Presented By:

Ali Liénaux, Marie Longré, Vice-President of Clinical Operations SAP Program Administrator

Identification and Accommodation of Employees with Substance Abuse Issues

Substance Abuse in Substance Abuse in the Workplacethe Workplace

Presentation Overview

1. Employer Responsibilities2. Alcohol and Drug Policies:

An Employer’s Tool3. Psychoactive Substances:

Overview and Signs and Symptoms

4. Workplace Responses: SAP vs. EAP Assistance

SECTION 1: SECTION 1:

Employer Responsibilities

Employer Responsibilities

Accommodation

Privacy Safety

Employer Responsibilities1. Safety

Bill C-45: An Amendment to the Criminal Code of Canada (2003)

217.1 Everyone who undertakes, or has the authority, to direct how another person does work or performs a task is under a legal duty to take reasonable steps to prevent bodily harm to that person, or any other person, arising from that work or task.

Criminal Code, R.S.C. 1985, c. C-46

Employer Responsibilities1. Safety (cont’d)

Employer Civil Liability Vicarious liability for incidents at

work caused by employee use of drugs and/or alcohol– Hoefling v. The Driving Force

Inc., 2006 ABQB 30– R. v Dofasco Inc. (2007 ONCA

769 (Ontario Court of Appeal, 2008)

Employer Responsibilities2. Duty to Accommodate

All individuals should have an opportunity … to have their needs accommodated , consistent with their duties and obligations…without being hindered in or prevented from doing so by discriminatory practices based on race, national or ethnic origin, colour, religion, age, sex, sexual orientation, marital status, family status, disability or conviction for an offence for which a pardon has been granted.

Canadian Human Rights Act, R.S.C.1985, c. H-6, s. 2, Purpose of the Act.

Employer Responsibilities2. Accommodation (cont’d)

Employers are required to accommodate disabilities if they know about them

Addictions often hidden due to employee denial

What is “Reasonable Accommodation?”

Employer Responsibilities3. Privacy

Employer must:– Ensure the workplace is safe– Accommodate disabled

employees

WHILEWHILE– Balancing employees’ rights

to privacy

Employer Responsibilities3. Privacy (cont’d)

DiscriminationBona Fide Occupational

Requirement (BFOR)Determining “present”

impairment

Drug Testing: A “Justifiable” Drug Testing: A “Justifiable” Breach of Employees’ Right Breach of Employees’ Right to Privacy?to Privacy?

SECTION 2: SECTION 2:

Alcohol and Drug Policies: An Employer’s Tool

Alcohol and Drug Policies: An Employer’s Tool

An effective Alcohol and Drug (A & D) Policy is:– Tailored to the specific needs

of a company– A “reasonable” and

“responsible” response to a company’s needs

Butler, B. (2008, May 26). Reality Check on Alcohol and Drug Policies and Testing Programs: The Canadian Situation. Presentation at the Insight Conference, “The Critical State of Workplace Alcohol and Drug Testing,” Toronto.

Alcohol and Drug Policies: An Employer’s Tool (cont’d)

An effective A & D Policy strikes a balance between:– Controlling/deterring use

(standards, investigation tools, consequences of breach)

ANDAND– Preventing misuse (education,

training, EAP)

Butler, B. (2008, May 26). See above reference.

Alcohol and Drug Policies: An Employer’s Tool (cont’d)

Influence of a well-developed A & D Policy:– Deterrence– Encourages self-help– Demonstrates that Employer

is proactive

SECTION 3: SECTION 3:

Psychoactive Substances: Overview and Signs and Symptoms

Range of Substance Use

Recreational Use – casual, non-problematic

Substance Abuse – moderately problematic, may have mild cravings/withdrawal symptoms, may impact on work/relationships

Substance Dependence – very problematic, likely to impact work/relationships, physical/psychological problems/withdrawal symptoms

Drug Tolerance

Takes more of that substance to produce the same effect

Due to the body’s healthy desire for balance, attempts to counteract the effects of the drug

Almost all psychoactive substances taken regularly over a period of time lead to tolerance

Significantly increases the risk of drug overdose

Recognizing Signs and Symptoms

Absenteeism/lateness Frequent breaks Mood swings Alcohol on breath Irritability Memory loss/lapse Borrowing money

Physical Signs of Substance Abuse

Slowed, staggering walk, poor coordination

Red, watery eyes, pupils smaller or larger than usual, blank stare

Puffy face, blushing or paleness

Cold, sweaty palms

Physical Signs of Substance Abuse (cont’d)

Tremors or shakes of hands, feet, head

Extreme hyperactivity, unusual talkativeness

Needle marks on arms, legs, feet

Emotional Experience of Substance Abuser

Denial of problem Anger at self and others Mistrust of others Controlling Low self esteem Avoidance of feelings Isolation

Enabling: Help or Harm?

Rescuing behaviour that allows substance abuser to maintain his/her way of life

Enabler takes responsibility, blame or makes accommodations for substance abuser

Becomes pattern for family, friends, co-workers, management

We Need to Deal with Substance Abuse @ Work

Increase of employee suffering which is hidden

Social cost of inactivity are staggering

Increase of cost to organizations – health care, WSIB claims, lost

productivity – impact on corporate culture is

enormous

It is our job!

SECTION 4: SECTION 4:

Workplace Responses: SAP vs. EAP Assistance

Workplace Responses

Employees may request assistance (i.e. self-disclosure)– Best case scenario– Respond supportively

according to A & D Policy

Workplace Responses (cont’d)

Employees may be hiding the problem– More difficult situation– Engage in non-accusing

conversation – Respond supportively according to

A & D Policy in the following situationsPositive drug/alcohol testWith training, can act using “Reasonable

Cause”

– Disciplinary action

Substance Abuse Professionals (SAPs)

Regulated term under 49 CFR Part 40 of US DOT and specifies the following:– Professional qualifications– Addictions experience– Training and rigorous exam– Monitored continuing education– Subject to DOT audits

SAP is not a regulated term in Canada

Substance Abuse Professionals (cont’d)

Use of a DOT SAP ensures:– Properly credentialed– Addictions experience– Understands workplace

concerns– Background in the community– Understands appropriate

reporting constraints– Makes appropriate relapse

prevention recommendations

EAP Counselling

Voluntary Confidential Designed for employees

with self-disclosed issues No need for diagnostic tools

SAP Assessment and Reporting

Mandatory Not confidential – reports

provided to the Employer Designed for employees who

have breached A & D Policy or US DOT Regulation

Requires objective diagnostic tools

SAP Assessments and Reporting (cont’d)

Reports and Assessments should:– Balance the

organizations legal requirement and right to privacy

– Understand current federal and provincial legal and human rights rulings

SAP Process

1. Organization determines level of reporting

2. SAP conducts a thorough professional assessment

3. SAP determines type of treatment OR education needed

4. SAP refers employee to the community resource best matching needs

5. SAP provides organization’s representative with initial report

SAP Process (cont’d)

6. SAP tracks progress of employee through treatment or education

7. SAP provides company representative with updates and notifies rep if employee fails to comply

8. SAP conducts post-treatment (education) follow-up assessment to determine level of employee compliance

9. SAP provides company representative with follow-up report, which includes relapse-prevention recommendations

Company Representative’s Options

IWS strongly suggests that the employer follow the SAP’s recommendations

However, the employer is not obligated to accept the SAP’s counsel regarding follow-up requirements or additional support programs

Company Representative’s Options (cont’d)

Organization can use SAP’s recommendations solely to advise its decisions regarding employee’s follow-up (including Last Chance Agreement) should employment continue

The accommodation and successful reintegration of an employee struggling with substance abuse is a life saving task.

Thank You!Thank You!