MSC Conference 2018 - 2 hour Reasonable Suspicion...The liverburnsthe ethanol (i.e., causes a...

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WELCOME!

Don [email protected]

612-801-9623

When is it Reasonable

Suspicion?

To identify employees/customers who are impaired by alcohol and/or drugs in order to

make the workplace safer.

Goal

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Goal

Employee RightsPublic Safety

Reasonable Suspicion is......

Intended to address dangerous situations before

they get worse

Intended to make your workplace safer for you,

your employees, and customers

Helpful in reducing your liability

Reasonable Suspicion is not......

Intended to eliminate drug use

Intended to eliminate employees

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Individuals who were in serious trouble

with alcohol and drugs showed significant

improvement in behavior and work

adjustment during the months immediately

following an intervention to confront

substance abuse problems that were

intruding on their productivity.

Prevalence of Drug Use

in Society

National Survey

Drug Use and Health (NSDUH)

• 131 million (52%) people consider themselves

drinkers

• 6.7% consider themselves heavy drinkers

• 22.6 million people (8.9%) have used illicit

drugs in the past month

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• 17.4 million consider themselves current

marijuana users

• 77% use marijuana in combination with other

illicit drugs

National Survey

Drug Use and Health (NSDUH)

Percent of high school seniors reporting

lifetime use

70% alcohol (51% drunk)

45% marijuana

22% any Rx drug

13% narcotics other than heroin

5% cocaine 2% meth 1.5% heroin

SOURCE: Monitoring the Future Survey, 2011. University of Michigan. N= 50,000 studentsat 420 U.S. public and private high schools and middle schools.

• Minnesota ranks 8th for incidents of driving under the influence of illicit drugs at 5.7%

• 1 in 6 high school seniors reported driving after using alcohol or drugs (Minnesota Student Survey)

MN Statistics

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• 19.5 Million illicit drug users (12 years old and up)

• 56,000 12-17 year old dependent on inhalants

• 3.3 Million Americans used an ADHD substance

last year

U.S. Statistics

• 1.5 Million Emergency Room visits were associated with drug use/abuse (SAMHSA)

• 56% of those were due to illicit drug use/abuse

• 600,000 were due to non-medical use prescription or over-the-counter medications

U.S. Statistics

• 15.1 million abuse prescription drugs (up from

7.8 million in last decade)

• 3% of 12-17 year olds reported current abuse of

prescription drugs (2nd to marijuana and ahead of

cocaine, meth, ecstasy, and heroin)

U.S. Statistics

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National Safety Council Survey

2017

• More than 70% of US employers feel the impact

of prescription drug misuse in their workplaces

• Only 19% of employers feel ‘extremely

prepared’ to deal with prescription drug misuse

• 13% are ‘very confident’ that employees can

spot the signs of misuse

• 76% do not offer training to help close that

knowledge gap

National Safety Council Survey

2017

• 81% of policies are lacking at least one critical

element of an effective drug-free workplace

program

• Encouragingly, 70% would like to help

employees who are struggling with prescription

drug misuse return to their positions after

completing treatment

• 10.8% of high school seniors reported using

illicit drugs during the past year

• 6.1% reported use in the month before the

survey was conducted.

SAMHSA National Household

Survey on Drug Abuse

Substance Abuse and Mental Health Services

Administration

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Partnership for a Drug-Free

America

• 20% of teenagers has abused a prescription

painkiller to get high

• 10% of teenagers has abused an OTC product

(cough medicine)

What is a Drug?

Any substance which, when taken into the

human body, can impair the ability of the

person to perform designated tasks safely.

Definition

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Thresholds

• Threshold is very high

• There is no doubt that something happened

• Threshold used to convict someone in criminal

court

Beyond a Reasonable

Doubt

• Strong likelihood that what you know is actually

true

• Less than Beyond a Reasonable Doubt

• Threshold used by police to make an arrest or

convict someone in civil court

Probable Cause

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• Threshold is very low

• More than a mere hunch or guess

• Less than Probable Cause

• Based on Totality of the Circumstances

• Threshold that police use to contact a

person/vehicle to investigate a crime

Reasonable Suspicion

• having sound judgment; fair and sensible

• supported or justified by fact or circumstance

• a prudent person would come to the same

conclusion given the same facts

Reasonable

• imagination of anything to be the case or to be

likely; a notion of something

• a feeling or thought that something is possible,

likely, or true.

Suspicion

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MN Statute 181.950

A basis for forming a belief based on specific

facts and rational inferences drawn from those

facts.

This is your threshold!


Drug Testing in

the Workplace

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MSS 181.951Authorized Drug and Alcohol Testing

• Pursuant to written policy

• Not on an arbitrary or capricious basis

• After job offer has been made – All applicants

• As part of annual routine physical exam

• Random testing for safety sensitive positions


• Treatment Program testing if:

– Referred for treatment or evaluation for

chemical dependency

– Participating under employee benefit plan


• Reasonable Suspicion testing if:

– Is under the influence

– Violates written rules for use, possession, sale,

transfer of drugs or alcohol

– Personal injury to self or another employee

– Caused a work related accident

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MSS 181.952Policy Contents

• Who is subject to testing

• Circumstances when required or requested

• Right to refuse and consequences of refusal

• Discipline for a positive test

• Right to explain positive test or pay for retest

• Appeal procedures

• Notice to be provided to all employees/applicants

Know Your

• How the subject presents

• Is it different than in the past?

• Physical changes

A

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A

Overt physical signs such as:

• Hyperactivity

• Change in speech patterns

• Poor coordination

• Bruxism

• Muscle tone/tremors

A

Indifference to personal hygiene:

• Body Odor

• Chemical Odor

• Halitosis

• Profuse sweating

• Significant change in body weight

B

• Frequent, prolonged and often unexplained

absences

• Involvement in accidents (both on and off

the job)

• Inappropriate excuses for behavior

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C

• Erratic work patterns and reduced productivity

• Changes in friends and associates

• Improper reaction to real or imagined criticism

Divided AttentionConcentrating on more than one thing at a time

(mental tasks and physical tasks)

Typical Simultaneous Job CapabilitiesRequired for Successful Performance

• Information Processing

• Short-term Memory

• Judgment/Decision Making

• Balance

• Quick Reactions

• Clear Vision

• Small-Muscle Control

• Coordination of Limbs

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Alcohol

A family of closely-related chemicals made up of hydrogen, carbon and oxygen

Alcohol is the MostAbused Drug in the

United States

Some Types of Alcohol

Methyl Alcohol (Methanol)

Ethyl Alcohol (Ethanol)

Isopropyl Alcohol (Isopropanol)

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Production of Ethanol

FermentationYeast combines with sugars from fruits or grains in a chemical reaction that results in ETOH

DistillationFermented beverage is boiled at a controlled temperature to extract and concentrate the ethanol fumes

Standard-Sized Drinks

A Can of Beer12 ounces of fluid @ 4% alcohol equals 0.48 ounces of pure ethanol

A Glass of Wine

4 ounces of fluid @ 12% alcohol equals 0.48 ounces of pure ethanol

A Shot of Whiskey (80-Proof)

1 and 1/4 ounces @ 40% alcohol equals 0.50 ounces of pure ethanol

Absorption of Alcohol

Getting the ethanolout of the stomachand into the blood

StomachWalls Stomach

Walls

StomachWalls

Pylorus

80%

20%

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On a full stomach, alcohol is usually absorbed

within 1½ hours

On an empty stomach, alcohol is usually absorbed

within ½ hour

Absorption of Alcohol

Distribution of Alcohol

Getting the ethanol into the body’s tissuesand organs

Basic Principle

Ethanol goes wherever it finds water

The Brain The Liver Muscle Tissue

Which Parts Don’t?

Bones and Fatty Tissue

Which Parts of the Body haveLots of Water?

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…Male is 68% water

…Female is 55% water

The Average…

Elimination of Alcohol

Direct ExcretionBreath, sweat, tears, urine, etc.

MetabolismPrimarily in the liver

Getting the ethanol out of the body

Metabolism in the Liver

The liver burns the ethanol (i.e., causes a chemical reaction of ethanol with oxygen).

The ultimate products of the chemical reaction are carbon dioxide and water.

Due to metabolism, the average person’s AC drops by about 0.015 per hour.

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Drug Categories And

Their Observable Effects

Central Nervous System

Depressants

Alcohol

Barbiturates

GHB

Anti-anxiety Tranquilizers

Anti-Depressants

Paxil

Many Others

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Central Nervous System Depressants

• Legally prescribed for depression, anxiety,

phobias, and other psychotic disorders.

• Slow down the process of the brain and

many other functions that the brain controls.

Indicators of Impairment

• Reduced inhibitions

• Divided attention impairment

• Slowed reflexes and reactions

• Impaired judgment and

concentration

• Impaired vision

• Drowsiness

• Lack of coordination

• Slurred mumbled or incoherent speech

• Emotional instability

• Drunk-like behavior

• Eyes droopy and watery


Stimulants

Cocaine

Ritalin

Amphetamines

Khat

Methamphetamine

Adderall

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Stimulants

• Relieve fatigue

• Aid in weight reduction

• Reduce the need for sleep

• Increase energy and confidence levels

General Indicators of CNS

Stimulants• Restlessness

• Anxiety

• Euphoria

• Talkativeness

• Excitation

• Irritability

• Bruxism

• Body tremors

• Exaggerated reflexes

• Loss of appetite

If subject snorts substance:

• Runny nose

• Redness to nasal area

• Peyote

• Psilocybin

• LSD

• MDMA (Ecstasy)

• Bufotenine

• ‘Plant Food’/’Bath Salts’

• Salvia Divinorum

• NBOMe

VI-10

Hallucinogens

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Hallucination

An hallucination is a sensory experience of something that does not

exist outside the mind.

SynesthesiaA Transposition of Sensory Modes

• Sounds may be transposed into sights.

• Sights may be transposed into odors

• Dazed appearance

• Body tremors

• Perspiring

• Memory loss

• Paranoia

• Disoriented internal clock

• Nausea

• Difficulty with speech

• Piloerection

• Statements suggesting hallucinations


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Dissociative Anesthetics

PCP (Phencyclidine) and its Analogs

Ketamine

Dextromethorphan

Ketaject

Vetalar

Xyrem

Overview of Dissociative

Anesthetics

• Drugs that inhibit pain by cutting off or dissociating

the brain’s perception of pain

• Induce a state of sedation, immobility,

amnesia and analgesia


• Increased pain threshold

• Repetitive speech

• Hallucinations

• Confused

• Possibly violent and combative

• “Moon walking”

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• Blank stare• Loss of memory• Perspiring heavily• Warm to touch• Incomplete, slurred verbal responses• Cyclic behavior• Agitated• Rigid muscle tone• Disoriented• Nonresponsive• Chemical odor


• Heroin

• Oxycontin

• Morphine

• Codeine

• Vicodin

• Demerol

• Methadone

• Darvon

• Buprenorphine

Narcotic Analgesics

14% of U.S. residents report

nonmedical use of Rx pain relievers

U.S. consumes 80% of opioids worldwide

SOURCE: 2009 National Survey on Drug Use and Health (NSDUH). SAMHSA and the Division of

Pharmacologic Therapy, Center for Substance Abuse Treatment, SAMHSA,

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Narcotic Analgesics

• Lowers perception of pain, rather than stopping

nerve transmission (differs from anesthetic)

• Induce euphoria, alter moods, and produce sedation

• Physically addicting properties and severe

withdrawal symptoms

• Users may develop a tolerance to the drug (larger

dose required to achieve same feeling)

Potency Relative to Morphine

� Heroin 2x

� Codeine 1/8x

� Demerol 1/10x

� Percodan =

� Fentanyl 8x

� Alpha-Methyl Fentanyl (China White) 80x

� Methadone 1/2x (Long Acting)

• “Track marks”

• “On the nod”

• Nausea

• Drowsy

• Slowed reflexes and reactions

• Low, slow, raspy speech

• Itching

• Dry mouth

• Euphoria

• Flaccid muscle tone

• Pupils visibly and obviously constricted


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Inhalants

Gasoline

Glues

Paint (Toluene)

Hair Spray

Anesthetic Gases

• Odor of the inhaled substance

• Dizziness, numbness

• Traces of the substance around the face and nose

• Bloodshot, watery eyes

• Distorted perception of time and distance

• Confused, disoriented appearance


• Light headedness

• Flushed face, possible sweating

• Intense headaches

• Slow, thick, slurred speech

• Nausea

• Non communicative

• Floating sensation


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• Marijuana

• Hashish

• Hashish Oil

• Marinol

• Synthetic Cannabinoids

Cannabis

Marijuana corrupts neurochemical endocannabinoids that play

key roles in memory formation, learning, decision-

making...

…and is

Addictive.

SOURCE Ruben Baler, a neuroscientist with the National Institute on Drug Abuse (NIDA).

Quoted in USA Today, 12/7/2012.

2014 Monitoring the Future University of Michigan

• One in six teens who use marijuana are

expected to become addicted

• As many as ½ of daily users are expected to

become addicted

• 6% of high school seniors reported daily

marijuana use

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• Odor of marijuana

• Impaired perception of time and distance

• Marked reddening of whites of eyes

• Body tremors

• Impairs attention

• Relaxed inhibitions


• Disoriented

• Possible paranoia

• Increased appetite

• Eyelid tremors

• Slowed internal clock

• Dilated pupils

6-83


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58% favor legalization

Program

Synthetic Cannabinoid Products

• Not structurally related to THC, but has longer

duration of action.

• Sold commercially since 2002 as “SPICE” and as it’s

parent compound

JWH-0181-pentyl-3-(1-napthtoyl)indole

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Synthetic Cannabinoid Effects

• Panic attacks

• Agitation

• Tachycardia (range of 110 to 150 BPM)

• Elevated blood pressure

• Anxiety

• Pallor

• Numbness and tingling

• Seizures

• Convulsions

• Visual changes

• Color enhancement

• Uncontrollable laughter

• Euphoria

• Talkativeness

• Sexual stimulation

• Time impairment

• Sedation

• Sleep aid

• Analgesia

• Anti-depressant

Synthetic Cannabinoid Effects

Poly Drug Use

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Poly Drug Use

The practice of using two or more drug categories

at the same time

The body will exhibit a combination of these

effects

Prevalence of Drug and

Alcohol Use• Alcohol is the most popular "mixer" with other drugs

• Cannabis is another popular "mixer", and frequently

shows up in combination with Cocaine, PCP, and

various other drugs

• The "speedball", a combination of Cocaine and

Heroin, remains popular

Poly Drug Use

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Tolerance

• May exhibit relatively little evidence of physical impairment.

• Even tolerant drug users, when impaired, usually exhibit clinical evidence (i.e. vital signs, eye signs, muscles, bruxism, etc.).

Reasonable SuspicionREMEMBER:

• More than a mere hunch or guess

• Less than Probable Cause

• Based on Totality of the Circumstances

THANK YOU!

Don [email protected]

612-801-9623

MSC Conference 2018 - 2 hour Reasonable Suspicion...The liverburnsthe ethanol (i.e., causes a...

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