immediate past president the substance abuse program administrators association jeff sims, c-sapa,...

Immediate Past PresidentThe Substance Abuse Program

Administrators Association

Jeff Sims, C-SAPA, C-SI

Most aggressive actions occurred since the late 1980’s:

- The Anti-Drug Abuse Act of 1986 (directed U.S. Secretary of Labor to initiate efforts to address the issue)

- President Reagan’s Executive Order 12564, Drug-Free Federal Workplace (made it a condition of employment to refrain from using illegal drugs)

- Drug-Free Workplace Act of 1988 (required federal contractors and grantees to have drug-free workplaces)

- Drug-Free Workplace Act of 1998 (establish grant programs that assist small businesses in developing drug-free workplaces)

- Omnibus Employee Testing Act of 1991 (required transportation industry employers to conduct alcohol and drug testing for employees in “safety sensitive” positions) It created a model for non-regulated employers now follow.

In 2006, estimated 20.4 million Americans were current illicit drug users, which is a rate of 8% among all Americans. No significant changes in recent years.

About 57 million people, or more than one-fifth (23.0 %) of the population age 12 and over, participated in binge drinking (having five or more drinks one the same occasion at least once in the past 30 days).

In 2006, of the 17.9 million current illicit drug users age 18 and over, 13.4 million (74.9 percent) were employed.

Similarly, among 54.0 million adult binge drinkers, 42.9 million (79.4 percent) were employed.

Of the 20.6 million adults classified with substance dependence or abuse, 12.7 million (61.5 percent) were employed full-time.

Data provided by the Substance Abuse and Mental Health Services Administration, (2007). Results from the 2006 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H-32, DHHS Publication No. SMA 07-4293). Rockville, MD.

While about half of all U.S. workers work for a small and medium sized businesses (those with fewer than 500 employees), and nine in ten employed current illicit drug users.

Almost nine in ten workers with alcohol abuse dependences work for small medium employers.

However, smaller firms do not perform testing.

More likely to be involved in an accident and file a workers’ compensation claim

More likely to quit or get fired More likely to steal from workplace More likely to miss work More likely to be in a confrontation Less productive

Substance abusers are: 3.6 times more likely to be involved in a

workplace accident 5 times more likely to file a workers’

compensation claim As many as 50% of all workers’

compensation claims involve substance abuse

80% of those injured in “serious” drug-related accidents at work

are not the drug abusing employees… but innocent co-workers

and others.

Return On InvestmentHow much does s/a cost per drug

user? $7,000 (national average)

How many drug users do you have? 17% of workforce (national average) Use their figure

How many employees do you have?

Do the Math! 250 employees multiplied by % of drug users in their

workplace (5%) multiplied by $7000 equals cost of s/a compare to cost of drug testing

(300 tests at $45 per test average)

250 x 5% =1313 x $7,000 =$91,000

300 (drug tests/year) x $45 (cost per test)=$13,500

$ 91,000 -13,500=$ 77,500 SAVINGS!

A comprehensive drug-free workplace program includes:

1. Policy2. Supervisor training3. Employee education4. Employee assistance5. Drug testing (Alcohol testing)

Employees All employees Safety-sensitive employees All employees under certain

circumstances Temps, contract workers, seasonal

hires Union workers

Traditionally… pre-employment post-accident reasonable suspicion Random Return to duty Follow up

Marijuana Cocaine Opiates

10/1/2010 w/ separate confirm for heroin Amphetamines

10/1/2010 w/separate confirm for MDMA Phencyclidine (PCP)

The primary drugs of abuse

Observe Document Confront Refer Follow through

Watch For These Signs Absenteeism “On the job” absenteeism Accidents Difficulty in concentration Confusion Spasmodic job performance Lowered efficiency Physical behaviors Relationship issues at work

Only observable and verifiable facts allowed - not rumors

Record all actions and behaviors

Include statements or pertinent facts

State time, date, location

List witnesses

Use documentation to outline job performance issues Avoid being

manipulated by accepting excuses

Be firm and honest Do not get

personally involved Do not become an

armchair diagnostician

After any confrontation, a referral system is needed Outpatient services Inpatient services Support groups Testing programs

Return to work contract Explain company’s disciplinary policy Set up specific work goals and criteria Evaluate job performance Follow-up drug and alcohol testing Family issues

Speed things up Slow things down Confuse signals Block signals Combination of the

above

The brains pleasure centers

Drug: Marijuana, Hashish, Hashish OilClassification: HallucinogenAdministration: Smoked or swallowedAppearance:

Dry crushed leaves (marijuana) Hand-rolled cigarettes (joints) Hard chunks of resin (hashish) Dark viscous liquid (hashish oil)

Detection time in urine: _______?

In 2001, over 12 million Americans age 12 and older used marijuana at least once in the month prior to being surveyed. That is more than three quarters (76 percent) of the total number of Americans who used any illicit drug in the past month in 2001. Of the 76 percent, more than half (56 percent) consumed only marijuana; 20 percent used marijuana and another illicit drug; and the remaining 24 percent used an illicit drug or drugs other than marijuana(1).

Although marijuana is the most commonly used illicit drug in the United States, among students in the 8th, 10th, and 12th grades nationwide its use remained stable from 1999 through 2001(2). Among 8th graders, however, past year use has decreased, from 18.3 percent in 1996 to 15.4 percent in 2001. Also in 2001, more than half (57.4 percent) of 12th graders believed it was harmful to smoke marijuana regularly and 79.3 percent disapproved of regular marijuana use. Since 1975, 83 percent to 90 percent of every 12th grade class surveyed has found it "fairly easy" or "very easy" to obtain marijuana(3).

Data for drug-related hospital emergency department visits in the continental United States recently showed a 15 percent increase in the number of visits to an emergency room that were induced by or related to the use of marijuana from 96,426 in 2000 to 110,512 in 2001. The 12 to 34 age range was involved most frequently in these mentions. For emergency room patients in the 12 to 17 age range, the rate of marijuana mentions increased 23 percent between 1999 and 2001 (from 55 to 68 per 100,000 population) and 126 percent (from 30 to 68 per 100,000 population) since 1994(4).

Sponsored by a’ TEST consultants, inc., and funded by the U.S. Small Business Administration – Paul D. Coverdell Drug-Free Workplace Program

– Short term memory loss– Depth perception issues– Dreamy, relaxed feeling– Increased senses of sight, smell, taste, and

hearing – leads up to excessive smoking and “munchies”

– Hallucinations– Anxiety– Impaired muscle coordination

MARIJUANA EFFECTSMARIJUANA EFFECTS

Rapid, loud talking Sleepiness Lack of motivation Reduced

concentration Reduced inhibitions Sexual dysfunction Giggly, ridiculous

conversation

Drug: Cocaine

Classification: Stimulant, local anesthetic

Administration: Snorted, injected, smoked

Appearance: White crystalline powder, bitter numbing taste, odorless, from coca plant leaves

Clinical Effects: Euphoria, motor and verbal hyperactivity, mood swings, inflated self-esteem

Detection Time in Urine: 2-4 days

Weight loss Paranoia Anxiety, irritability Elevated blood pressure Increased heart rate Sleeplessness-fatigue Psychological problems

Cold sweats Coma, convulsions Dilated pupils Nose bleeds Depressed or sad Talkativeness Self-confidence < >

020406080

100120

Min. Length Per Minute Max. Length Per Minute

Smoked (freebase) immediateInjected secondsSnorted 30 secondsOrally 3-5- mins

Length of a rush

Drugs: Morphine, Heroin, Codeine, Oxycodone Hydromorphone

Classification: Narcotic analgesicAdministration: Swallowed, smoked or

injectedAppearance: White, brown, or black

powder, injectable liquids, tablets, capsules (various sizes and colors)

Detection Time in Urine: 3 days

Euphoria Drowsiness Respiration

depressed Pain management Psychological

dependence

Sleepiness Slowed reflexes Confusion Poor concentration Slurred speech Constricted pupils Shaking Diarrhea or cramps

MRO’s may request quantitative values of codeine/morphine 2000 ng/ml or less suggest poppy

seeds or RX 2500 ng/ml or above with codeine

present rules out poppy seeds, may be a RX, or illegal use of morphine or heroin

Drug: PhencyclidineClassification: Hallucinogen, anestheticAdministration: Smoked, swallowed, or

injectedAppearance: Pills, capsules, powders Detection Time in Urine: 2 days or 8 days

in severe overdose

Psychedelic reaction

Hallucinations Combative

behavior Symptoms of

insanity Catatonic state Reduced work

motivation

Convulsion Muscle rigidity Profuse sweating Slurred speech Involuntary eye

movements Inappropriate

remarks

Drug: Methamphetamine, amphetamineClassification: CNS stimulant (speed)

Administration: Swallowed, injected, smoked

Appearance: Powders, crystals, capsules, tablets

Detection Time in Urine: 24 - 48 hours

Palpitations Tachycardia Hypertension Dizziness Insomnia Hallucinations

Euphoria then restlessness

Agitation Irritability Extreme paranoia Weight loss Malnutrition Tooth decay

Drug: EthanolClassification: PsychoactiveAdministration: Wine, beer, liquorAppearance: Liquid, several colorsDetection in Urine: Generally 1 ounce of

alcohol is eliminated per hour Note: Urine alcohol testing cannot

withstand a court challenge

Trembling or DT’s Dizziness Staggering Weepy, bloodshot eyes Lethargic behavior Hallucinations, convulsions

Aggressiveness Nausea or vomiting Alcohol

breath(fruity smell) do not be mistaken by a diabetic(acetone)

Incoherent (slurred) speech

Unconsciousness

Contact Jeff @ 800.837.8648, Ext 117, or by email @

jpsims@atestinc.com

Any Questions????Any Questions????