Understanding Substance Abuse

Resource to help understand what Substance Abuse is:

https://nida.nih.gov/publications/drugfacts/understanding-drug-use-addiction

Substance use disorder is a cluster of physiological, behavioral, and cognitive symptoms associated with the continued use of substances despite substance-related problems, distress, and/or impairment, such as impaired control and risky use.

Addiction is a state of psychological and/or physical dependence on the use of drugs or other substances, such as alcohol, or on activities or behaviors, such as sex, exercise, and gambling.

Adapted from the APA Dictionary of Psychology

Sub·stance a·buse

noun

• 1.overindulgence in or dependence on an addictive substance, especially alcohol or drugs.

Substance abuse, also known as drug abuse, is the use of a drug in amounts or by methods that are harmful to the individual or others. It is a form of substance-related disorder. Differing definitions of drug abuse are used in public health, medical, and criminal justice contexts. In some cases, criminal or anti-social behavior occurs when the person is under the influence of a drug, and long-term personality changes in individuals may also occur. In addition to possible physical, social, and psychological harm, the use of some drugs may also lead to criminal penalties, although these vary widely depending on the local jurisdiction.

Drugs most often associated with this term include alcohol, amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, hallucinogens, methaqualone, and opioids. The exact cause of substance abuse is not clear, but there are two predominant theories: either a genetic predisposition or a habit learned from others, which, if addiction develops, manifests itself as a chronic debilitating disease.

Alcohol Abuse in the Workplace

Recognize the physical signs and symptoms of alcohol misuse. What signs and symptoms would you add?

Constricted Pupils – Narrowing or compressing of the pupil of the eye.

Bloodshot or Watery Eyes – Extreme reddening of, or water-filled eyes. May also have a glassy-like film over eyes.

Blackout – Temporary, but not necessarily total loss of consciousness. Forgetfulness of events occurring over periods of time also constitutes a blackout.

Lack of Coordination, unsteady gait – Inability to perform acts or arrange items in the proper relative order.

Sleepy or stuporous condition – Dazed or confused look or reaction to an otherwise normal situation (e.g., not recognizing a familiar object or individual). Lethargic. Mental or physical inactivity. Lack of emotion, feeling, or enthusiasm to things generally found exciting or interesting.

Aggressive or antagonistic behavior – Hostile behavior (e.g., physical fights, loud verbal, abusive conversations).

Slurred Speech – Indistinct, incoherent word pronunciation (e.g., nonsense-sounding syllables and/or sentences during a conversation).

Slowed reaction rate – Delayed stimulus response to circumstances or events (e.g.,non-instantaneous, startled reaction to a loud, unexpected, frightening noise).

Dulled mental processes – Not very alert or responsive. Lacking mental agility.

Alcohol is the most abused drug in society today. It is a depressant and affects vision, judgement, reaction time, memory, and most important, public safety. Apparent drunkenness is easy to detect, and so it is assumed that most employees would not show up for work in this condition. However, it is possible for one’s state of intoxication to be less outwardly visible, thereby giving a person a false sense of security in feeling that he/she can function cohesively while only a “little buzzed”. In either case, the resulting effect can be fatal.

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The following case scenarios are for practice to test your knowledge. We will re-visit the same case scenarios later in the course to see how your answers may have changed!

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Case Scenarios:

Case 1

Joe has been a metropolitan transit bus driver for 10 years. Recently, you have noticed that he is very lethargic. In fact, several of his co-workers have reported seeing him falling asleep on the job. One day you notice a prescription container labeled “Contains alcohol, and will cause drowsiness” on his desk. When asked about his recent downshift in his energy level, he looks at you with a glazed-over expression and says that he has not been getting much sleep lately due to the new baby. You make a reasonable suspicion referral but he refuses to take the test.

What do you do?

What do you do in the event that he does confide in having an ailment that warrants medication, but failed to mention this to you earlier for fear of losing his job?

Case 2

Mary was hired by a large transit system as a forklift operator only 4 weeks ago. Based on her prior job qualifications and experience, the personnel administrator has informed you that she holds a CDL and drove snowplows in a previous position. As a result, she may sometimes be asked to fill in for personnel whom you do not supervise. This morning, due to heavy snowfall, the division chief asks that Mary be placed on stand-by and be prepared to supplement the snowplow crew at a moment’s notice, if needed. During lunch at the local restaurant, unbeknownst to her, you saw her drinking beer with her meal.

What do you do?

Case 3

Eight years ago Gerard tested positive for illegal drug use after undergoing a “reasonable suspicion test.” Company policy permitted Gerard to return to work after completing the recommended treatment. Up until 2 months ago he has been on time, rarely absent, and produces high quality work in a timely manner. Since then you have noticed an increase in “sick,” or “in late” calls from him. What do you do?

In addition to these symptoms, you notice that on each of his breaks for the past 2 weeks, he has been drinking from a dark-colored flask, and a fellow supervisor reports smelling the odor of alcohol on his breath on several occasions.

What do you do?

Case 4

A fellow supervisor reports overhearing telephone conversations between a dispatcher and a scheduler, which seem to suggest that they have both been cited (on separate occasions) for drunk driving offenses involving their personal automobiles. Their personnel file contains documented reports from co-workers stating that on several occasions they have been seen passed out in the lavatory, or their car. What do you do?

Today, the dispatch log shows that on average, incoming calls were not being acknowledged by the dispatcher until the fourth to sixth ring, even when there were no active calls. On two such occasions you happened to be walking by the station and made the same observation. At that time, when you asked the dispatcher if he had not heard the ring of the incoming call, or seen the console light, he responded truthfully in the negative, but in an antagonistic and aggressive tone of voice.

What do you do?

• For 1 in 10 people, abuse leads to addiction
• Addiction to alcohol and other drugs have phases
  • Primary Phase
  • Crucial Phase
  • Chronic Phase

• Non-responsive (fixed)
  • Dilated – sensitivity to light
  • Constricted
• Convergence
• Tracking
• Drooping eye-lids
• Bloodshot

• Involuntary jerking of the eye
• Occurs naturally as the eyes gaze to the side when the eyes are rotated at high peripheral angles
• When a person is impaired by alcohol, nystagmus is exaggerated and may occur to lesser angles
• An alcohol-impaired person will also often have difficult smoothly tracking a moving object

• PCP (Phencyclidine)
• THC – (Marijuana or Cannabinoids
• Amphetamines
• Cocaine
• Opioids
  • Codeine, Morphine, Heroin, Synthetics are: Hydrocodone, Hydromorphone, Oxycodone, Oxymorphone