WiFi. Network: Renaissance Conference Password: officeteamfield. Sponsored by:

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1 WiFi Network: Renaissance Conference Password: officeteamfield Sponsored by:

2 THE DRUG BUZZ RIGHT NOW Christine Clearwater President, Drug-Free Solutions Group, LLC for The Associated General Contractors of America

3 A GROWING CHALLENGE We have a greater number of drugs to select from We are abusing more dangerous substances than ever before We have much stronger drugs than ever before We have more substance abusers than ever before A Growing Challenge We are abusing drugs at a younger age

4 IN 2017 Over 72,000 died of a drug overdose, which equals 197 people every day. This includes illicit drugs and RX opioids

5 TODAY S GOAL FOR SOUND DECISIONS Marijuana maze 1 2 Opioid challenge OSHA ruling 3 4 Putting it together

6 MARIJUANA WHAT DO YOU BELIEVE

7 WHAT IS THE APPROACH? Not a moral issue~ It s a business decision!

8 WHAT IS MARIJUANA? Most used illegal drug in U.S. Product of the hemp plant - Cannabis Sativa Up to 30 times stronger in past 20 years Has 3 times more carcinogens than cigarettes Smoked - edibles - vaporized - mouth spray - drink - capsules chewed Has 483 chemicals in the cannabis plant Mind altering chemical is THC (delta-9-tetrahydrocannabinol) It is addictive

9 MARIJUANA CHALLENGES? Laboratory research and pharmacologic application vs Federal restrictions Recreational vs Medical use NO UNIFIED BASE OF INFORMATION Benefit vs Harm use State vs Federal Law

10 WHERE ARE WE NOW? THC Primary psychoactive ingredient STUDIES Cancer Epilepsy - HIV/AIDS Glaucoma MS finding: CBD CBN No psychosis & addresses anxiety, cancer pain; severe epilepsy; multiple sclerosis; chronic inflammation Weakly psychoactive & addresses anxiety, pain; appetite, convulsions

11 SOME EFFECTS OF MARIJUANA SHORT-TERM Altered senses & impaired psychomotor skills Poor coordination, lowered reaction time, impaired body movement Depth perception & impaired driving & other psychomotor skills Impaired memory, concentration, difficulty with thinking & problemsolving Mood altering, distrust, fear, disorientation LONG-TERM Reduced ability to learn, retain information & understand things clearly Depression, apathy & lack of motivation Physical and mental illness including, psychosis & addiction

12 WHY DOES IT REMAIN A SCHEDULE I DRUG? 01 High potential for abuse DEA classifies marijuana as a Schedule I drug because 02 No currently-accepted medical use 03 Lack of accepted safety

13 GENERAL STATUS OF WORKPLACE MARIJUANA ADA: Not current use State: Laws & regulations vary Workers Comp: Not solely with card Federal: Schedule 1 Overview Unemployment Comp: Misconduct

14 APPROACHES AT WORK 01 ALLOW Always attach to work - NOT what do on personal time 02 NOT ALLOW 03 SET RULES

15 THREE APPROACHES AT WORK 1. ALLOW: Don t test for it (recreational or medicinal-except DOT) 2. NOT ALLOW: Follow in compliance with federal law even with medical marijuana card/recommendation Discipline, up to and including termination, for use possession or being under the influence - even with a medical marijuana card

16 3 APPROACHES AT WORK 3. SET RULES - ALLOW WITH STIPULATIONS: Not discriminate or retaliate against an employee based solely on his/her status as certified, registered medical marijuana user For safety, not place an applicant/employee in a safety-sensitive position If in a safety-sensitive position treat as a RX that must be reported when RX may affect ability to do job function (have clear RX procedures) Establish all job descriptions as part of their essential job duty to include: the ability to operate in a constant state of alertness, and safe manner

17 COMPANY S NEED TO TAKE A STANCE Companies need to decide what position to take.... with the idea that position may need to change in the future

18 TODAY S GOAL Marijuana maze 1 2 Opioid challenge OSHA ruling 3 4 Putting it together

19 SNAP SHOT ON OPIOIDS Treats acute/chronic pain-switches off brain Pain receptors-dulls central nervous system Most widely prescribed drug in the U.S. 98.6% of inpatient surgery patients receive opioids to manage pain 1 in 15 patients receiving opioids post-surgery > chronic users 8-10% of those employed have an opioid abuse disorder 80% of opioid addicts start with a prescription

20 HOW GOT TO NATIONWIDE HEALTH CRISIS Out-of-control opioid addiction began by the powerful influence of lobbying from the pharmaceutical companies Were misrepresented to government regulators as relatively safe Simultaneously, doctors encouraged to prescribe opioids in massive quantities. Results = an epidemic (ruined careers, lives and death ~100 victims daily.

21 3 TYPES OF OPIOIDS Prescription Codeine Fentanyl Morphine Oxycodone Hydrocodone Synthetic Car fentanyl Demerol Norco Methadone Heroin Illegal version (poppy plant) cheaper alternative

22 WHY DANGEROUS TO A USER Highly addictive and readily available Toll on major body systems: heart, lung infections, diseases (HIV, hepatitis) respiratory, digestive & immune systems Depression, sleepiness, nausea and vomiting Long-term use may make pain worse Extensive psychomotor impairment

23 WHY DANGEROUS TO WORKPLACE Drug over-utilization coupled with a workers compensation claim may lead to: Impact job safely (impaired coordination, reaction, time motor skills, thinking) Prolong opioid use > increased lost time from work Increase medical costs & higher risk of surgery Increase duration of paid temporary disability Accidental overdose Impact employee s life expectancy

24 MARIJUANA SOLVE OPIOID EPIDEMIC? Is it replacing/adding one addictive substance with another Each affects different receptors (brain s reward system) Both stimulate release of dopamine and brain wants more and begin to need more for same high It can be a contributing factor to opioid addiction NEED OBJECTIVE DATA

25 EMPLOYERS CAN MAKE A DIFFERENCE! Employers need to be at the forefront PATIENTS WILL TAKE THE MOST AFFORDABLE AND ACCESSIBLE TREATMENT AVAILABLE

26 6 STEPS EMPLOYERS NEED TO TAKE! 1. Internally - Provide Education and Training to: Increase awareness and recognize signs of who may be at risk for addiction & benefit from help Encourage services employees can take advantage of (EAP, health plan, other resources for treatment) Engage and empower employees to be responsibility for their life choices

27 STEP 2 - PROCEDURES 2. Internal - Procedures to Manage RX Use: WHO: Those in a safety-sensitive position to report if use may negatively impact performance TO DO: Bring note from prescribing licensed physician with specified restriction per job function and term of prescription (not type or why drug being taken) WHO: Receives note and makes decision on reasonable accommodation option into non-safety-sensitive position

28 STEP 3 - ALTERNATIVES 3. Externally Viable Alternatives to Health Plans & Third-party Administrators Reduce opioid use by researching what providers are doing to postsurgery/injury Encourage physicians to communicate about the dangers of opioids Limit opioid coverage to a network of pharmacies/providers Change benefits to steer employees to doctors/surgeons and facilities using alternatives to opioids Get post-injuries/surgery clearances by company physician

29 STEP 3 EXTERNALLY ALTERNATIVES CONTINUED Demand & cover opioid-free options for pain management; encourage lifestyle of activity - exercise/stretch programs physical & psychotherapy chiropractic care Tai Chi / yoga mindfulness / biofeedback massage nutrition Maintain extended drug panels for drug testing MRO report with positive test result for legitimate pain prescription can include not just a negative but with potential safety concerns

30 STEPS 4-6: OTHER OPTIONS 4. Offer prescription drug disposal sites. 5. Share outcomes of positive efforts with employees and community, when possible. 6. Support friends, family, caregivers and co-workers who may be suffering from addiction.

31 STRONG SENTIMENTS ARE NOT ENOUGH Epidemic will not end until patients have access to affordable comprehensive treatment for: pain management; and substance abuse disorders Remember some people s bad choice doesn t mean they still aren t great people with an opportunity to re-prove themselves EMPLOYERS MUST STEP UP

32 TODAY S GOAL Marijuana maze 1 2 Opioid challenge OSHA ruling 3 4 Putting it together

33 NEW OSHA RULING STOPPING YOU IN YOUR TRACKS?

34 POST-ACCIDENT TESTING & RETALIATION OSHA STATEMENT: Improve Tracking Of Workplace Injuries to Avoid Retaliation PER OSHA Employers lack procedures for reporting injuries and illnesses = post-accident testing can be unreasonable

35 POST-ACCIDENT TESTING & RETALIATION PERCEPTION BY INDUSTRY: Must have reasonable suspicion = therefore no post-accident testing STATUS AND WHY COMPLY: Into effect 1/1/18 - It makes sense

36 ESTABLISHING POST-ACCIDENT Definition Timing Decision process Referral Procedures

37 DEFINITION FOR A POST-ACCIDENT DRUG AND ALCOHOL TEST An unplanned, unexpected, unintended or intended event which occurs on company property, on company business, or during work hours, or which involves company-supplied or personal vehicles while being used for company purposes and which results in at least one of the following: A fatality of any party Bodily injury of any party requiring immediate medical treatment away from the accident scene Any damage to a motor vehicle / in excess of $$$ Non-vehicular property damage in excess of $$$ Other Other Due to time constraints, formal estimates are not required. A supervisor s estimate is acceptable for the purposes of determining the need for a drug and alcohol test based on the definition above. Employees are required to immediately notify XXX of any accident.

38 THE DECISION PROCESS 01 A fatality of any party Decide if employee may have caused or contributed to the accident AND The accident included at least one of the following 02 Bodily injury of any party requiring immediate medical care away from the scene Note: Some states: safety sensitive positions/ and/or must believe drugs or alcohol may be involved 03 Any damage to vehicle or property in excess of $$$

39 THE DECISION-MAKING PROCESS A post-accident test will never delay any necessary, immediate medical treatment. However, testing should be performed as soon as possible following the accident.

40 TIMING FOR A POST-ACCIDENT TEST A post-accident alcohol test must occur within 8 hours following the accident A post-accident drug test must occur within 32 hours following the accident

41 TIMING FOR A POST-ACCIDENT TEST If the test is not administered within the appropriate timeframes, the supervisor must perform these three steps: 1. Cease attempt to test 2. Call the designated person(s) 3. Document why the test did not occur Note: An employee is responsible for remaining available for testing. If need be, the employee may leave the scene of an accident for the period necessary to obtain assistance in responding to the accident, materials to secure the accident site, or necessary emergency medical care.

42 COMPONENTS FOR POST-ACCIDENT TESTING Definition Decision Process Timing Referral Procedures

43 TODAY S GOAL Marijuana maze 1 2 Opioid challenge OSHA ruling 3 4 Putting it together

44 SIX PROGRAM OBJECTIVES PROMOTE awareness of the company s position PROVIDE meaningful deterrent PROTECT employees, company customers and public ENSURE fair process for the detection of abusers PROVIDE a safe, healthy productive workplace Program Objectives SUPPORT efficient operations

45 BEST PRACTICES COMPONENTS TO ACHIEVE THESE 6 PROGRAM OBJECTIVES: 1. Policy: Non-regulated (long/short) & Regulated) 2. Legal Reviews (50 States) 3. Employee Education 4. Manager Training 5. Drug and Alcohol Testing

46 REMINDER Doing nothing is the most harmful course of action you can take It is harmful for the employee, for his/her co-workers, for the employee s family, for you, for the company, and for the general public

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48 DSG SERVICES 1. Policy (non-regulated & regulated) 2. Legal Reviews (50 States, Canada & Mexico) 3. Employee Education and Manager Training 4. Program Audits / Policy Reviews 5. Speeches / Workshops / Webcasts 6. Drug and Alcohol Testing Coordination For information or courtesy policy review, contact Christine Clearwater at or christine@drugfreeatwork.com