Understanding, recognizing, and handling substance abuse at the workplace.

1. Reasonable Suspicion

2. Employed Substance Users
• 75 percent of the nation’s current illegal drug
users are employed - and 3.1 percent say they
have actually used illegal drugs before or
during work hours.
• 79 percent of the nation’s heavy alcohol users
are employed - and 7.1 percent say they have
actually consumed alcohol during the
workday.

3. Substance Use At Work
• An estimated 3.1 percent of employed adults actually
used illicit drugs before reporting to work or during work
hours at least once in the past year, with about 2.9
percent working while under the influence of an illicit
drug.22
• An estimated 1.8 percent of employed adults consumed
alcohol before coming to work, and 7.1 percent drank
alcohol during the workday.23
• An estimated 1.7 percent of employed adults worked
while under the influence of alcohol, and 9.2 percent
worked with a hangover in the past year. 24
http://www.dol.gov/asp/programs/drugs/workingpartners/stats/wi.asp

4. Small Businesses Most Vulnerable
• About nine in 10 employed current illicit drug users
and almost nine in 10 employed heavy drinkers work
for small and medium sized firms.31
http://www.dol.gov/asp/programs/drugs/workingpartners/stats/wi.asp

5. Abusers’ Affect on the Workplace
• Higher rates of turnover and absenteeism.
• More likely to have worked for more than three
employers in the past year.25
• More likely to have skipped work more than
two days in the past month.26
• More likely to have missed more than two days
of work due to illness or injury.27
http://www.dol.gov/asp/programs/drugs/workingpartners/stats/wi.asp

6. Impact On Co-Workers
Furthermore, the impact of employee substance use
and abuse is a concern that extends beyond the
substance-using employee.
• There is evidence that co-worker job performance
and attitudes are negatively affected.28 Workers
have reported being put in danger, having been
injured or having had to work harder, to re-do work
or to cover for a co-worker as a result of a fellow
employee’s drinking.29
http://www.dol.gov/asp/programs/drugs/workingpartners/stats/wi.asp

7. (mad, sad, ashamed, afraid, hurt, glad)
Lead to use of: Work
MOOD
Background
ALTERING
DRUGS
Sexual
Orientation Marital
Parental
Loss of control Consequences
Gender Ethnicity Status
When? Status Legal
How much? Family/friends
Behavior Education Financial
Medical
Social
Employment

8. Consequences of Using
Mood-Altering Drugs
Legal Family-Friends
OWI Relationships lost
Unlawful drinking activities Relationships estranged
Domestic violence Relationships divorced
Felonies Family dysfunction
Shoplifting Child custody disputes
Fraud
Financial Medical
Fines Direct health issues
Insurance & medical costs Other exacerbated conditions
Insufficient funds Injury or accident
Indebtedness Premature death
Cost of drug purchases

9. Consequences of Using
Mood-Altering Drugs
Social Employment
Preoccupation with use Performance
Decline in social network Absenteeism
Deterioration in Reputation
appearance Injury
Rules violation
Job Loss

10. Recognizing Problems
Addiction
The irresistible compulsion to use
alcohol and other drugs despite
adverse consequences.
It is characterized by repeated failures to
control use, increased tolerance and
increased disruption in the life.

11. Recognizing Problems (continued)
• If not aware of this at the time, why?
• If aware of at the time, what thoughts and
feelings did you have about this?
What, if any, actions did you take?
• What did you not know about that “O”?

12. On-The-Job Indicators of Addiction
Early Phase
Disease Progression Impact Visible Signs
• Uses to relievetension • Decrease efficiency Job Performance
• Tolerance increases • Criticism from boss • Mistakes
• Memory blackouts • Miss deadlines
• Lies about use Attendance
• Late
• Absent
• General Behavior
• Co-workers complain
• Overreact to criticism
• Ill
• Lies

13. Middle Phase
Disease Progression Impact Visible signs
• Sneaks use • Loss of job Job Performance
• Guilty about use advancement • Spasmodic work pace
• Tremors • Warnings • Difficulty
• Depression • Family issues concentrating
• Loss of interest in activities • Money issues Attendance
• Wage garnishment • More days off, vague
reasons
General Behavior
• Undependable
• Avoids co-workers
• Exaggerates
• Unreasonable
resentment

14. Late Middle Phase
Disease Progression Impact Visible Signs
• Avoids discussion of • Disciplinary action Job Performance
issue • Trouble with law • Far below expectations
• Attempts to control fail • 30% efficiency Attendance
• Neglects food • Serious family issues • Frequent time off
• Isolates • Doesn’t return from
lunch
General Behavior
• Aggressive; belligerent
• Domestic problems
interfere
• Loss of ethical values
• Won’t talk about issue

15. Late Phase
Disease Progression Impact Visible Signs
• Believes that other • Final warnings at work Job Performance
activities interfere with • Termination • Formal discipline
use • Serious financial issues • No improvement
• Blames people, places Attendance
and things for problems • Prolonged
unpredictable
absences
General Behavior
• Use on the job
• Physical
deterioration

16. Observable Effects
Alcohol - Staggering gait, slurred speech, odor of alcoholic
beverage may be general (alcohol) or specific (beer, whiskey,
wine), shaky hands, decreased eye-hand coordination.
Cannabis - (Marijuana) Reddening of the eyes, sometimes
rambling, excited speech patterns, euphoria (laughing out of
context), distorted sense of time.
Cocaine - Dilated pupils, talkativeness, sniffing, runny nose, fast
mood swings (from down and irritable to up and happy within a
few minutes, perhaps coinciding with a trip to the restroom),
frequent trips to the restroom or a secluded area to use more
cocaine.

17. Observable Effects (continued)
Amphetamines (and other stimulants) - Dilated pupils,
talkativeness, restlessness, over-excitement, irritability,
aggressiveness, paranoia, stereotypical behavior (sit and
stare and twist hair for hours at a time).
Narcotics (Opioids) - Pinpoint pupils, sweating, nausea
(novice user only), nodding (user may appear to drop off to
sleep periodically), overly calm, detached look, needle
marks over veins on arms and hands.

18. Observable Effects (continued)
Depressants - Intoxication similar to alcohol - perhaps
more exaggerated, drowsiness.
Hallucinogens - Dilated pupils, usually an inability
to carry on a rational conversation about common
things (work schedule) for more than one or two
minutes, may be responding to things not apparent to
observer.

19. Observable Effects (continued)
Phencyclidine (PCP) - Speech is sparse and
purposeless, jerky eye movements (mystagmus), unusual
body posture (often rigid), often aggressive or combative
behavior, extreme bizarre or violent behavior can occur.
Inhalants (glue, paint, aerosol sprays, etc.) - Odor of
paint, gasoline, etc.; paint on hands or face - often
entire hand(s) will be covered; slurred speech; staggering
walk; lack of coordination; extreme “drunken” behavior.

20. Five-Panel Drug Screen
• Amphetamines (uppers, speed, meth)
• Cannabinoids
• Cocaine (coke, crack, rock)
• Opiates (codeine, heroin, morphine, )
• Phencyclidine (PCP) (angel dust)

21. Detection Periods
Drug Detection Period
Alcohol (Ethanol) Three to 10 hours -
about one hour per beer
Amphetamine One to two days
Barbiturates (Secobarbital or One to two days
Butalbital)
Benzodiazepines light to Three to five days
moderate use

22. Detection Periods (continued)
Cannabinoids
(marijuana metabolites)
Single use Two days
Several times/week Two weeks
Daily Three to six weeks
Methadone Two to three days
Methaqualone (Quaalude) Two weeks

23. Detection Periods (continued)
Opiates (Morphine, Codeine, Heroin) One to two days
Phencyclidine (PCP) Two days to two weeks
Propoxphene (Darvon) Six hours to two days

24. Detection Periods
These are approximate detection times for the
drug or metabolites in urine. The actual
detection time depends on individual
metabolism and the dose of the drug.

25. Defining Reasonable Suspicion
When Does It Exist?
• Reasonable Cause is . . .Suspicion based on specific,
contemporaneous, articulable observation, by a trained
supervisor, of employee alcohol misuse or illegal drug use
based on the appearance, behavior, speech or body odors
of the employee.
• When to Test:
When have . . .Specific Documentable
Objective First-hand
Immediate
OBSERVATIONS

26. Reasonable Cause
• Reasonable Cause ≠ Probable Cause
• Testing for Reasonable Suspicion . . .
– Determines (non)compliance with requirements to
remain drug-free and unimpaired by alcohol at work
– Requires substantial documentation
• Testing for Reasonable Suspicion
– Is not based on hearsay or hunches
– Is not based on stereotypes, personal feelings or gut
instincts toward a particular employee
– Is not a diagnosis of alcoholism or drug addiction

27. Supervisor Intervention Steps
When supervisor suspects employee violation
of the workplace alcohol and drug policy.

28. Step One
IDENTIFY
Abnormal behavior (Signs of alcohol
misuse/illicit drug use)

29. Step Two
DOCUMENT
(Second witness observations)
(Reasonable Suspicion Incident Report)

30. Step Three
CONFRONT
According to Supervisory Protocol Guidelines

31. Step Four
CONFIRM
Via authorized alcohol/drug test

32. Supervisory Protocol
1. Complete front page of documentation report.
2. Remove the employee from their work area
and meet in a confidential office.
3. Have another company representative (and a
union member, if relevant) for the meeting as a
witness.

33. Supervisory Protocol (continued)
4. Explain to the employee the reason for your
meeting.
– Have any previous or presently documented facts
(documentation report) regarding observations of
the employee’s behavior or actions, which have
warranted reasonable suspicion, available.
– Suspicion is not reasonable, and thus not a basis for
testing if it is based solely on third party
observations and reports. You must observe.

34. Supervisory Protocol (continued)
5. Ask:
“Are any physical or medical conditions that might
explain his/her currently abnormal
appearance, behavior, speech or body odor?”
(Document ALL responses on the documentation
report).
6. Inform the employee that, based on your
observations, he/she is required to undergo an
alcohol and/or drug test.

35. Supervisory Protocol (continued)
7. Transportation to the collection site.
8. Make arrangements to have the employee
transported home.

36. Supervisory Protocol (continued)
9. Complete backside of documentation report.
10. Based on test results, decide on disciplinary
action and SAP/EAP referral.
11.Continue to monitor and follow up (inform
appropriate management personnel and/or the
SAP/EAP counselor of any ongoing
performance or behavioral concerns and
improvements).

37. Enabling & Supervisory Traps
Enabling:
Action you take that protects the employee from
the consequences of his/her actions and actually
helps the employee to NOT deal with the problem.

38. Examples of Enabling
• Covering up - providing alibis, excuses, doing their
work
• Rationalizing - developing reasons why their behavior
is reasonable and acceptable
• Withdrawing/avoiding - avoiding contact
• Blaming - yourself for their use, anger at them
• Controlling - taking responsibility, get rid of
drugs, move to another job
• Threatening - without follow through

39. Examples of Supervisor Traps
• Sympathy
• Excuses
• Apology
• Diversions
• Innocence
• Anger
• Pity
• Tears

40. Supervisory Do’s
• Do emphasize that you are concerned about work
performance or conduct.
• Do have documentation of performance in front of you
when you talk with the employee.
• Do remember that many issues get worse without
assistance.
• Do emphasize that conversations with EAP are
confidential.
• Do explain that EAP is voluntary and exists to help
employees.
• Do call the EAP prior to discus making a referral.

41. Supervisory Don’ts
• 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. Stick strictly to
what you hear, smell and see.
• 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. If you threaten disciplinary action, follow
through.

42. Review
• Most employees assume that they cannot use
alcohol or drugs immediately before or during
work. Why is a policy necessary? Why is teaching
necessary?
• What types of drug testing does our policy cover?
• What drugs are tested for?
• How can I tell when an employee is “not in
condition” to perform his/her work?

43. Review (continued)
• What does fitness-for-duty mean?
• Is it really possible to determine whether an
employee is actually under the influence of
alcohol or drugs?
• What should I do if an employee comes in
smelling of alcohol or beer and/or is hung over?
• How should I handle borderline cases where I
think the employee may be unfit for duty but I am
not sure?

44. Review (continued)
• What level of alcohol or other drugs does the company
consider to be over the limit?
• How do I proceed if the employee raises as a defense
that they are using a controlled substance as doctor-
prescribed medication?
• Some employees may fear a supervisor will use the
fitness-for-duty test to get them. How does the policy
deal with this concern?
• How important is it to have another observer present
when I question an employee?

45. Review (continued)
• What if an employee refuses to produce a specimen
and/or sign a consent form for purposes of a fitness-
for-duty screening?
• What should I do if an employee refuses to surrender
a suspicious substance when so instructed?
• What should I do if I see more than one employee
engaged in suspicious behavior and I think the
possibility exists that they will become hostile if
confronted?

46. Review (continued)
• In a fitness-for-duty situation, who will escort the
employee to the hospital/clinic for testing?
• What should I do if an employee insists on leaving
on their own before or after a fitness-for-duty
screen?
• How long does it take to get results back from a
fitness-for-duty test?
• Before we discipline an employee based on one lab
test, should we consider a retest to validate the
result?

47. Review (continued)
• In several places, the policy references
appropriate disciplinary action, up to and
including discharge for policy violation. Have we
established discipline standards?
• Will the discipline be different for a clerical
person versus a represented employee versus an
upper management person?
• Who determines if a supervisor is fit for duty?

48. Review (continued)
• What if an employee is arrested off property
for suspected drug activity?
• What if an employee agrees to treatment?
• What role(s) does the EAP have in the
administration of our substance abuse policy?

49. Educating Your Employees
• Reason for the policy
• Policy overview
• Be able to explain the testing process
• Educate them about EAP
• Self-reporting
• Handouts
• Impaired professional

50. You May Have a Problem If…
• Others (family, friends, co-workers) have
expressed concern to you about your use.
• Your use has impacted your work, your
relationships.
• Your use has resulted in medical, financial or legal
issues.
• You have to use more of the substance to get the
same effect.
• It is all “cost” and no “benefit.”

51. Someone You Know May Have
a Problem If…
• You worry about their use and their ability to
fulfill their roles (as a worker, spouse, parent).
• You have taken over duties they usually did to
compensate for them not doing them.
• You avoided attending activities because of
concerns of how they would act at the event if
they drank.
• You have made attempts to limit their use of the
substance.