Patterns and severity drug and alcohol abuse evolve over time for addicted non-DOT and DOT employees alike, as their illness of addictive disease grows more chronic. These at-risk workers pose a broad continuum of jeopardy related to human and financial costs to organizations, so discovering ways spot these workers early can save untold suffering and loss.
Helping non-DOT and DOT supervisors identify these workers is critical to preserving lives and preventing catastrophes, but education must have impact and “stickiness.” Indeed, non-DOT supervisor training is the sole path to achieving this goal. The U.S. DOT knows this, of course, and makes training mandatory for regulated professions. But what about non-DOT supervisors, which we are concerned with here?
Let’s examine what works and what doesn’t in training of supervisory personnel, and focus on 17 successful training concepts that are tried and proven over the past 20 years. Training is about educating supervisors. But effective training create proactive supervisors.
We will also explore the impact of non-DOT supervisor training used by hundreds of EAPs and companies worldwide, discuss why it works, how to apply its concepts in the training setting, and how to engage supervisors before and after training so they act with self-motivation rather than reverting to past patterns of benign neglect in overseeing workers.
First things first. Non-DOT supervisors outnumber DOT supervisors by millions and likewise the number of employees who are non-regulated versus not regulated dwarfs DOT regulated positions. The business world must reach out and train these managers because millions of addicts are slipping through the cracks of ignorance and inaction. The power of intervention from training lies here.
Regarding drug and alcohol use and symptoms, there’s no difference, whatsoever among these employee. Addictive disease is addictive disease. However, there is something very obvious: Non-DOT supervisors are rarely trained in workplace substance abuse and reasonable suspicion training, whereas DOT supervisors are required under federal law to be educated for one hour in alcohol and one hour in other drugs of abuse, signs, symptoms, dangers of use, and effects on behavior. It is the non-DOT supervisors who are the untapped force in the America that can launch a powerful war against substance abuse risk in the workplace.
The only difference between Non-DOT and DOT Reasonable Suspicion Training for Supervisors is a time difference and the provision of a mandated requirement concerning the content of training and the subjects/drug categories it must cover.
Since there must be 100 times as many non-dot employees and supervisors in the United States, you will ironically see little discussion in everyday management literature concerning training. The emphasis is on the DOT supervisors for whom the U.S. Department of Transportation mandates drug and alcohol awareness training in a lengthy one alcohol and one hour drug abuse awareness program.
I propose a new renaissance of substance abuse awareness in reaching supervisors with training. Hence, we must discuss what to do about the risk associated with non-dot employees and how to help non-DOT supervisors in their ability to spot substance abuse on the job and take action to intervene immediately when the signs and symptoms are spotted by the trained eye.
If this article motivates your company to install appropriate training to help reduce loss of life and property, or prevent your company’s financial demise, then bingo!
Many symptoms of substance abuse use and addiction are so subtle as to be mistaken as symptoms of other problems and stress issues most people face. This has given way to the myth that addiction or substance abuse is caused by stress. Nothing could be further from the truth.
This myth is not the only one undermines intervention and recovery of addicts. Others include morality models that blame addiction on a loss of morality; religious models that proclaim evil creates alcoholism, character-deficit models that blame addiction on a weak constitution or poor willpower, psychological ill-health models that blame addiction on a underlying psychiatric condition, and what I believe is the most confusing of all, the too much abuse model. (This myth-model of how addiction begins and ensues is based upon the idea that drinking too much or using drugs too much causes addiction to be acquired. (i.e. “don’t drink too much, you might become alcoholic.)
These mythological models are important ones to grasp because they truly form the rationale for training supervisors in understanding substance abuse, addiction, addictive disease, and the myths and misconceptions upon which most people depend as a way of explaining their world view of these conditions.
Non-DOT reasonable suspicion training must make an impact on these long-held mistaken views of addiction because if they do not, then the ability to confront employees under the influence will be dramatically reduced. Why? Supervisors stay blind to what’s in front of them, and by habit of thinking, remain avoidant and inhibited because they do not have an intervention model that fully comprehensible.
The other advantage of training supervisors and getting past all the myths is causing these managers to self-diagnose their own addiction. If statistics are anywhere close to being accurate, one out of ten supervisors is alcoholic or drug addicted. The blind will never be able to lead the blind. But education is naturally confrontational, and many people do admit their problem and self-refer after a close call or near miss associated with a drinking or drug using incident.
So, training not only dispels myths, it re-educates non-dot supervisors to discard their harmful and biased views of addiction where risk of substance abuse poses dangers for self or others in the job.
What more, realize that you, your best friend, mother, and the guy down the street each has a solid idea about what alcoholism is, what causes it, and what it looks like. Everyone knows what someone looks like when they are drunk or stoned, correct? Because alcohol use is everywhere, these questions become answered naturally by everyone. Also, realize that 1 out of 4 people have an alcoholic in their family. And no one has an addict in their family who has also not found their settled upon answer for what caused that addiction and how to prevent it in themselves or someone they know.
Let’s compound this a bit further: All alcoholics have a definition of alcoholism (addiction) that excludes themselves. This is simply part of the denial process. And if any symptoms within that definition are eventually acquired--because addiction is after all—a progressive disease, then guess what? The addict changes their definition. See how this works?
Most of America is a risk from employees who abuse substances, somewhere or at some time. Information given to supervisors can’t just offer signs and symptoms information associated with drugs of abuse and alcohol use. It must also offer information in an effective way that creates proactive supervisors. This I have learned how to do.
Besides the goal of motivating the reader to get excited about non-DOT supervisor training, this article will outline 17 tips for doing it, and help you find the resources that are guaranteed to make the biggest impression on supervisors so they do one very important thing – become proactive on reasonable suspicion of workplace substance abuse.
Thirty years ago, non-DOT drug and alcohol awareness was strongly concerned about the drugs such as PCP – it wreaked havoc on society. It’s still around, but it is very difficult to find because formula substances to create PCP are now highly controlled. If you loved that old formula for Theraflu – and hate the lousy job the current version offers in cold or flu relief, then you can witnessing the impact of society’s efforts to control PCP. The active ingredients were removed to help prevent its formulation by illicit chemists.
Before we begin, realize that training does not have to 100% audio/visual. It can include group discussion, education, examination of true and false questions, and handouts or tip sheets that must be read or closely examined, printed, and considered by reader.
Tip #1: Help Non-DOT Supervisors Understand that What Causes a Problem Is One
I always hit supervisors up front with a key concept: Understanding that alcohol and drug problems cause problems, not the other way around. If an employee has marital problems, financial problems, stress problems, emotional problem, problems with teenagers, or other issues – do not accept these problems on face value—ever. These personal problems are often what you will see as a supervisor, and what you will also be told explains a drinking or drug use problem.
Realized that what cause a problem, is one, and occupational alcoholism has proven this to be the case for decades.
No, we are not talking about non-DOT supervisors diagnosing or jumping to conclusions. Quite the opposite. We want these managers NOT to jump to conclusions, the most obvious one being accepting on face value what appears to the untrained eye as the “true and convenient problem” affecting the employee. So alcohol and drug education is about helping supervisors make a big paradigm shift in understanding addictive disease properly.
Hint: If you are conducting live training with supervisors, ask managers in your audience to challenge this assumption of “alcoholism causing problems, not the other way around.” No one may raise their hand initially. So push a bit. Ask again, “come on, for the sake of argument, help me out here. Play devil’s advocate and challenge this assumption “that other problems are caused alcoholism.” Engaging your audience in this way will cause participants to clear up their own myths and misconceptions as they hear the arguments.
For extra impact, have a discussion with your supervisors about how addiction, drug and alcohol abuse can cause problems in these areas of human suffering: marital, legal, financial, mental, family, medical, and job problems. Discuss types or problems, and how substance abuse contributes to these things.
Tip #2: End the Confusion about Drug and Alcohol Abuse Terms
Alcoholism, drug addictions, chemical dependency, and addictive disease are interchangeable terms. Certain terms are also used in different parts of the country based upon a wide variety of addiction treatment philosophies and models. In the East, addictive disease or just the word alcoholism is more common. On the west coast, “chemical dependency” is more common.
Regardless, get the nomenclature out of the way with your non-DOT supervisor training. Don’t get bogged down with what alcohol abuse and drug abuse is versus alcoholism or drug addiction. Also, but sure to discuss the reality that every addiction treatment program worth a penny sees addiction to any chemical from pot to cocaine to alcohol to opioids---as addictive disease, and addictive disease is treatment with abstinence from all psychoactive substances.
Addiction is a disease process and it is primary. Patients are therefore taught to manage their disease in order to prevent relapse in the same way diabetics are taught to manage their illness. Use of alcohol or drugs begins with experimentation or peer pressure for almost any drinker. Physiologic susceptibility determines from that point the progression of the disease. But other factors can influence severity and course of the disease.
Alcoholism was declared a disease in 1957 by the American Medical Association. And it was declared a disease in 1956 by the World Health Organization. This is over 60 years ago. For those supervisors and others who don’t think alcohol and drug addictions are diseases, this will make the right impression.
Research demonstrates most people believe alcoholism (addiction) to be a disease, however, this belief does not contribute easily to self-diagnosis because of denial. Most people attempt to define alcoholism by behaviors (how much one drinks, when, or what), and this definition always excludes the person’s unique definition.
Tip #3: Help Non-DOT Supervisors See the Power of Job Security as a Lever for Motivating Employees to Accept Treatment
Many people buy into the myth that no one enters treatment and gets well unless they really want it badly enough. This is false.
More accurate is that almost all patients enter treatment coerced into doing so voluntarily. Then employees in treatment are educated. Education than dissolves the myths and misconceptions, and feeling subjectively better again is what motivates employees to buy into the disease model, accept the nature of the illness, and grow in motivation to stay well. This is also referred to as “bring the body and mind will follow” technique.
Success rates for treated employees are very high with good follow-up. The Arlington Hospital in Arlington, VA (now the Virginia Hospital Center) followed treatment patients for two years and discovered a 90% success rate with good follow up (aggressive follow up is probably a better phrase for it) with one short-term relapse or less. Follow up for employees treated for addictive disease should naturally be even higher. Don’t scoff. Almost every patient that exits treatment is motivated and excited about never drinking or drugging again. And to keep this way, very close follow up is required.
Workplace symptoms may not appear for 15 years or more with alcoholics. Indeed the workplace is that last place where dysfunction generally appears. Years before, an employee may have problems at home and this length of time with many coworkers adapting to dysfunction gives way to our next tip: Stop the Use of the term “functional alcoholic.”
Tip #4: Convince Non-DOT Supervisors to Discard the Term “Functional Alcoholic.”
Functional alcoholism typically describes an alcoholic who appears to have minimal or no occupational, psychological, or social dysfunctions as observed by those around him or her. This term is a severe form of enabling, and is often used by coworkers or subordinates of the alcoholic boss. Consider what this term really means, and you will quickly realize that its true translation is: “the drinking problems exists, but it doesn’t bother me or others I know.”
A discussion of the phrase “functional alcoholic” is a good one for your non-DOT supervisors. There is no such thing as functional cancer, and the same is true with alcoholism as a chronic disease. Family members, who typically suffer for years and long before the job or performance at work is affected, virtually never use this term. Most will not call their alcoholic parent or spouse a functional alcoholic. The term functional alcoholic is almost exclusively use with the workplace context.
Tip #5: Alcohol and Drugs of Abuse
Alcohol and drugs of abuse must be discussed in DOT training, but make sure that you provide an overview of the same substances—alcohol, marijuana, depressants, amphetamines and stimulants, PCP, and Narcotics, Opioids, and Designer Drugs.
Here’s a hint. Also discuss substances of abuse common among drug-using teens. There are two reasons for this. 1) You are probably not going to get another chance to help families via these supervisors and 2), young adults who are employees in the 17/18 year range who use illicit substances and are employed with the company many have experiences with many types of licit drugs and odd hallucinogens available from the Internet—from Salvia to Spice to Bath Salts to GHB and THC products.
A Few Words about Alcohol
A discussion of alcohol, although seemingly boring compared to other drugs, is in fact the most commonly abused substance. This includes in the workplace. Use of alcohol and myths surrounding it as we have discussed must be addressed. See below for more information.
When discussing alcohol, talk about how common alcohol is – that 70% of the workforce drinks alcohol on average and 10% of these employees experience some stage of alcoholism from early to late stages and recovery.
Tip #6: Discuss Financial Impact of Alcoholism
Discuss the cost of alcoholism. 25% of the an alcoholic employees’ wages are lost on average because of lost productivity, turnover, absenteeism, and other factors. And if 10% of the 70% of drinkers in any company are alcoholic, it can readily be calculated what the cost of alcoholism is to any organization.
Tip #7: Help Non-DOT Supervisors Understand Tolerance.
I like to show supervisors a chart that depicts the effect of tolerance to alcohol. Again, tolerance is associated with an initial prerequisite to acquiring addiction. Non-alcoholic drinkers do not have significant tolerance changes.
Tolerance reverses as alcoholics get sicker, however. Behavioral differences shown are caused by the nervous system’s ability to tolerate larger quantities of alcohol and still function. This education can help supervisors understand why drunk employees may appear completely sober, and in some cases completely sober at work and forget everything said while drunk the day before!
The alcoholic may wake up at night to drink, drink in the morning, or hide alcohol in order to drink when needed, but without being seen or detected.
Many recovering workers have reported that Vodka was the drink of choice in their later years because the smell was least detectable. Alcoholics may feel guilt and shame for maintenance drinking behaviors, but it is easier to cope with this guilt than seek treatment. What’s the impact of non-DOT supervisor training when managers consider these issues.
Blackouts (a hallmark sign of possible alcoholism) demonstrates the nervous system’s adaptation to alcohol. A blackout is a short-term amnesia state characterized the inability to recall what happened during a period of drinking even though one did not pass out or fall asleep. It is rare for a non-alcoholic to have a blackout. Most social drinkers will pass out, fall asleep, or throw up before having a blackout. Tolerance reverses as the liver deteriorates in later years.
Tip #8: Cross Addiction
There is no reason to spend more than a minute or even two on the subject of cross tolerance and cross addiction, but it helps supervisors appreciate the disease aspect of addition and why the alcoholic employee can’t use prescription sleeping pills (or at least why they are contraindicated). The reason? Supervisors learn about employee problems, and they will hear about drugs recovering addicts use—from prescription drugs to marijuana.
Tip #9: Maintenance Drinking
Again, just a minute of information—or less. But get the point across. Employees who are in later stages of alcoholism “maintenance drink.” And they typically do not look drunk on the job. And this lack of inebriation behaviors can fool supervisors. It is these issues that interfere with drug and alcohol education most training attempts to provide supervisors.
Tip #10: Loss of Control
Alcoholic experience loss of control. Loss of control is a hallmark of addiction and addictive disease. It means much more than going to a party and being unable to stop drinking once you stop, which is rare for even most alcoholics.
Social drinkers can consistently predict their ability to control all the factors shown above, including their decision to over use alcohol, or get drunk. Getting drunk does not mean you’re an alcoholic it simply means you abused alcohol. Here's something to think about: Getting drunk is a choice for the social drinker. It is a symptom of the disease for the alcoholic. Discuss this idea with supervisors if you have time.
Tip #11: Understanding Denial
Alcohol or drug addicts with job problems who are in denial about their addiction are often convinced that other problems cause their job performance shortcomings. Such employees are able to convince the supervisor that these other problems are primary. This is the first step toward prolonged toleration of performance problems by supervisors. They become convinced they understand the employee’s problems and begin to accommodate tolerate these problems as they grow worse. (Spouses of alcoholics do the same thing.)
Tip #12: Substances of Abuse of Which Supervisors Are Unaware
Club drugs, Predatory Drugs, Inhalants, Meth – it is important for supervisors to know about these substances, so their ability to identify patterns, oddities of behavior, and be naturally suspicious in an appropriate way is increased.
Tip #13: Job Performance and Substance Abuse – Performance vs. Diagnosis
The key to effectively managing troubled employees with alcoholism or drug addiction problems (or any personal problem) is to focus only on job performance issues like absenteeism, behavior, or quality of work. Avoiding discussions about whether an employee has a drug or alcohol problem and avoiding the need to decide what kind of personal problem exists, if any, results in more alcoholic and drug addicted employees being referred. The EAP staff completes the assessment and determines the diagnosis. Of course, this does not mean the supervisors don’t need to understand the signs and symptoms of substance abuse.
Tip #14: List of Performance Symptoms
Give supervisors a list of performance symptoms that they can use to support documentation so what they document appears factual, quantifiable, and devoid of subject comments that undermine administrative actions by human resources, which necessary. A solid list of performance symptoms helps managers consider other behaviors that do not necessarily appear obvious. So, such a list acts like a menu to aid the supervisors in formulating a plan.
Tip #15: Educate Non-DOT Supervisors Avoiding Diagnosing Employees
It’s easier than most supervisors think slip into a diagnostic thinking mode. For example, discussing an employee’s possible drinking or drug problem invites a discussion about what to do about it.
Such discussions lead the supervisor to accept the employee’s plan for getting help. Employees with alcoholism or drug addiction problems may seek help from time to time, but is frequently the wrong help, half measures, misdirected, not professionally monitored, or improper.
Employees will always seek help that least interferes with continued drinking. Searching for a doctor who prescribes cross addictive, cross tolerant medications is a good example. All lead to the same result --- a continuation of the drinking or drug problem.
Tip #16: Show Non-DOT Supervisors How They Enable
Enabling can take form in many ways. Enabling allows an alcoholic or drug addict to avoid responsibility for the direct or indirect consequences of a drinking or drug use. Enabling is something that people do who are in relationships with alcoholics or drug addicts. These could family, friends, and of course, coworkers. As long as you are in a relationship with an alcoholic or drug addict, it will be very difficult not to enable.
Tip #17: Explain Treatment
Supervisors should understand what happens in treatment if they should ever refer an employee. Why? Because many people have horrendous ideas about what happens in treatment. Clearing up the myths will more room for
Rest of the Best
Consider the following added elements in your Non-DOT drug and alcohol awareness training for supervisors. The EAP role, constructive confrontation, best tips for supervisor referral, excuses employees use to avoid being referred to testing for reasonable suspicion; plenty of discussion about alcohol.
See the entire program above in a compact ONE HOUR NON-DOT REASONABLE SUSPICION TRAINING.