Drug-Free Safety Program Employee Education Presented by: HealthSpan EAP (formerly Life Management Systems EAP) 225 Pictoria Drive, Suite 320 Cincinnati, OH 45246 513-551-1500 1-800-733-0257 All Rights Reserved Unauthorized use, duplication, and/or distribution is prohibited Welcome to the online Drug Free Safety Program Employee Education session presented by your employee assistance program, HealthSpan EAP. If you have any questions please contact Diane Pipes, LISW, LCSW at 513-551-1484. Today we are going to learn about alcohol and other drugs. The objectives for the training are… Objectives Review the disease model of addiction. Discuss the impact of recreational alcohol and drug use on workplace safety. Review signs, symptoms, safety concerns and effects of commonly abused substances. Provide community resources and information where employees and their loved ones can seek assistance. Another objective of today’s training is to ensure you are familiar with your company’s drug and alcohol policy. Do You Know The Answers? What is the purpose of the policy? Who is covered by the policy? What behavior is prohibited? Are employees required to notify supervisors of drugrelated convictions? What are the consequences for violating the policy? What type of employee assistance is available to employees needing help? How is employee confidentiality protected? A few statistics to help us understand why this topic is so important. Drug dependent workers have 200-400% more accidents on the job! 47% of all serious workplace accidents have drug or alcohol involvement! Drug dependent workers use twice the amount of healthcare benefits! Drug dependent workers are 5 times more likely to file a worker’s comp. claim! Drug dependent workers are 16 times more likely to be absent from work! Dangerous and Expensive Substance abuse cost drains more than $100 Billion from American businesses annually! Check the Numbers • It is untrue that most drug users are poor or unemployed. • About 9 million regular drug users went to work this morning in the US. More numbers Some of us want to believe people with jobs don’t have substance abuse problems but… 90% of alcoholics are employed!! 74% of drug addicts are employed!! National Institute on Drug Abuse, Department of Health and Human Services, DHHS). How Substance Abuse Affects the Workplace Employee health Employee morale Productivity Security / Theft Decision making Safety Organizational image Insurance cost Now let’s look at each one. How Substance Abuse Affects the Workplace Employee health – Alcohol and drugs cause many short and long term health problems resulting in absences from work. How Substance Abuse Affects the Workplace Productivity - Productivity is reduced by employees who are present at work but whose efficiency or quality is compromised because of their substance abuse. They are much more likely to be slower, preoccupied and prone to mistakes. How Substance Abuse Affects the Workplace Decision making - Substance abuse may affect your ability to think through a situation and make the best choice. An impaired person usually does not think about the consequences of his/her actions in the same way that a sober person does. How Substance Abuse Affects the Workplace Organizational image – Employees with substance abuse problems who interact with customers may harm the perception of their company. Also the public may not want to buy goods or services from a company with a reputation for employing substance abusers. How Substance Abuse Affects the Workplace Theft - Employees with substance abuse issues many turn to theft to support their habits, stealing from the workplace and/or their co-workers. How Substance Abuse Affects the Workplace Employee morale – Coworkers’ attitude and performance are greatly affected by the substance abuse of those who use drugs and alcohol. Frequently coworkers report having to re-do the work of other employees, work harder because of the other employees and do more because the other employees do less. How Substance Abuse Affects the Workplace Safety – Employees who abuse drugs and alcohol are 3.5 times more likely to be injured or cause injury to coworkers. Being under the influence of drugs and/or alcohol impairs your ability to focus on details, to be fully aware of your surroundings and it slows down reaction time to threats or dangers. As a result, situations that could have been prevented become accidents for the employee and his or her coworkers. How Substance Abuse Affects the Workplace Insurance cost - Healthcare costs for employees with alcohol problems are twice as high as those for other employees. Now let’s take a look at alcohol. Alcohol How is it absorbed and eliminated? How does it affect the body? What is the difference between alcohol use, abuse and dependency? So remember alcohol is quick to enter your body; it is rapidly absorbed through the mucous membrane of the body, mainly the intestines. But slow to leave; once it is in your blood, your body is not good at eliminating it. Which one of these has the highest alcohol content? Don’t be fooled!!! If you answered they are all the same, you are right! The standard ways we consume alcohol (12oz. Beer, 5oz. Wine, 1.5 oz. of 80 proof Liquor) each have almost exactly the same amount of alcohol in them. But remember glass size and “pours” can vary!! There is no way to speed up the elimination from your body. Coffee, energy drinks, cold showers, exercise, water etc. will have no effect on “sobering up”. Time is the only way. Alcohol on the Job Most workplace alcohol policy violations do not involve actually drinking at work. Usually, someone has used alcohol too close to reporting to work. Blood Alcohol Percentage The actual percent of one’s blood composed of alcohol. Most of us are used to the cut-off of .08 for DUI arrest but most workplaces do not permit any alcohol in the blood. General guidelines based on weight, health and age: Once your blood alcohol level has peaked, assuming you stop drinking, it will only fall about 0.015% per hour. Each drink (can of beer, glass of wine, shot of liquor) will take about one hour to leave your body (assuming standard oz. of alcohol per drink). Over time, alcohol can have devastating effects on your body. Here are just a few of the long term health consequences… Gastrointestinal Illness Liver Disease Damaged Immune System Heart Disease Brain Damage Reproductive Problems Contributes to Fetal Alcohol Syndrome There are also short term dangers!!! Alcohol creates safety risks because it slows down and distorts the messages your brain sends to your body. Alcohol affects your vision too. Even at relatively low levels of consumption, alcohol reduces the ability of the eyes to work properly. The ability to judge distance and speed of moving objects is particularly impacted. And there’s more. Here are a few more effects on the brain… Reduces ability to make good decisions, or solve complex problems. Increases the time it takes to react to things, such as the time it takes to avoid dangerous moving objects. Impairs short-term memory and damages long-term memory. Impairs balance, coordination and speech. My Safety, Your Safety If you have alcohol in your system while on the job, you are an increased danger to yourself and others. If you work with someone who is impaired by alcohol, you are at a higher risk of being hurt than the person who is impaired. Use, Abuse and Dependency What’s the difference between alcohol use, alcohol abuse and alcohol dependency? Many Americans drink alcohol. The Centers for Disease Control estimate about 60% of adults drink alcohol, but most drink in moderation without any negative results of their drinking. What is alcohol use? Any harmful consumption of alcohol. This implies alcohol use that causes either physical (brain disorders, anemia) or mental (loss of memory, difficulty learning) damage. A person drinks despite recurrent social, interpersonal, occupational and legal problems as a result of alcohol use. What is alcohol abuse? Alcoholism is a physical dependence on alcohol. What is alcohol dependency? Alcohol dependence includes all of the symptoms of alcohol abuse plus… Drink-seeking behavior (only going to social events that will include drinking or hanging out with others who drink). Alcohol tolerance (having to drink increasing amounts to achieve previous effects). Withdrawal symptoms (getting physical symptoms such as nausea, headaches, and sweats after going a short period of time without drinking). Drinking to relieve or avoid withdrawal symptoms (such as drinking to stop the “shakes” or to “cure” a hangover. A return to drinking after a period of abstinence (deciding to quit drinking but unable to follow through). What is alcohol dependency? The Disease Model of Addiction Alcohol is a physically addictive drug. Addiction to alcohol is a progressive and ultimately fatal disease. The good news is we know more about alcohol addiction than many other diseases. The Disease Model of Addiction Wide ranging bodies of evidence support the concept that addiction is an illness. It is a brain disorder. Like other illnesses, it has risk factors, a typical sequence of progression, can result in death, and is treatable. Stopping, does not cure the illness. Further support is given to the concept that addiction may be genetically predisposed. People with a close family member who were alcoholic have a higher probability of becoming alcoholic themselves. That is, alcoholism seems to run in families. Addiction is a family disease. It tends to trend and repeat with family groups across generations and tends to result in predictable, dysfunctional behavior within the family by the user and by other non-using family members. Genetics So what are some common traits of addicts? As the disease progresses, alcoholics develop an increased tolerance for alcohol. (Increasing amounts required to achieve the same buzz.) Alcohol addicts begin to lose control over when, where, and how they drink. Alcohol becomes more and more influential in the person’s life and health. They are less and less able to drink without drinking to the point of intoxication. They begin to lose control over how they behave. Often doing/saying things they wouldn’t sober. They continue to use alcohol or other drugs despite negative consequences. Once someone has reached a particular stage of alcohol use, he or she will return to that stage and resume their progression towards dependency with the next drink, even if they abstain from use for a long time. Intervention as early in the progression as possible is key. Employment can be the last thing to go. Because employment provides money, many substance abusers protect it and do anything to keep their workplace from finding out. Ultimately their work is effected throughout the disease. A Progressive Disease Treatment Alcohol addiction needs to be medically treated, as withdrawal symptoms can be very serious. Because alcohol is physically addictive, people who are dependent will get sick if they stop drinking. They may have hallucinations, seizures, pain, sleeplessness etc. Death is also a risk. Most experts agree support is important, such as an AA or other sober support groups. Often treatment needs to be repeated. Relapses are common and recovery is a life-long process. Relapses Once someone is alcohol dependent, any drinking can be risky. Alcoholism is a progressive illness that simply continues if there is a relapse. Relapses are very common. Alcoholism is never “cured”, but “managed”. Drugs other than Alcohol What is a drug? In the strictest sense, a drug is anything natural or artificial that alters your thinking, feeling, emotions, behavior, or physical state when ingested. For purposes of this training ...a drug is any substance that the use of is prohibited or regulated by one’s employer and/or by regulations to which one’s employer is subject. This also includes alcohol. Drugs in the Workplace What drugs am I tested for? 6-Panel Drug Test Amphetamines (dexedrine, adderall) Cocaine Phencyclidine (PCP) Cannabanoids (Marijuana) Opiates (heroin) Ecstasy Amphetamines(dexedrine, adderall) Cocaine Cannabanoids (marijuana) Opiates (heroin) Phencyclidine (PCP) Barbituates (seconal) Benzodiazepines (valium, xanax, klonopin) Methadone Propoxyphene (narcotic pain relievers) 9-Panel Drug Test Let’s take a look at the different types of drugs. Stimulants Increased heart rate Suppresses appetite Feel energized Suppresses sleep False sense of alertness Cardiac risk What do stimulants do to you? What are some of the effects? An estimated 13 million Americans abuse amphetamines. Amphetamines are powerful stimulants, like cocaine. They produce wakefulness, increased activity and decreased appetite. These drugs produce feelings of euphoria, well-being and selfconfidence. Amphetamines True amphetamines come in tablets or capsules, although they are sometimes ground up and/or diluted before use. Look-alike drugs are also made in underground labs. Amphetamines may be swallowed, snorted, or injected. Amphetamines Tolerance develops rapidly leading to addiction. Withdrawal symptoms include craving, exhaustion, depression, mental confusion, insomnia, extreme hunger, psychosis, intense anxiety. Health problems include cardiomyopathy, heart attacks, hypertension, liver damage, impotence, ulcers, etc. Amphetamines Cocaine Made from the coca plant. Powder Cocaine - salt form of the alkaloid present in the leaves of the plant. How do people use cocaine? What are the methods of ingestion? Snorting the powdered form through the nose Smoking free-base rock cocaine Injecting cocaine solution into a vein Chewing leaves of the coca plant What are some of the effects of cocaine in the workplace? Poor attention to detail Cost of use often leads to theft Paranoid thinking, aggressive behavior Absenteeism Mood swings What is crack? How is it different than cocaine? Crack is produced by dissolving powdered cocaine in a mixture of water and baking soda. The mixture is boiled until a solid substance is formed (crack rocks). Crack is nearly always smoked. This delivers large quantities of the drug to the lungs producing an immediate intense euphoric effect. Crack cocaine is cheaper than cocaine and is more addictive. Effects last only 5-15 minutes. Weight loss Agitation Irritability Insomnia High blood pressure Irregular heartbeat Restlessness Impulsive behavior What are some of the signs and symptoms of stimulants abuse? Depressants Slow the heart, brain function and metabolism Induce sleep Relax muscles Numb nerves Take the edge off A few marijuana facts 2nd largest cash crop in the U.S. #1 positive drug test in the workplace Source: NIDA Marijuana is the most commonly used illicit drug. Daily or near daily use of marijuana increased from 5.1 million in 2007 to 7.6 million in 2012. Source: Lexology Marijuana / Cannabis The dried leaves and flowering tops of the cannabis plant is usually smoked via joint, pipe or water pipe (bong). The psychoactive ingredient in marijuana is THC. Stays in your system… THC is not water soluble and is stored in the fat cells of the body, sometimes for weeks after the last usage. Therefore a positive drug test is possible 4-6 weeks after last use and maybe longer for heavy users. You cannot... Legally use, possess, or grow pot for any reason in the state of Ohio. You can not purchase marijuana in another state where it is legal, and legally possess it in Ohio. Test positively for marijuana because of casual secondhand smoke. Test positive for wearing hemp-based clothes or jewelry. Claim a positive test is unrelated to work time or activities. Dilated (large) pupils Bloodshot eyes Sleepy appearance Reduced motivation Difficulty thinking Distorted sensory perceptions Dry mouth Euphoria (temporary feelings of elation and energy) Feeling sluggish Red, puffiness under the eyes Impaired judgment Impaired short-term memory Inappropriate laughter Increased heart rate Increased appetite, craving sweets Reduced coordination Temporary feelings of reduced anxiety or stress Sadness/depressed mood Sensation that time is passing slowly What are some of the signs and symptoms of marijuana use? Prescription drug abuse is … The use of a prescription medication in a way not intended by the prescribing physician. For example, taking more than the prescribed amount. Most common in young people. Drugs most often abused include painkillers, sedatives, anti-anxiety medications and stimulants. Nearly 3 out of 4 drug overdose deaths are now caused by prescription painkillers. In 2008, some 14,800 deaths were attributed to the pills – "more than cocaine and heroin combined." More than 12 million Americans reported using prescription painkillers in 2010 without a prescription or just for the high that they cause. CDC in Atlanta Narcotic drugs are often called opiates because they are derived from the opium poppy plant or made synthetically. Narcotics has several meanings – one of which refers to all illegal drugs of abuse. Natural opiates include opium, morphine, and codeine. Semi-synthetic narcotics include Oxycodone and Dilaudid. Opiates/Narcotics Opiads are used medically for pain relief. These are dependency producing drugs. They are Central Nervous System depressants. When used medically, narcotics are given orally or intramuscular injection. When abused they are smoked, snorted, or subcutaneous (skin popping) or intravenous (mainlining). Opiates In 2011, 4.2 million Americans aged 12 or older (or 1.6 percent) had used heroin at least once in their lives. It is estimated that about 23 percent of individuals who use heroin become dependent on it. • NIH Heroin Use What does someone look like who is using heroin? Shortness of breath Dry mouth Constricted (small) pupils Sudden changes in behavior or actions Disorientation Cycles of hyper alertness followed by suddenly nodding off Droopy appearance, as if extremities are heavy Some common signs and symptoms of heroin use are… What are some of the materials connected to heroin use? Needles or syringes not used for other medical purposes Burned silver spoons Aluminum foil or gum wrappers with burn marks Missing shoelaces Straws with burn marks Small plastic bags, with white powdery residue Water pipes or other pipes Constipation Depression Low blood pressure Decreased breathing rate Confusion Sweating Poor coordination What are some of the signs and symptoms of opioid painkillers abuse? What are some other signs of drug abuse in general? Stealing, forging or selling prescriptions Taking higher doses than prescribed Excessive mood swings or hostility Increase or decrease in sleep Poor decision making Appearing to be high, unusually energetic or revved up, or sedated Continually “losing” prescriptions so more prescriptions must be written Seeking prescriptions from more than one doctor If you or someone you care about, may have a substance abuse problem, a trained chemical dependency counselor is essential to do a thorough evaluation. Your EAP can provide a substance abuse assessment and make the appropriate recommendation for which level of care is right for you or other household members. There is no cost to the employee for an assessment. HealthSpan EAP can help There are many places in the Cincinnati area to get help. The following slide lists some of those resources. Bethesda Oak 513/569-6116 Bethesda Blue Ash 513/489-6011 Gateway Recovery Center 513/861-0035 Northland Intervention Center 513/753-9964 CCAT 513/381-6672 Community Behavioral Services Hamilton 513/887-8500 Community Behavioral Services Middletown 513/424-0921 St. Elizabeth Falmouth – KY 859/572-3500 St. Elizabeth Outpatient – KY 859/212-5384 Resources In Greater Cincinnati For More Information Contact Us 513 / 551-1500 or toll-free at 800 / 733-0257 or visit us on the web Healthspannetwork.com