Transcript Does Drug Testing Work?

DOT-Mandated Drug and
Alcohol Testing
Reasonable Suspicion
Supervisory Training
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Workplace Impacts of Substance Abuse
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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
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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. )
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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
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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
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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
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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
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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
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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
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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
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The Problem Employee
• Workplace signs of alcoholism or alcohol abuse include:
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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
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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
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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
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Alcohol Misuse
Signs and Symptoms
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Effect of Alcohol
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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
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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
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Alcohol Concentrations
• Peak BAC based on alcohol drinks per hour
Body Weight
in Pounds
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100
.04
.08
.11
.14
.17
.21
120
.03
.06
.09
.11
.14
.17
140
.03
.05
.08
.10
.12
.14
160
.02
.05
.07
.09
.11
.12
180
.02
.04
.06
.08
.09
.11
200
.02
.04
.05
.07
.09
.10
220
.02
.03
.05
.06
.08
.09
Alcohol Elimination
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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
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Alcohol Elimination: Number of hours to 0.00 BAC
This is the approximate number of hours to zero BAC from the time drinking began.
120#
140#
160#
180#
200#
220#
29 hrs
24 hrs
22 hrs
19 hrs
17 hrs
16 hrs
14 Drinks
27 hrs
23 hrs
20 hrs
17.5 hrs
16 hrs
15 hrs
13 Drinks
25 hrs
21 hrs
19 hrs
16 hrs
15 hrs
14 hrs
12 Drinks
23 hrs
20 hrs
17 hrs
15 hrs
13.5 hrs
13 hrs
11 Drinks
21 hrs
18 hrs
16 hrs
14 hrs
12 hrs
12 hrs
10 Drinks
19 hrs
16 hrs
14 hrs
12.5 hrs
11 hrs
11 hrs
9 Drinks
18 hrs
15 hrs
13.5 hrs
11.5 hrs
10.5 hrs
10 hrs
8 Drinks
16 hrs
13.5 hrs
12 hrs
10 hrs
9 hrs
9 hrs
7 Drinks
14 hrs
12 hrs
10.5 hrs
9 hrs
8 hrs
8 hrs
6 Drinks
12 hrs
10 hrs
9 hrs
8 hrs
7 hrs
6.5 hrs
5 Drinks
10 hrs
8.5 hrs
7.5 hrs
6.5 hrs
6 hrs
5.5 hrs
4 Drinks
8 hrs
7 hrs
6 hrs
5.5 hrs
5 hrs
4.5 hrs
3 Drinks
6 hrs
5 hrs
4.5 hrs
4 hrs
3.5 hrs
3.5 hrs
2 Drinks
4 hrs
3.5 hrs
3 hrs
3 hrs
2.5 hrs
2 hrs
1 Drinks
2 hrs
2 hrs
2 hrs
1.5 hrs
1 hrs
1 hrs
15 Drinks
Discussion:
• Part of brain with different responses to alcohol
• General slowing of various functions, some earlier than others
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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 retarded
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)
Speech & Fine Motor
(.08 - .10)
Balance
(.25 - .35)
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
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Odor of alcohol on breath
Poor judgment, increased risk taking behavior
Decreased reasoning ability, forgetfulness
Slower reflex reactions
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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
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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
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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
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Reasonable Suspicion Testing
Signs & Symptoms of Drug Use
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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
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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.
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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
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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
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Speech Patterns
• Stimulants create rapid, pressured speech
patterns
• Narcotics produce slow, thick, slurred speech
• Hallucinogens may produce nonsense, fantasy
speech
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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
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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 eyehand coordination and creates unsteadiness
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