provide information about physical, behavioral, speech and performance indicators of substance abuse...
TRANSCRIPT
FTA Supervisory Awareness - Reasonable Suspicion Training
Presented by:
Bev Krieger & Linda De HerreraPrecision Compliance, Inc.
ADOT/AZTASPRING CONFERENCE 2013
• Provide information about physical, behavioral, speech and performance indicators of substance abuse
• Increase knowledge of the effects of substance abuse on health, safety and workplace
• Learn how to identify and confront substance abuse in the workplace
• Build Supervisor confidence in making the reasonable suspicion decision to test
Today’s Objectives
• Required 60 minutes minimum training on drugs and 60 minutes on alcohol to make a reasonable suspicion observation.
• This training is for• Supervisors• Management• Lead people• *Anyone who is in a position to observe safety sensitive staff
Today’s Objectives, continued
• Those employees who:• Operate a Revenue Vehicle (whether it is in revenue service
or not)• Maintain or Repair of revenue service vehicles• Control or Dispatch• Employees who operate a vehicle that requires a CDL• Perform Security and carry a firearm• Supervisors who actually perform safety sensitive duties
Who is considered Safety Sensitive?
• Volunteers who do not receive any remuneration for services are exempt from testing:
(unless the volunteer is driving a vehicle that requires a CDL)
Who is considered Safety Sensitive? continued
Marijuana – 18.1 Million people 12 years and older Cocaine – 1.4 Million people 12 years and older
• Crack -359,000 people < 12 years old
Amphetamine • Methamphetamine – 439,000 people > 12 years old• Ecstasy (MDMA) – 555,000 people > 12 years old
Opiates • Heroin – 800,000 people > 12 years old
PCP – 21,000 > 12 years old
Psychotherapeutics - illegal use of prescription drugs 6.1 Million
Nationwide Trends in Drug Abuse
Within the past 30 days
*Source: 2010 National Institute on Drug Abuse
131.3 million Americans 12 yrs and older drank alcohol in the past month • 58.6 million “binge drinking” (5 or more drinks on the same occasion)• 16.9 million “heavy drinking” (Binge drinking on at least 5 days in a 30
day period)• 19 million admit to drinking on the job or just prior to going to work• 28.6 million people had driven under the influence of Alcohol at least
once in the past year
*Source: 2010 Household Survey on Drug Use
Who Uses Alcohol & How Much ?
• Cocaine Up to 4 days in the urine• Amphetamine 24-48 hours• Marijuana Up to 30 days• PCP Up to 8 days• Opiates 2 days• Alcohol Generally dissipates at a
rate of 1 oz. per hour and a half
Detection Times
• Pre-employment (must do drug test; may do alcohol)• Post Accident/Incident• Random
• Reasonable Suspicion (Today’s Focus)• Return-to-Duty (Must be an observed collection)
• Follow-up/unannounced (Must be an observed collection)
TYPES OF TESTING REQUIRED BY THE DOT/FTA
Post Accident Review Video
Toleration of drugs or alcohol in the workplace by doing nothing or ignoring the fact that the problem exists constitutes avoidance of responsibility by management. In court, both a company and its managers may be held accountable for failing to act in both the employee’s and the public’s interests by not challenging alcohol and drug problems in the workplace. You can be liable because you knew there was a problem, yet took no action.
Remember!
• Know the organization’s program and policy as it relates to the drug and alcohol program
• Be able to explain the program• Ensure an employee is fit for duty• Know where to refer employees for help and information• Observe and evaluate employee job performance and
safety• Identify behavior that may indicate safety concerns
Things You're Expected to Do!
It is not your job to diagnose alcohol or drug abuse problems
or, provide treatment or counseling services to employees with problems
or, act as the police or an expert in substance abuse
or, put yourself or anyone else in danger
Things You are Not Expected to do
• Specimen Validity Testing
Urine Drug Testing Process
Initial Screening - Immunoassays Confirmations - Gas
Chromatography/Mass Spectrometry (GC/MS)
Cut-off levels established by the DOT Split sample protocol for employees who
wish to challenge the results
Drug Testing Process, continued
• A licensed physician with knowledge of substance abuse disorders.
• An impartial professional, independent from the lab or the company, who, makes a final determination on whether a person was using a drug legally or illegally “The Gatekeeper” of all the drug test results.
Medical Review Officer (MRO)
• Breath Testing (screening and Confirmation)
• Saliva Alcohol Test (screening only)
Testing can occur just prior to, during and immediately after an Employee performs safety sensitive duties.
• Marijuana• Cocaine• Amphetamine
• Ecstasy• Methamphetamine
• Opiates• Pain Killers
• Phencyclidine (PCP) Testing can occur anytime a
Safety Sensitive Employee is on duty.
Urine Drug Test Alcohol Test
Testing Methods
• A safety sensitive employee is immediately removed from safety sensitive duties
• A referral must be made to a Substance Abuse Professional (SAP)
• Employee Cannot return until recommended by SAP and• Return to Duty test is negative and• Followed by unannounced, follow-up testing
Consequences of a Positive Test
Commercial Marijuana Candy
MarijuanaFunny, It Doesn’t Look Like Weed Anymore!
Marijuana is a dry, shredded green and brown mix of leaves, flowers, stems, and seeds from the hemp plant Cannabis sativa.
In a more concentrated, resinous form, it is called hashish.
The main psychoactive (mind-altering) chemical in marijuana is delta-9-tetrahydrocannabinol, or THC.
Marijuana smoke has a pungent and distinctive, usually sweet-and-sour, odor.
What is Marijuana?
• Smoked in hand-rolled cigarettes (joints)
• Smoked in pipes or water pipes (bongs).
• Smoked in blunts—cigars that have been emptied of tobacco and refilled with a mixture of marijuana and tobacco.
• Can also be mixed in food sold as candy or brewed as a tea.
How is Marijuana Used?
Cigarette papers Roach Clip holders Small pipes made of bone, brass or glass Large pipes called bongs
Common Paraphernalia
• Pot• Weed• Grass• 420• Ganja• Dope• Herb• Joint• Blunt• Cannabis
• Reefer
• Mary Jane
• Buds
• Stinkweed
• Nuggets
• Rope
• Gangster
• Skunk
• Boom
• Blaze
Street Names/Marijuana
Signs Red eyes Dry mouth Sleepiness Impaired reactions Decrease in short term
memory Dilated pupils
Symptoms Memory loss Euphoria Time distortion Decreased motor
coordination Paranoid behavior “Munchies”
Marijuana
• Impairs driving• Difficulty in decision making• Lazy, “I don’t care” attitude• Impaired short term memory• Impacts visual ability to follow moving objects• Time distortions• Difficulty in concentration• Smell of marijuana
Workplace Indicators
Cocaine
Cocaine is a drug (paste) extracted from the leaves of the South American coca plant. Usually processed into a powder.
It is a strong stimulant that effects the body's central nervous system.
Cocaine is the most potent stimulant of natural origin and a popular recreational drug.
What Is Cocaine?
Crack cocaine" is a mix of cocaine and baking powder (sodium bicarbonate). The ingredients are boiled down to a solid substance. It is then dried and then broken into small lumps or 'rocks‘ that are off -white in color.
What Is Cocaine? continued
Snorted Injected Smoked Rubbed on the gums When smoked, the cocaine vapors reach the
brain much quicker than snorting, producing an intense but short-lived euphoric rush and - very quickly - a compelling desire for more.
How is it Used?
Single edged razor blade Small mirror or piece of smooth metal Rolled up dollar bill Half straw or metal tube Small screw cap vial Folded paper packet
Common Paraphernalia
White Pony Flake “C” The Lady Cain Neurocain Rock Powder
Coke Crack Snow Dust Toot Line Nose Candy Sneeze
Street Names for Cocaine
Rush of energy Feeling of “euphoria” Racing heart rate Rise of blood pressure
and body temperature
Dilated pupils Runny nose Talkative Irritable Argumentative Difficulty sitting still Massive burst of
energy Extreme joy
Signs and Symptoms
• False sense of confidence may cause poor performance and accidents
• A false sense of Bravado interferes with relationships with coworkers
• Dramatic mood and energy swings • May disappear from the workplace area during the day• Poor attention to detail and warnings• Paranoia causes unpredictable and violent behavior which may
effect employee inter-personal relationships• Absenteeism, tardiness and forgetfulness
Workplace Indicators
Opiates
All opiates are derived from opium, a juice extracted from certain varieties of poppy.
Narcotics/Pain Killers/Depressants• Opiates (Natural)
• Morphine• Codeine
• Opioides (Synthetic)• Heroin• Opium• Hydrocodone (Hycodan)• Oxycodone (Percodan)• Demerol• Darvon
What are Opiates?
Heroin• Is an illegal form of opiates, it mimics
the action of naturally occurring endorphins
on the brain by producing euphoria.• Injection has always been the popular method for heroin use
because it is the most effective way to obtain a “high.”• Heroin with higher purity is usually snorted or smoked.
What are Opiates?
Prescription opiate abuse is on the rise as well. Oxycodone, especially in its pure, time-release form (Oxycontin), is very dangerous when misused.
What are Opiates? continued
Taken orally in pill form Smoked in powdered form Snorted in powdered form Injected in liquid form
How are Opiates Taken?
Needles and syringes
Glass or metal pipes Cut straws Small pieces of
aluminum foil. Tunicates
Common Paraphernalia
Heroin Black Tar Opium, Morphine and Smack China White Horse “M” Miss Emma Hillbilly Heroin (Oxycodon)
Street Names - Opiates
Mental dullness Poor coordination Lethargy and drowsiness Cold, moist skin Crawling skin (itching) Slurred speech Constricted pupils
Signs and Symptoms
• Nausea• Dull Expression/Droopy Eyelids• Confusion• Lack of Coordination• Cold and Clammy Skin• Needle Tracks
Signs and Symptoms, continued
• Lack of coordination• Impaired driving ability• Impaired mental and physical functions• Drowsiness• Fatigue• Itching• Reduced vision
Workplace Indicators
Amphetamines
Central nervous system stimulant Amphetamine is the name given to a group of synthetic stimulants which
are chemically similar to adrenaline, the hormone used for 'fight or flight' emergencies.
Can be used medically to treat • Narcolepsy• Depression• Attention Deficit Hyperactivity Disorder (ADHD)
Methamphetamine and Ecstasy are the illegal drugs in the amphetamine class
What are Amphetamines?
Methamphetamine or “Meth” Is the most potent drug of this category. It is highly addictive. Methamphetamine operates on the brain by producing a surge
of dopamine production, giving the user a sense of euphoria, lasting up to 12 hours.
The fast acting effects produced when injected
or smoked is an extreme pleasure sensation called a “rush”.
What are Amphetamines?
Methamphetamine or “Meth” Meth is a crystal-appearing rock that
can be ground into powder and,
when flaked, looks like small
shards of glass. Crystal meth is often produced in
home laboratories. Abusers will begin to show signs of
dental decay including loss of teeth.
What are Amphetamines? continued
Ecstasy (MDMA) A mixture of methamphetamine or amphetamine and a hallucinogen. It is
manufactured in home laboratories. When a person takes XTC, the drug causes the brain to produce higher
levels of serotonin, which are chemicals produced by the brain. The body has difficulty regulating temperature or hydration while under the
affects of Ecstasy. Ecstasy gets its name from the feeling of euphoria that most users claim
when taking the drug.
What are Amphetamines? continued
Pure MDMA is a white powder but street ecstasy is usually pressed into pills, usually colored and stamped with different brand logos.
What are Amphetamines? continued
Taken orally in pill form Snorted or rubbed on the gums Smoked with a pipe or crushed
soda can Injected
How are Amphetamines Taken?
syringes needles spoons pipe or tube
Common Paraphernalia
• Bennies • Bumble Bees• Cross Tops• Crystal Meth• Hearts• Hot Ice• Pep pills• Uppers• Ice
• Methedrine• Dex• Speed• Crank• Meth• Crystal• Black Beauty• “X” (ecstasy)• Hug drug (ecstasy)
Amphetamine Street Names
• Tremors• Talkativeness• Inability to concentrate• Aggressive behavior• Dry mouth• Poor appetite• Inability to sleep
• Dilated pupils• Hyper-excitability• Heart palpitations• Increase heart rate/blood
pressure• Sweating• Rapid breathing• Itching
Signs and Symptoms
• Inability to concentrate• The jitters• Careless behavior• Angry outbursts• Extreme wakefulness• Increased speech and motor activity• When coming “down “extreme fatigue
Workplace Indicators
The Faces of Meth
9 months later2 months later
Phencyclidine (PCP)
Originally designed as an animal tranquilizer. It was never intended for human use.
Acts as a hallucinogen, stimulant, depressant and an anesthetic all at the same time.
PCP can trigger a number of negative effects. “Flashbacks” may occur after the initial experience. These
effects sometimes last for up to six weeks
What is PCP?
Snorted Swallowed Smoked Injected The liquid form is generally poured onto a
cigarette or marijuana joint and smoked.
How is PCP Taken?
Foil wrappings Small vials of liquid. Cigarettes that appear to have been dipped in
chemicals may indicate PCP use.
Common Paraphernalia
• Angel Dust• Ozone• Rocket Fuel• Wack • Purple Rain• Killer Joints (when added to marijuana)
PCP Street Names
Memory Loss Violent behavior Delirium Paranoia Psychosis Convulsions Delusions resulting in
injury
Extreme mood shifts Both stimulant and
depressant properties Difficulty in speaking Staggering gait Numbness in extremities Disorganized thoughts Apathy Rigid muscles
Signs and Symptoms
• High accident potential• Loss of coordination• Hallucinations• Distorted speech• Violent behavior• Paranoid behavior • Psychotic episodes
Workplace Indicators
Video – Drugs
Alcohol
Absorbed through stomach and small intestineTakes 3-5 minutes to reach the brain
(Blood/Brain Barrier)Takes About 30-60 minutes for absorption/full effectBody eliminates alcohol at the rate of a drink every
hour and a halfAlcohol can be found in candies, mouthwash and
medicationsFood slows absorption
Alcohol in the Body
Alcohol Absorption
Beer12 oz x 5% = 0.6 oz of ethanol
Wine5 oz x 12% = 0.6 oz of ethanol
Distilled Spirits (80 proof) A standard Serving contains the same amount of
ethanol as beer or wine (0.6 oz of ethanol)
Its All The Same
• Lapse of memory• Smell of an Alcohol Beverage• Excessive mouthwash , aftershave
or perfume• Relationship dysfunction• Finances out of control• Loss of interest in prior hobbies
and activities
• Decreased Inhibitions• Dizziness• Nausea• Slow reflexes• Slurred speech• Blackouts • Poor concentration
Signs and Symptoms
Conciousness
Involuntary Muscles
Large Motor
Fine Motor
Memory
Judgment
Effects of Alcohol
1-4 drinks: Inhibitions loweredOverly friendly behaviorInhibits good judgmentInappropriate behaviorRepetitive speech
5-8 drinks: Loss of motor controlSlow reaction timeBalance problemsEye hand coordination impairedSlurred speechUninhibited speech
Effects of Alcohol, continued
5-8 drinks: ConfusionDifficulty rememberingDrowsiness
9-plus drinks: Loss of ability to reasonLoss of major muscle controlStuporUnconsciousness Blackouts Alcohol poisoningDeath
Conciousness
Involuntary Muscles
Large Motor
Fine Motor
Memory
Judgment
Initial Screen:less than 0.02% BAC = Negative Result0.02% BAC or greater = Confirmation
Confirmation: (15-30 minutes after screen)less than 0.02% BAC = Negative Result0.02%-0.039% BAC = Off duty for 8 hours or next shift which ever is greater or test again with results less than 0.02%0.04% BAC or greater = Policy Violation/SAP referral
Federal Alcohol Cut-off Levelsand Consequences
• Performance of a safety sensitive function is prohibited:
• When having an alcohol concentration of 0.02% or greater• If alcohol (of any form) is consumed within four hours of
reporting for safety sensitive duties.• Use of alcohol is prohibited for 8 hours following an
accident or until testing is completed• Refusal to submit to a required test
Prohibited Alcohol Behavior
• Unexplained absences• Over reaction to criticism or
directions• Changes in appearance• Incessant apologies• Less concern about safety• Unreliable
• Smell of Alcohol• Lack of coordination• Increased accidents• Poor coworker relations• Lack of efficiency• Confusion
Workplace Indicators
• Use is defined as taking a substance (alcohol, illegal drugs or prescription drugs in higher doses than prescribed)
• Abuse is defined as continued use with negative legal, workplace and personal consequences (stopping is still a choice at this point)
• Addiction (“Chemical Dependence, Alcoholism, Drug Addiction”) is defined as the point at which the individual can no longer stop on his/her own, despite SEVERE consequences
DEFINITION OF ALCOHOL USE, ABUSE AND ADDICTION
Video - Alcohol
Reasonable Suspicion
Interview, Referral and Testing
Be Attentive To:• Rising accident rates• Increased absenteeism or tardiness• Monday/Friday absences• Decreased productivity• Deteriorating coworker relationships• Peculiar and improbable excuses
Observation
• Be Attentive To: continued.
• Late arrival and early departures• Excessive sick leave• Confusion and inability to concentrate• Irresponsibility• Generally lowered efficiency• Mood swings, especially between morning & afternoon• Over-reaction to real or imagined criticism• Wide swings in morale• Borrowing money• Co-workers’ complaints
Observation
Signs and Symptoms of possible substance use/abuse must be:
Contemporaneous:
• Short Term Indicators• Appearance• Speech• Behavior • Body Odor• Paraphernalia
When to Make a Referral
Signs and symptoms must be:• Objective
• Use the “Reasonable and Prudent Rule”• Is this employee fit for duty?• Would another trained supervisory come to the same
conclusion?
• Specifically describe the signs and symptoms. • Don’t use general terms like “drunk”, “acting strange”
or “weird”.
Making a Referral, continued
A Reasonable Suspicion Testing Referral must be based on:
• Actual Knowledge (not hearsay)• Specific Indicators based on observation • Inappropriate Behavior • Performance Problems (and short term indicators)• Articulable/objective observations
Making a Referral, continued
• Immediately remove the employee from Safety- Sensitive duty
• Interview the employee in a private area• Be prepared with your documentation• Be confident, diplomatic and polite but firm
Taking Action
• Tell employee of your findings and concerns• Be objective/no opinions regarding indicators:
• Behavior• Appearance• Odors• Paraphenalia
• Give the employee a chance to explain
The Interview
• Explain your concerns, the regulations and the reasonable suspicion procedure.
• Expect denial, anger or threats• Employee has the right to refuse; explain the
consequences• Escort the employee to the collection site and arrange
transportation home• Testing must be done for both Alcohol and Drugs
Remember: Alcohol testing should be done before the urine collection
The Interview, continued
• Don’t diagnose substance abuse or guess at what drug someone is using.
• Don’t confront the employee in front of other employees• Don’t accuse the employee of using illegal drugs or
alcohol; stick to what signs and symptoms you see.• Don’t enable the employee by making excuses,
covering for the employee or giving them money.
Supervisory Pitfalls
• Don’t put yourself in the role of counselor.• Listen, don’t give advice• Know where to refer someone if they need professional
help • Don’t discuss your decision or results with other employees.• Don’t fall prey to sympathy or excuses (“you know my wife left
me”, “I have been up for the past 3 nights with the baby” ). It may be true, however, it doesn’t change the fact that the employee appears to be unfit for duty.
• Don’t make threats
Supervisory Pitfalls, continued
• Required documentation must be maintained for 2 years.
• Document reasons for any delay greater than 2 hours. • Cease attempts for alcohol testing after 8 hours/Drugs 32 hours
• Use your agency’s Referral Form.
Documentation Requirements
Employee Manipulations• Angry Outbursts:(“How dare you accuse me”)
• Don’t react! Wait until the employee has run out of steam, then calmly continue. Focus on performance and safety
• Denial: (“No way, nothing is wrong”)• Have documentation on hand. Focus the interview on
performance indicators, concerns about safety (both the employee’s and the public’s safety)
What to Expect
Employee Manipulations, continued
• Threats (“I’ll go to an attorney”, “I’ll quit”)• Remind the employee he/she may do whatever
he/she chooses however, as a supervisor your responsibility is to uphold the agency’s policy and protect the safety of the company and the general public.
What to Expect
• All discussions regarding an employee’s drug or alcohol test results, or performance problems should be done in private.
• If an employee chooses to tell coworkers about their private concerns, that is his/her decision.
• Do not release information without a specific written release from the employee.
CONFIDENTIALITY!
Case Studies
What Would You Do?
Jerry was at the end of his shift performing a post trip inspection on his bus.
A new dispatcher for the company observed Jerry and came to the conclusion that Jerry had been drinking.
The dispatcher approached Jerry and accused him of being drunk. Jerry denied that he was intoxicated. He said that he had donated blood to a blood bank two days earlier and has felt light-headed ever since.
Case Study #1
Jerry also stated that he felt ill while driving back from his route and that may be why the dispatcher believed that he had been drinking.
The dispatcher told Jerry he wobbled going from the time clock to the break room. The dispatcher also told Jerry that in the past ten years in his previous position at a cab company he had handled at least twenty cases of drunk drivers so he considers himself and expert and knows what a person who has been drinking looks like.
Lets discuss the facts….
Case Study #1 continued
Derek is the Maintenance Supervisor at the local transit agency. As he was scheduling vehicles for preventative maintenance appointments he saw Michael Smith and Jim Ross the two night shift mechanics walk past him coming from the direction of the men’s locker room. Derek went into the locker room, and noticed a set of keys, a pack of cigarettes, and a straw about three to four inches long, with a white residue on one end sitting on a bench.
Case Study #2
Derek immediately called the men back into the locker room. He asked if the items belonged to either of the mechanics. Michael said that he left his keys and cigarettes but he had no idea where the straw came from. Jim also denied the straw belonged to him.
Derek took the two men in to his office, he explained and documented his decision and informed them that he was going to refer them for a reasonable suspicion test.
Let’s discuss the facts…
Case Study #2 continued
Acme Transit’s dispatcher receives a call from a woman stating that she had been on the road with one of Acme’s buses and the bus was traveling in an erratic manner and moving at a high rate of speed.
When the bus arrives at the garage the dispatcher calls the driver in and explained the phone call he received and asked if the driver had consumed alcohol or used drugs any time before or during his shift. The driver responded that he had not and he was not driving erratic or fast.
Case Study #3
The dispatcher did not smell alcohol on the driver nor did he notice any other indicators that would call for a reasonable suspicion test. However, trying to maintain good relations with the public and based on the caller’s observations the dispatcher felt that there was reasonable suspicion and possible safety concerns. The dispatcher informed the driver that he had to go to the collection site for a reasonable suspicion test.
Lets discuss the facts…
Case Study #3 continued
Case Study #4As a supervisor you notice that Max, one of your best operators, has been coming in late for the past couple of weeks. His uniform isn’t as well pressed as it used to be. He is quiet and sometimes grumpy, unlike his usual friendly behavior.
You know that many years ago he had a problem with alcohol abuse. You are concerned that he may be in trouble again. You question if you should send him in for a test just to be sure he is ok. You decide its better to be safe than sorry and send him for a test.The result is negative.
Let’s discuss the facts…..
Case Study #4 continued
A few weeks later you notice that Max is lethargic, and was stumbling off the bus. His speech is a bit slow and erratic. You decide to interview him. He states that he has been up all night with a sick baby because his wife left him a few weeks ago.
You decide that you should test him again, but Max gets angry and refuses, saying that he was already tested and results were negative. He said, “I have enough hassles in life and won’t put up with this harassment”.
Lets discuss the facts….
Remember!Safety Starts with You.
Thank You!