm and honest • Do not get personally involved • Do not become an armchair diagnostician

20. REFER After any confrontation, a referral system is needed • Outpatient services • Inpatient services • Support groups • Testing programs

21. FOLLOW THROUGH • Return to work contract • Explain company’s disciplinary policy • Set up specific work goals and criteria • Evaluate job performance • Follow-up drug and alcohol testing • Family issues

22. HOW DO DRUGS WORK • Speed things up • Slow things down • Confuse signals • Block signals • Combination of the above The brains pleasure centers

23. MARIJUANA Drug:Marijuana, Hashish, Hashish Oil Classification:Hallucinogen Administration:Smoked or swallowed Appearance: • Dry crushed leaves (marijuana) • Hand-rolled cigarettes (joints) • Hard chunks of resin (hashish) • Dark viscous liquid (hashish oil) Detection time in urine: _______?

24. Marijuana - Extent of Use In 2001, over 12 million Americans age 12 and older used marijuana at least once in the month prior to being surveyed. That is more than three quarters (76 percent) of the total number of Americans who used any illicit drug in the past month in 2001. Of the 76 percent, more than half (56 percent) consumed only marijuana; 20 percent used marijuana and another illicit drug; and the remaining 24 percent used an illicit drug or drugs other than marijuana(1).Although marijuana is the most commonly used illicit drug in the United States, among students in the 8th, 10th, and 12th grades nationwide its use remained stable from 1999 through 2001(2). Among 8th graders, however, past year use has decreased, from 18.3 percent in 1996 to 15.4 percent in 2001. Also in 2001, more than half (57.4 percent) of 12th graders believed it was harmful to smoke marijuana regularly and 79.3 percent disapproved of regular marijuana use. Since 1975, 83 percent to 90 percent of every 12th grade class surveyed has found it "fairly easy" or "very easy" to obtain marijuana(3).Data for drug-related hospital emergency department visits in the continental United States recently showed a 15 percent increase in the number of visits to an emergency room that were induced by or related to the use of marijuana from 96,426 in 2000 to 110,512 in 2001. The 12 to 34 age range was involved most frequently in these mentions. For emergency room patients in the 12 to 17 age range, the rate of marijuana mentions increased 23 percent between 1999 and 2001 (from 55 to 68 per 100,000 population) and 126 percent (from 30 to 68 per 100,000 population) since 1994(4).

25. MARIJUANA EFFECTS • Short term memory loss • Depth perception issues • Dreamy, relaxed feeling • Increased senses of sight, smell, taste, and hearing – leads up to excessive smoking and “munchies” • Hallucinations • Anxiety • Impaired muscle coordination Sponsored by a’ TEST consultants, inc., and funded by the U.S. Small Business Administration – Paul D. Coverdell Drug-Free Workplace Program

26. MARIJUANA OBSERVED BEHAVIORS • Rapid, loud talking • Sleepiness • Lack of motivation • Reduced concentration • Reduced inhibitions • Sexual dysfunction • Giggly, ridiculous conversation

27. COCAINE Drug:Cocaine Classification:Stimulant, local anesthetic Administration:Snorted, injected, smoked Appearance:White crystalline powder, bitter numbing taste, odorless, from coca plant leaves Clinical Effects:Euphoria, motor and verbal hyperactivity, mood swings, inflated self-esteem Detection Time in Urine:2-4 days

28. COCAINE EFFECTS • Weight loss • Paranoia • Anxiety, irritability • Elevated blood pressure • Increased heart rate • Sleeplessness-fatigue • Psychological problems

29. COCAINE OBSERVABLE BEHAVIOR • Cold sweats • Coma, convulsions • Dilated pupils • Nose bleeds • Depressed or sad • Talkativeness • Self-confidence < >

30. COCAINE - TIME FACTORS Length of a rush

31. Drugs:Morphine, Heroin, Codeine, Oxycodone Hydromorphone Classification:Narcotic analgesic Administration:Swallowed, smoked or injected Appearance:White, brown, or black powder, injectable liquids, tablets, capsules (various sizes and colors) Detection Time in Urine:3 days OPIATES

32. OPIATE EFFECTS • Euphoria • Drowsiness • Respiration depressed • Pain management • Psychological dependence

33. OPIATES OBSERVABLE BEHAVIOR • Sleepiness • Slowed reflexes • Confusion • Poor concentration • Slurred speech • Constricted pupils • Shaking • Diarrhea or cramps

34. MY BREAD HAD POPPY SEEDS ON IT! • MRO’s may request quantitative values of codeine/morphine • 2000 ng/ml or less suggest poppy seeds or RX • 2500 ng/ml or above with codeine present rules out poppy seeds, may be a RX, or illegal use of morphine or heroin

35. PCP - Angel Dust Drug:Phencyclidine Classification:Hallucinogen, anesthetic Administration:Smoked, swallowed, or injected Appearance:Pills, capsules, powders Detection Time in Urine:2 days or 8 days in severe overdose

36. PCP EFFECTS • Psychedelic reaction • Hallucinations • Combative behavior • Symptoms of insanity • Catatonic state • Reduced work motivation

37. PCP OBSERVABLE BEHAVIORS • Convulsion • Muscle rigidity • Profuse sweating • Slurred speech • Involuntary eye movements • Inappropriate remarks

38. AMPHETAMINES Drug:Methamphetamine, amphetamine Classification:CNS stimulant (speed) Administration:Swallowed, injected, smoked Appearance:Powders, crystals, capsules, tablets Detection Time in Urine:24 - 48 hours

39. AMPHETAMINE EFFECTS • Palpitations • Tachycardia • Hypertension • Dizziness • Insomnia • Hallucinations

40. AMPHETAMINE OBSERVABLE BEHAVIORS • Euphoria then restlessness • Agitation • Irritability • Extreme paranoia • Weight loss • Malnutrition • Tooth decay

41. Meths Impact on Kids

42. Hotel Rooms – Mobile Meth Labs

43. ALCOHOL Drug: Ethanol Classification: Psychoactive Administration:Wine, beer, liquor Appearance:Liquid, several colors Detection in Urine:Generally 1 ounce of alcohol is eliminated per hour Note: Urine alcohol testing cannot withstand a court challenge

44. ALCOHOL EFFECTS • Trembling or DT’s • Dizziness • Staggering • Weepy, bloodshot eyes • Lethargic behavior • Hallucinations, convulsions

45. ALCOHOL OBSERVABLE BEHAVIORS • Aggressiveness • Nausea or vomiting • Alcohol breath(fruity smell) do not be mistaken by a diabetic(acetone) • Incoherent (slurred) speech • Unconsciousness

46. Any Questions???? Thanks! Contact Jeff @ 800.837.8648, Ext 117, or by email @ jpsims@atestinc.com