Transcript DFSP_EE_2015_online

Drug Free Safety Program
Employee Education
Presented by HealthSpan EAP
Welcome to the online Drug Free Safety
Program Employee Education session
presented by your employee assistance
program, HealthSpan EAP.
If you have any questions please contact
Diane Pipes, LISW, LCSW at 513-551-1484.
Today we are going to learn about alcohol and
other drugs. The objectives for the training are…
Objectives
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Discuss the impact of recreational alcohol and drug use
on workplace safety.
Review the disease model of addiction.
Review signs, symptoms, safety concerns and effects of
commonly abused substances.
Provide community resources and information where
employees and their loved ones can seek assistance.
Another objective of today’s training is to ensure
you are familiar with your company’s drug and
alcohol policy. The following slide asks several
fundamental questions about your policy. It is
important for you to know the answers to
questions such as these. It is important for you
to know your policy.
Do You Know The Answers?
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What is the purpose of the policy?
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Who is covered by the policy?
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What behavior is prohibited?
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Are employees required to notify
supervisors of drug-related
convictions?
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What are the consequences for
violating the policy?
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What type of employee
assistance is available to
employees needing help?
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How is employee confidentiality
protected?
Millions of Americans are affected each day by alcohol and
drug abuse. Substance abuse can ruin an individual’s
health, break up families, damage careers and lead to
incarceration. Some people even lose their lives.
Addiction has become widespread in our communities and
our society.
While America makes up only five percent of the world’s
population, we consume sixty percent of the world’s
illegal drugs.
Substance abusers do not leave their dangerous
behaviors at home or outside when they enter their
workplaces. They jeopardize the safety and health of
themselves, their co-workers and the general public. The
following slide shows two very important statistics relevant
to this.
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Among the full-time employed work force, almost 15
million are heavy drinkers of alcohol.
Up to 40% of industrial fatalities and 47% of industrial
injuries (almost half!!) can be linked to alcohol
consumption and alcoholism.
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NCADD
More Numbers
Some of us want to believe people with jobs don’t
have substance abuse problems but…
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90% of alcoholics are employed.
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74% of drug addicts are employed.
National Institute on Drug Abuse, Department of Health and Human Services,
DHHS).
So how do those numbers really affect me?
How Substance Abuse
Affects the Workplace
What do Employers Expect of their Employees?
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Employers expect their staff to have a concern for safety
(their own, their co-workers, and the public).
Employers expect timely attendance.
Employers expect job knowledge.
Employers expect productive work behaviors.
Employers expect company loyalty and support.
Employers expect honesty.
The use and abuse of alcohol and other drugs is one of the
most costly and preventable problems that compromises
all of these expectations.
Let’s take a look at a few ways substance abuse affects
the workplace.
Productivity
Workers who are hungover or distracted by a drug
problem cannot focus on or do their jobs at an
optimum level. They are much more likely to be
slower, preoccupied and make mistakes.
Accidents
Employees with drug or alcohol problems tend to be
much more accident-prone than their co-workers.
Absenteeism
According to the American Council for Drug
Education, substance abusers are up to "ten times
more likely to miss work" than their drug-free coworkers.
Cost
Claims filed by workers for health, emotional or
psychological issues pertaining to drug abuse can
lead to higher insurance premiums for the employer.
This cost is often passed on to all employees.
Reputation
Drug-abusing employees who interact with customers
and others entities may irreparably harm the
perception of the company they represent.
Alcohol
Now let’s take a look at alcohol.
Alcohol and Work
There are two ways in which employees get
into trouble by drinking alcohol.
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Drinking before or during work hours.
Heavy drinking the night before going into
work.
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Generally speaking, each drink (can of beer, glass of
wine, shot of liquor) will take about one hour to leave
your body (assuming standard ounces of alcohol per
drink).
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There is no way to speed up the elimination from your
body. Coffee, cold showers, energy drinks, exercise,
water, etc. will have no effect on “sobering up”.
Over time, alcohol can have devastating effects
on your body. Here are just a few of the long
term health consequences…
Long Term Health
Consequences
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Gastrointestinal illness
Liver disease
Damaged immune system
Heart disease
Brain damage, dementia
Reproductive problems
Psychiatric problems
Contributes to fetal alcohol syndrome
There are also short term dangers!!!
Short Term Risks
Alcohol creates safety risks because it slows
down and distorts the messages your brain
sends to your body. It disrupts the
functioning of the central nervous system.
Alcohol Affects Vision
Even at relatively low levels of consumption,
alcohol reduces the ability of the eyes to
work properly. The ability to judge distance
and speed of moving objects is particularly
impacted.
More Effects on the Brain
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Reduces the ability to make good decisions, or
solve complex problems.
Increases the time it takes to react to things, such
as the time it takes to avoid dangerous moving
objects.
Impairs short-term memory and damages long-term
memory.
Impairs balance, coordination and speech.
The Difference between
Alcohol Use and Alcohol
Related Disorders
We used to classify drinking behaviors as alcohol use,
alcohol abuse or alcohol dependency, but the times have
changed.
We now just classify drinking behaviors as alcohol use and
alcohol use disorder. Alcohol use disorder can be mild,
moderate or severe.
Alcohol Use
Many Americans drink alcohol. The Centers for Disease
Control estimate about 60% of adults drink alcohol, but
most drink in moderation without any negative results of
their drinking.
Now let’s look at Alcohol Use Disorder. This is
the new diagnosis for people when alcohol
becomes problematic.
Alcohol Use Disorder
So what is Alcohol Use Disorder?
It’s a problematic pattern of alcohol use
leading to clinically significant impairment or
distress, as manifested by at least two of the
following criteria, and occurring within 12
months .
Alcohol Use Disorder
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Alcohol is often taken in larger amounts or
over a longer period than was intended.
There is a persistent desire or unsuccessful
efforts to cut down or control alcohol use.
A great deal of time is spent in activities
necessary to obtain alcohol, use alcohol, or
recover from its effects.
Craving, or a strong desire or urge to use
alcohol.
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Recurrent alcohol use resulting in a failure to fulfill major
role obligations at work, school, or home.
Continued alcohol use despite having persistent or
recurrent social or interpersonal problems caused or
exacerbated by the effects of alcohol.
Important social, occupational, or recreational activities
are given up or reduced because of alcohol use.
Recurrent alcohol use in situations in which it is
physically hazardous.
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Alcohol use is continued despite knowledge of having a
persistent or recurrent physical or psychological problem
that is likely to have been caused or exacerbated by
alcohol.
Tolerance, as defined by either of the following:
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A need for markedly increased amounts of alcohol to achieve
intoxication or desired effect.
A markedly diminished effect with continued use of the same
amount of alcohol.
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Withdrawal as manifested by either of the following:
a. the characteristic withdrawal syndrome for alcohol.
b. Alcohol (or closely related substance, such as a
benzodiazepine) is taken to relieve or avoid withdrawal
symptoms.
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Alcohol withdrawal syndrome is a potentially life-threatening
condition that can range from anxiety and shakiness to seizures
and delirium tremors. Headaches, insomnia, sweating and
vomiting may also occur.
The disorder can be classified as either:
 Mild- presence of 2-3 symptoms
 Moderate – presence of 4-5 symptoms
 Severe – presence of 6 or more symptoms.
You simply count the number of symptoms or
criterion that apply to the person.
Binge Drinking
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We used to associate binge drinking with college
students. However, new research shows that it is
common among students, but 70% of binge drinking
episodes involve adults age 26 years and older.
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Binge drinking is rising and is one of the most
dangerous patterns seen in alcohol use statistics. In
fact, about 75% of the alcohol consumed by adults in the
United States is in the form of binge drinking.
Binge Drinking
Binge drinking is defined as consuming several
drinks over a short period of time.
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Binge drinking is defined as:
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For women, 4 or more drinks on a single occasion
(within a 2 hour period).
For men, 5 or more drinks on a single occasion
(within a 2 hour period).
Binge Drinking
Alcohol abuse statistics show the following about
binge drinking:
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More men than women binge drink.
Binge drinkers are 14 times more likely to report
alcohol-impaired driving.
The Disease Model Of
Addiction
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We now classify addiction as a disease. This does NOT
mean the person is not responsible for their behaviors.
The addiction disease model defines drug and alcohol
addiction as a unique, irreversible and progressive
disease that cannot be cured, but can be arrested
through abstinence.
There is evidence that, in certain individuals, each
incidence of substance abuse chemically alters the brain
causing them to become dependent on the substance.
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The disease model demonstrates a progressive process
where, over time, people with addiction experience
powerful cravings and if they don't respond quickly
enough, strong and sometimes deadly withdrawal
symptoms occur.
Continued use of the substance can also result in
irreversible damage to the brain, liver, kidneys and other
vital organs.
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People facing drug and alcohol addiction cannot control
their need for alcohol or other drugs, even in the face of
negative health, social or legal consequences. This lack
of control is the result of alcohol or drug-induced
changes in the brain.
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Using drugs repeatedly over time changes the structure
of the brain.
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Addiction occurs when an array of changes occur in
the brain that strengthens new memory
connections. The changes in the brain are
responsible for the distortions of cognitive and
emotional functioning that characterize addicts,
particularly the compulsion to use drugs.
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Those changes, in turn, cause behavior changes.
Drugs, other than Alcohol
So now let’s take a look at some of the drugs that are
included in your drug tests.
What drugs am I tested for?
6-Panel Drug Test
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Amphetamines
Cocaine
Phencyclidine
Cannabanoids
Opiates
Ecstasy/MDMA
10-Panel Drug Test
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Amphetamines
Cocaine
Cannabanoids
Opiates
Phencyclidine
Barbituates
Benzodiazepines
Methadone
Propoxyphene
Ecstasy/MDMA
Prescription Drug Abuse
First we will take a look at an epidemic in our
country –
Prescription drug abuse
What is prescription drug abuse?
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The use of a prescription medication in a way not
intended by the prescribing physician. For example,
taking more than the prescribed amount or taking a
medication that has been prescribed for somebody else.
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Most common in young people but new trends are
developing.
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Drugs most often abused include painkillers, sedatives,
anti-anxiety medications and stimulants.
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The Centers for Disease Control and Prevention has
classified prescription drug abuse as an epidemic.
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Nearly 3 out of 4 drug overdose deaths are now caused
by prescription painkillers.
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More than 12 million Americans reported using
prescription painkillers in 2010 without a prescription or
just for the high that they cause.
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CDC in Atlanta
The Prescription Opioid Abuse Epidemic
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The latest research tells us that over 2 million Americans
suffer from substance use disorders related to
prescription opioid pain relievers.
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One of the consequences of this epidemic are overdose
deaths, which have more than quadrupled in the past 15
years.
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The causes of this epidemic are complex, but they
include over-prescription of pain medications. In 2013
alone, 207 million prescriptions were written for
prescription opioid pain medications.
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Addiction can quickly happen to anyone who has been
injured on the job, been to the dentist to have teeth
pulled, or has a chronic illness.
Also, people may begin using prescription drugs non
medically for many reasons - to lose weight, to feel
good, to improve mood, etc.
People who have a history of victimization, adverse
social conditions or trauma, are more at risk.
Signs and Symptoms of Opioid Painkillers Abuse
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Constipation
Depression
Low blood pressure
Decreased breathing rate
Confusion
Sweating
Poor coordination
Now let’s take a look at the different
types of drugs.
Stimulants
The Effects of Stimulants
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Increased heart rate
Suppresses appetite
Feel energized
Suppresses sleep
False sense of alertness
Cardiac risk
Amphetamines
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Amphetamines are powerful stimulants, like cocaine.
These drugs produce feelings of euphoria, well-being
and self-confidence.
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An estimated 13 million Americans abuse
amphetamines.
Amphetamines
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True amphetamines come in tablets or capsules,
although they are sometimes ground up and/or diluted
before use.
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Amphetamines may be swallowed, snorted, or injected.
Methamphetamines
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Similar to amphetamines
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Extremely addictive stimulant
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Can be taken orally, smoked, snorted, or injected
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Immediate, very intense euphoria followed by a
hard crash
A form of methamphetamine is crystalline
methamphetamine (“ice” or “crystal meth”).
Because “crystal meth” is inexpensive to make
and highly addictive, it has become a seriously
dangerous drug in our society.
Signs and Symptoms of
Methamphetamine Abuse
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Extreme weight loss
Severe dental problems (“meth mouth”)
Skin sores caused by scratching
Anxiety
Confusion
Insomnia
Mood disturbances
Violent behavior
Symptoms of psychosis, such as paranoia, visual and
auditory hallucinations, and delusions (for example, the
sensation of insects crawling under the skin).
Cocaine
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Made from the coca plant.
Powder cocaine - salt form
of the alkaloid present in
the leaves of the plant.
In high doses, much more
dangerous than the other
stimulants.
The Methods of Ingestion
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Snorting
The powdered form through the nose
Smoking
Free-base rock cocaine
Injecting
Cocaine solution into a vein
Chewing
Leaves of the coca plant
The Effects of Cocaine in the Workplace
Although many people using cocaine think they can
hide their use, the effects show.
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Poor attention to detail
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Cost of use often leads to theft (cocaine is
expensive)
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Paranoid thinking, aggressive behavior
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Absenteeism
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Mood swings (intense high, followed by lows when
not using)
Crack
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Crack is produced by dissolving powdered
cocaine in a mixture of water and baking soda. The
mixture is boiled until a solid substance is formed
(crack rocks).
Crack is nearly always smoked. This delivers large
quantities of the drug to the lungs producing an
immediate intense euphoric effect. Crack cocaine
is cheaper than cocaine and is more addictive. The
effects last only 5-15 minutes.
Signs and Symptoms of Stimulants
Abuse
People who use stimulants over a period of time may
experience the following:
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Weight loss
Agitation
Irritability
Insomnia
High blood pressure
Irregular heartbeat
Restlessness
Impulsive behavior
Marijuana/Cannabas
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Marijuana is the most widely used illicit drug in
America.
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It is a dry, shredded green and brown mix of
leaves, stems and flowers of the cannabis
plant. It is usually smoked via joint, pipe, blunt,
or water pipe (bong). It can also be mixed into
brownies or cookies and brewed as a tea.
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The psychoactive ingredient in marijuana is
THC.
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When smoking marijuana, the effects are
typically felt within a few minutes, with a peak
high at about 10-30 minutes.
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THC is not water soluble and is stored in the fat
cells of the body, sometimes for weeks after the
last usage.
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Therefore a positive drug test is possible 4-6
weeks after last use and maybe longer for
heavy users.
Signs and Symptoms of Marijuana Use
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Dilated (large) pupils
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Impaired judgment
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Bloodshot eyes
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Impaired short-term memory
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Sleepy appearance
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Inappropriate laughter
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Reduced motivation
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Increased heart rate
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Difficulty thinking
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Distorted sensory perceptions
Increased appetite, craving
sweets
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Dry mouth
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Reduced coordination
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Euphoria (temporary feelings of
elation and energy)
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Temporary feelings of reduced
anxiety or stress
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Feeling sluggish
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Sadness/depressed mood
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Red, puffiness under the eyes
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Sensation that time is passing
slowly
Opiates
Opiates
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Opiates are used medically for pain relief. These are
dependency producing drugs.
They are central nervous system depressants.
When used medically, narcotics are given orally or
intramuscular injection. When abused they are smoked,
snorted, or subcutaneous (skin popping) or intravenous
(mainlining).
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Narcotic drugs are often called opiates because
they are derived from the opium poppy plant or
made synthetically. Narcotics has several
meanings – one of which refers to all illegal drugs
of abuse.
Natural opiates include opium, morphine, and
codeine.
Semi-synthetic narcotics include oxycodone and
dilaudid.
Recently many communities have seen a dramatic
increase in the use of heroin.
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Ohio has the 12th highest drug overdose mortality rate
in the United States.
Kentucky has the 3rd highest drug overdose mortality
rate in the United States.
Signs and Symptoms of Heroin Use
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Shortness of breath
Dry mouth
Constricted (small) pupils
Sudden changes in behavior or actions
Disorientation
Cycles of hyper alertness followed by suddenly nodding
off
Droopy appearance, as if extremities are heavy
Materials Connected to Heroin Use
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Needles or syringes not used for other medical
purposes
Burned silver spoons
Aluminum foil or gum wrappers with burn marks
Missing shoelaces
Straws with burn marks
Small plastic bags, with white powdery residue
Water pipes or other pipes
Why are we seeing so many people using heroin
now?
The research is showing us there is a link
between prescription opioid painkillers, such as
Vicodin and Oxycontin.
Prescription opioid pain medications such as Oxycontin
and Vicodin can have effects similar to heroin when taken
in doses or in ways other than prescribed, and research
now suggests that abuse of these drugs may actually open
the door to heroin abuse.
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Three recent studies indicated that almost half of the
young people who inject heroin, abused prescription
opioids before moving on to use heroin.
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Some individuals stated they began using heroin
because it was cheaper and easier to obtain than
prescription opioids.
Resources
Where to Go for Help
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If you or someone you care about, may have a
substance use problem, a trained mental health
professional is essential to do a thorough evaluation.
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HealthSpan EAP can provide an assessment and make
the appropriate recommendation for which level of care
is right for you or other household members.
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There is no cost to the employee for an assessment.
There are many places in the Cincinnati area to get help.
The following slide lists some of those resources.
If you need additional help finding resources, call us at
HealthSpan EAP. Again, there is no charge for a phone
call.
Resources
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Bethesda Oak
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513/569-6116
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Bethesda Blue Ash
513/381-6672
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513/489-6011
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Gateway Recovery Center
Northland Intervention Center
Community Behavioral Services
Middletown
513/424-0921
513/861-0035
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Community Behavioral Services
Hamilton
513/887-8500
Beckett Springs
513/942-9500
CCAT
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St. Elizabeth Falmouth - KY
859/572-3500
513/753-9964
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St. Elizabeth Outpatient – KY
859/212-5384
For More Information
Contact Us
513 - 551-1500
or toll-free at
800 - 733-0257
or visit us on the web
www.healthspannetwork.com