DOT-Mandated Drug and Alcohol Testing

1. DOT-Mandated Drug and Alcohol Testing Reasonable Suspicion Supervisory Training

2. Workplace Impacts of Substance Abuse • 3.5 X more workplace accidents • 2.7 X more absences • 3 X more medical benefits usage • 10-20% decreased productivity • Increased loss/shrinkage • Higher incidence of workplace violence

3. DOT Drug & Alcohol Rules • Prohibited conduct • Use of controlled substances/illicit drugs and/or alcohol while on company property or while on-duty • Testing positive for drugs or alcohol • Refusing to test (including adulterating or tampering with a drug/alcohol test) • Use of alcohol 4 hr. before duty (8 hrs. for flight crew) • Use of alcohol after an accident prior to alcohol test (8 hrs. )

4. Consequences of DOT Violation • Immediate removal from safety-sensitive duty • Applicants cannot be hired • Referral information on Substance Abuse Professionals must be provided by employer • Must complete return to duty process prior to resuming safety-sensitive duties • For an alcohol test result of .02-.039 BrAC, employee must be temporarily removed from duty • 24 hrs. for CDL employee; 8 hrs. for FRA; 8 hrs or retest of <0.02 for all others Additional disciplinary actions are up to employer

5. DOT Drug and Alcohol Testing • Pre-employment drug testing • Post-offer alcohol testing is authorized, not required • Reasonable cause/suspicion drug/alcohol testing • Based on behavior, conduct or appearance • Post-accident drug/alcohol testing • For DOT defined work-related accidents. • Random drug/alcohol testing • PHMSA & USCG do not have random alcohol testing • Return to duty and follow-up drug/alcohol testing • as part of DOT return to duty process

6. Testing Procedures • Urine drug testing • Evidential breath alcohol testing for alcohol • Employees will complete custody and control forms to document every test • Tests will be conducted by qualified, trained personnel • Drug test results will be reported to the MRO and then to designated Company contacts • Alcohol test results are reported by the alcohol technician to the Company representative

7. Drug Testing • Urine specimen provided by employee in private toilet enclosure • Specimens poured into two bottles-labeled and sealed in employee’s presence • Analyzed at a SAMHSA-certified laboratory—2 tests performed on the specimen before reporting it as positive • Laboratory results reported to physician MRO • MRO will contact employee and conduct interview to determine if prescription medications or other medical factors explain the test result • MRO reports final result to Company representative • Employee has the right to have the “split specimen” tested at a second laboratory to reconfirm the original findings.

8. Alcohol Testing • If initial test detects alcohol (0.02 BAC), a confirmation breath test is conducted after 15 minutes. If second test is 0.04 or greater it is a positive test. • DOT rules allow use of a saliva or non-evidential breath device for the initial test. • Confirmation test must always use an EBT • Any test result less than 0.02 is a negative. • Mouthwash, cough syrup, cold medicines, breath sprays, if used according to directions, will not produce a positive confirmation test • Breath alcohol test will not detect acetone, ketones, and other biologically produced substances • Breath alcohol test is equal to a blood alcohol test

9. Reasonable Suspicion Testing Procedures • Observe employee; isolate him/her away from work area and coworkers • Request another supervisor/manager to observe/interact with employee • Complete supervisory checklist/reasonable suspicion documentation • Escort employee to testing site • Retain copies of testing forms • Arrange to have employee transported home • Employee cannot return to work until negative test results are received.

10. Reasonable Suspicion Testing Supervisory Training Dr. Donna Smith dsmith@firstlab.com 727-343-0283 727-204-8549

11. Reasonable Suspicion - Definition • Reasonable suspicion: • is based on observations of an individual • Contemporaneous—just before, during, or after duty period • What the supervisor sees, hears or smells • is based on objective, documented criteria • Capable of being expressed as signs or symptoms of possible use of drugs/alcohol • Reasonable suspicion testing: • is used to “rule out” or eliminate alcohol or drug use as a cause of the individual’s behavior or appearance • is not a diagnostic tool

12. Reasonable Suspicion • Decision to test must be based on supervisor’s observations (whenever possible 2 supervisors/managers should observe employee) • Supervisor making observations must have completed training in RS testing • Observations must be specific, contemporaneous and articulable, and must be documented on the Supervisor’s Checklist • Should test within 2 hours, discontinue after 8 hours

14. The Problem Employee • Workplace signs of alcoholism or alcohol abuse include: • chronic lateness • excessive absences • decreased productivity • poor performance • problem interactions with others • Time and attendance problems and changes in performance and productivity levels cannot trigger a reasonable suspicion test

15. Supervisor’s Role • Identify the specific observations of employee behavior and appearance • Confront the employee concerning the requirement to undergo a test • Fully explain the consequences of the employee’s refusal to comply • Supervisor does not need to identify the specific drug associated with the behavior or appearance • Supervisor should be alert to changes in the employee’s usual behavior and appearance

16. Confronting the Employee • Confronting the employee is the most difficult task • Confrontation should remain focused on employee behavior and appearance • RS test should be explained as a means to “rule out” prohibited drug/alcohol use • Do not accuse the employee of being “drunk” , “high” or under the influence of alcohol or drugs

17. Alcohol Misuse Signs and Symptoms

18. Effect of Alcohol • Alcohol is a drug • Alcohol acts as a stimulant • Alcohol’s overall effect is a sedative or depressant • Alcohol’s effects vary from individual to individual • Alcohol’s effects on an individual vary from occasion to occasion • One drink metabolizes in approximately 1 1/2 hours • The higher the BAC, the more pronounced the effects of alcohol

19. Alcohol Facts • BAC is based on individual’s body weight, amount of alcohol consumed, and the time period over which it was consumed • A 160-lb. person metabolizes approximately 1½ drinks per hour, or BAC decreases at a rate of 0.015 per hour • One Drink • 12 ounces of beer • 4½ ounces of wine • 1 to 1½ ounces of 80-86º liquor • Alcohol concentration is measurable during absorption, peak, and elimination phases

20. Alcohol Concentrations • Peak BAC based on alcohol drinks per hour

21. Alcohol Elimination • 170 lb male eliminates .015 g/mL per hr • 2 drinks per hr for 7 hrs; • Stops drinking at 1 AM • 2 AM= .190 BAC; asleep • 3 AM=.175 BAC • 4 AM=.160 BAC • 5 AM= .145 BAC • 6 AM= .130 BAC; alarm goes off • 7AM= .115 BAC; drives to work • 8 AM= .100 BAC; starts work • 12 Noon= .040 BAC; Under the influence; violation of policy

22. Alcohol Elimination: Number of hours to 0.00 BAC This is the approximate number of hours to zero BAC from the time drinking began.

23. Discussion: • Part of brain with different responses to alcohol • General slowing of various functions, some earlier than others

24. Mental functions affected by Alcohol Use • Cognitive functions are first effected • Individual is unaware of impact at low levels (.02-.04) • Judgment, computation, decision making, short term memory retrieval Mental (.02 - .04)

25. Alcohol affects sensory perception • Vision - decreased object tracking, night an peripheral vision background • Hearing - diminished acuity, ability to sort background noise • Smell - decreased sensitivity and selectivity • Taste - decreased sensitivity and selectivity Sensory (.04 - .06) Mental (.02 - .04)

26. Psychomotor Functions Speech is one of the earliest motor skills to be affected Speech changes may include over-enunciation, slurring, or exaggerated speech patterns Coordination, reflexes and fine motor dexterity are diminished Reaction times are slower, movements appear delayed or retarded Speech & Fine Motor (.08 - .10) Sensory (.04 - .06) Mental (.02 - .04)

27. Gross Motor Skills • Gross motor skills are one of the last categories of functioning to be effected • Most noticeable area is gait • Head movements, spatial relationships and torso movements are effected Speech & Fine Motor (.08 - .10) Gross Motor (.10 - .25) Sensory (.04 - .06) Mental (.02 - .04)

28. Balance and Navigation • Balance is controlled by the inner ear • Alcohol intoxication vertigo (room spin) • Nausea and vomiting Gross Motor (.10 - .25) Speech & Fine Motor (.08 - .10) Balance (.25 - .35) Sensory (.04 - .06) Mental (.02 - .04)

29. Life Threatening BAC Levels • Brain stem involvement • Slowing of autonomic nervous system functions • Coma (respiratory and cardiovascular function depressed) • Death (respiratory and cardiovascular systems failure) Gross Motor (.10 - .25) Speech & Fine Motor (.08 - .10) Balance (.25 - .35) Sensory (.04 - .06) Mental (.02 - .04) Brain Stem (.35 - .45)

30. Signs of Alcohol Intoxication • 0.02 - 0.08 • Odor of alcohol on breath • Poor judgment, increased risk taking behavior • Decreased reasoning ability, forgetfulness • Slower reflex reactions

31. Signs of Alcohol Intoxication • 0.08 and above • Clumsiness, staggering, unsteady gait • Poor coordination, slowed reflex, diminished reaction times • Bloodshot eyes, impaired tracking ability • Slurred speech patterns • Exaggerated emotion, excitement, belligerent attitude • Disheveled clothing, poor personal grooming • Flushed complexion, sweating

32. Alcohol Odor • Alcohol beverages have a characteristic, distinct odor • Odor of alcohol persists on the breath following alcohol use • Individuals often try to mask the odor by using breath fresheners

33. Multiple Signs and Symptoms • Many signs and symptoms of alcohol or drug use can be due to other causes • A good “rule of thumb” is document at least two symptoms • odor of alcohol on breath is the most definitive sign of recent alcohol use • If signs and symptoms are associated with either alcohol or drug use, you should conduct both urine and breath tests

34. Reasonable Suspicion Testing Signs & Symptoms of Drug Use

35. Illicit Drugs • Testing for marijuana, cocaine, amphetamines, opiates, and PCP • Drugs are detectable in the urine long after the acute intoxication phase • Marijuana is detectable for several days after use and is cumulatively stored in the body • Positive thresholds ensure that passive exposure or unknowing ingestion does not produce a positive drug test

36. Impact of Illicit Drugs • Mental and motor functioning are affected for many hours after use of the drug • Some studies show measurable motor and mental functioning impact for up to 24 hours after marijuana use • Stimulant drug use (cocaine, amphetamines) often contributes to sleep deprivation which impacts mental and motor functioning • Sedative drugs slow motor and mental functioning for hours after use • Observable effects (physical signs and symptoms, speech, motor functioning)of drug use are often not present for more than a few hours after use. .

37. Appearance Signs and Symptoms • Appearance changes due to drug use range from subtle to extreme • Personal grooming often deteriorates or dramatic changes in hairstyle, clothing may occur • Eyes are very susceptible to the effects of drugs: • eye movements such as tracking ability are affected • pupil size is altered • bloodshot, watery or unfocused eyes • Profuse sweating, the chills, flushed or pallid complexion may be dues to the effects of the drugs • Marijuana has a distinct odor when smoked that clings to the user’s breath and clothing

38. Personality Changes • Personality changes are the most difficult to specify • Supervisor needs to be alert to changes in the employee’s usual personality traits or expression • Personality changes due to drug use often are sudden and dramatic

39. Speech Patterns • Stimulants create rapid, pressured speech patterns • Narcotics produce slow, thick, slurred speech • Hallucinogens may produce nonsense, fantasy speech

40. Social Interaction Changes • Changes in social interaction are not specific to the drug • Changes in social interaction vary from individual • Supervisors should be alert to changes in the employee’s usual patterns of interacting with others

41. Psychomotor Changes • Stimulants speed up the body’s motor activity • Sedatives or narcotics slow down motor functions • Hallucinogens may produce bizarre motor movements • Marijuana delays reaction times, impairs eye-hand coordination and creates unsteadiness