Reasonable Suspicion Training for Drug and Alcohol Use

1. Reasonable Suspicion Trainingfor Drug and Alcohol Use • Presented by: • T.E.A.M., INC.

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

8. Testing levels (gates) for positive InitialConfirm Alcohol 0.08 0.08 Marijuana 50 15 Cocaine 300 150 Opiates 2,000 2,000 Amphetamines 1,000 500 PCP 25 25 [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 TEAM • 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 $60-100 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-.03Slight euphoria, loss of shyness 0.04-.06Relaxed, lowered inhibitions, minor impairment of reasoning 0.07-.09Affected balance, speech, vision, reaction time, hearing 0.10-.125Significant impairment 0.13-.20Gross impairment, lack of control 0.30Loss 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. RECOGNIZE . . . RECORD . . . RESPOND . . . REFER . . . the worker who used by documenting facts because it’s your job ! for required testing A supervisor’s role (the 4 R’s)

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. 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 When you document the incident

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. 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 If the member responds with:

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. Keep in mind: • Get your questions and concerns clarified • The association will support you • You aren’t accusing a member of using • Be confidential and discreet • Testing is only a tool to rule outuse • Be thorough with your documentation • BOTTOM LINE: THIS IS ABOUT WORKPLACE SAFETY

40. Always remember … TEAM EAP • 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!!! TEAM, INC. can help… CALL 651-642-0182