DOT-Mandated Drug and Alcohol Testing

1
DOT-Mandated Drug and Alcohol Testing

• Reasonable Suspicion
• Supervisory Training

2
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

3
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. )

4
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 lt0.02 for all others
• Additional disciplinary actions are up to
  employer

5
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

6
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

7
Drug Testing

• Urine specimen provided by employee in private
  toilet enclosure
• Specimens poured into two bottles-labeled and
  sealed in employees presence
• Analyzed at a SAMHSA-certified laboratory2 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.

8
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

9
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.

10
Reasonable Suspicion Testing

• Supervisory Training
• Dr. Donna Smith
• dsmith_at_firstlab.com
• 727-343-0283
• 727-204-8549

11
Reasonable Suspicion - Definition

• Reasonable suspicion
• is based on observations of an individual
• Contemporaneousjust 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 individuals behavior
  or appearance
• is not a diagnostic tool

12
Reasonable Suspicion

• Decision to test must be based on supervisors
  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
  Supervisors Checklist
• Should test within 2 hours, discontinue after 8
  hours

13
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

14
Supervisors 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
  employees 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
  employees usual behavior and appearance

15
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

16
Alcohol Misuse

• Signs and Symptoms

17
Effect of Alcohol

• Alcohol is a drug
• Alcohol acts as a stimulant
• Alcohols overall effect is a sedative or
  depressant
• Alcohols effects vary from individual to
  individual
• Alcohols 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

18
Alcohol Facts

• BAC is based on individuals 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

19
Alcohol Concentrations

• Peak BAC based on alcohol drinks per hour

20
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 policy

21
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 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

Mental (.02 - .04)
24
Alcohol affects sensory perception Vision -
decreased object tracking, night an peripheral
vision background Hearing - diminished acuity,
ability to sort background noise Smell -
decreased sensitivity and selectivity Taste -
decreased sensitivity and selectivity
Sensory (.04 - .06)
Mental (.02 - .04)
25
Psychomotor Functions Speech is one of the
earliest motor skills to be affected Speech
changes may include over-enunciation, slurring,
or exaggerated speech patterns Coordination,
reflexes and fine motor dexterity are
diminished Reaction times are slower, movements
appear delayed or retarded
Speech Fine Motor (.08 - .10)
Sensory (.04 - .06)
Mental (.02 - .04)
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• 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

Speech Fine Motor (.08 - .10)
Gross Motor (.10 - .25)
Sensory (.04 - .06)
Mental (.02 - .04)
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• Balance and Navigation
• Balance is controlled by the inner ear
• Alcohol intoxication vertigo (room spin)
• Nausea and vomiting

Gross Motor (.10 - .25)
Speech Fine Motor (.08 - .10)
Balance (.25 - .35)
Sensory (.04 - .06)
Mental (.02 - .04)
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• 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)

Gross Motor (.10 - .25)
Speech Fine Motor (.08 - .10)
Balance (.25 - .35)
Sensory (.04 - .06)
Mental (.02 - .04)
Brain Stem (.35 - .45)
29
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

30
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

31
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

32
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

33
Reasonable Suspicion Testing

• Signs Symptoms of Drug Use

34
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

35
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
• Observable effects (physical signs and symptoms,
  speech, motor functioning)of drug use are often
  not present for more than a few hours after use.
  .

36
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 users breath and clothing

37
Personality Changes

• Personality changes are the most difficult to
  specify
• Supervisor needs to be alert to changes in the
  employees usual personality traits or
  expression
• Personality changes due to drug use often are
  sudden and dramatic

38
Speech Patterns

• Stimulants create rapid, pressured speech
  patterns
• Narcotics produce slow, thick, slurred speech
• Hallucinogens may produce nonsense, fantasy speech

39
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
  employees usual patterns of interacting with
  others

40
Psychomotor Changes

• Stimulants speed up the bodys 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