Friday, November 2, 2018

43 Signs and Symptoms of Substance Abuse Explained for DOT Supervisors: Staggering and Stumbling at Work (1 of 43)

Staggering and stumbling is human behavior that demonstrates loss of control for some reason and associated
Reasonable Suspicion Training stumbling and staggering as s symptom in DOT
with one's psycho-motor skills. When we think of loss of control, we conjure up engines of tripping over objects, a disheveled look, or other behavior or appearance associated with being under the influence.

Remember however that you can say someone is under the influence, indeed staggering and stumbling could result from many other causes include a stroke, heart attack, or other syndrome associated with the brain and balance.

Staggering and stumbling in the workplace can be a classic symbol of drunkenness or being under the influence of a substance, but you will seldom if ever see an employee in the workplace in this condition as if they are on alley in a Hollywood move scream Stella in the rain.

And there are two reasons why loss of psycho-motor skills is likely to be so severe that it becomes obvious. The first is that most people aren't stupid enough to get so drunk at work that they will actually lose control and stumble--that is, normal social drinkers who know their limits from past drinking experiences, and know the consequences of consuming too much alcohol.

The second reason that you are unlikely is that alcoholics will have such high tolerance to alcohol, that they do not lose control of their psycho-motor functions. An alcoholic in middle stages of the disease can easily leave a building go to lunch, and be so drunk that the average person would stumble down the hallway. However, because tolerance and its increasing capacity is so pronounced with alcoholics, that they will not appear drunk at all.

Wednesday, October 24, 2018

Signs and Symptoms of Drug Using, Alcoholic, or Bombed Employees: Let's Discuss Them

Let's talk about the signs and symptoms of drug using, alcoholic, and bombed employees. Within the scope of this post's title is a lot to discuss, but let's start with some general issues. 

Signs and symptoms may be more complex than they first appear.

Many are impossible to observe unless you are a drug addiction treatment expert, and many that are obvious -- like needle tracks and blood under a white long sleeved shirt--you will never see in a million years.

Not all needle users shoot a hypo in their arm in the same place the nurse draws your blood. Addicts can shoot up anywhere on their body, including the soles of their feet. A high is more important than pain. And there are other places they also use and shoot...but will forgo a discussion about them.

So you see, signs and symptoms require a bit of discussion. Such discussions are critical because all supervisors need the information if they are ever going to spot an at-risk employee.

That is the name of the game--spot the risk and intervene with the proper management tools so you find the truck driver who is going to blow through an intersection and wipe out a bunch people. A short discussion about symptoms allows the supervisor to grasp the true nature of drug use in the workplace.


If you think you are going to spot drug addicts actively using on the job by walking into one in the bathroom, and pushing open the wrong stall door, think again.

The way you prepare to spot signs and symptoms is by engaging frequently with your employees. That's it--getting to know them. You develop relationships with them, and over time develop a sixth sense for when something is wacko or wrong. Then you act.


A word of caution about signs and symptoms. Don't try to determine what kind of drug addict or alcoholic is working in your company. Simply focus on job performance, attendance, quality of work, availability, attitude, conduct, and other behavior. You will go much further.

The employee you refer to an EAP (you do have one right!?!?!) with very stubborn performance problems associated with attendance or disappearing on the job will be an addict about 40-50% of the time. And you will have no idea that was the nature of the performance problem. With this introduction, we will dive into the individual symptoms in the next post. See you then. If you need DOT 2-hour drug and alcohol awareness training for yourself or your company, click here or click picture on the far right of the blog. Talk to you soon.






DOT supervisor training understanding performance measures

Friday, October 5, 2018

Make Sure DOT Drug and Alcohol Training for Supervisors Includes the New Opioid's Addendum

The U.S. Department of Transportation has a new mandatory requirement for drug and alcohol awareness. They want four important opioids mentioned in the education of supervisors.
This new requirement is because the U.S. Department of Health and Human Services
new opioids needed in training of supervisors image
revised the Mandatory Guidelines for Federal Workplace Drug Testing Programs. 

As a result, expanded federal urine workplace drug testing now includes four Schedule II drugs:
Hydrocodone, 
Hydromorphone, 
Oxycodone, 
and Oxymorphone.  

Each one is used for pain management depending on the needs of the patient or circumstances.

We've included this additional information in the Web Course, PowerPoint, DVD, and Web Video programs.

You can preview the full unabridged complete program for DOT supervisors here.

Tuesday, August 7, 2018

DOT Supervisor Training: Don't Let Supervisor Sabotage Treatment

Reasonable suspicion training is designed to save lives and prevent losses, but supervisors often undermine
Reasonable Suspicion Training
their own role in a drug free workplace after being educated and successfully identifying substance abusing workers who are subsequently referred to treatment for addictive disease. What's going on?
After an employee returns from treatment, the risk is high that relapse will occur. However, most people—and I would  say even some addiction treatment professionals—do not understand the hair-trigger mentality of the recovering patient (employee) and the strong desire they may have to drink or use drugs again. What's missing is an excuse to do so, and one that be rationalized. Who better than to supply this than authority figure like a supervisor.

Alcoholics are magnets for enablers. They love enablers because these individuals can facilitate and support the addicts ready-on-deck and willing to drink or drug fragile state. Without defense mechanism helping the addict to feel less guilt, the alcohol or addict cannot satisfy their desire to use. Unless you understand enabling and its dynamics, the chances of your playing an unwitting role in relapse is high because the addict will consciously or unconsciously signal you to play along, be provocative, or same something inappropriate that will be latched on to as a doorway to facilitate relapse.

The language and behavior of addicts and alcoholics is riddled with defense mechanism dynamics. They are extremely subtle, and often unconscious. Although your psychology 101 class in college may not have more than a a few, there are actually over 40 defense mechanisms exist. You may have heard of denial or rationalizing, perhaps projection and suppression, but there are dozens more. Most escape awareness.

They key point is that supervisors and family members are sitting ducks for being re-hooked into a pathological communication dynamic with employees who have been in treatment because of the alcoholic or addict’s efficient use of their defense mechanisms.
Reasonable Suspicion Training
An example of this subtle and pathological communication and the undermining dynamic is illustrated in the following example:
An employee comes back to work from alcoholism treatment at a local hospital after a positive test that led to his identification, referral to testing, and subsequent treatment.

After a week on the job, the employee appears tired and mentions to the supervisor, “Boy, keeping up with everything the EAP wants me to do, handling this workload, and also going to AA meetings five nights a week is about to kill me.”

What you would say if an employee made such statements? The best answer is to "try harder. You have a lot of responsibilities." Something...anything that does not "buy off the employee" is what your reaction should be. After training in DOT Supervisor Training or Reasonable Suspicion Training, will you sabotage what you learned?

It is unlikely in the moment or within the context of what’s been said, that you would see the relapse bear trap in front of you. However, you are about to spring  it.

Compassion and empathy are the tools for killing addicts. Addicts will manipulate to have you feel sorry for their situation, but more importantly, give them permission to do something less strenuous than the recovery program that has been assigned to them by the treatment provider. Compassion and sympathy are traps. To act on these heart strings is called “killing the addict with kindness.” What's need is tough love. That's what go the addict into treatment in the first place.

If you are a compassionate sort of person, you may fall for this manipulation being described above. The response desired by your employee would be something highly sabotaging like this: “Wow, that’s a lot Jim. Five meetings a week! I hope you aren’t overdoing it. Work-life balance is also important. Will the treatment program let you take a night off from AA? Maybe your should ask."

You have just been suckered.

You have enabled the employee, sprung the trap, helped blow this employee’s recovery program. “Wait you’d say, I didn’t say or do a damn thing! The employee is responsible for their own decisions!”

You’re right, they are. No one is going to blame you for his lack of follow through or subsequent relapse, but here is what’s going to happen: The employee will rationalize a night off from AA after this discussion when they go home. And one night off leads to more. A more leads to all. And all leads to risk. And risk leads to an event. And that event causes a drink.

When you step into an employee’s personal problems, no matter how subtle, you help the employee step away from what is difficult, which is following the instructions. Addicts, like diabetics, who don't follow instructions relapse.


Your statement of empathy and concern has greased the skids for the full blown rationalization of skipping out on a meeting. Relapse is now only a matter of weeks or months at most.

Thursday, July 12, 2018

DOT Supervisor Training---Is Fentanyl Abuse a Concern for Management?

Unless you’ve been living under a rock, you are aware that the United States is in the midst of an unprecedented opioid crisis.

Pain medications like hydrocodone have long been the focus of news, but a much stronger version of the pain killer, fentanyl, has begun stealing the spotlight. It’s important for supervisors to be informed about his drug, because lives of unsuspecting employees could be at stake if fentanyl is in your workplace.
Fentanyl is a prescription pain killer that’s 50 to 100 times more potent than morphine. It’s most often used for post-surgical pain and extreme chronic pain. When prescribed by a doctor, it’s taken as a lozenge, injection or a patch. However, illicit drug manufacturers have made fentanyl a street drug. Street fentanyl can be ingested as a tablet or blotter paper, or snorted as a powder.

The problem with fentanyl is that overdose risk is very high, not only for the drug user, but for anyone who comes in contact with it. First responders have overdosed on fentanyl simply by having some of the powder rub off their skin. Without a quick dose of naloxone, a drug that reverses fentanyl’s affects on the respiratory system, people exposed to it can die.


A recent report from the Centers for Disease Control and Prevention stated that between July 2016 and September 2017, opioid overdoses rose 30 percent in the U.S. Although this statistic includes all opioids, including heroin, it shows that the epidemic is getting worse.
Tougher prescribing guidelines for opioids have driven some addicts to the street to get pain relief or a high. It’s more difficult to judge the strength of street fentanyl, making overdose risk very high.

Unless you’ve had recent DOT supervisor training or reasonable suspicion training, you may not be aware of symptoms related to fentanyl abuse. Watch our for employees who seem very lethargic, suffer mood swings or seem to be packing on the pounds. Fentanyl abusers also can hallucinate or have abnormal thoughts. Employees complaining of pounding in the ears, chest tightness or a rapid heartbeat could be on fentanyl.

If you suspect an employee is abusing fentanyl, be very cautious touching his clothing or belongings. Make sure that employees know to avoid touching or inhaling any powdery substance that they encounter.

If an employee stops breathing, call 911 immediately. Fentanyl affects receptors in the brain linked to respiration, and an overdose usually involves respiratory arrest or distress. Follow the 911 operator’s instructions until help arrives.

For DOT Reasonable Suspicion Training, visit https://www.workexcel.com/reasonable-suspicion-dot-drug-alcohol-training-for-supervisors-2hr-Certificate/

Thursday, April 12, 2018

Relationships with Problem Drinkers

If one of your employees is in a relationship with a problem drinker, they may have behavioral symptoms that could lead you to believe that they--themselves--have a drug or alcohol problem! These employees in relationships with addicts slowly acquire problematic ways of managing communications, social interactions, behaviors, and uncertainties that create conflict with those around them. These are normal responses to addiction-affected relationships. As the disease advances and they may find yourself having to manage these things more often and experiencing emotional stress, creating health issues that contribute to absenteeism. They may have physical symptoms like stomach problems, depression, and sleep problems. If you are a DOT Supervisor, talk to a counselor or your EAP if your company has one, and things appear confusing. A professional will help decide what's going one and suggest options for you to consider. DOT Reasonable Suspicion Supervisor Training for Drug and Alcohol Awareness can be found here.

Monday, April 9, 2018

Federal Railway Administration Post-Accident Drug Testing Training Now Mandatory for 60 Minutes

The Federal Railway Administration now mandates post-accident testing training for supervisors.

This is pretty complex stuff, but all supervisors on railroads and related contractors must be trained. Not to worry. When you purchase our FRA Post Accident Training, you will get the complete Web Course that you keep and  own and install on your own company server. Supervisors can return any time to review the details, even after an accident.

Location of the Training Link:
The program to assist railroads and contractors in meeting mandatory training requirements for the U.S. Federal Railway Administration post-accident training for supervisors is now available at WorkExcel.com here. These are supervisors who are responsible for regulated service employees per Part 219.11 (g). Specifically, the requirement is to provide training on the qualifying criteria for FRA post-accident testing, and the role of the supervisor in post-accident collections.

Training above is in addition to the one hour of drugs of abuse education and awareness and the one hour of alcohol misuse education and awareness that has been around for quite a while. This makes training for Railway supervisors three hours, instead of two.

This training mandatory and regulated by the U.S Federal Railway Administration as authorized and required under Part 219, Subpart C Testing Requirements.

Background of this Requirement
In 1985, to further its accident investigation program, FRA began conducting alcohol and drug tests on railroad employees who had been involved in serious train accidents that met its specified criteria for post-accident testing (see 49 CFR 219.201). Since the program’s inception, FRA has routinely conducted post-accident tests for alcohol and for certain drugs classified by the Drug Enforcement Administration (DEA) as controlled substances because of their potential for abuse or addiction.

What's Covered in the Program

+ History of railroad accidents and rationale for drug testing
+ Understanding the contents of "Tox Boxes" - the materials
+ Qualifying and non-qualifying events for post-accident drug testing
+ Flow chart representing to successful Post Accident Testing action steps
+ Evacuation to prevent exposures
+ Definition of impact accidents
+ Which crew members to have tested
+ Other regulated employees to test for five qualifying events
+ Refusal to test issues, questions, actions
+ Recalling employees who must be tested
+ Review of Toxicology Boxes, contents, and purpose
+ Paperwork associated with post-accident testing
+ Timely collection
+ Medical treatment priority over testing
+ Where to collect urine specimens in odd situations
+ Sealing and transporting, managing and shipping toxicology specimens
+ Death and post-mortum testing
+ Resources
+ Contacts an the U.S. Railway Administration for Questions
+ Test Questions
+ Handouts
+ Certificate Printable
Discussion of Required Training

We discuss the circumstances associated with different accidents like major train accidents where testing is required; what happens when there is a fatality; impact accidents, fatal train incidents, passenger train accidents, human-factor highway-rail grade crossing accidents and incidents and how drug testing relates to these events. 

We cover the issues associated with the use of “Tox Boxes”;what a regulated employee is; exceptions to training under a multitude of circumstances; responding to incidents; how to obtain specimens; roles and responsibilities; penalties for refusal to test; communications; shipping specimens; how to decide if an employee or employees need to be tested; responsibilities of railroads and employees; requirement by employees to participate in testing; testing of fatalities; time frames within which testing must occur; who must be tested for what; timely specimen collection; breath testing issues; recalling employees for testing after a qualifying event; status of injured employees and post-accident testing; place of specimen collections; consent to be tested is implied for all employees, and no special permission is required; obtaining cooperation of a facility for the purpose of testing; the role of the National Response Center and reporting employees who refuse testing; specimen collection and handling; handling of specimens; forms and proper completion; shipping specimens; FRA access to breath test results; mandatory testing and specimen collection from fatalities; notification of authorities and coroners and medical examiners;