Transcript Chasing the Dragon – Substance Abuse in the Workplace

NLOHSA 59th Annual Conference
14 May 2015
Nadine Wentzell, BSc(Pharm) MAdEd
Workplace Drug & Alcohol Consultant
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Statistical realities – defining the problem
 Employers’ and employees’ responsibilities
 Strategies for organizational wellness

© 2014 Nadine Wentzell Consulting Inc
A bottle of Bayer’s ‘Heroin’
 Sold as a non-addictive
substitute for morphine
 Used to treat children
suffering with a “strong
cough”
Between 1890 and 1910
© 2014 Nadine Wentzell Consulting Inc
Psychoactive drugs
 Change or affect the way people think, feel
and/or act
 Have physical effects as well
Affects on the mind/brain set them apart
from other drugs
 Alcohol, prescription, non-prescription or over-
the-counter (OTC), and street drugs
© 2014 Nadine Wentzell Consulting Inc

Substance Use – “recreational”
 Self administration of a psychoactive substance (WHO, 2006)

Substance Misuse – potentially
harmful/problematic
 Legal
 Social
 Interpersonal
 Financial and/or
 Professional© 2015
problems
(Canadian
Nadine Wentzell Consulting
IncNurses Association, 2002)

Substance Abuse and Dependence –
Addiction/ Substance Use Disorders
 Maladaptive/unhealthy pattern of substance use
▪ Recurrent and significant adverse consequences
▪ Related to the repeated use of substances
(American Psychiatric Association, 2000)
© 2015 Nadine Wentzell Consulting Inc
A person does not move to addiction immediately;
it’s a process
 A relationship with psychoactive drugs develops
 Elements present in addiction include:

 Pre-occupation with use
 Compulsion to use
 Continued use despite negative
consequences
 Loss of control
 Return to use (relapse)
© Nadine Wentzell Consulting Inc 2014

Workplace misuse
 Occurs within a specific number of hours during a
work shift (breaks, lunches, other times on the job)
 Productivity and safety implications

Workforce misuse
 Occurs during non-work hours
 Influences on-the-job performance
 Associated with absenteeism, turnover and
productivity costs
© Nadine Wentzell Consulting Inc 2014
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Concern
 Safety
 Avoidance of harm to self and/or others
© Nadine Wentzell Consulting Inc 2014
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Concern
 Safety
 Avoidance of harm to self and/or others
© Nadine Wentzell Consulting Inc 2014
How to deal appropriately with employees
who may be:
*unfit for work due to
substance abuse
Which impacts health, safety
and productivity
© 2014 Nadine Wentzell Consulting Inc

11% use alcohol at work
 4% used 4 hours prior

10% reported being illicit drug users
 Primarily marijuana

1% reported using drugs at work


2% used within 4 hours prior
88% reported using prescription medications
© 2014 Nadine Wentzell Consulting Inc
 Employee & Family Assistance Programs (EFAP)
or Employee Assistance Programs (EAP)
 Work rules/standards re drug and alcohol use
 “Fitness for duty” requirements
▪ Occupational Health & Safety – OHS
Is this enough?
© 2015 Nadine Wentzell Consulting Inc

Atlantic Canada
 NL – highest percentage of heavy drinkers (9.4%)
 NB – close second (8.4%)

8.7% of Canadian drinkers reported harm from
alcohol
 BC (9.9%); NS & NL (9.6%)
Canadian Alcohol & Drug Use Monitoring Survey (2008)
© 2015 Nadine Wentzell Consulting Inc

Use is highest
on both coasts
 NS (13.4%); BC (13.1%) [1]
Doubled since 1994 – now 14%
 Greatest percentage in 18-24 year olds
 20% use weekly; 18% use daily

[2]
[2]
1.
Canadian Alcohol and Drug Use Monitoring Survey (2008)
2.
Canadian Addiction Survey: Canadian Center on Substance Abuse (2004)
© 2015 Nadine Wentzell Consulting Inc
[2]
Other than THC
 17% reported using in lifetime
 Over last year 3% reported use of any one
 Cocaine; speed; ecstasy; hallucinogens or heroin
 Highest levels in younger age groups (18-24 yrs)
*Canadian Addiction Survey (2004) Canadian Centre on Substance Abuse
© 2015 Nadine Wentzell Consulting Inc

Recent data =
 Prescription medicine => the most commonly
abused substance after cannabis (marijuana)

In 2011
 More than 6 million Americans over age 12
reported abusing prescription drugs during the
previous month
http://www.phrma.org.prescription-drug-abuse
© Nadine Wentzell Consulting Inc 2014


In 2010 USA had 8.76 million prescription
drug abusers
Abuse by numbers:
 Stimulants
1.1 million
 Tranquilizers
2.2 million
 Painkillers
5.1 million
Where do they come from?
© Nadine Wentzell Consulting Inc 2014
www.drugabuse.gov/related-topics/trends-statistics/infographics/abuse-prescription-pain-medications-risks-heroin-us
© Nadine Wentzell Consulting Inc 2014
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No reliable national data on rates of
prescription opioid (narcotic) abuse
Indications of increasing rates of morbidity
and mortality
International prescribing of opiates
 2004 – 6th
 2012 – 2nd only to the US
© 2014 Nadine Wentzell Consulting Inc
Codeine - Tylenol® #2, #3
Fentanyl - Duragesic®
Hydrocodone - Tussionex®
Hydromorphone - Dilaudid ®
Oxycodone – Percocet®, OxyNeo®
Morphine – MS Contin®
© Nadine Wentzell Consulting Inc 2014
No reliable national data on rates of Rx opioid
abuse
 Indications of increasing rates of morbidity and
mortality
 International prescribing of opiates

 2004 – 6th
 2012 – 2nd only to the US
© Nadine Wentzell Consulting Inc 2014
Pain Relief Medication (Opiates)
Students were asked about non-medical use of
pain relief pills including
Percocet®/ Percodan®, Tylenol #3®, Oxycontin®,
and codeine
 11.7% of students used pain pills
 not prescribed for them or
 without a doctor telling the student to take them
© Nadine Wentzell Consulting Inc 2014
Non-medicinal use of pain medications
Proportion of males : females = similar
 Proportion of students “using” increased
with grade level

 Grade 7 - 4%
 Grade 9 - 11.3%
 Grade 10 - 13.9%
 Grade 12 - 16.4%
© Nadine Wentzell Consulting Inc 2014
Readily available
 Comparatively “cheap”
 Not illegal drugs
 Safer to use than street drugs
 Believed to have fewer side effects
 Can claim to have prescription
 Less shame/stigma attached to using

© Nadine Wentzell Consulting Inc 2014
• Overall issues
• Supervisors
• Employees
• Community
© Nadine Wentzell Consulting Inc 2014

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

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Employee health
Co-worker health
Workplace and public safety
Operational productivity
Liabilities
Corporate reputation
© 2014 Nadine Wentzell Consulting Inc
Absenteeism
Disability
Claims
Workers Comp Claims
Sick Leave
Benefit Costs
Overtime pay for
compensatory work
Presenteeism
Insurance
claims
Replacement costs for
damaged equipment
???
Litigation
???
© 2014 Nadine Wentzell Consulting Inc
Workplace
Concern
Before (baseline)
After treatment
(61 days post)
Absenteeism
$8100
$2734
Tardiness
$932
$312
Conflict with Managers
$411
$193
Conflict with coworkers
$460
$193
Lost productivity
$2916
$1147
Aggregate Value
$12,819 (US $)
$4614 (US $)
*Based on an average salary $45,000
+ benefits
© 2014 Nadine Wentzell Consulting Inc

Annual productivity losses in Atlantic Canada
(2002) related to alcohol, tobacco & illegal drug
use = $2.1 billion Rehm (2006)Cost of Substance Abuse in Canada 2002:
Highlights

Making addiction treatment easily accessible to
employees yields a 565% ROI
Ontario Mental Health Association; Office of the Auditor General

Comprehensive corporate wellness programs
return an average of $3 for every dollar spent
Problematic Substance Abuse that Impacts the Workplace; 2011
© 2014 Nadine Wentzell Consulting Inc

Occupational Health & Safety Act
 Employers are responsible for health, safety and
welfare of employees
 Employers must minimize or eliminate all safety
risks that have the potential to harm employees
 Workplaces can be found liable for irresponsible
and negligent actions of employees who may be
under the influence of a substance
© 2014 Nadine Wentzell Consulting Inc

Occupational Health & Safety Act
 Shared responsibility for a safe workplace
 Fitness for duty requirement
 Individual responsibility for own safety and that
of co-workers
 Cooperation with employer
 Application of training received
© 2014 Nadine Wentzell Consulting Inc

Federal & Provincial Human Rights
Legislation
 Current or former dependence on drugs or
alcohol is considered a disability under the
federal act
 Legislation prohibits discrimination based on a
disability
© 2014 Nadine Wentzell Consulting Inc

Drug & Alcohol Program
 Oversight team - cross-section of employees
 Create a Policy – balanced, fair and respectful
 Plan for implementation

Education and awareness
 Senior management
 Supervisors
 Employees

Ongoing review and revision
© Nadine Wentzell Consulting Inc 2014
A Balanced Approach:
1. Prevention
2. Assistance
3. Deterrence initiatives
Begins with a Drug & Alcohol Policy
© 2014 Nadine Wentzell Consulting Inc

Promotes change
 In inappropriate and/or potentially dangerous
behaviour before it impacts the workplace

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Encourages and promotes assistance
Ensures everyone understands
 Roles
 Rules
 Consequences

Fair, respectful and consistent
© Nadine Wentzell Consulting Inc 2014
Focus on health and safety
 Emphasis on education and training
 Guidance and support for supervisor action
 Minimizes the possibility of arbitrary actions
 Promotes ongoing evaluation

 Effectiveness and objectives
 Cultural and/or workplace changes
© Nadine Wentzell Consulting Inc 2014
Ensures transparency throughout the process
 Promotes a collaborative approach
 Uses clear and understandable wording
 Balances between awareness, treatment and
support, and discipline measures
 Focuses on:

 Health and safety
 Ongoing education
© 2014 Nadine Wentzell Consulting Inc
Identify what policies and guidelines
are currently in place
 Ask supervisors what they need/want to
address concerns
 Identify what employees know or expect
 Investigate available resources for treatment
and support, and make accessible to
employees (SAE, etc.)

© 2014 Nadine Wentzell Consulting Inc
Develop and enforce clear policies on drug
and alcohol use
 Be fair and consistent in your approach

 Dignity and respect
Provide education to all employees
 Reinforce the shared responsibility for
identification and action

© 2014 Nadine Wentzell Consulting Inc
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Train supervisors and managers
Educate employees
Manage performance
Support employees with
substance abuse problems
- Self-identification
- Post policy violation

Identify the process for assessment, treatment,
education & Return-to-Work
© 2014 Nadine Wentzell Consulting Inc
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Statistical realities – defining the problem
Employers’ and employees’ responsibilities
Strategies for organizational wellness
----------------------------------------------- What is your ACTION?
© 2014 Nadine Wentzell Consulting Inc
“There’s a problem at your workplace that nobody wants to look at.
Everybody knows that it exists, that it’s big and that it’s dangerous.
We’d rather cover our eyes and pretend it’s not there.
Maybe we’ll peek out once in a while to see if it’s gone yet.
The bad news is that it’s not going anywhere.
As a matter of fact, it’s growing …. We don’t want to know it’s there
– because with knowledge comes responsibility.
Employers cannot get away with pretending they don’t know there
are problematic substance use and addiction issues in their
workplace. ‘What I don’t know won’t hurt me’ just doesn’t cut it
for employers.”
© Nadine
Wentzell Consulting
Inc 2014 on Substance Abuse
Mary Anne
Arcand
– BC Council
602-331 Lacewood Drive
Halifax, NS
B3S 1K6
902.444.3636 (office)
902.209.3701 (cell)
[email protected]
www.NadineWentzell.com