Educating supervisors about substance abuse is best accomplished when you also help them grasp the idea of something called drug tolerance. Drug tolerance has a simple meaning – your body requires more of the substance in order to achieve the same psychoactive effect desired – the high or the buzz. This is a nervous system reaction, and it occurs with all addicts. Alcoholism, cocaine addiction, opiates, they all build tolerance. In fact, build up of tolerance is part of the diagnosis of addiction and substance use disorders.
This is a problem for alcoholics and drug addicts for several reasons:
⧫ Being at work drunk and unnoticed. Tolerance to a drug is the body’s way--and particularly your nervous system’s way--of getting use to the presence of a substance. In the beginning there is a pleasant high or buzz the addict may perceive as the chemical reacts fully to your nervous system following consuming the substance. The nervous system chemicals that create a sense of pleasure begin failing at re-capturing their chemical messengers and aren't as efficient. And your feeling of getting "high" suffers. One's response to the drug is therefore diminished.
An overdose however can still kill. Drink alcohol on top of drug use or the other way around, and death can happen. Tolerance to a drug is not a reversible phenomenon, and it is considered linked and part of the disease process. Can you see why understanding this content is important in DOT reasonable suspicion training to help supervisors gain appreciation for just signs and symptoms, but disease of addiction that more often affects employees under the influence?
⧫ Withdrawal Symptoms. Withdrawal symptoms affect employees’ ability to perform. An employee may actually be more capable of performing under the influence with a high blood alcohol content than if they were completely sober at 0.00 BAC, but in withdrawal and needing a drink in order to prevent going into seizures, shaking uncontrollably, or even DTs. (Delirium Tremens) All psycho-motor skills of the employee drug or alcohol user can be affected. So, a solid checklist of these signs and symptoms is important to give employees in a DOT compliance training class or presentation, especially a PowerPoint reasonable suspicion training class.
⧫ Increased Risk by Employees. Employees will be at risk for more accidents when they are using substances on the job. And believe it or not, as I alluded to, an increased number of accidents can happen to employees who are in withdrawal on the job, but with zero BAC levels.
⧫ Skills in Being a B.S. Artist. Alcoholic employees must be come BS artists to keep you guessing, and see them as cooperative, jolly, personal favorites of yours. This attitude toward alcoholic employees will keep their performance curve higher in your mind that it actually is in a quantifiable form. This is part of the enabling pattern. Employees who talk a good game but have absenteeism issues and poor work quality are not satisfactory workers simply because they appear to highly positive personalities. Don’t let supervisors be lured into this dynamic, and address this problem in reasonable suspicion training
⧫ Attendance and Availability Impact. Employees with drug and alcohol problems will eventually have attendance problems—not showing up for work. They may look good at work, but they are alcoholic and behaviors will eventually catch up to them. And you never know when it will happen. Fridays, Mondays, and the day after payday are the most common absence days for addicts.
The other attendance related problems is availability – disappearing on the job. This can happen at lunch time or a couple hours after employees come to work when the BAL drops and they need a drink to fix it.. Drug and alcohol policies at hospitals typically do not cover medical doctors. Did you know that? Medical doctors average 2x the alcoholism rate of other persons. Now you know why. The protest the policy and get it changed. What medical doctor on staff at a hospital will ever subject themselves to a random drug screen? None.