Immediate Past President The Substance Abuse Program Administrators AssociationJeff Sims, C-SAPA, C-SI

Most aggressive actions occurred since the late 1980s: - The Anti-Drug Abuse Act of 1986 (directed U.S. Secretary of Labor to initiate efforts to address the issue) - President Reagans 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 claimMore likely to quit or get firedMore likely to steal from workplaceMore likely to miss workMore likely to be in a confrontationLess productive

Substance abusers are:3.6 times more likely to be involved in a workplace accident5 times more likely to file a workers compensation claimAs 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 Investment

How 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 employeesmultiplied by % of drug users in their workplace (5%)multiplied by $7000equals cost of s/acompare 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:PolicySupervisor trainingEmployee educationEmployee assistanceDrug testing (Alcohol testing)

EmployeesAll employeesSafety-sensitive employeesAll employees under certain circumstancesTemps, contract workers, seasonal hiresUnion workers

Traditionallypre-employmentpost-accidentreasonable suspicionRandomReturn to dutyFollow up

MarijuanaCocaineOpiates 10/1/2010 w/ separate confirm for heroinAmphetamines 10/1/2010 w/separate confirm for MDMAPhencyclidine (PCP)The primary drugs of abuse

ObserveDocumentConfrontReferFollow through

Watch For These SignsAbsenteeismOn the job absenteeismAccidentsDifficulty in concentrationConfusionSpasmodic job performanceLowered efficiencyPhysical behaviorsRelationship issues at work

Only observable and verifiable facts allowed - not rumors

Record all actions and behaviorsInclude statements or pertinent factsState time, date, locationList witnesses

Use documentation to outline job performance issuesAvoid being manipulated by accepting excusesBe firm and honestDo not get personally involved Do not become an armchair diagnostician

After any confrontation, a referral system is needed Outpatient servicesInpatient servicesSupport groupsTesting programs

Return to work contractExplain companys disciplinary policySet up specific work goals and criteriaEvaluate job performanceFollow-up drug and alcohol testingFamily issues

Speed things upSlow things downConfuse signalsBlock signalsCombination of the aboveThe 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 ProgramShort term memory lossDepth perception issuesDreamy, relaxed feelingIncreased senses of sight, smell, taste, and hearing leads up to excessive smoking and munchiesHallucinationsAnxietyImpaired muscle coordinationMARIJUANA EFFECTS

Rapid, loud talkingSleepinessLack of motivationReduced concentrationReduced inhibitions Sexual dysfunction Giggly, ridiculous conversation

Drug: CocaineClassification: Stimulant, local anestheticAdministration: Snorted, injected, smokedAppearance: White crystalline powder, bitter numbing taste, odorless, from coca plant leavesClinical Effects: Euphoria, motor and verbal hyperactivity, mood swings, inflated self-esteemDetection Time in Urine: 2-4 days

Weight lossParanoiaAnxiety, irritabilityElevated blood pressureIncreased heart rateSleeplessness-fatiguePsychological problems

Cold sweatsComa, convulsionsDilated pupilsNose bleeds Depressed or sadTalkativenessSelf-confidence < >

Length of a rush

Chart1

5453045

109090120

Smoked (freebase) immediate

Injected seconds

Snorted 30 seconds

Orally 3-5- mins

Sheet1

Ingestion MethodRushMin. Length Per MinuteMax. Length Per Minute

Smoked (freebase)immediate510

Injectedseconds4590

Snorted30 seconds3090

Orally3-5- mins45120

Sheet1

Smoked (freebase) immediate

Injected seconds

Snorted 30 seconds

Orally 3-5- mins

Length of Cocaine Rush

Sheet2

Sheet3

Drugs: Morphine, Heroin, Codeine, Oxycodone HydromorphoneClassification: 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

EuphoriaDrowsinessRespiration depressedPain managementPsychological dependence

SleepinessSlowed reflexesConfusionPoor concentrationSlurred speechConstricted pupilsShakingDiarrhea or cramps

MROs may request quantitative values of codeine/morphine2000 ng/ml or less suggest poppy seeds or RX2500 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 reactionHallucinationsCombative behaviorSymptoms of insanityCatatonic stateReduced work motivation

ConvulsionMuscle rigidityProfuse sweatingSlurred speechInvoluntary eye movementsInappropriate remarks

Drug: Methamphetamine, amphetamineClassification: CNS stimulant (speed)Administration: Swallowed, injected, smokedAppearance: Powders, crystals, capsules, tabletsDetection Time in Urine: 24 - 48 hours

PalpitationsTachycardiaHypertensionDizzinessInsomniaHallucinations

Euphoria then restlessnessAgitation IrritabilityExtreme paranoiaWeight lossMalnutritionTooth 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 DTsDizzinessStaggeringWeepy, bloodshot eyesLethargic behaviorHallucinations, convulsions

AggressivenessNausea or vomitingAlcohol breath(fruity smell) do not be mistaken by a diabetic(acetone)Incoherent (slurred) speechUnconsciousness

Contact Jeff @ 800.837.8648, Ext 117, or by email @ jpsims@atestinc.comAny Questions????