Monday, February 15, 2021

Critical Follow Tips for DOT Employees Treated for Addiction After Identification for Reasonable Suspicion

One of the most important functions in reducing risk to American workplaces is providing effective follow up and tracking of recovering alcoholics and drug addicts.

This task is easier said that done, not just because addicts can be an elusive bunch, but because few addiction treatment professionals really know how to do it well. Why?

The root cause of follow up failure is not lack of good communication. Instead, it is failure to undestand or having a poor understanding of the chronic disease model of addiction--not knowing what is involved in recovery.

Reasonable suspicion training is critical for DOT supervisors, but have ever heard the trainer discus follow?

Everyone knows follow up is important, but very few managers or companies that have a crucial stake in the recovery of the worker and preventing relapse ask, “what happens in follow-up?”

With thousands of dollars spent on one employee after referral to treatment, and enormous risk to self, family, and community, the successful recovery of the alcoholic or drug addict cannot be overstated. Unfortunately, far from being overstated, this topic is often entirely ignored.

In following up an employee treated for addictive disease, especially one who is a DOT (U.S. Department of Transportation) worker referred for using drugs or alcohol on the job, many questions are required and a frequency of these questions asked of the employee is crucial to help the worker move toward complete abstinence of psychoactive drug use and elimination of beverage alcohol entirely from his or her life. Note that any representation to you that abstinence is not required for successful treatment of a DOT employee in treatment, is absolutely unacceptable.

This article therefore is authored to help DOT supervisors and managers, even if they have had DOT training, understand follow-up, what is supposed be going on behind the scenes, and when relapse happens having some appreciation for the dynamics in the big, mysterious “why.”

It goes without say that each contact, whether in person or by voice phone, should be recorded in a note making system. This allows not only a record, but the ability to track the pattern of what I called “diminished recovery syndrome” or DRS. Diminished recovery syndrome is a pattern of behaviors or lack thereof that demonstrate a diminishing involvement in the patient’s self-treatment necessary to recover from addictive disease and move into sobriety.

After treatment, these contacts to be weekly. And the following questions are also included.


Is the DOT Employee Abstinent from Alcohol and Psychoactive Drug Use

Of course, the most important question to asking the newly recovering DOT employee whether or not they have been completely abstinent. Are you thinking that these employees will lie? Think again. Self-reporting is extremely accurate, but another more powerful reason exists, which explains honesty in interview questions and follow-up. That reason is abstinence and excitement at being sober. A week out of treatment, very few employees will drink or use drugs. If relapse comes, typically come many weeks or months later.

The employee should also be queried about  complete abstinence from alcohol and drugs of abuse or substances that could have a psychoactive effect. This includes “Near beer” or “O’Douls beer. If the answer to any question demonstrates relapse, then intervention and motivational counseling to get back into recovery must occur at once.

Abstinence refers to cessation of any alcohol products, medicinal products with alcohol as an ingredient, or other mood altering substances. Consumption of any of these substances is tantamount to relapse. As you can see, it is extremely important for the treatment program to educate the patient about steps needed in recovery. Expect problems otherwise.

Record of: Last contact the employee had with the employee assistance program

DOT workers in recovery should be in touch with an employee assistance program. And every company of any appreciable size should have an EAP. There simply is no excuse in allow the behavioral risk exposure to exist otherwise. And this includes 800# programs that almost entirely rely upon self-referral, and only skim the surface in identifying important and urgent behavioral risk exposures of troubled employees.

EAPs are closest to the employer and present significant ability to motivate employees to participate, and stay involved with their recovery programs. A lack of EAP participation means the employee has the ability to distance themselves from the leverage or threat posed by job loss or some other disciplinary action for failure follow through with treatment recommendations.

We will continue in the next post with more critical questions in follow up. In the meantime, do you need reasonable suspicion training? If so, you can purchase training here at WorkExcel.com or you can see a preview of the full program at this preview page. You can also print the brochure here and fax it to us or phone us at 1-800-626-4327. Please phone 843-981-4759 if you get voice mail at 800-626-4327. Don’t leave a voice mail.


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