Drug & Alcohol Awareness

Bureau of Workers Comp PA Training for Health & Safety (PATHS)

Supervisor Level Training

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General Information
This presentation will assist you with meeting initial training
and program requirements for a drug-free workplace. This is not an all-inclusive training program. It should be noted that the U.S. Department of Transportations (DOT) Office of Drug and Alcohol Policy and Compliance: - advises the Secretary on national and international drug testing and control issues and - is the principal advisor to the Secretary on rules related to the drug and alcohol testing of safetysensitive transportation employees in:
aviation railroads pipelines

trucking mass transit other transportation industries

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More Information on DOT

The U.S. DOT Office of Drug and Alcohol Policy and Compliance also publishes regulations and provides official interpretations regarding: Drug and alcohol testing, including how to conduct tests; and Evaluation and treatment procedures necessary for returning employees to duty after testing violations. For more specific information for your industry go to www.dot.gov/odapc

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More on Transportation
If your company requires an employee to have a Commercial Drivers License, including these types of companies (partial list):
Own or lease a commercial vehicle Federal, state and local governments For hire & private motor carriers Civic organizations (American Legion, DAV, Scouts) Churches

Then you must comply with urine drug testing & alcohol testing requirements for: - DOT - FMCSA
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Supervisor Training Outline

1. Objectives & Overview of Training Program 2. Drug Program & Workplace Policy 3. Supervisors Responsibilities 4. Performance vs. Crisis Situations 5. Recognizing Problems (Signs & Symptoms)
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Supervisor Training Outline

6. Intervention and Referral 7. Protecting Confidentiality 8. Continued Supervision 9. Enabling & Supervisor Traps 10. Dos and Donts for Supervisors
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Objectives of Training
Supervisors will be able to: Identify the different components of the DrugFree Workplace Policy

Identify their role in implementing the DrugFree Workplace Policy

Utilize available resources to develop a DrugFree Workplace Policy for their workplace
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Learning Objectives
Supervisors will be able to: Identify and investigate potential crisis situations Recognize workplace problems that may be related to alcohol and other drugs Intervene in problem situations Refer employees who have problems with alcohol and other drugs for assistance Protect employee confidentiality Continue to supervise employees who have been referred for assistance Avoid enabling and supervisor traps
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The Unseen Reality

Think PAs workplaces are drug free? Think again.
75% of drug users are employed Almost one in ten employees has a substance abuse problem 24% of workers admit to drinking during the workday at least once in the past year 15% of U.S. workers report using alcohol or being impaired on the job in the past year
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The Cost of Substance Abuse

Increased Health Care Costs Increased Workers Compensation Premiums Increased Workplace Violence

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Substance Abuse
Individuals who abuse drugs or alcohol are three and a half times more likely to be involved in a workplace accident compared to individuals who do not abuse drugs or alcohol 47% of industrial injuries are directly related to alcohol abuse or alcoholism
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The Facts Drug & Alcohol Abuse

Workers have higher rates of turnover & absenteeism More likely to have worked for 3 employers in the previous year More likely to skip 2 days of work in a month Also more likely missed 2 or more days due to injury or illness
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Drug-Free Workplace Policy

Accomplishes two major things: 1. Sends a clear message that use of alcohol and drugs in the workplace is prohibited 2. Encourages employees who have problems with alcohol and other drugs to voluntarily seek help

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Drug Program & Workplace Policy

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Drug-Free Workplace Policy

Policy exists to:

- Protect the health & safety of all employees, customers and the public
- Safeguard employer assets from theft and destruction

- Protect trade secrets

- Maintain product quality, company integrity and reputation

- Comply with the Drug-Free Workplace Act of 1988 and/or any other applicable laws
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Drug-Free Workplace Policy

Policy should answer these questions: What is the purpose of the policy and program? Who is covered by the policy? When does the policy apply?

What behavior is prohibited?

Are employees required to notify supervisors of drug-related convictions?

Does the policy include searches?

Does the program include drug testing?
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Drug-Free Workplace Policy

What are the consequences for violating the policy? Are there Return-to-Work Agreements? What type of assistance is available to employees? How is employee confidentiality protected? Who is responsible for enforcing the policy? How is the policy communicated to employees?
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Drug Program
Comprehensive drug free workforce approach should include these components: Policy Supervisor training Employee education Employee assistance Drug testing

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The Co-workers
Performance and attitudes negatively affected Reported being put in danger Have been injured

Worked harder
Must re-do work

Cover for a co-worker

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Establishing a Policy/Program
Here are several resources (links) to assist you with establishing a specific program for your company
Pennsylvania AFL-CIO Appalachian Council CSAP RADAR Network State Center (Pennsylvania) Drug Free Pennsylvania, Inc. Pennsylvania National Guard Counterdrug Program Commonwealth of Pennsylvania

DOL Policy Writing Assistant

www.dol.gov/elaws/drugfree.htm
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Assistance
Employee Assistance Programs (EAP) Employee provided healthcare insurance Various Federal, State and Local programs

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Reasons for Not Implementing ESAAPs

Substance abuse is not a problem

Insufficient time to develop and maintain a policy

The policy would be too costly Too much uncertainty about liability

Lack of information

REALITY =
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Incentive to Implement ESAAPs

Only 1 out of every 5 Pennsylvania employers plans to address substance abuse in the workplace The number increases to 2 out of every 3 when workers compensation premium discounts were mentioned *
*While PA presently has no provisions for granting financial consideration for implementing an ESAAP, this may be legislatively addressed in the future

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ESAAP is an Effective Solution

Southern Pacific Railroad reports that accidents dropped by 71% after they implemented an ESAAP One electric supply company documents a 39% decrease in absenteeism after implementation of an ESAAP

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Supervisors Responsibilities

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Supervisors Responsibilities
Responsible to:

Maintain a safe, secure and productive work environment for everyone

Evaluate and discuss performance w/employees Treat all employees fairly Act in a manner that does not demean or label people

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NOT your Responsibility to

Diagnose drug and alcohol problems Have all the answers Provide counseling or therapy Be a police officer

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Legally Sensitive Areas

Safeguard employees confidentiality

Ensure the policy is clearly communicated

Establish procedures to investigate alleged violations

Provide due process and ample opportunity for response to allegations

If testing is included, ensure quality control and confirmation of positive tests Conform to union contracts, if applicable
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Performance vs. Crisis Situations

The A Team!

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Performance & Potential Crisis Situations

Distinguishing between a crisis situation and a performance problem Crisis situations are less common than performance problems and can consist of: - Dangerous behavior Threatening behavior Obvious impairment Possession of alcohol and other drugs Illegal activity
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Questions to Consider
What exactly did you see? Does there appear to be illegal activity, policy violations or unusual behavior taking place? Is a group of people involved or just a single employee? Are you the direct supervisor to anyone involved in the incident? Are reliable witnesses available? Is any physical danger involved in taking action or not taking action?
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Questions to Consider
Is the situation serious enough to require calling security or law enforcement?

Is there a specific policy that applies?

Does the situation require expert consultation from Human Resources, the Employee Assistance Program (EAP), if applicable, or security? Is this a situation that calls for reasonablesuspicion testing? Have you documented what you have seen and what you have done in response?
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Steps to Consider

When you meet with the employee:

Hold the meeting in a private area

Have a second individual in attendance

Inquire about the behavior, rumor or report

Inform the employee of your concerns

Get his or her explanation of what is happening If you feel there is a problem, notify your superior Document what occurred, what was said and done, etc.
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Actions to Take
If evidence or suspicion of recent use, based upon the employees response and your companys drugfree workplace policy:
Refer the employee to the EAP (if applicable)

Place the employee on suspension until a formal investigation takes place Arrange for the employee to be escorted home

Escort the employee to a collection site for the drug test, if applicable
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Signs & Symptoms

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Addiction
The irresistible compulsion to use alcohol and other drugs despite adverse consequences It is characterized by repeated failures to control use, increased tolerance & increased disruption in the family

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Signs of Addition
Examples of common performance problems that may be indicators include:
Poor attendance

- Tardiness
- Unexplained absences - Long lunches
Co-worker or customer complaints

Mistakes Missed deadlines

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General Signs
Abrupt changes in attendance, quality of work and production Unusual outbreaks of temper Changes in mood

Acting paranoid or confused

Not taking responsibility for actions Changes in attitude Withdrawing from family and friends
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General Signs
Drastic change in physical appearance

Changes in grooming habits

Associating with known drug users Has more money than usual Acting secretive with both actions and possessions

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Pupil Reference

Fixed and not reactive to changes in light may indicate other problems beside a potential drug issue Take note and document
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Medical Conditions
Be aware: some of the same symptoms may be caused by medical conditions and this must also be taken into consideration This may also require a medical response

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Medical Conditions
Nausea Mood changes

Nervous/jittery
Cold, clammy, sweating

Anxiety
Irritability Confusion

Rapid heartbeat

These are all symptoms of hypoglycemia, from mild to severe reactions. They can appear very similar to the signs of drug and alcohol abuse. Being aware that they also exist may avoid a medical emergency, so supervisors response may still be necessary.
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Medical Conditions
Weakness Poor coordination Difficulty walking Lethargy Loss of consciousness Hypothermia Irreversible brain damage, heart problems

These are all symptoms of hypoglycemia, from mild to severe reactions. They can appear very similar to the signs of drug and alcohol abuse. Being aware that they also exist may avoid a medical emergency, so supervisors response may still be necessary.
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Alcohol & Drugs

The Basics

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Substance Abuse
When someone abuses or has an addiction to alcohol or other drugs it affects themselves as well as other people around them:

Emotionally
Behaviorally Physically

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Alcohol
Odor (breath or on person)

Intoxication/drunk
Glazed look Lack of focus

Uncharacteristically passive or combative

Argumentative

Deterioration of personal hygiene

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Alcohol
Dysfunctional

Absenteeism (Mondays)
Blackouts Loss of memory Fixated on drinking (both social & professional) Trouble with relationships Difficulty walking
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Cannabis (Marijuana)
Other: Hashish, Hashish oils Active ingredient: Tetrahydrocannabinol (THC) Not physically addictive, moderately addictive psychologically

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Cannabis
Effects

Euphoria
Impaired memory Concentration Knowledge retention

Loss of coordination
Loss of motivation Animated behavior Other similar conditions that impair work and personal relationships

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Cannabis What the Supervisor May See

Work level decrease Increase of incidents Loss of concentration

Repeating instructions
Breakage Out of character behavior

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Inhalants

Not regulated as typical drugs

Commonly found substances that produce certain effects similar to scheduled drugs Examples: glue, marking pens, gasoline, butane, amyl nitrite and aerosol sprays

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Inhalants
Loss of muscle control Slurred speech Respiratory failure Cardiac arrest Number of other physical symptoms Brain & lung damage Can be fatal (even in small amounts)
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Inhalants What the Supervisor may see

Paint on nose or fingers

Drunk-like reaction Trouble breathing

Loss of strength/control
Fatigue Lack of coordination

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Stimulants
Signs & Symptoms Increased heart rate Alertness Agitation Decreased appetite

Respiratory functioning
Restlessness

Psychological dependency
Physical dependency

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Stimulants
Effects

Dilated pupils Dry mouth Drug nose look Runny nose Sinus/nasal problem Nose bleeds Bad breath Euphoria

Fidgeting No interest in food or sleep Irritability Argumentative Nervous Talkative with no direction

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Stimulants What the Supervisor may see

Increase in errors Increased risk of accidents Weight loss (facial)

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Depressants
Frequent doctor trips for nervousness, anxiety, stress, etc. Acting drunk (without odor) Limited or no facial expression or animation Personality is flat Lacking energy

Slurred speech

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Narcotics
Signs & Symptoms
Acting lethargic or drowsy Constricted pupils/not reactive Redness & raw nostrils from inhalation Track marks Slurred speech Frequent trips to doctors for pain medication Increase in frequency and amount of prescribed pain medication w/o doctor consent Sweating, vomiting, coughing & sniffling, twitching, loss of appetite

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Why Synthetic?
Feels like a marijuana high Danger of not knowing all of the ingredients in the synthetic product Contaminated with impurities

Do not test positive on THC drug test

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Designer Drugs
Psychoactive substances, stimulant Amateur chemists - cookers Injected, smoked, snorted or ingested Rapid onset (1-4 minutes) Short duration of action (30 minutes to a few hours) Fentanyl is one of the 3 common bases for designer drugs = 80 to 100 times more potent then Heroin

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Designer Drug
Common Drugs Ecstasy Adam Lovers Speed Special K Fantasy Natures Quaalude Effects
Physical
Hypertension, blurred vision, tremors, drooling, anorexia, impaired speech, paralysis, seizures, brain damage, death

Psychological
Confusion, irritability, anxiety, emotional, irrational, depression, amnesia, violent behavior, insomnia
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Bath Salts
Synthetic Drugs Plant food Not for human consumption Synthetic drug is similar to a natural drug from Khat Plant

Crystals or capsules may contain anesthetic lidocaine

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Bath Salts Brand Names

Brand Names Incense Chemical Sprays JWH-015, 018, 019, 073, 200, 398

Genie Yucatan Fire King Krypto Mr. Nice Guy K-3 Red Magic Blueberry Medication Super Skunk

HU-210, 211
CP 47, 497

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Bath Salts
Signs & Symptoms

Agitation
Extreme nervousness Fast heartbeat Increased blood pressure

Tremors/shaking
Vomiting Hallucinations Seizures

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Bath Salts What the Supervisor may see

Avoidance
Red-faced

Appears out of it Sense of heart problems Sweaty Cool Grabbing chest

Shaking/dropping
things

Sick
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Hallucinogens
LSD Peyote Psilocybin Mushrooms

PCP
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Hallucinogens
Signs & Symptoms

Dilated pupils
Heavy sweating Strong body odor

Self absorbed
Slurred speech Confusion

Distorted senses
Hallucinations Distorted view of themselves

Isolated/detached
Time (unaware) Changes in mood and behaviors
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Hallucinogens What the Supervisor may see

Fixed small pupils Sweating Hyper sensitive Separated from reality

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OTC Drugs
Both prescription and OTC drugs can affect the worker in numerous ways especially if a reaction or drug interaction occurs Hard to predict; may have the same symptoms as alcohol or drug use, but could be caused by legal drugs Consider a policy on OTC drugs in the workplace based on the job description
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Common OTC & Prescription

Opioids Topiramate Antihistamines Antidepressants Sedative Hypnotics Anti-Anxiety

Medications

Skeletal muscle relaxants Anti-Diabetic Medications Cold medicines Allergy Medications

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Intervention & Referral

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Intervention & Referral

Steps to take with a performance problem:

Document the performance problem or issue

Prepare Set the stage

Use constructive confrontation

Refer for assistance Schedule a follow-up on progress towards meeting performance goals
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Constructive Confrontation
Tell employee you are concerned about his/her performance State problem(s)/situation(s) Refer to documentation of specific events Avoid over-generalizations Ask for explanation

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Constructive Confrontation
Avoid getting involved in discussions of personal problems

Try to get employee to acknowledge what you see as the problem

State what must be done to correct problem Set time frame for performance improvement

Specify consequences if problem continues

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Continued Supervision
After constructive confrontation and referral, the employee will need:

Continuing feedback about behavior and performance Encouragement to follow through with continuing care and support groups Accurate performance appraisals and fair treatment Time to adjust to doing things differently Respect for his or her privacy Open lines of communication Corrective action if old behaviors reappear
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Confidentiality

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Protecting Confidentiality
For supervisor referrals to be effective, an employee needs to know that: Problems will not be made public Conversations with an EAP professional or other referral agent are private and will be protected All information related to performance issues will be maintained in his/her personnel file
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Protecting Confidentiality
Information about referral to treatment will be kept separately Information about treatment for addiction or mental illness is not a matter of public record and cannot be shared without a signed release from the employee If an employee chooses to tell co-workers about his/her private concerns, that is his/her decision When an employee tells his/her supervisor something in confidence, supervisors are obligated to protect that disclosure
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EAP Services
If EAP Services Available, employees are also assured: EAP records are separate from personnel records and can be accessed only with a signed release from the employee EAP professionals are bound by a code of ethics to protect the confidentiality of the employees and family members that they serve There are clear limits on when and what information an EAP professional can share and with whom

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The Law Requires

Disclosure of child abuse, elder abuse and serious threats of homicide or suicide as dictated by state law Reporting participation in an EAP to the referring supervisor Reporting the results of assessment and evaluation following a positive drug test Verifying medical information to authorize release time or satisfy fitness-for-duty concerns as specified in company policy Revealing medical information to the insurance company in order to qualify for coverage under a benefits plan
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Enabling & Supervisor Traps

CAUTION!

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Enabling
Enabling: Actions you take that protect the employee from the consequences of their activities and actually help them NOT to deal with the problem Examples of enabling:
Covering Up

Blaming

Rationalizing

Controlling

Withdrawing/Avoiding
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Threatening
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Supervisor Traps
Sympathy Excuses Apology Diversions Innocence Anger Pity Tears

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Supervisor Dos
DO emphasize that you only are concerned with work performance or conduct DO have documentation or performance in front of you when you talk with the employee DO remember that many problems get worse without assistance DO emphasize that conversations with an EAP, if applicable, are confidential DO explain that an EAP, if applicable, is voluntary and exists to help the employee DO call an EAP, if applicable, to discuss how to make a referral
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Donts for Supervisors

DONT try to diagnose the problem DONT moralize; limit comments to job performance and conduct issues only DONT discuss alcohol and drug use

DONT be misled by sympathy-evoking tactics

DONT cover up; if you protect people, it enables them to stay the same

DONT make threats that you do not intend to carry out

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A Roadmap to a Safer, Drug-Free Workplace

Identify and investigate crisis situations Recognize workplace problems that may be related to alcohol and other drugs Intervene in problem situations Refer employees who have problems with alcohol and other drugs Protect employee confidentiality Continue to supervise employees who have been referred to assistance Avoid enabling and common supervisor traps
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A Safer, Drug-Free Workplace

Recognize the impact of alcohol and drug abuse on the workplace Understand and follow the Drug-Free Workplace Policy Know the types of assistance available Visit www.samhsa.gov, the website for the Substance Abuse and Mental Health Services Administration (SAMHSA), maintained by the US Department of Health and Human Services
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Additional Resources
To assist you in your program development, you can contact us for your own PowerPoint copy of: Drug & Alcohol Awareness-Employee

Department of Labor and Industry Bureau of Workers Compensation Email: RA-LI-BWC-Safety@pa.gov Phone: (717) 772-1635
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PATHS
PA Training for Health and Safety
PATHS is a no fee state-wide service providing Pennsylvania employers and employees with coordinated Health and Safety resources through easy access and affordability

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PATHS
At the PATHS Website you can:
View . . . Health & Safety Training PowerPoint briefings Access Safety Talks (Toolbox Talks)

Review . . . Course descriptions, objectives, and schedules

Participate. . . Employers can register online to participate in webinars and training sessions. Most sessions are free and are open to everyone
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PATHS

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PATHS
To Access PATHS
www.dli.state.pa.us/PATHS

or
www.dli.state.pa.us
Workers Compensation icon Health & Safety Division PATHS
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Contact Information
To contact a Health & Safety Training Specialist: Bureau of Workers Compensation 1171 South Cameron Street Room 324 Harrisburg, PA 17104-2501 717-772-1635 RA-LI-BWC-Safety@pa.gov

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Questions

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