ANSWERING THE QUESTION OF IMPAIRMENT, TO CHANGE THE WAY WE SEE

THE WORLD

John Brown

DriveABLE, Vice President

Edmonton, Alberta

Key Presentation Take-Aways

• THE NEED FOR IMPAIRMENT TESTING

• WHAT IS IMPAIRMENT?

• EMBRACING A MULTI-FACETED APPROACH TO FIND A SOLUTION

• THE COMPONENTS TO ADDRESS THE QUESTION OF IMPAIRMENT

• ESTABLISH IMPAIRMENT USING COGNITIVE SCIENCE

• UP AND COMING TECHNOLOGY

HOW MANY OF YOU HAVE AN ESTABLISHED DRUG POLICY WITHIN

YOUR TRANSIT SYSTEM?

HOW MANY ARE CONCERNED ABOUT THE FITNESS TO WORK OR, IN SPECIFIC, THE FITNESS TO DRIVE

OF YOUR EMPLOYEES?

THE NEED FOR IMPAIRMENT TESTING

THE CHALLENGES IN ESTABLISHING IMPAIRMENT

• No definitive impairment threshold

▪ A quantitative threshold for per se laws for THC, following cannabis use, cannot be scientifically supported

▪ Limited application for serum assessment

• Differing speed in which opiates/opioids are metabolized

• Chronic versus casual users

• Dramatic increase in multi-source impairments

• Decisions are subjective

THE CHALLENGES IN ESTABLISHING IMPAIRMENT

• Decisions are referenced from generalized evidence

• Low accuracy of the Standard Field Sobriety Test

• Lack of resources for drug recognition expert training programs

• Limited impaired driving convictions across jurisdictions

• Focus has been directed to a single “Holy Grail Test”

SOLUTIONS CURRENTLY ADDRESSING THE ISSUE

Urine samples

Blood testing

Breathalyzer

Saliva swabs

EMBRACING A MULTI-FACETED APPROACH TO FIND A SOLUTION

• Establish an assessment protocol

• Encompasses the strengths of different components

• Ensures that people are fairly treated (people are not discriminated against)

• Components all lead to answering the question of whether a person is impaired

• It operationalizes a policy, by ensuring each step is followed, to maintain consistency in application and collection of evidence

Identify candidates based on established policy

Capture information to establish “reason to suspect”

Establish impairment using cognitive science

Establish reason for impairment

THE COMPONENTS TO ADDRESS THE QUESTION OF IMPAIRMENT

Respond

Selection sampling or observational evidence

Official documentation of observable evidence of

potential impairmentEstablish if impairment exists at a point in time using evidence based cognitive measures

If impairment is established, determine cause via Serum test or physician evaluation

Use evidence to drive corrective or disciplinary action

IDENTIFY CANDIDATES BASED ON ESTABLISHED POLICY

The importance of a strong drug and alcohol policy:

• Provides the framework for consistent and fair impairment testing within the workplace

• Establishes transparency between employer and employee, by setting clear expectations

• Sets out the criteria for being selected, either on a periodic or random basis

• Provides insight into what each step of the “Impairment assessment” protocol will involve

CAPTURE INFORMATION TO ESTABLISH “REASON TO SUSPECT”

Establishing “Reason to Suspect”:

The Reason to Suspect screening process:

▪ Administered by a trained individuals

▪ The steps followed to align with the organization’s drug and alcohol policy

▪ Comprehensive documentation

CAPTURE INFORMATION TO ESTABLISH “REASON TO SUSPECT”

Embrace the benefits of technology:▪ Guides the administrator through the process (reduces the risk of

inexperience)▪ Addresses the requirements set out in the drug and alcohol policy

(“takes the policy to the field”)▪ Enables consistency of policy application and screening outcomes▪ Ensures information that is needed, is captured in the correct format

and is complete▪ Establishes a level of objectivity and fairness to the assessment▪ Streamlines the documentation process and provides a standardized

report, specific to the employee being assessed

ESTABLISH IMPAIRMENT USING COGNITIVE SCIENCE

Why is cognition an important component, when looking at impairment?

▪ Cognition encompasses how a person understands the world and acts in it

▪ It is the set of mental abilities or processes that are part of nearly every human action while we are awake. Cognitive abilities are brain-based skills we need to carry out any task

▪ In the event that a person’s cognitive skills have been compromised (regardless of the cause), there is an increased likelihood of the person concerned being unable to complete a task correctly, which could put their life and the lives of others at risk

Using driving as a proxy to “safety sensitive” performance

Compelling evidence exists in support of the notion that Cannabis, like alcohol and like opioids, can impair skills required for safe driving

The required cognitive skills and capacities for safe driving include:

▪ alertness, attention, concentration, coordination, reaction time, memory, ability to multi-task, perceptual abilities, thought processing, judgment, and insight

The cognitive skills required for safety-sensitive work tasks overlap to varying degrees with those required to safely operate a vehicle

Driving can be viewed as a proxy for determination of levels of impairment for other safety-sensitive duties

ESTABLISH REASON FOR IMPAIRMENT

▪ Blood, Saliva, Urine

▪ Physician examination

▪ Provide factual evidence to what is causing impairment:

▪ Medical conditions

▪ Opioids, Opiates

▪ Environmental factors

RESPOND

▪ Information collected from each of the steps, empowers decision makers to respond appropriately

▪ Standardized evidence is collected in a central repository to support:

▪ Disciplinary action

▪ Medical rehabilitation

▪ Collection of data to identify focus areas for risk

▪ Proactive nature allows the employer to address the risk before it materializes and ensure safer work environments

Questions?