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Supervisor Drug / Alcohol Training for University of Idaho

Supervisor Drug / Alcohol Training for University of Idaho. February 11, 2015. Agenda. Cost of Substance Abuse in the Workplace Impact of alcohol and drug abuse Signs and Symptoms of Substance Abuse Stages of Addiction in the Workplace – alcohol and other drugs Supervisor Responsibilities

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Supervisor Drug / Alcohol Training for University of Idaho

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  1. Supervisor Drug / Alcohol Training forUniversity of Idaho February 11, 2015

  2. Agenda • Cost of Substance Abuse in the Workplace • Impact of alcohol and drug abuse • Signs and Symptoms of Substance Abuse • Stages of Addiction in the Workplace – alcohol and other drugs • Supervisor Responsibilities • Reasonable Suspicion Testing

  3. Substance Abuse and the Workplace • Economic cost of alcohol and drug abuse is estimated at $366 b/year - cancer $171 b; diabetes $131 b (NIDA) • 77% of illegal drug users hold either full-time or part-time jobs • Studies have shown that employees who are substance abusers are more likely to: • Frequently change jobs • Show up late or are absent from work • Be less productive • Become involved in a workplace accident • File a workers compensation claim (Source: US Department of Health & Human Services, (2009); The Center for SA Prevention at the US Dept. of HHS)

  4. Impact of Alcohol and Drug Abuse • $12 billion lost annually to accidents and lost time • Employees who test positive: • Incur 300%+ more health costs • Are 1/3 less productive • Are absent from work three times as often • File twice as many worker’s compensation claims • Use twice as many medical benefits • Are 60% more likely to be responsible for accidents • Each employee pays about $640 per year to cover the cost incurred by substance users

  5. Effects of Drugs and Alcohol on Individuals Depression Low self esteem Outbursts Anger Mood swings Weight gain or loss Unkempt appearances Smell of alcohol Slow reaction time Impaired coordination Slowed or slurred speech Irritability Excessive talking Poor motivation or lack of energy Accidents or injuries Blackouts, sweating, chills Legal problems Poor job performance Family problems Sexual behavior that increases the risk of HIV infection Aggression Burnout Anxiety Paranoia Denial Inability to sit still Limited attention span

  6. Effects of Drugs and Alcohol on the Workplace Performance deterioration Productivity decreased Decision making impaired Risk to employee and public safety Decline in employee morale Security risks Employee health issues Increased absences Tardiness Inaccuracy Missed deadlines Increased accidents Organizational image and community relation issues Risk to overall company profits

  7. Effects of Drugs and Alcohol on Home Strained relationship with spouse/ significant other and children DUI’s Deflecting responsibilities Missed events of children – e.g. school plays, games. Isolating behaviors Health problems – medical bills Legal problems Job loss Financial stressors Borrowing money from others Credit collectors Decreased intimacy Secrets Blaming others

  8. Medical Problems • AIDS • Tuberculosis • Certain types of cancer • Higher risk for all cancer • Pancreatitis • Mental Illness (60% to 75% co-occurring) • Cirrhosis of the liver • Hepatitis • Lung Problems • High blood pressure • Heart problems • Diabetes A sound drug policy and educated workforce helps reduce all these effects

  9. Using a substance to modify or control mood or state of mind in a manner that is illegal or harmful to oneself or others Abuse Potential consequences of abuse include: • Accidents or injuries • Blackouts • Legal problems • Poor job performance • Family problems • Risk-taking behaviors

  10. How to Recognize Substance Abuse • Observe behaviors, look for changes in behavior, personality and mood • Identify physiological changes—hyperactivity, coordination problems • Remember, it is not your role to diagnose anyone with suspected substance abuse; these are signs and symptoms to respond to cautiously and immediately, but they do not necessarily mean that a person is a substance abuser.

  11. Work Signs of Substance Abuse • Being careless, repeatedly making mistakes • Damaging equipment or property • Accidents, regardless of whether that individual is the one who is injured • Being unreliable/being a slacker—not carrying one’s load • Showing a lack of detail in performing routine job duties • Being unwilling to follow directions • Being argumentative • Giving elaborate, increasingly unbelievable excuses • Being unresponsive to usual cajoling • Taking unnecessary risks • Disregarding safety for self and others

  12. Addiction • The irresistible compulsion to use alcohol and other drugs despite adverse consequences • Characterized by repeated failures to control use, increased tolerance and increased disruption in the family

  13. Stage Two Increased absenteeism Difficulty with co-workers (unreasonable resentment) Borrows money from co-workers with increasing frequency Excess of excuses/alibis Reduced performance Increased minor accidents Outward signs of abuse Hangovers Physical signs Stages of Chemical Dependency in the Workplace • Stage One • On the job “absenteeism” • Signs of difficulty in personal life • Difficulty concentrating • Complaints of not feeling well • Decreased efficiency • Avoids supervisor • Occasional shortened days • In late • Long lunches • Out early

  14. Stage Four Significant personal losses Decreased self-respect Totally undependable Increased substance abuse Visible physical deterioration Generally incompetent Threat of job loss or actual job loss Illness, death, imprisonment Stages of Chemical Dependency in the Workplace • Stage Three • Repeated absences of several days (sometimes, without notification) • Broken promises to supervisor • Problems with courts/spouse • Apparent money problems • Extreme fluctuations in personality or mood • Refuses to discuss problems • Underperforming

  15. Anxiety Dysphoria ProlongedDRUGUSE CRF = Stress DA = Dysphoria Serotonin = Dysphoria GABA = Anxiety/panic Neuropeptide Y = Stress Norepinephrine = Stress Abstinence Why treatment and follow-up testing are crucial! Urges Cravings Relapse

  16. Components of Comprehensive Drug Abuse Treatment

  17. Alcohol and other Drugs • Sedatives • Marijuana • Cocaine • Amphetamines and methamphetamines • Opiates/narcotics • Hallucinogens, psychedelics and PCP

  18. Immediate Effects of Alcohol • Odor on breath • Initial stimulation, followed by depressed nervous system • Flushed skin • Glazed appearance of the eyes • Slowed reaction time • Impaired motor skills • Difficulty focusing

  19. Alcohol • Stays in the body for up to 24 hours • Effects • Body processes .015 BAC per hour • BAC = 0.10: Simple reactions, such as braking are 11% slower • BAC = 0.05 Complex reactions, such as braking, steering and shifting are 41% slower • BAC 0.5 Usually fatal

  20. Blood Alcohol Levels .02Mellow feeling, less inhibited, body warmth .05 Noticeable relaxation, impaired coordination .08 Limit for DUI, impaired judgment .10 Noisy, embarrassing behavior, mood swings .15 Impaired balance, clearly drunk .30 Many pass out .40 Most pass out, some die .50 Breathing stops, many die

  21. Blood Alcohol Levels

  22. Blood Alcohol Levels

  23. So what if I went out last night! • 2:00 AM - Go to bed with BAC of .19 • 4:00 AM - Sleeping with BAC of .16 • 6:00 AM - Get up for work with BAC of .13 • 7:00 AM- Leaving home with BAC of .115 • 8:00 AM- At work with BAC of .10 • 9:00 AM - Spills coffee with BAC of .085 • 10:00 AM - Still impaired at .07 • 12:00 Noon - Still impaired at .055

  24. Sedatives • Sedatives are depressants, typically prescribed for anxiety management or as a sleep aid • They have similar effects to alcohol • High potential for overdose with all sedatives, particularly when combined with alcohol • Look for these signs and symptoms of abuse: • Eyes react slowly to light • Slurred speech • Drowsiness • Disorientation • May mimic alcohol abuse symptoms, but without odor

  25. Opiates/Narcotics • Opiates are narcotics, derived from the poppy plant • They are injected into a vein, swallowed, smoked or snorted • In small doses as painkillers, narcotics cause an initial feeling of euphoria • This is followed by drowsiness, nausea and vomiting. • Intoxication can cause the pupils of the eyes to constrict, confusion, mental dullness or slurred speech • Heroin is highly addictive; withdrawal symptoms begin within four to six hours after the last injection

  26. Opiates • Heroine and prescription drugs • Oxycodone, Oxycontin (up 4x) (Percodan/Percocet) • Codeine • Methadone • Delaudid • Ultram • Vicodin (Hydrocodone -Lortab) • Surge of euphoria ("rush") • Warm flushing of the skin • Dry mouth, constipation • Constricted pupils • “On the nod," an alternately wakeful and drowsy state • Mental functioning becomes clouded

  27. Depressants Effects When Operating Machinery • Impaired reaction time • Visual distortion/pinpoint pupils • Lowered concentration • Less inhibited, more risk taking • React in anger to other motorists • High followed by stupor • Difficulty focusing

  28. Stimulants • Cocaine (snorted) Crack (smoked) • Amphetamines • Crank, Ice, Crystal, Speed • Methamphetamine • Ecstasy (MDMA) up 2% (stim + halluc) • Prescription Drugs • Ritalin, Concerta, Adderall

  29. Immediate Effects • Euphoria • Mind races • Dilated pupils • Increased blood pressure, heart rate, respiration rate and body temperature

  30. Stimulants – Signs and Symptoms of Abuse Restlessness and depression Lapses in attention and concentration Aggressive behavior, grandiosity Overreaction, suspiciousness, paranoia Restlessness, talkative but changes subject Sweating/tremulous Blurred vision Dry mouth frequent lip licking; nose bleeds

  31. Stimulants - Effects When Operating Machinery • Impaired coordination • Lapses in attention and concentration • Tendency to overreact/overcompensate • Impaired judgment • Distorted vision and difficulty in seeing • False sense of alertness and security • Anxiety, irritability, accident prone

  32. The Meth Brain

  33. Faces of Meth (Multnomah County)

  34. Marijuana THC (Pot, grass, joint, reeferPot, grass, sinsemilla, blunts, mota, yerba, grifa ,Aunt Mary, Boom, Chronic (marijuana alone or marijuana with crack), Dope ganja, Gangster, Hash, Herb, Kif, Mary Jane, Pot, Reefer, Sinsemilla, Skunk, Weed) Hash, hashish Tranquilizes, alters mood; perception Can impact memory, immune function, motivation, anxiety, mood, and cause psychosis (COMT gene).

  35. Facts On Marijuana Reddened eyes Giddiness Moodiness Slowed reflexes Reduced concentration Problem-solving difficulties Anxiety/panic • Trance-like state • Short-term memory loss • Slowed speech • Lackadaisical “I don’t care” attitude • Distorted sense of time

  36. Signs and Symptoms of Abuse • Rapid, loud talking • Excessive laughter • Sensory distortion • Increased appetite • Odor similar to burnt rope/sweet grass • Paraphernalia • Suspiciousness, paranoia

  37. Facts on Marijuana (cont.) • Workplace Issues: • Delayed decision-making • Time distortions • Diminished concentration • Impaired short-term memory • Impaired visual tracking • Erratic ability to understand and learn • Interpersonal conflict/suspiciousness

  38. Medical Marijuana Card • Card is protection for owner from getting citation for possession and growing. • Not a prescription or an authorization for DOT or workplace • Does come in prescription forms: Marinol, Cesamet, and Sativex (UK, Canada) used for nausea and pain in patients with CA and MS pain • Rx is safer and can be covered by some insurances and allowed by some employers

  39. Hallucinogens Phencyclidine (PCP) Acts like hallucinogen, depressant/stimulant Signs and symptoms: Dilated pupils Rigid muscles, strange gait Impaired coordination Severe confusion Unpredictable moods (passive to violent) Jerky eye movements, dilated pupils Delusions, anxiety, panic, terror Increased blood pressure Seizures; convulsions

  40. Phencyclidine: Effects When Operating Machinery • Impaired coordination • Risk-taking behaviors • Reduced concentration • Severe disorientation

  41. Other Drugs of Concern • Salvia Divnorum (Sal, Magic Mint, Mystic Sage) • Herb found in Sierra Mazatec Region in Mexico • Used as psychedelic and smoked • Stimulates opioid receptors • Analgesia, hallucinations, changes in visual perception, mood, and external reality, difficulty interacting with self/surroundings, Dizziness • People like it for the “trip,” happiness, hallucinations • Dislike it for short duration, fatigue, heaviness, dizziness • Oral use from liquid extract, leaves, tea, pills, seeds

  42. Other Drugs of Concern • Synthetic Marijuana(K2; Spice, Serenity, Genie, Hush, etc.) • Ingredient (JWH) impacts canabinoid receptors • Dry mouth, Light headed, blurred vision, agitation, restlessness, normal pupils, perceptual changes, time distortion, mild anxiety/paranoia, sedation, exhaustion • Up to 4 times more powerful than marijuana • March 1st 2011 DEA banned possession and distribution

  43. Other Drugs of Concern • Synthetic Stimulants(Bath Salts, Plant food, Ivory wave, Red Dove, Blue silk, Cloud Nine and, etc.) • Active Ingredients vary: MPDV, Mephedrone, Pyrovalerone • Cocaine/Meth-like effects including, aggression, paranoia, suicide • Intense cravings, high risk for overdose – increased ER visits – deaths reported in US and Europe • White House has issued ER alerts -- Legislation to ban in HI, MI, LA, KY

  44. Inhalants Volatile Solvents Thinners, removers, cleaning fluids, gas (benzene, toulene), glues, correction fluid, felt markers Aerosols (propellants contain solvents) Spray paints, deodorants, cooking sprays, fabric sprays Gases (i.e., medical gases) Ether, chloroform, nitrous oxide (whipped cream can), butane lighters, refrigerants (Freon) Nitrites (work by dilating blood vessels/relax muscles) Cyclohexyl nitrite, isobutyl nitrite, amyl nitrite (video head cleaner, room deodorizer, leather cleaner, liquid aroma). Used to enhance sexual experience

  45. Inhalants • Signs • Chemical odors on breath/clothing • Paint/stains on face/hands/cloths • Hidden empty containers/soaked rags • Drunk/disoriented appearance • Slurred speech • Nausea or loss of appetite • Inattentiveness, lack of coordination, irritability, depression.

  46. Drug Abuse and Mental Illness • Signs of drug use similar to symptoms of mental illness… • Depression • Irritable, angry, sad, anergia, amotivation, anhedonia, problems concentrating, hopelessness • Mania • Racing mind/speech, irritable, euphoria, grandeur, many started projects, spending

  47. Drug Abuse and Mental Illness • Mental illnesses • Psychotic Disorder • Audio/visual hallucinations, flat affect, depression • Anxiety • Irritability, fearful, avoidance, panic symptoms, agoraphobia • Americans with Disabilities Act (ADA) • Covers Chemical Dependency/Abuse • Does not cover if test positive

  48. Drug / Alcohol Testing • Types of testing • Pre-employment • Post-accident • Random • Reasonable Suspicion • Return to duty • Follow-up

  49. DRUGS Dilated pupils, red eyes Slowed reactions Dizziness Impaired motor skills Blush colored skin Inability to concentrate Dry mouth Review of General Signs and Symptoms of Use ALCOHOL • Odor- breath or body • Bloodshot or glazed eyes • Slowed reaction • Slurred speech • Impaired motor skills • Flushed skins • Loss of Balance http://www.ncadd.org/index.php/learn-about-alcohol/signs-and-symptoms

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