Drug Alcohol Awareness Bureau of Workers Comp PA

Drug & Alcohol Awareness Bureau of Workers’ Comp PA Training for Health & Safety (PATHS) Supervisor Level Training PPT-039 -02 1

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 Transportation’s (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 PPT-039 -02 2

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 PPT-039 -02 3

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 PPT-039 -02 4

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) PPT-039 -02 5

Supervisor Training Outline 6. Intervention and Referral 7. Protecting Confidentiality 8. Continued Supervision 9. Enabling & Supervisor Traps 10. Do’s and Don’ts for Supervisors PPT-039 -02 6

Objectives of Training Supervisors will be able to: ü Identify the different components of the Drug. Free Workplace Policy ü Identify their role in implementing the Drug. Free Workplace Policy ü Utilize available resources to develop a Drug. Free Workplace Policy for their workplace PPT-039 -02 7

Learning Objectives Supervisors will be able to: ü Identify and investigate potential crisis situations ü Recognize workplace problems that may be related to alcohol and other drugs ü Intervene in problem situations ü Refer employees who have problems with alcohol and other drugs for assistance ü Protect employee confidentiality ü Continue to supervise employees who have been referred for assistance ü Avoid enabling and supervisor traps PPT-039 -02 8

The Unseen Reality Think PA’s 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 PPT-039 -01 PPT-039 -02 12 9

The Cost of Substance Abuse • Increased Health Care Costs • Increased Workers’ Compensation Premiums • Increased Workplace Violence PPT-039 -02 13 10

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 PPT-039 -02 11 14

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 PPT-039 -02 12

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 PPT-039 -02 13 8

Drug Program & Workplace Policy hol o c l & A ram g u Dr rog P / y Polic PPT-039 -02 14

Drug-Free Workplace 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 PPT-039 -02 15

Drug-Free Workplace 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? PPT-039 -02 16

Drug-Free Workplace Policy l l l What are the consequences for violating the policy? Are there Return-to-Work Agreements? What type of assistance is available to employees? l How is employee confidentiality protected? l Who is responsible for enforcing the policy? l How is the policy communicated to employees? PPT-039 -02 17

Drug Program • Comprehensive drug free workforce approach should include these components: - Policy Supervisor training Employee education Employee assistance Drug testing PPT-039 -02 y ompan C r u o Y Drug & am l Progr Alcoho 18

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 PPT-039 -02 19

Establishing a Policy/Program • Here are several resources (links) to assist you with establishing a specific program for your company üCommonwealth of Pennsylvania üAFL-CIO Appalachian Council üCSAP RADAR Network State Center (Pennsylvania) üDrug Free Pennsylvania, Inc. üPennsylvania National Guard Counterdrug Program • DOL Policy Writing Assistant üwww. dol. gov/elaws/drugfree. htm PPT-039 -02 20

Assistance • Employee Assistance Programs (EAP) • Employee provided healthcare insurance • Various Federal, State and Local programs EA P PPT-039 -02 21

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 = PPT-039 -02 22

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 PPT-039 -02 23

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 PPT-039 -02 24

Supervisors’ Responsibilities PPT-039 -02 25

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 PPT-039 -02 26

NOT your Responsibility to • Diagnose drug and alcohol problems • Have all the answers • Provide counseling or therapy • Be a police officer PPT-039 -02 27

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 PPT-039 -02 28

Performance vs. Crisis Situations The “A” Team! PPT-039 -02 29

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 PPT-039 -02 30

Questions to Consider ü What exactly did you see? ü Does there appear to be illegal activity, policy violations or unusual behavior taking place? ü Is a group of people involved or just a single employee? ü Are you the direct supervisor to anyone involved in the incident? ü Are reliable witnesses available? ü Is any physical danger involved in taking action or not taking action? PPT-039 -02 31

Questions to Consider ü Is the situation serious enough to require calling security or law enforcement? ü Is there a specific policy that applies? ü Does the situation require expert consultation from Human Resources, the Employee Assistance Program (EAP), if applicable, or security? ü Is this a situation that calls for reasonablesuspicion testing? ü Have you documented what you have seen and what you have done in response? PPT-039 -02 32

Steps to Consider l 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. PPT-039 -02 33

Actions to Take If evidence or suspicion of recent use, based upon the employee’s response and your company’s drugfree workplace policy: Ø Refer the employee to the EAP (if applicable) Ø Place the employee on suspension until a formal investigation takes place Ø Arrange for the employee to be escorted home Ø Escort the employee to a collection site for the drug test, if applicable PPT-039 -02 34

Signs & Symptoms PPT-039 -02 35

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 PPT-039 -02 36

Signs of Addiction 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 • PPT-039 -02 37

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 PPT-039 -02 38

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 PPT-039 -02 39

Pupil Reference • Fixed and not reactive to changes in light may indicate other problems beside a potential drug issue • Take note and document PPT-039 -02 40

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 PPT-039 -02 41

Medical Conditions • Nausea • Mood changes • Nervous/jittery • Anxiety • Cold, clammy, sweating • Irritability • Rapid heartbeat • Confusion 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. PPT-039 -02 42

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. PPT-039 -02 43

Alcohol & Drugs The Basics PPT-039 -02 44

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 PPT-039 -02 45

Alcohol • Odor (breath or on person) • Intoxication/drunk • Glazed look • Lack of focus • Uncharacteristically passive or combative • Argumentative • Deterioration of personal hygiene PPT-039 -02 46

Alcohol • Dysfunctional • Absenteeism (Mondays) • Blackouts • Loss of memory • Fixated on drinking (both social & professional) • Trouble with relationships • Difficulty walking PPT-039 -02 47

Cannabis (Marijuana) • Other: Hashish, Hashish oils • Active ingredient: Tetrahydrocannabinol (THC) Not physically addictive, moderately addictive psychologically PPT-039 -02 48

Cannabis Effects • Euphoria • Loss of coordination • Impaired memory • Loss of motivation • Concentration • Animated behavior • Knowledge retention • Other similar conditions that impair work and personal relationships PPT-039 -02 49

Cannabis – What the Supervisor May See • Work level decrease • Increase of incidents • Loss of concentration • Repeating instructions • Breakage • Out of character behavior PPT-039 -02 50

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 PPT-039 -02 51

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) PPT-039 -02 52

Inhalants – What the Supervisor may see • Paint on nose or fingers • Drunk-like reaction • Trouble breathing • Loss of strength/control • Fatigue • Lack of coordination PPT-039 -02 53

Stimulants Signs & Symptoms • Increased heart rate • Agitation • Alertness • Decreased appetite • Respiratory functioning • Psychological dependency • Restlessness • Physical dependency PPT-039 -02 54

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 PPT-039 -02 55

Stimulants – What the Supervisor may see • Increase in errors • Increased risk of accidents • Weight loss (facial) PPT-039 -02 56

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 PPT-039 -02 57

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 PPT-039 -02 58

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 PPT-039 -02 59

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 • • • PPT-039 -02 60

Designer Drug Common Drugs Effects • • Physical Ecstasy Adam Lovers Speed Special K Fantasy Nature’s Quaalude – Hypertension, blurred vision, tremors, drooling, anorexia, impaired speech, paralysis, seizures, brain damage, death • Psychological – Confusion, irritability, anxiety, emotional, irrational, depression, amnesia, violent behavior, insomnia PPT-039 -02 61

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 PPT-039 -02 62

Bath Salts Brand Names Incense Chemical Sprays Brand Names • • Genie Yucatan Fire King Krypto Mr. Nice Guy K-3 Red Magic Blueberry Medication Super Skunk • JWH-015, 018, 019, 073, 200, 398 • HU-210, 211 • CP 47, 497 PPT-039 -02 63

Bath Salts Signs & Symptoms • Agitation • Tremors/shaking • Extreme nervousness • Vomiting • Fast heartbeat • Hallucinations • Increased blood pressure • Seizures PPT-039 -02 64

Bath Salts – What the Supervisor may see • Avoidance • Appears “out of it” • Red-faced • Sense of heart problems – Sweaty – Cool – Grabbing chest • Shaking/dropping things • Sick PPT-039 -02 65

Hallucinogens • LSD • Peyote • Psilocybin • Mushrooms • PCP PPT-039 -02 66

Hallucinogens Signs & Symptoms • Dilated pupils • Self absorbed • Heavy sweating • Slurred speech • Strong body odor • Confusion • Distorted senses • Isolated/detached • Hallucinations • Time (unaware) • Distorted view of themselves • Changes in mood and behaviors PPT-039 -02 67

Hallucinogens – What the Supervisor may see • Fixed small pupils • Sweating • Hyper sensitive • Separated from reality PPT-039 -02 68

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 PPT-039 -02 69

Common OTC & Prescription • Opioids • Topiramate • Antihistamines • Antidepressants • Sedative Hypnotics • Anti-Anxiety • Skeletal muscle relaxants • Anti-Diabetic Medications • Cold medicines • Allergy Medications PPT-039 -02 70

Intervention & Referral PPT-039 -02 71

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 PPT-039 -02 72

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 PPT-039 -02 73

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 PPT-039 -02 74

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 PPT-039 -02 75

Confidentiality CO NF ID EN TIA L PPT-039 -02 76

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 PPT-039 -02 77

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 PPT-039 -02 78

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 l EAP professionals are bound by a code of ethics to protect the confidentiality of the employees and family members that they serve l There are clear limits on when and what information an EAP professional can share and with whom l PPT-039 -02 79

The Law Requires l l l 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 PPT-039 -02 80

Enabling & Supervisor Traps CAUTION! PPT-039 -02 81

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: l Covering Up l Blaming l Rationalizing l Controlling l Withdrawing/Avoiding l Threatening PPT-039 -02 82

Supervisor Traps • • Sympathy Excuses Apology Diversions • • PPT-039 -02 Innocence Anger Pity Tears 83

Supervisor Do’s • 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 PPT-039 -02 84

Don’ts for Supervisors • DON’T try to diagnose the problem • DON’T moralize; limit comments to job performance and conduct issues only • DON’T discuss alcohol and drug use • DON’T be misled by sympathy-evoking tactics • DON’T cover up; if you protect people, it enables them to stay the same • DON’T make threats that you do not intend to carry out PPT-039 -02 85

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 PPT-039 -02 86

A Safer, Drug-Free Workplace • Recognize the impact of alcohol and drug abuse on the workplace • Understand 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 PPT-039 -02 87

Additional Resources To assist you in your program development, you can contact us for your own Power. Point copy of: ü “Drug & Alcohol Awareness-Employee” Department of Labor and Industry Bureau of Workers’ Compensation Email: RA-LI-BWC-Safety@pa. gov Phone: (717) 772 -1635 PPT-039 -02 88

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 PPT-039 -02 89

PATHS At the PATHS Website you can: Ø View. . . Health & Safety Training Power. Point briefings Ø Access “Safety Talks” (Toolbox Talks) Ø Review. . . Course descriptions, objectives, and schedules Ø Participate. . . Employers can register online to participate in webinars and training sessions. Most sessions are free and are open to everyone PPT-039 -02 90

PATHS PPT-039 -02 91

PATHS To Access PATHS http: //www. portal. state. pa. us /portal/server. pt/communit y/paths/20277 or www. dli. pa. gov • Individuals • “Workers Compensation” • PATHS PPT-039 -02 92

Contact Information Health & Safety Training Specialists 1171 South Cameron Street, Room 324 Harrisburg, PA 17104 -2501 (717) 772 -1635 RA-LI-BWC-PATHS@pa. gov Like us on Facebook! https: //www. facebook. com/BWCPATHS PPT-039 -02 93

Questions PPT-039 -02 94