Tuesday, June 28, 2016

Hey, Where Are All the Wierd Drugs in the Workplace--Like Bromo Dragon Fly or Devil's Breath?

When you are instructed in reasonable suspicion training, do not get caught up in all the information and hype about what are the worst drugs in the workplace. Drugs like Salvia, Bath Salts, Spice/K2, Ketamine, Devil's Breath, Benzo Fury, Dipt, Bromo Dragon Fly, etc. etc. You can visit YouTube to learn about these substances, but you are never, ever going to see them in the workplace. You will however see absenteeism. That you can document. And that you can refer for! Drug abuse signs and symptoms? Forget it, you ain't going to see them. But if your organization has a decent EAP not run by a managed care company (which by the way totally screwed up the EAP field and decimated it by 50% of the programs in 20 years, and I maintain that mass shootings are a direct result with the shooters not referred for help but were known troubled employees in companies that had no EAP or a terrible one-- i.e., the Orlando Shooter should have been referred to an EAP by the employer for outrageous behavior) then you will get these weird drug users into treatment. DOT Supervisors used to be told to avoid looking for drug abuse signs and symptoms, and tons of addicts were referred to treatment because of performance issues. Stick to this model and enjoy the drug and alcohol training in the signs and symptoms education. It's entertaining, but that is about it.  The the field went bonkers, and we started telling supervisors to look for signs and symptoms. It hasn't worked, as predicted but the real pros in this field. But since we are here, and now teaching signs and symptoms, remember this: Do not be fooled into thinking that if you do not see signs and symptoms of drug abuse in the workplace that they are not there.

Friday, June 24, 2016

DOT Supervisors Should Understand Early Stages of Alcoholism

Don't get me wrong. This is has nothing to do with you diagnosing employees. It has to do with dispelling myths and misconceptions that keep you as a DOT Supervisor following reasonable suspicion training, from ignoring  your responsibilities for intervening on the job with an employee who demonstrates a problem. So, start with yourself. It's always best and understand the following If you drink, know the early signs of alcoholism. You may spot symptoms that allow you to be better prepared to self-diagnose the illness if it becomes necessary. Once social drinking begins, neurological and behavioral signs and symptoms begin to emerge in susceptible persons. These may include tolerance, often misperceived as a positive ability to drink more “efficiently” or in greater amounts than peers without feeling alcohol’s effects. You may notice fewer adverse consequences the next morning after heavy drinking and increasingly look forward to the next opportunity to drink. You may seek out peers who drink with the same capacity as yourself. Memory loss while drinking (blackouts) may occur. You may see alcohol as a positive way to feel stimulated, and may experience boredom if unable to drink in the evening. Alcoholism is not an equal-opportunity illness. Research shows that a family history of addictive disease places one at higher risk for it. There is a myth that self-referral never happens, and that some horrible incident must force an alcoholic into treatment. Not true. A screening with a professional counselor takes only minutes, and your score and concern over the above symptoms may lead you to accept help early to avoid such an incident.

Sunday, June 19, 2016

Employee Blackouts on the Job: Oh Yeah, They Happen

They are called Aviation Medical Examiners. And they work for the federal government. More precisely, they are internists and addiction medicine physicians who are frequently members of the American Medical Society on Addiction Medicine, and their job is to follow alcoholic airline pilots. I know, you never thought about how many alcoholic airline pilots there might be right, right? There are thousands of them. And they still fly plane's loads of passengers. In 1984, the U.S. Federal Aviation Administration was following over 1500 such alcoholic (abstinent, sober alcoholics) pilots. There are alcoholic pilots caught drinking while flying or under other illegal circumstances. Guess what. They must all attend Alcoholics Anonymous after treatment because it works. They have no choice if they want to keep their jobs. And they must be sober two years before they can fly again. Can you think of a better reason to go? All of this is to say, that if recovery from alcoholism did not work, there would be no recovering alcoholic airline pilots still flying. Do they relapse? Yes. The success rate however approaches 90%. I know all of this of course because I interview the had Aviation Medical Examiner. Did you know that there have been recorded incidents of alcoholic airline pilots flying in blackouts? Yep, they did not remember flying from point A to point B. Blackouts (a hallmark sign of possible alcoholism) demonstrates the nervous system’s adaptation and tolerance to alcohol. A blackout is a short-term amnesia state characterized the inability to recall what happened during a period of drinking even though one did not pass out or fall asleep.  It is rare for a non-alcoholic to have a blackout.  Most social drinkers will pass out, fall asleep, or throw up before having a blackout. Someday you may have an employee sitting in front of you who is in a blackout. Scary stuff. DOT Supervisor Training typically omits these fascinating discussions about blackouts, but frankly if the reasonable suspicion training program you face does not address it, you will bewildered about what to do.

Saturday, June 11, 2016

HEROIN: Drug and Alcohol Training for Supervisors in Reasonable Suspicion

Heroin addicts are a fascinating group of employees. While still employed, they can be the most convincing, well dressed, hardest working, and loyal workers on your payroll. There is just one problem, they are a runaway train. Heroin users frequently mess up their use which cause them to be absent from work without notice. And if they are not absent from work, they frequently have employees who will cover up their drug use and consequences because they do not want to see the employee fired. So the most amazing part of the heroin addicted employee is 1) complete and sudden absenteeism without phoning in  or prior notification, possibly gone for 2-3 days, and 2) lying like hell, convincingly to explain the absenteeism. There is a third thing -- missing items, materials, or tools that can be sold for money to buy more heroin. Heroin addicts are extremely difficult to treat because they believe a heroin habit if properly managed will not affect the social  or occupational well-being. Their supplier of the drug is person with whom they have the closest relationship.
As a DOT Supervisor, you will be completely stumped when this employee ends up in treatment or failing to follow through after working with you for 25 years.

Friday, June 10, 2016

Keeping Employee's Sober and In Treatment: Not Your Problem, But on Second Thought...

dot reasonable suspicion training followup chart
You actually are key. Now, don't let that put a lot of pressure on you as a DOT Supervisor. Reasonable Suspicion Training does not include any mandatory requirement to learn about follow-up, but would you like to know more about how it is done? It's the employee's responsibility of course to follow-through with any treatment recommendations or education recommendations, but in the case of treatment, it gets much trickier. Here is a follow-up chart that we recommend to employee assistance professionals or medical staff who are seeking to keep an employee in treatment who has been diagnosed as having addictive disease. The idea in this follow up system I created is to capture or catch the pending relapse and intervene before it can happen be weekly review of the employee's participation in a program of recovery. The most important factor in this chart is diminished involvement in the recovery program, and specifically, AA meetings. For example: An employee after exiting treatment following a positive DOT test participates gladly in 5 AA meeting per week, and has a sponsor with whom he or she speaks with five days per week. All of a sudden this drops to 3 meetings per week and verbal contact with the sponsor twice per week. ALARM!!!!!!!!!!!!!!!!!! No relapse yet, but it is coming. And you have a motivated employee. A lack of follow up as you can see will contribute directly to the failure of the patient's recovery. The treatment program should handle all of these details, but as a supervisor, you should continue to document performance issues and provide work-related feedback to the employee regularly.

Thursday, June 9, 2016

Reasonable Suspicion and Marijuana: Here's How Spot Use on the Job (Glassy Eyes)

reasonable suspicion training what a pot smoker with glassy eyes looks like
Yep, glassy eyes....usually not allergies.
DOT Supervisor Training includes information about Marijuana of course, and the first thing you need to know is that it is addictive. Here is a photo of a guy stoned on pot at work.

You may not see this image in typical reasonable suspicion training, but here it is for your review. If you have never used pot (and there are millions of adults who have not) this photo is a classic. It's addictive, and yeah, complete with withdrawal symptoms too. Medical physicians use Simitrol treat the withdrawal syndrome. All who experiment with the drug will not become addicted. Just like alcohol. No different. Some become addicted and some don't. It's about ten percent, and guess what -- if you have alcoholism in your family, you're at higher risk.  Addiction is characterized by withdrawal symptoms that include irritability and cravings for some, which can be intense enough to require medication in a treatment setting.  A two to four fold increase in tolerance is not unusual for heavy marijuana users. Research has demonstrated that marijuana alters brain chemistry making users susceptible to other drug use.  This is accompanied by cellular withdrawal with abrupt cessation of the drug after long term use.  THC has the same impact as heroin on the key brain site that influences addiction to other drugs.  90% of poly-drug users say that marijuana was their first drug.

Wednesday, June 8, 2016

Don't Get "Tripped Up" as a DOT Supervisor

Someday you are going to confront an employee who has alcohol on his or her breath. You will use this as evidence that the employee may be under the influence. No problem, until the employee tells you rather convincingly, that he or she is entering an alcoholism treatment program today, and the treatment program told the employee not to stop drinking because the withdrawal will make it more difficult for them to do a proper detox. Guess what. This is exactly what treatment programs do. And it is perfectly medically valid. So you may say, whew, wipe your brow, and decide that there is no need to make a big stink out of the alcohol on the employee’s breath. There is only one catch. A treatment program would never say to continue going to work drinking, and even if it did, it makes no difference. Send the employee to testing. Never assume an alcohol or drug problem is properly treated simply because the employee reports having quit is entering treatment. There is a difference between self-imposed abstinence and understanding how to manage addictive disease properly using an applied daily program of recovery recommended by addiction specialists. DOT Supervisor Training often comes up short on explaining these small nuances, but now you know! And it is difficult to include every small nuance in reasonable suspicion training, but this is one I thought you might find interesting

Tuesday, June 7, 2016

Ditch the Term "Functional Alcoholic"

Reasonable suspicion training often omits (almost all of the training I've seen) any discussion about the concept of "functional alcoholism." If you are a DOT supervisor and have been trained in drug and alcohol awareness, and are still using this term, you have failed to grasp one of the most important educational elements in DOT supervisor training. Labeling someone a functional alcoholic is a strong and reinforcing enabling behavior. It is used to describe someone the enabler believes to be alcoholic, but also seems to “function” acceptably in their occupational or social activities--at least the ones that you are most familiar with. And this is the point. Usually these are areas where the enabler knows the alcoholic best. There is no such thing as functional alcoholism, just as there is no such thing as functional cancer. Both are chronic potentially fatal illnesses that grow worse over time. The term functional alcoholism allows the enabler to continue the advantages of the relationship they have with the alcoholic, even while the role as an enabler grows worse. The defense is called “minimizing", and it kills more alcoholics with kindness that cirrhosis. This tip sheet on Functional Alcoholism used in Reasonable Suspicion Training will give you more information.

Monday, June 6, 2016

The Eyes and Ears of Supervisors Are Employees in Acting On Reasonable Suspicion

Sorry to say it, but it's true. Employees are key in reasonable suspicion training, so they need employee awareness training in substance abuse.

Reasonable suspicion training includes education for supervisors about the signs and symptoms of possible drug or alcohol use on the job. This education is crucial, but here is the truth. Employees should also be educated. They are on the front lines in the fight against workplace substance abuse. They point to problems so supervisors can act. The problem getting in the way is enabling.

Although the federal regulations say nothing for the most part about employees being educated about drugs and alcohol on the job and the various signs and symptoms that demonstrate potential use, coworkers are by default, the eyes and ears of the supervisor. Don't get me wrong. This is not their job, and training should never include any direction or guidance or even suggest that they should be the eyes and ears of the supervisor, but guess what: They are. That's the reality.

This happens by employees recognizing that something is wrong or knowing something associated with drug and alcohol use on the job is occurring, and then informing the supervisor who takes the proper action. If you do not educate employees as part of the reasonable suspicion training curriculum at least to the extent that they will stop enabling their fellow coworkers, then it is unlikely that you will obtain the impact you want from your DOT reasonable suspicion training of supervisors.

DOT Supervisor Training and Reasonable Suspicion Training should discuss the following enabling behaviors. These are the most common enabling behaviors of employees that will undermine your drug free workplace. Can you think of any others to include in your reasonable suspicion training for supervisors? 1) Accepting apologies and assurances for the temporary nature of problems. 2) Failing to confront problems caused by absenteeism and tardiness. 3) Doing the job of coworker.  Feeling sorry for coworker. 4) Caring and understanding “too much.” 5) Failing to confront drinking practices for fear of losing a friend.  6) Considering coworker a “functional alcoholic” who doesn’t affect you (yet.) 7) Protecting a coworker from management. 8) Promising to confront coworker if problems gets worse, and then adapting to “worse”, and not confronting coworker. 9) “Working around” the personality or drinking pattern of the alcoholic in order to have a functional relationship (i.e., anticipating mood swings, irritability in work interactions.) 9) Loaning large amounts of money. You can get a handout that includes these items in the DOT reasonable suspicion training program avialable in PowerPoint, DVD, Video, or online web course for reasonable suspicion training online.

Sunday, June 5, 2016

Reasonable Suspicion Training Factoid: Alcohol Use Can Look Quite Normal

As a supervisor governed by the DOT reasonable suspicion training guidelines, you are naturally going to receive a lot of scrutiny if you ever decide not confront an employee who who may be under the influence for drugs or alcohol on the job.

This portion of the alcoholic progress curve will be insightful. Can you see how the alcohol use in the beginning of the addiction progression can be quite normal. This however is the typical pattern. Reasonable suspicion training with WorkExcel.com covers these normal looking symtpso and how to make them fool you.

Saturday, June 4, 2016

Alcohol and Drug Training is Useless Without Enabling Education (But DOT Training Does Not Require It!)

Alcohol and drug training education of the enabling pattern for reasonable suspicion training free dot materials
Alcohol and drug training must include enabling education so the dot supervisor interrupts this limiting pattern of behavior. Enabling training and awareness is therefore a must in alcohol and drug training for supervisors. This represents the first line of attack on the ignorance about addictive disease. Enabling at work is behavior exhibited by coworkers or supervisors that helps the addict not realize or face the consequences of his or her problem behavior resulting directly or indirectly from the alcohol or drug use.  Enabling typically appears as the "right" thing to do in response to the problem behavior but helps the alcoholic or addict escape responsibility for actions or problematic events.  DOT Supervisors are particularly vulnerable to practicing enabling behaviors, and the difficulty increases with the amount of time in the relationship between supervisors and supervised employee. Alcohol and drug training is almost useless without the education associated codependency, enabling, and manipulation. The ability of the addict to deny, rationalize, externalize, and minimize problems while having others accept excuses and explanations helps the addict get sicker. This image below offers free dot materials to help you grasp this concept better. It is a good image to study and will help you understand the enabling pattern we are talking about.

Alcohol and Drug Training Education of the Supervisor Enabling Pattern:

Friday, June 3, 2016

Reasonable Suspicion Training: How DOT Supervisors Enable--Even If They Drug/Alcohol Experts

If you don't think you are capable of enabling an employee who has a drug and alcohol problem, think again. Reasonable suspicion training often includes, and it must include all the signs, symptoms, effects, impact, dangers, etc. of drug and alcohol use. However, there is no requirement for supervisors to understand how all of this is undermined by enabling, so here is the list of enabling behaviors you are vulnerable to:
  • Ignoring job performance problems of the DOT employee, hoping they will go away, or are temporary.(This is an easy one to do on a busy and harried day.)
  • Threatening disciplinary action without following through on such threats. (It's just so much trouble, and maybe things will turnaround.)
  • Avoiding confrontation of employees who are considered friends. (Woops. The employee will say you are pot calling the kettle black.)
  • Avoiding confrontation because you are a heavy drinker like the employee needing referral. (Your drinking problem is worse!) The honest answer to this problem is to ignore your drinking issues for the time being, and do your job. Yes, that is best decision for now.
  • Accepting excuses for ongoing job performance problems.
  • Accepting employee’s request to avoid use of the EAP in favor of other helping options.
  • Ignoring the return of job performance problems after an EAP referral until they reach a intolerable level.
  • Not acting to arrange a reasonable suspicion breath test when the odor of alcohol exists—accepting explanations (medicine, etc.) for it.
  • Protecting the employee from personnel actions while increasing personal involvement to assist the employee.

Thursday, June 2, 2016

High Risk for Alcoholism and Alcohol Abuse DOT Workplaces

Is there such a thing as a high risk occupation with a greater likelihood that DOT employees with either be drunk on the job or suffering the effects of alcohol abuse or alcoholism? The answer is yes. But there is a catch.

Since alcoholism is not a "equal opportunity" illness (sound politically correct, but it is absolutely false) and those with genetic predispositions to it are more at risk, it stands to reason that jobs and industries that include a fair amount of socializing around alcohol will naturally possess a greater degree of alcohol and drug related problems among their employees.

So here is something for DOT Supervisors to remember: businesses with a high value on social activity with frequent use of alcohol or the traditional use of alcohol at lunch will see greater problems. These can include businesses associated with self-employment, and for example law firms, insurance agencies, the military brass, or other businesses where the employee with a biogenic predisposition to alcoholism has the opportunity to tax their susceptibility more.

Are there more lawyers with alcoholism for instance than school teachers? What about medical doctors who answer to no one but themselves and can easily drink at lunch? The answer is absolutely yes. High male demographic work groups with strong social ties to consuming alcohol will experience more alcoholism.

Industries characterized by frequent opportunity to use alcohol (or drugs), for example, organizations with higher rates of business travel, sales travel, evening work shifts with after-hours socializing with alcohol; isolated employees without direct supervision (i.e., non-office-like environments); exposure to served alcoholic beverages (airlines, hotel, restaurants); accessibility to addictive drugs: pharmaceutical, medical, and nursing occupations all have more drug related and alcohol related problems.

Are there more nurses who are alcoholic because they often socialize around alcohol after the 11 p.m. shift? Yes, alcoholism among nurses is twice the rate for non-nurses. But wait, it isn't the work shift or drinking alcohol after work that causes alcoholism, correct? Correct. It's genetic susceptibility, right? Right. Nurses are more likely to come from alcoholic families than other professions. The reason: codependency, a learned behavior at home. Are you having trouble with this post and this discussion? Is it flying in the face of your beliefs? Read the book, "Under the Influence" by James Miliam. It explains all. It is a mind blowing book about  genetics, susceptibility, and alcoholism. One of the few books in the bookstore on the subject of alcoholism that is worth picking up.