Topic: Substance Abuse in the Work Place Method of Presentation: Lecture / Handout / Video / Class Exercise Location of Training: Space large enough to accommodate all trainees. Training Materials: Video: Substance Abuse in the Mining Industry (Short Ver.) MSHA VC901 Subs Abuse - is it our Problem? Drug- We’re all under the influence. Handouts: Mood-Altering Drugs Drugs & My Job Drug & Alcohol Use at Work - Some Common Signs Evaluation Quiz Other: Local Yellow Pages Phone Book Those Being Trained: Anyone eligible for part 48 training. Time Requirements: 30-45 Minutes (Without Video: 20-30 Minutes). Documentation Required: Class Roster MSHA Form 5000-23 (Check 'Other' in part 5 & write Sub.Abuse) Training Evaluation: Post lesson 10 question quiz. ------------------------------------------------------------------------------------------------ Instructor's Guide A) Training site and time should be selected for the convenience of the worker. First aid may need to be given at any time or in any place, so the training sight need not be specific. B) Familiarize yourself with the lesson plan prior to giving it. C) After the whole training group has assembled, pass around any documentation roster that is required and distribute any handouts needed for the lesson. D) Inform the group that this lesson is part of their annual MSHA refresher training. Inform the trainees that the topic for the lesson will be covering Substance Abuse in the Mining Industry. E) Tell the group that this will be a 4 part session consisting of: 1. How does Alcohol & Drug Use effect Work? 2. Signs of Drug Use in the Workplace. 3. What can I do? 4. Wrap Up. F) Present the sections in order and as outlined in the Instructor's Outlines. Continue to encourage group participation. G) As you end each section, take note of problems the group sees concerning complying with the information contained in the training session. In other words, how hard will it be to actually put this training into practice at work. Submit these notes to the company's Safety Department along with all other required documentation. H) If a question is asked that you do not know the answer to - DO NOT GUESS at the answer. Find the answer from an appropriate source and get that answer back to the person who asked it. ---------------------------------------------------------------------------------------------------- Section 1 - How Does Alcohol & Drug Use Effect Work? Time: 15 min. Goal: Trainees will gain a basic understanding of how the use of mood-altering substances effect work performance and especially how that relates to safety. Objective: Trainees will be able to list specifically how drugs can effect their own ability to do their assigned tasks. (Class participation exercise at end of section.) Scope: 1. Major Mood altering Drug Categories - Classifying Drugs By their Effect. 2. Skilled Behavior (a definition) and How these drugs effect Skilled Behavior. 3. Specific Skilled Behaviors in Mining and how they are effected. Procedure: Lecture/Class Participation I. Introduction - The purpose of the following section is to give the trainees a brief overview of what are called the Major Mood-Altering Drugs. Explain this purpose to the trainees and say that this is not intended to be a full blown lesson in Pharmacology. Distribute the Handouts: 1.) Mood-Altering Drugs 2.) How could drugs effect someone doing my job? II. Major Mood-Altering Drugs - Definitions & Questions A. Definitions: Start off by asking trainees for their definitions of the following terms. Then give these definitions. DRUG - A drug is any non-nutritive substance taken into the body that reacts with, enhances, or alters normal body chemistry. It is a substance that is usually taken for the purpose improving physical and/or mental well-being. Major Mood-Altering Drug - Any drug that significantly effects the central nervous system and produces a noticeable change in the user's mental functioning and ability to perform skilled behaviors. B. Refer to handout (Following Page) and ask if any students have particular questions about specific drugs. Use Instructor Notes to answer these questions. ----------------------------------------------------------------------------------------------------- Mood-Altering Drugs Drug Category Examples Drug Effects Depressants Alcohol Lowered pulse rate and blood pressure Seconal Slowed reaction time and drowsiness Valium Weak emotional control and "Intoxication" Librium Large doses can cause unconsciousness, coma & death Stimulants Amphetamines Increased pulse rate and blood pressure Cocaine Feelings of alertness & a false sense of confidence CAT Large Mood swings (Euphoric to Depressed) Large doses can causes paranoia, convulsions and death Narcotics Codeine Pain relief Demerol Shallow breathing Heroin Poor judgment and self control Morphine Large doses can cause respiratory arrest & death Hallucinogens LSD Increased pulse rate & blood pressure PCP Distortion of the senses, hallucinations Mescaline Panic, violence or paranoia can occur DMT Death caused by accident or suicide Cannabis Marijuana Increased pulse rate and appetite Hashish Some loss of coordination THC Distortion in the perception of time passage Large doses can cause hallucinations Deliriants Solvents Loss of coordination (Vol.F/HCs) Glue Confusion & hallucinations Gasoline Even occasional use can damage brain, liver, kidney Freon Large doses can cause convulsions & death ---------------------------------------------------------------------------------------------- Section 1 - How Does Alcohol & Drug Use Effect Work? (Continued) III. Skilled Behavior - What it is and how drugs effect it. A. Definition of "Skilled Behavior" - Ask trainees for their definition, then give this one. A Skilled Behavior is any behavior that requires learning and practice to get good at. All jobs at a mine can be classified as a skilled behavior. Skilled behaviors require good judgment or decision-making skills. Good judgment requires that the worker be as attentive to his surroundings as possible. IV. Specific effects on specific jobs. A. Driving Skills (Mobile Equipment) - How do drugs effect this skill? 1. Depressants & Driving Slowed Reaction Time - Can't stop in time. Drowsiness - Falling asleep at the wheel is generally not good. 2. Stimulants & Driving Over-reaction - Over-steering a turn. Over confidence means taking unnecessary risks. 3. Narcotics & Driving Slowed Reaction Time - Can't stop in time. 4. Hallucinogens/Marijuana & Driving Perceptual distortion - Hard to follow the road if it looks like live snake. Time distortion - reaction times can be screwed up either way - Slow or Fast. 5. Deliriants (Volatile Hydrocarbons) & Driving Perceptual distortion - Judging distance is all screwed up. Loss of coordination - Hard to stop if your foot keeps hitting the accelerator. B. Class participation exercise ( Drugs & My Job handouts - following page) Do the exercise on the Drugs Effecting My Job handout. ------------------------------------------------------------------------------------------------ List some effects this drug type could have on a person doing the same type of Job that YOU do. DRUG TYPE Depressant & How would sluggishness or slowed reaction times effect safety? Narcotics _______________________________________________________ _______________________________________________________ _______________________________________________________ Stimulant How would nervousness or recklessness effect safety? _______________________________________________________ _______________________________________________________ _______________________________________________________ Hallucinogens How would grossly distorted perception effect safety? & Deliriants _______________________________________________________ _______________________________________________________ _______________________________________________________ Marijuana How would mildly distorted perception and apathy effect safety? _______________________________________________________ _______________________________________________________ _______________________________________________________ ----------------------------------------------------------------------------------------------- Section 2 - Signs of Drug Use in the Work Place Time: 15 min. Goal: Trainees will gain basic understanding of the signs & symptoms of Substance Abuse in the work environment. Objective: Trainees will be able to correctly answer questions about the Signs & Symptoms of Substance Abuse in the workplace. Scope: 1. Signs of Abuse in the Workplace. 2. What can be Done? Procedure: Lecture / Handouts Section 2 - Signs of Drug & Alcohol Abuse in the Workplace A. Why should I be concerned? Distribute the Drug & Alcohol Use at Work handout. 1. (Current Percent of Fatalities in mining where Alcohol & Drugs are involved.) 2. Statistically 10% of any work force has an addiction problem. 3. Anyone using a mood-altering drug at work Cannot function as well as he should. B. How can I recognize a drug or alcohol problem with a fellow worker? Go over Drug & Alcohol Use At Work handout. (Next Page) Explain that these common signs are not positive indicators of Drug or alcohol use. They only indicate that SOME problem is going on with the worker. If a Drug or alcohol problem is suspected, it should be evaluated professionally. ------------------------------------------------------------------------------------------------- Behaviors that could indicate Substance Abuse in the Workplace 1. Absenteeism that's frequent or for questionable reasons. 2. Long lunch hours or other breaks. 3. Decreased Job Performance. 4. Leaving work early or arriving late. 5. Avoiding supervisors or other workers. 6. Changed behavior or personality. 7. Poor personal hygiene or appearance. 8. Smell of Alcohol on Breath Don't be part of the Problem... Supervisors & fellow workers enable the Abuser to continue when they do the following: 1. Letting an employee repeatedly function below accepted standards. 2. Letting their own feelings of loyalty to the abuser stop them from taking action. 3. Covering up for a fellow employee's chemical abuse. 4. Accepting the abuser's excuses for drinking or using. 5. Ignoring the problem. Be Part of the Solution. You can be part of the solution by refusing to let the Abuser's problem become a problem for you. When you force a drug and alcohol abuser to deal with the consequences of their behavior, you make it more difficult for them to continue using. You also increase the chances that they will seek help. Pay attention to warning signs of Drug & Alcohol Use. Make it clear to everyone that drug or alcohol use is unacceptable in the workplace. Take action when a fellow employee's performance or safety becomes a problem. NEVER ignore it. It only gets worse. Questions? Contact a professional. ------------------------------------------------------------------------------------------------- Section 3 - What can I do? Time: 10 min. - 30 min. with Video Goal: To give employees and employers some ideas on what to do to help a worker with a drug use problem. Objective: Trainee will be able to list the actions that he can take if he suspects a fellow worker has drug or alcohol problem. Scope: 1. Substance Abuse in the Mining Industry video. (If used) 2. Review company policy on this subject. 3. Looking up Local Resources in the Phone Book. Procedure: Video / Lecture I. Introduce and show Video. II. Have a company person review the company's Substance Abuse Policy (if any) III. What else can I do? A. Talking to the person directly. 1. If you feel that you can talk to the person, tell them about the behaviors you are actually SEEING, such as being late or sleeping on the job. If he was not always like that, tell him about your concerns regarding these changes. Offer to help if you can. But also suggest that help is available elsewhere. (See Phone exercise below.) DO NOT tell them you think they have a drinking or drug problem, if you have not actually seen them drinking or using on the job. B. Looking for Help in the Phone Book 1. Start off by asking the trainees what Headings they would look under if they wanted to find some professional help for someone with a substance abuse problem. 2. Look up the numbers and write them on the board or flip-chart. They should include the numbers of agencies similar to the following: Social Services Local Mental Health Agencies Local Hospitals Out-patient or In-patient Substance Abuse Treatment Centers E.A.P for Hire Organizations Local Alcoholics Anonymous or Narcotics Anonymous Help Lines. ---------------------------------------------------------------------------------------------------------- Section 4 - Wrap Up Time: 5 min. Goal: To answer any trainees Questions and evaluation their level of retention. Objective: Trainee will take an 8 question quiz. Scope: 1. Q & A Period 2. Quiz Procedure: Quiz / Class Participation I. Question & Answer Period II. Give quiz located on next page. ------------------------------------------------------------------------------------------------- Program Retention Evaluation Please answer the following questions by circling the letter in front of the most correct answer. This evaluation is to see whether I was a good teacher or not. Thank you. 1. Which of the following substances can cause the user to become sluggish? a. LSD b. Beer c. Cocaine 2. Marijuana causes problems with ability to judge accurately. a. TRUE b. FALSE 3. The use of Cocaine can cause a person to be an unsafe worker because: a. He feels overconfident. b. His reactions are slowed down. c. He is sneezing all the time. 4. A person has gotten into trouble three times in the last month because of alcohol use. This type of alcohol use is normal. a. TRUE b. FALSE 5. A person with alcohol on their breath can be ignored if they aren’t staggering. a. TRUE b. FALSE 6. To help a worker with a possible drug or alcohol problem: a. The worker should be fired. b. The company should contact a local agency that can professionally evaluate the person. c. Both the workers and the company should ignore it. 7. If a prescription for a narcotic pain killer says to take one, taking two will not cause a problem and will make you feel better. a. TRUE b. FALSE 8. Use of any mood altering substance increases your chances of having an accident. a. TRUE b. FALSE ------------------------------------------------------------------------------------------------- Instructor Notes: Major Drug Types A. Depressants: Medical Use - Sleep aid, Sedative & Tranquilizer 1. Definition - Any Drug that slows down the speed at which normal brain activity occurs. Different types of these drugs slow down different parts of the brain. 2. Noticeable Effects Lowered pulse rate and blood pressure. Slowed reaction time & Drowsiness. Weak emotional control & "Intoxication". Large doses can cause unconsciousness, coma & death. 3. Examples - Barbiturates(Sleeping Pills), Tranquilizers, Alcohol B. Stimulants: Medical Use - Appetite Suppressant (Questionable) 1. Definition - Any Drug that increases the speed at which normal brain activity occurs. Different types of these drugs speed up different parts of the brain 2. Noticeable Effects Increased pulse rate and blood pressure. Feelings of alertness and a false sense of confidence. Loss of appetite. Large Mood swings (Euphoric to Depressed). Heavy doses can cause paranoia, hallucinations, convulsions & death. 3. Examples - Amphetamines, Methamphetamine, Cocaine, CAT C. Narcotics: Medical Use - Pain Reliever 1. Definition - Any drug chemically (natural or synthetic) related to Opium. 2. Noticeable Effects Pain relief. Shallow breathing. Reduced hunger & thirst. Poor judgment & self control. Constricted pupils of the eye. Large doses can cause respiratory arrest & death. 3. Examples - Codeine, Morphine, Demerol, Heroin --------------------------------------------------------------------------------------------------- Instructor Notes: Major Drug Types Continued D. Hallucinogens: Medical Use - None. 1. Definition - Drugs that cause significant distortion of the senses, especially vision & hearing. 2. Noticeable Effects Increased pulse rate & blood pressure. Distortion of the senses, hallucinations. Panic, violence or paranoia can occur. Death caused by accident or suicide. 3. Examples - LSD, DMT, STP, PCP(Phencyclidine), Mescaline, Psylocybin E. Cannabis (Marijuana): Medical Use - Possible Glaucoma Treatment 1. Definition - Any form of marijuana or it's primary hallucinogenic drug THC. 2. Noticeable Effects Increased pulse rate and appetite. Some loss of coordination . Distortion in the perception of time passage. Large doses can cause hallucinations (especially if laced with other drugs.) Chronic lethargy (Can't get motivated to do much) 3. Examples - Marijuana, Hashish, THC F. Deliriants (Volatile Fluro/Hydrocarbons): Medical Use: None 1. Definition - A group of chemicals known as Volatile Fluro/Hydrocarbons. They are not drugs by definition. They are used as solvents, refrigerants or adhesives. They all produce an vapor and inhalation is the prime method of abuse. See what an MSDS says about inhaling the vapors of some of those smelly industrial solvents. These are also the chemicals that trash the Ozone Layer. 2. Noticeable Effects Loss of coordination. Confusion & hallucinations. Even occasional use can cause brain, liver, kidney & bone marrow damage. Large doses can cause convulsions & death. 3. Examples - Spray Paint, Gasoline, Paint Thinner, Glue, Freon --------------------------------------------------------------------------------------------- Instructor Notes: Normal and Abnormal Use of Drugs & Alcohol I. The more drugs used - the greater the problem. These notes deal with how bad drug use can get. But, before getting into how bad drug use can get, let's figure out why people use mood- altering drugs to begin with. Then we'll try and figure out the differences between 'Normal Use', 'Abuse' and 'Addiction'. II. Why do People Use Mood-Altering Substances? A. The reason people use drugs & alcohol goes right back to the definition of what a drug is. DRUG - A drug is any non-nutritive substance taken into the body that reacts with, enhances, or alters normal body chemistry. It is a substance that is usually taken for the purpose improving physical and/or mental well-being. B. Drugs & Alcohol are used because they make you feel good (mental well-being). That, in the final analysis, is the Basic Reason why anyone would introduce a potentially dangerous substance into the body. C. So why do people think they need to improve their mental well being? Now you get into all the classic so called "reasons" why people use drugs & Alcohol. Such as, "If you had a wife ike mine...", or "I have too much stress on the job.", etc. III. Use, Abuse & Addiction - What's the Difference? A. One difference between Use and Abuse comes from the differences in WHY people want to improve their well being. (Refer to "C." in the last section.) 1. A person who already has a good sense of well-being will usually use alcohol to enhance an already pleasant state of mind. This is called NORMAL USE. Examples of this would include: A wedding or anniversary celebration, wine with an excellent meal or a social gathering of friends. All of the above situations already have an element of pleasure associated with them. The alcohol is used only to enhance this. 2. A person who is not feeling good and who attempts to gain a sense of well-being by using drugs or alcohol is ABUSING the drug. This is using the drug as a medication to make them feel good. This does not address the problem that caused the person to feel bad in the first place. A doctor would say, "Your treating the symptoms - not the problem." This is not good medicine. In this way, alcohol and drugs delay problem solving. In most cases, delaying the problem does not make it go away. Net result? Using alcohol or drugs makes the problem worse. This is ABUSE. -------------------------------------------------------------------------------------------------- Instructor Notes: Normal and Abnormal Use of Drugs & Alcohol (Continued) Examples of drug Abuse include: Drinking to overcome shyness or feel comfortable, socially. Using drugs to be accepted by peers and thereby, overcome loneliness. Drinking because your job is too stressful. Drinking because of a bad argument with a family member. B. Another difference between Use and Abuse are the Consequences. 1. Normal Use usually does not have any bad results. 2. If bad results occur during or after use, then the substance was Abused. Hangover (Physical consequences) Getting into a fight that you wouldn't normally have.(Social consequences) Feeling bad about making a fool of yourself. (Mental consequences) Drunk driving ticket. (Legal consequences) Taking a second prescription pill when the prescription says to take only one. This is the old 'More is better' syndrome and can result in a bad physical reaction. Don't play doctor with prescription medication. C. Addiction - Addiction is certainly Abuse...but with a few added twists. 1. One way of telling the difference between an Abuser and an Addict is to look at how they each respond to a really nasty substance abuse episode. After drinking, a person attempts to drive home and has an accident that results in a bad injury and a Drunk Driving ticket. An Abuser will not want to drink and drive ever again. And he Won't. He has the ability to learn from his experience and modify his behavior. An Addict will not want to drink and drive ever again but, unlike the Abuser, he will probably repeat this behavior again. The Addict will find other things to blame for those bad consequences other than his drug or alcohol use, This means that the use of the drug has become more important the bad results it generates. And because the addict gets so good at not blaming his drug use anything he will no longer associate his drug use with those problems. ------------------------------------------------------------------------------------------------ Instructor Notes: Normal and Abnormal Use of Drugs & Alcohol (Continued) 2. How can a drug become more important than the negative results it generates? This leads to another way of distinguishing an Abuser from an Addict. An Addict can develop a Physical Dependency on the drug. This means that the addict's body has gotten used to the drug. Without the drug the body becomes physically sick. So, an addict with a physical dependency is now using the drug just to feel Normal! An Addict can also develop a Psychological Dependency on the drug. This means that without the drug, the addict feels emotionally bad. Again, the addict is now taking the drug to get from Bad back to Normal. You will notice that the Basic Reason for using drugs has changed. Instead of using the drug to feel good, the addict now uses it just to feel Normal. The lack of the drug always generates a bad feeling physically, emotionally or both. This is why an addict will continue to use a drug...even in the face of bad consequences. This is also why the addict will always try to come up with reasons to justify his continued drug & alcohol use. 3. If an addict doesn't appear to care about the bad consequences of his drug use, how much can he care about how often those consequences involve YOU? This is where the Safety issue comes in. Drug and alcohol Abuse & Addiction are not just dangerous to the Drug User, it's dangerous for the non-drug-using worker as well. 1997 Certified Part 48 Training