DOT-Mandated Drug and Alcohol Testing

Reasonable SuspicionSupervisory 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 othersAdditional 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.

7

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.

9

Reasonable Suspicion Testing

Supervisory TrainingDr. Donna Smith

dsmith@firstlab.com727-343-0283727-204-8549

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 tool11

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

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

appearance14

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

1

2

3

4

5

6

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

• 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 policy20

120# 140# 160# 180# 200# 220#

15 Drinks 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

Alcohol Elimination: Number of hours to 0.00 BAC

This is the approximate number of hours to zero BAC from the time

drinking began.

22

Discussion:

• Part of brain with different responses to alcohol

• General slowing of various functions, some earlier than others

23

Mental(.02 - .04)

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

24

Mental(.02 - .04)

Sensory(.04 - .06)

Alcohol affects sensory perception

Vision - decreased object tracking, night an peripheral vision background Hearing - diminished acuity, ability to sort background noiseSmell - decreased sensitivity and selectivityTaste - decreased sensitivity and selectivity

25

Mental(.02 - .04)

Sensory(.04 - .06)

Speech & Fine Motor(.08 - .10)

Psychomotor Functions

Speech is one of the earliest motor skills to be affectedSpeech changes may include over-enunciation, slurring, or exaggerated speech patternsCoordination, reflexes and fine motor dexterity are diminishedReaction times are slower, movements appear delayed or retarded

26

Mental(.02 - .04)

Sensory(.04 - .06)

Speech & Fine Motor(.08 - .10)Gross Motor

(.10 - .25)

•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

27

Mental(.02 - .04)

Sensory(.04 - .06)

Speech & Fine Motor(.08 - .10)

Gross Motor(.10 - .25)

Balance(.25 - .35)

Balance and Navigation

• Balance is controlled by the inner ear

• Alcohol intoxication vertigo (room spin)

• Nausea and vomiting

28

Mental(.02 - .04)

Sensory(.04 - .06)

Speech & Fine Motor(.08 - .10)

Gross Motor(.10 - .25)

Balance(.25 - .35)

Brain Stem (.35 - .45)

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)

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