Identification and Accommodation of Employees with Substance Abuse Issues

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Substance Abuse in the Workplace

• Identification and Accommodation of Employees
  with Substance Abuse Issues

Presented By Ali Liénaux, Marie Longré,
Vice-President of Clinical Operations SAP
Program Administrator
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Presentation Overview

1. Employer Responsibilities
2. Alcohol and Drug Policies An Employers Tool
3. Psychoactive Substances Overview and Signs and
   Symptoms
4. Workplace Responses SAP vs. EAP Assistance

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SECTION 1

• Employer Responsibilities

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Employer Responsibilities

• Accommodation
• Privacy Safety

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Employer Responsibilities1. Safety

• Bill C-45 An Amendment to the Criminal Code of
  Canada (2003)
• 217.1 Everyone who undertakes, or has the
  authority, to direct how another person does work
  or performs a task is under a legal duty to take
  reasonable steps to prevent bodily harm to that
  person, or any other person, arising from that
  work or task.

Criminal Code, R.S.C. 1985, c. C-46
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Employer Responsibilities1. Safety
(contd)

• Employer Civil Liability
• Vicarious liability for incidents at work caused
  by employee use of drugs and/or alcohol
• Hoefling v. The Driving Force Inc., 2006 ABQB 30
• R. v Dofasco Inc. (2007 ONCA 769 (Ontario Court
  of Appeal, 2008)

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Employer Responsibilities2. Duty to Accommodate

• All individuals should have an opportunity to
  have their needs accommodated , consistent with
  their duties and obligationswithout being
  hindered in or prevented from doing so by
  discriminatory practices based on race, national
  or ethnic origin, colour, religion, age, sex,
  sexual orientation, marital status, family
  status, disability or conviction for an offence
  for which a pardon has been granted.

Canadian Human Rights Act, R.S.C.1985, c. H-6, s.
2, Purpose of the Act.
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Employer Responsibilities2. Accommodation
(contd)

• Employers are required to accommodate
  disabilities if they know about them
• Addictions often hidden due to employee denial
• What is Reasonable Accommodation?

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Employer Responsibilities3. Privacy

• Employer must
• Ensure the workplace is safe
• Accommodate disabled employees
• WHILE
• Balancing employees rights to privacy

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Employer Responsibilities3. Privacy (contd)
Drug Testing A Justifiable Breach of
Employees Right to Privacy?

• Discrimination
• Bona Fide Occupational Requirement (BFOR)
• Determining present impairment

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SECTION 2

• Alcohol and Drug Policies An Employers Tool

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Alcohol and Drug Policies An Employers Tool

• An effective Alcohol and Drug (A D) Policy is
• Tailored to the specific needs of a company
• A reasonable and responsible response to a
  companys needs

Butler, B. (2008, May 26). Reality Check on
Alcohol and Drug Policies and Testing Programs
The Canadian Situation. Presentation at the
Insight Conference, The Critical State of
Workplace Alcohol and Drug Testing, Toronto.
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Alcohol and Drug Policies An Employers Tool
(contd)

• An effective A D Policy strikes a balance
  between
• Controlling/deterring use (standards,
  investigation tools, consequences of breach)
• AND
• Preventing misuse (education, training, EAP)

Butler, B. (2008, May 26). See above reference.
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Alcohol and Drug Policies An Employers Tool
(contd)

• Influence of a well-developed A D Policy
• Deterrence
• Encourages self-help
• Demonstrates that Employer is proactive

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SECTION 3

• Psychoactive Substances Overview and Signs and
  Symptoms

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Range of Substance Use

• Recreational Use casual, non-problematic
• Substance Abuse moderately problematic, may
  have mild cravings/withdrawal symptoms, may
  impact on work/relationships
• Substance Dependence very problematic, likely
  to impact work/relationships, physical/psychologic
  al problems/withdrawal symptoms

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Drug Tolerance

• Takes more of that substance to produce the same
  effect
• Due to the bodys healthy desire for balance,
  attempts to counteract the effects of the drug
• Almost all psychoactive substances taken
  regularly over a period of time lead to tolerance
• Significantly increases the risk of drug overdose

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Recognizing Signs and Symptoms

• Absenteeism/lateness
• Frequent breaks
• Mood swings
• Alcohol on breath
• Irritability
• Memory loss/lapse
• Borrowing money

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Physical Signs of Substance Abuse

• Slowed, staggering walk, poor coordination
• Red, watery eyes, pupils smaller or larger than
  usual, blank stare
• Puffy face, blushing or paleness
• Cold, sweaty palms

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Physical Signs of Substance Abuse (contd)

• Tremors or shakes of hands, feet, head
• Extreme hyperactivity, unusual talkativeness
• Needle marks on arms, legs, feet

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Emotional Experience of Substance Abuser

• Denial of problem
• Anger at self and others
• Mistrust of others
• Controlling
• Low self esteem
• Avoidance of feelings
• Isolation

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Enabling Help or Harm?

• Rescuing behaviour that allows substance abuser
  to maintain his/her way of life
• Enabler takes responsibility, blame or makes
  accommodations for substance abuser
• Becomes pattern for family, friends, co-workers,
  management

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We Need to Deal with Substance Abuse _at_ Work

• Increase of employee suffering which is hidden
• Social cost of inactivity are staggering
• Increase of cost to organizations
• health care, WSIB claims, lost productivity
• impact on corporate culture is enormous
• It is our job!

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SECTION 4

• Workplace Responses SAP vs. EAP Assistance

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Workplace Responses

• Employees may request assistance (i.e.
  self-disclosure)
• Best case scenario
• Respond supportively according to A D Policy

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Workplace Responses (contd)

• Employees may be hiding the problem
• More difficult situation
• Engage in non-accusing conversation
• Respond supportively according to A D
  Policy in the following situations
• Positive drug/alcohol test
• With training, can act using Reasonable Cause
• Disciplinary action

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Substance Abuse Professionals (SAPs)

• Regulated term under 49 CFR Part 40 of US DOT and
  specifies the following
• Professional qualifications
• Addictions experience
• Training and rigorous exam
• Monitored continuing education
• Subject to DOT audits
• SAP is not a regulated term in Canada

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Substance Abuse Professionals (contd)

• Use of a DOT SAP ensures
• Properly credentialed
• Addictions experience
• Understands workplace concerns
• Background in the community
• Understands appropriate reporting constraints
• Makes appropriate relapse prevention
  recommendations

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EAP Counselling

• Voluntary
• Confidential
• Designed for employees with self-disclosed issues
• No need for diagnostic tools

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SAP Assessment and Reporting

• Mandatory
• Not confidential reports provided to the
  Employer
• Designed for employees who have breached A D
  Policy or US DOT Regulation
• Requires objective diagnostic tools

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SAP Assessments and Reporting (contd)

• Reports and Assessments should
• Balance the organizations legal requirement and
  right to privacy
• Understand current federal and provincial legal
  and human rights rulings

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SAP Process

1. Organization determines level of reporting
2. SAP conducts a thorough professional assessment
3. SAP determines type of treatment OR education
   needed
4. SAP refers employee to the community resource
   best matching needs
5. SAP provides organizations representative with
   initial report

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SAP Process (contd)

1. SAP tracks progress of employee through treatment
   or education
2. SAP provides company representative with updates
   and notifies rep if employee fails to comply
3. SAP conducts post-treatment (education) follow-up
   assessment to determine level of employee
   compliance
4. SAP provides company representative with
   follow-up report, which includes
   relapse-prevention recommendations

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Company Representatives Options

• IWS strongly suggests that the employer follow
  the SAPs recommendations
• However, the employer is not obligated to accept
  the SAPs counsel regarding follow-up
  requirements or additional support programs

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Company Representatives Options (contd)

• Organization can use SAPs recommendations solely
  to advise its decisions regarding employees
  follow-up (including Last Chance Agreement)
  should employment continue

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Thank You!

• The accommodation and successful reintegration of
  an employee struggling with substance abuse is a
  life saving task.