DOT-Mandated Drug and Alcohol Testing

Reasonable Suspicion Supervisory Training 1

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 2

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. ) 3

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 4

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 5

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 6

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.

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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 8

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.

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Reasonable Suspicion Testing

Supervisory Training Dr. Donna Smith [email protected]

727-343-0283 727-204-8549 10

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 11

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 12

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 13

Supervisor’s Role

   behavior and appearance to undergo a test 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 14

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 15

Alcohol Misuse

Signs and Symptoms 16

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 17

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 18

Alcohol Concentrations

• Peak BAC based on alcohol drinks per hour

Body Weight in Pounds 100 120 140 160 180 200 220 1

.04

.03

.03

.02

.02

.02

.02

2

.08

.06

.05

.05

.04

.04

.03

3

.11

.09

.08

.07

.06

.05

.05

4

.14

.11

.10

.09

.08

.07

.06

5

.17

.14

.12

.11

.09

.09

.08

6

.21

.17

.14

.12

.11

.10

.09

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 20

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

15 Drinks 14 Drinks 13 Drinks 12 Drinks 11 Drinks 10 Drinks 9 Drinks 8 Drinks 7 Drinks 6 Drinks 5 Drinks 4 Drinks 3 Drinks 2 Drinks 1 Drinks

120#

29 hrs 27 hrs 25 hrs 23 hrs 21 hrs 19 hrs 18 hrs 16 hrs 14 hrs 12 hrs 10 hrs 8 hrs 6 hrs 4 hrs 2 hrs

140#

24 hrs 23 hrs 21 hrs 20 hrs 18 hrs 16 hrs 15 hrs 13.5 hrs 12 hrs 10 hrs 8.5 hrs 7 hrs 5 hrs 3.5 hrs 2 hrs

160#

22 hrs 20 hrs 19 hrs 17 hrs 16 hrs 14 hrs 13.5 hrs 12 hrs 10.5 hrs 9 hrs 7.5 hrs 6 hrs 4.5 hrs 3 hrs 2 hrs

180#

19 hrs 17.5 hrs 16 hrs 15 hrs 14 hrs 12.5 hrs 11.5 hrs 10 hrs 9 hrs 8 hrs 6.5 hrs 5.5 hrs 4 hrs 3 hrs 1.5 hrs

200#

17 hrs 16 hrs 15 hrs 13.5 hrs 12 hrs 11 hrs 10.5 hrs 9 hrs 8 hrs 7 hrs 6 hrs 5 hrs 3.5 hrs 2.5 hrs 1 hrs

220#

16 hrs 15 hrs 14 hrs 13 hrs 12 hrs 11 hrs 10 hrs 9 hrs 8 hrs 6.5 hrs 5.5 hrs 4.5 hrs 3.5 hrs 2 hrs 1 hrs

Discussion: • Part of brain with different responses to alcohol • General slowing of various functions, some earlier than others 22

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)

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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)

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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 reta rded

Speech & Fine Motor (.08 - .10) Sensory (.04 - .06) Mental (.02 - .04)

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•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

Gross Motor (.10 - .25) Speech & Fine Motor (.08 - .10) Sensory (.04 - .06) Mental (.02 - .04)

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Balance and Navigation • Balance is controlled by the inner ear • Alcohol intoxication vertigo (room spin) • Nausea and vomiting

Gross Motor (.10 - .25) Balance (.25 - .35) Speech & Fine Motor (.08 - .10) Sensory (.04 - .06) Mental (.02 - .04)

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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) Balance (.25 - .35) Brain Stem (.35 - .45) Speech & Fine Motor (.08 - .10) Sensory (.04 - .06) Mental (.02 - .04)

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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 29

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 30

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 31

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 32

Reasonable Suspicion Testing

Signs & Symptoms of Drug Use 33

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 34

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. 35

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 36

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 37

Speech Patterns

• Stimulants create rapid, pressured speech patterns • Narcotics produce slow, thick, slurred speech • Hallucinogens may produce nonsense, fantasy speech 38

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 39

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 40