Drug Abuse & Alcoholism

Size: px
Start display at page:

Download "Drug Abuse & Alcoholism"

Transcription

1 Drug Abuse & Alcoholism PRESENTED BY: ROBERT SWOTINSKY M D FOR MEDICAL EXAMINER COURSE P

2 Drugs, Drinking, and Driving CMV drivers - more fatalities than any other occupation. ~2/3rds of CMV driver fatalities involve highway crashes. If a CMV driver crashes after taking a sedative or opioid painkiller, or after drinking alcohol, the drugs/drinking will be deemed causative.

3 Drugs, Drinking, and Risk Fitness is about risk. Drug/alcohol risk is about cognitive impairment and/or sudden incapacitation.

4 Learning Objectives 1. Recognize drug or alcohol use that is disqualifying for CMV driver certification 2. Obtain additional information as needed 3. Recognize special considerations of return to duty exams after treatment for drug or alcohol abuse

5 Regulations - Drugs Qualified if: Does not use a controlled substance identified in 21 CFR Schedule I, an amphetamine, a narcotic, or any other habit-forming drug. Exception. A driver may use such a substance or drug if the substance or drug is prescribed by a licensed medical practitioner who: Is familiar with the driver s medical history and assigned duties; and, Has advised the driver that the prescribed substance or drug will not adversely affect the driver s ability to safely operate a commercial motor vehicle. 49 CFR (b)(12)

6 Regulations Drugs. Qualified if: Does not use a controlled substance identified in 21 CFR Schedule I, an amphetamine, a narcotic, or any other habit-forming drug. Exception. A driver may use such a substance or drug if the Medical Examiner decides it s ok.

7 Case #1. Marijuana use per state law. CMV driver uses medical marijuana in accordance with state law. Q. What is the best course of action for the Medical Examiner to take? A. Disqualify the driver. B. Give the driver a 3-month certification which would allow time for records to be received. C. Give the driver a 1-year certificate after verifying his marijuana use is consistent with state law. D. Give the driver a 2-year certificate after verifying his marijuana use is consistent with state law.

8 Regulations - Alcohol Qualified if: Has no current clinical diagnosis of alcoholism. 49 CFR (b)(12) What is current? Individualized assessment. Relapse is common. DSM V defines: early remission = at least 3 months sober. sustained remission = at least 12 months sober.

9 Crash Risk Increases With BAC ~# drinks BAC % Effects Start to see cognitive impairment, e.g., by testing. No measured increased crash risk. - Under DOT rules, at BAC, the driver is sent home for the day Start to see increased crash risk. - Under DOT rules, at.04 BAC, the driver is removed from driving and referred to substance abuse professional = DUI for personal vehicles

10 CMV drivers are also governed by FMCSA s drug/alcohol regulation FMCSA s drug/alcohol rule (49 CFR Part 382) implements DOT drug/alcohol testing procedures. DOT drug/alcohol tests (Part 382) are separate from DOT physicals (Part 391), even though they may be scheduled at the same visit. A test violation e.g., positive drug test, BAC of 0.04 or above -- means removal from driving and referral to a substance abuse professional (SAP).

11 Disqualifying drugs Regulation 1. Methadone Rationale many decades ago: Heroin abusers are unreliable, i.e., a safety risk. Still applies, even when methadone is prescribed for pain. 2. Insulin 3. Seizure medicines for seizures Guidance 1. Varenicline (Chantix) (linked to crash risk due to possible dizziness, seizures, arrhythmia, diabetes) 2. Warfarin (Coumadin) during 1 st month 3. Modafinil (Provigil) during 1 st 6 wks. (Provigil is indicated for treatment of excessive sleepiness due to OSA, shift work sleep disorder, and narcolepsy. If prescribed for narcolepsy, the driver is disqualified based on the disease.) For other prescribed drugs, the ME makes the decision to qualify or disqualify on a case-by-case basis. This includes buprenorphine (Suboxone), fentanyl, hydrocodone, hydromorphone, morphine, and oxycodone.

12 Guidelines for decisionmaking If the prescribing doctor responds unsafe, the ME should disqualify. If the prescribing doctor responds safe, the ME still makes the final decision qualified or unqualified. This is the current practice and expectation of MEs. (The regulation has yet to be updated.) Be strategic and efficient. Don t ask for the prescribing doctor s opinion if you ve already decided to disqualify. The ME can do a (non-dot) drug and/or alcohol test as part of the exam. Any drug test should include confirmatory tests of screenpositive results. If ME identifies current drug/alcohol use, ME should refer the driver to a substance abuse professional (addictionologist) for treatment.

13 Evaluating drugs and driving Consider the underlying disease/injury. Drugs are prescribed to improve function. Use of amphetamines generally improves driving ability. Evidence of increased crash risk with initial dosing of certain short-acting Schedule II painkillers. Evidence does not identify crash risk from long-term use of painkillers. Evidence of crash risk with benzodiazepines, too.

14 Case #2 What 3 prescription drugs/types of drugs are, by regulation, disqualifying?

15 Yes - Regular, frequent alcohol use Does the driver: Have a consumption pattern that indicates need for additional evaluation? Pass standardized screening questions, e.g., CAGE? Have a history of driver and/or family alcohol-related medical and/or behavioral problems? Have exam findings of alcoholism/problem drinking? Overall appearance and demeanor Tremor Enlarged liver Is the driver taking other medications that may interact with alcohol?

16 CAGE questionnaire Two yes responses indicate that the possibility of alcoholism should be investigated further. 1. Have you ever felt you needed to cut down on your drinking? 2. Have people annoyed you by criticizing your drinking? 3. Have you ever felt guilty about drinking? 4. Have you ever felt you needed a drink first think in the morning (eye-opener) to steady your nerves or get rid of a hangover?

17 Yes - Regular, frequent alcohol use Does the driver: Have a consumption pattern that indicates need for additional evaluation? Pass standardized screening questions, e.g., CAGE? Have a history of driver and/or family alcoholrelated medical and/or behavioral problems? Rehab, AA meetings DUIs Alcohol-related arrests

18 Yes - Regular, frequent alcohol use Exam findings suggestive of alcoholism/problem drinking: Overall appearance and demeanor Odor Tremor Enlarged liver

19 Yes Narcotic or other habit-forming drug use Is the drug use for: Therapeutic or habitual need? To alter mood, affect, or state of consciousness? To extend physical limits by use of stimulants? Does the driver have a history of drug rehabilitation? As a matter of health promotion, even if not disqualifying, the medical examiner should discuss with the driver: Risks associated with OTC diet, energy, and sleep aids Prescription and OTC pain medications Risks associated with combining medications and alcohol

20 Additional information sources 1. Past records of DOT physicals 2. Records from treating provider(s) 3. Discussion with treating provider(s) 4. Substance abuse specialists (distinguish from SAPs)

21 Case #3. Driver in treatment for alcoholism. CMV driver presents for self-pay DOT physical with alcohol on his breath. The ME learns from treating provider that the driver is struggling with alcoholism. 6 weeks later, the driver presents the ME with letter from alcohol rehab center stating he completed IOP treatment and has good prognosis for continued sobriety. What is the best course of action for the medical examiner to take? A. Disqualify the driver. B. Give the driver a 3-month certification which would allow time for records to be received. C. Give the driver a 1-year certificate. D. Give the driver a 2-year certificate.

22 Mental status exam Mini mental status exam Comprehensive and interaction Cognitive impairment Abnormal affect or behavior (depressed, paranoia, antagonistic, aggressiveness)

23 Diagnostic tests and/or referrals (non-)dot drug or alcohol tests, e.g., rapid urine test, breath alcohol test Use of Schedule I drug or use of any non-prescribed controlled substance is disqualifying Breath alcohol concentration >0.04 is disqualifying. But, any detectable BAC at the clinic raises questions. Blood tests for liver-related enzyme levels, e.g., GGT Referral for mental/emotional health assessment, e.g., for co-morbid mental illness

24 History of positive drug/alcohol tests? Breath alcohol technician Designated employer representative, e.g,. for record of past positive drug tests Medical review officer Substance abuse professional

25 Contact treating provider(s) Better for the ME to contact the treatment provider directly. Don t have the driver serve as intermediary. The toughest specialty from which to get information. A signed release is de regueur. Ask for copies of notes, including recent drug/alcohol test results.

26 Case #4. History of alcoholism. CMV driver reports history of alcohol abuse, goes to AA, takes naltrexone, and says he is sober. What is the best course of action for the medical examiner to take? (May select more than 1.) A. Disqualify the driver. B. Withhold determination pending old records. C. Withhold determination pending additional test results. D. Give the driver a 2-year certificate

27 Case #5. Driver on oxycodone and Fentanyl. CMV driver reports taking oxycodone and Fentanyl patches. Should the ME ask for prescribing physician s opinion? Yes If the prescribing physician says he is aware the patient operates a CMV and believes the patient safe to drive, must the ME qualify the driver? No Yes No

28 Treatment and assessment required after a drug and alcohol testing rule violation Separate from any medical assessment (DOT physical) the employer may require, the drug/alcohol testing rule allows the worker to return to driving after a rule violation only if he/she has completed treatment recommended by a substance abuse professional (SAP). The rule violation may be a positive drug or alcohol test, or it may be a refusal to take a required drug or alcohol test.

29 Substance abuse professional (SAP) two roles 1. Gatekeeper for treatment Evaluates drivers who have positive drug/alcohol tests or other violation(s) of DOT s drug and alcohol rule. Refers drivers to treatment; monitors treatment. Recommends type and duration of follow-up testing. 2. Treatment provider Per FMCSA, the medical examiner refers the examinee to a SAP for treatment if a drug/alcohol abuse problem is identified during the DOT physical.

30 SAP as gatekeeper for treatment after drug/alcohol test violation Drug or alcohol test violation 1. Removal from safety-sensitive duty 2. SAP referral SAP initial evaluation of worker SAP recommends treatment Worker gets treatment If SAP determines treatment not complete SAP follow-up evaluation of worker Fail SAP determines treatment is complete RTD subject to 1-5 yrs of follow-up tests, LCA Pass Return-to-duty drug/alcohol test Yes Employer takes worker back SAP letter re: 1. Compliance 2. Follow-up testing No (This refers to the DOT drug/alcohol testing programs, not to DOT physicals.)

31 Fitness-for-duty DOT Physical, e.g., b/o issues of substance abuse Types Return to duty DOT physical after absence, e.g., for drug/alcohol treatment. Fitness for duty DOT physical triggered by information the medical review officer receives whiel interviewing a donor about a positive drug test. Fitness for duty DOT physical triggered by employer concern, Standard forms and exam, but ME should be informed of, and focus on, the issue at hand. As always, can include necessary ancillary testing, e.g, non-dot drug and/or alcohol test. A DOT drug test looks only for amphetamines, cocaine, marijuana, opiates (targeted at heroin), and PCP.

ACOEM Commercial Driver Medical Examiner Training Program. Module 8: Drug Abuse & Alcoholism, Medication Use

ACOEM Commercial Driver Medical Examiner Training Program. Module 8: Drug Abuse & Alcoholism, Medication Use ACOEM Commercial Driver Medical Examiner Training Program Module 8: Drug Abuse & Alcoholism, Medication Use Drug Abuse - 49 CFR 391.41(b)(12)i)(ii)(A)(B) "A person is physically qualified to drive a commercial

More information

CITY OF ESSEXVILLE SUBSTANCE ABUSE POLICY

CITY OF ESSEXVILLE SUBSTANCE ABUSE POLICY CITY OF ESSEXVILLE SUBSTANCE ABUSE POLICY Department of Transportation Regulated Employees (Original Adoption November 29, 1995, Latest Revision November 17, 2008) I. PURPOSE The City of Essexville ( Employer

More information

MEDWAY SCHOOL BOARD POLICY DRUG AND ALCOHOL TESTING OF SCHOOL BUS DRIVERS

MEDWAY SCHOOL BOARD POLICY DRUG AND ALCOHOL TESTING OF SCHOOL BUS DRIVERS MEDWAY SCHOOL BOARD POLICY DRUG AND ALCOHOL TESTING OF SCHOOL BUS DRIVERS NEPN/NSBA CODE: EEAEAA The safety of our students, employees and the general public requires that our drivers perform their duties

More information

City of Lincoln Non-DOT Anti-Drug Plan & Non-DOT Alcohol Misuse Plan A. DRUGS

City of Lincoln Non-DOT Anti-Drug Plan & Non-DOT Alcohol Misuse Plan A. DRUGS City of Lincoln Non-DOT Anti-Drug Plan & Non-DOT Alcohol Misuse Plan A. DRUGS I. POLICY OVERVIEW ANTI-DRUG PLAN SUMMARY City of Lincoln (hereinafter referred to as the City) has a vital interest in maintaining

More information

D.O.T. (DEPARTMENT OF TRANSPORTATION) DRUG AND ALCOHOL TESTING POLICY

D.O.T. (DEPARTMENT OF TRANSPORTATION) DRUG AND ALCOHOL TESTING POLICY D.O.T. (DEPARTMENT OF TRANSPORTATION) DRUG AND ALCOHOL TESTING POLICY Purpose: Anoka-Hennepin School District #11 realizes the importance of providing a safe and healthy work place and minimizing the risks

More information

Karla Ramirez, LCSW Director, Outpatient Services Laurel Ridge Treatment Center

Karla Ramirez, LCSW Director, Outpatient Services Laurel Ridge Treatment Center Karla Ramirez, LCSW Director, Outpatient Services Laurel Ridge Treatment Center 1 in 4 Americans will have an alcohol or drug problems at some point in their lives. The number of alcohol abusers and addicts

More information

Drug and Alcohol Testing for Department of Transportation (DOT) Regulated Employees

Drug and Alcohol Testing for Department of Transportation (DOT) Regulated Employees Drug and Alcohol Testing for Department of Transportation (DOT) Regulated Definitions Alcohol Screening Test: An analytic procedure to determine whether an employee may have a prohibited concentration

More information

Human Resources Policy Manual Revision Date: January 2014 8.13 FEDERAL HIGHWAY ADMINISTRATION (FHWA) REGULATIONS ON DRUG USE AND ALCOHOL ABUSE

Human Resources Policy Manual Revision Date: January 2014 8.13 FEDERAL HIGHWAY ADMINISTRATION (FHWA) REGULATIONS ON DRUG USE AND ALCOHOL ABUSE 8.13 FEDERAL HIGHWAY ADMINISTRATION (FHWA) REGULATIONS ON DRUG USE This policy is adopted in order to comply with federal requirements concerning drug and alcohol testing of employees who hold positions

More information

Drug and Alcohol Abuse Training revised: October 2015

Drug and Alcohol Abuse Training revised: October 2015 Drug and Alcohol Abuse Training revised: October 2015 FMCSA is considering going to a seven panel and possibly ten panel. Hair testing may also be acceptable. What is a Drug? A substance which

More information

Mental Illness and Substance Abuse. Eric Goldberg D.O.

Mental Illness and Substance Abuse. Eric Goldberg D.O. Mental Illness and Substance Abuse Eric Goldberg D.O. Objectives Item 1 Define and understand Co-Occurring Disorder (COD) Item 2 Item 3 Item 4 Define substance abuse, substance dependence and, Substance

More information

Drug and Alcohol Testing for Bus Drivers

Drug and Alcohol Testing for Bus Drivers Drug and Alcohol Testing for Bus Drivers School bus drivers who operate a motor vehicle requiring a commercial driver's license are subject to a drug and alcohol testing program that fulfills the requirements

More information

Revised April 1, 2015 Page 1 of 5

Revised April 1, 2015 Page 1 of 5 Interview Date: Community Treatment Center 1215 Lake Drive Cocoa, Florida 32922 Phone: 321-632-5958 Fax: 321-632-2533 Do you have a substance abuse problem? Yes No Do you have a mental health diagnosis?

More information

Southlake Psychiatry. Suboxone Contract

Southlake Psychiatry. Suboxone Contract Suboxone Contract Thank you for considering Southlake Psychiatry for your Suboxone treatment. Opiate Addiction is a serious condition for which you may find relief with Suboxone treatment. In order to

More information

Alcohol & Chemical Dependence. Chisoo Choi, M.D. Internal Medicine Consultant Brookhaven Hospital Tulsa, Oklahoma

Alcohol & Chemical Dependence. Chisoo Choi, M.D. Internal Medicine Consultant Brookhaven Hospital Tulsa, Oklahoma Alcohol & Chemical Dependence Chisoo Choi, M.D. Internal Medicine Consultant Brookhaven Hospital Tulsa, Oklahoma Objectives Increased awareness of alcohol and chemical dependence problems Hallmarks of

More information

Drug and Alcohol Abuse Prevention Information

Drug and Alcohol Abuse Prevention Information Drug and Alcohol Abuse Prevention Information Fine Mortuary College (FMC) is committed to providing a drug-free environment for all college students and employees. Under the Drug-free Workplace Act and

More information

EL PASO COUNTY DEPARTMENT OF HUMAN RESOURCES

EL PASO COUNTY DEPARTMENT OF HUMAN RESOURCES EL PASO COUNTY DEPARTMENT OF HUMAN RESOURCES Program for Testing for Alcohol Misuse and Use of Controlled Substance by Drivers of Commercial Motor Vehicles Adopted Date: May 15, 1995 I. Policy- The County

More information

California Society of Addiction Medicine (CSAM) Consumer Q&As

California Society of Addiction Medicine (CSAM) Consumer Q&As C o n s u m e r Q & A 1 California Society of Addiction Medicine (CSAM) Consumer Q&As Q: Is addiction a disease? A: Addiction is a chronic disorder, like heart disease or diabetes. A chronic disorder is

More information

opiates alcohol 27 opiates and alcohol 30 April 2016 drug addiction signs 42 Ranked #1 123 Drug Rehab Centers in New Jersey 100 Top 10 380

opiates alcohol 27 opiates and alcohol 30 April 2016 drug addiction signs 42 Ranked #1 123 Drug Rehab Centers in New Jersey 100 Top 10 380 opiates alcohol 27 opiates and alcohol 30 April 2016 drug addiction signs 42 ed #1 123 Drug Rehab Centers in New Jersey 100 Top 10 380 effects of alcohol in the brain 100 Top 30 698 heroin addiction 100

More information

New York State Office of Alcoholism & Substance Abuse Services Addiction Services for Prevention, Treatment, Recovery

New York State Office of Alcoholism & Substance Abuse Services Addiction Services for Prevention, Treatment, Recovery New York State Office of Alcoholism & Substance Abuse Services Addiction Services for Prevention, Treatment, Recovery USING THE 48 HOUR OBSERVATION BED USING THE 48 HOUR OBSERVATION BED Detoxification

More information

Asset Marketing Services, Inc. Drug and Alcohol Testing Policy (MN)

Asset Marketing Services, Inc. Drug and Alcohol Testing Policy (MN) Drug and Alcohol Use Asset Marketing Services, Inc. Drug and Alcohol Testing Policy (MN) Illegal drug use in the workplace is against the law and highly detrimental to the safety and productivity of our

More information

Frequently asked questions

Frequently asked questions Naltrexone Pellet Treatment for Opiate, Heroin, and Alcohol Addiction Frequently asked questions What is Naltrexone? Naltrexone is a prescription drug that completely blocks the effects of all opioid drugs

More information

EPIDEMIC 4.6 % OF INDIVIDUALS 18 25 USED PAIN RELIEVERS FOR NON-MEDICAL REASONS. 1.5 MILLION YOUNG ADULTS USED PAIN RELIEVERS IN THE PAST MONTH.

EPIDEMIC 4.6 % OF INDIVIDUALS 18 25 USED PAIN RELIEVERS FOR NON-MEDICAL REASONS. 1.5 MILLION YOUNG ADULTS USED PAIN RELIEVERS IN THE PAST MONTH. Drug Court EPIDEMIC In the 10 years (1997 2007) the per capita retail purchases of Methadone, Hydrocodone and Oxycodone in the United States increased 13-fold, 4-fold and 9-fold, respectively. 4.6 % OF

More information

Death in the Suburbs: How Prescription Painkillers and Heroin Have Changed Treatment and Recovery

Death in the Suburbs: How Prescription Painkillers and Heroin Have Changed Treatment and Recovery Death in the Suburbs: How Prescription Painkillers and Heroin Have Changed Treatment and Recovery Marvin D. Seppala, MD Chief Medical Officer Hazelden Betty Ford Foundation This product is supported by

More information

Drug-Free Workplace Policy and Procedures July 16, 2015

Drug-Free Workplace Policy and Procedures July 16, 2015 Drug-Free Workplace Policy and Procedures July 16, 2015 Regional Transit Authority of Southeast Michigan Drug-Free Workplace Policy and Procedures Purpose In compliance with regulations governing anti-drug

More information

Drug and Alcohol Testing for Safety- and Security-sensitive Positions

Drug and Alcohol Testing for Safety- and Security-sensitive Positions [Minor revision posted 3/7/14 (replaces 1/27/12 edition)] Operating Policy and Procedure : Drug and Alcohol Testing for Safety- and Security-sensitive Positions DATE: March 7, 2014 PURPOSE: The purpose

More information

OVERVIEW WHAT IS POLyDRUG USE? Different examples of polydrug use

OVERVIEW WHAT IS POLyDRUG USE?  Different examples of polydrug use Petrol, paint and other Polydrug inhalants use 237 11 Polydrug use Overview What is polydrug use? Reasons for polydrug use What are the harms of polydrug use? How to assess a person who uses several drugs

More information

3.1. The procedure shall be applicable to all University employees.

3.1. The procedure shall be applicable to all University employees. LINCOLN UNIVERSITY Procedure: Confirmatory Testing for Substance Abuse Procedure Number: HRM 113p Effective Date: October 2008 Revisions: Review Officer: Chief Human Resources Officer 1. Purpose 1.1. It

More information

NORTHEAST COMMUNITY COLLEGE ADMINISTRATIVE PROCEDURE NUMBER: AP-3237.0 FOR POLICY NUMBER: BP 3237

NORTHEAST COMMUNITY COLLEGE ADMINISTRATIVE PROCEDURE NUMBER: AP-3237.0 FOR POLICY NUMBER: BP 3237 NORTHEAST COMMUNITY COLLEGE ADMINISTRATIVE PROCEDURE NUMBER: AP-3237.0 FOR POLICY NUMBER: BP 3237 ALCOHOL AND CONTROLLED SUBSTANCE TEST PROCEDURES FOR COMMERCIAL DRIVER S LICENSE PROCEDURES 1. PROCEDURE

More information

Chapter 18 Driving Under the Influence

Chapter 18 Driving Under the Influence Chapter 18 Driving Under the Influence 18-1 ALCOHOL AND OTHER DRUGS A. Select the word or phrase that best completes each of the following sentences and write the letter in the space provided. 1. 2. 3.

More information

Opioid overdose can occur when a patient misunderstands the directions

Opioid overdose can occur when a patient misunderstands the directions Facts About Opioid Overdose How Does an Overdose Occur? Opioid overdose can occur when a patient misunderstands the directions for use, accidentally takes an extra dose, or deliberately misuses a prescription

More information

These changes are prominent in individuals with severe disorders, but also occur at the mild or moderate level.

These changes are prominent in individuals with severe disorders, but also occur at the mild or moderate level. Substance-Related Disorders DSM-V Many people use words like alcoholism, drug dependence and addiction as general descriptive terms without a clear understanding of their meaning. What does it really mean

More information

Opioid Treatment Agreement

Opioid Treatment Agreement Opioid Treatment Agreement 1. I understand that my provider and I will work together to find the most appropriate treatment for my chronic pain. I understand the goals of treatment are not to eliminate

More information

åffi3##ffi Purpose Scope 2. Post-accident - 3. Reasonable suspicion - 4. Random - 5. Return-to-duty (RTD) - 6. Follow-up tests -

åffi3##ffi Purpose Scope 2. Post-accident - 3. Reasonable suspicion - 4. Random - 5. Return-to-duty (RTD) - 6. Follow-up tests - COMMBRCIAL DRIVBR'S LICBNSB DRUG & ALCOHOL POLICY REVISBD 3I3O/09 EXH BIT A åffi3##ffi Purpose Scope The purpose of this policy is to protect employees, co-workers and the public fi'om the risks posed

More information

Improving Outcomes in Patients Who are Prescribed Alprazolam with Concurrent Use of Opioids

Improving Outcomes in Patients Who are Prescribed Alprazolam with Concurrent Use of Opioids Improving Outcomes in Patients Who are Prescribed Alprazolam with Concurrent Use of Opioids Pik-Sai Yung, M.D. Staff Psychiatrist Center for Counseling at Walton Background and Rationale Alprazolam is

More information

2015 OPSC Annual Convention. syllabus. February 4-8, 2015 Hyatt Regency Mission Bay San Diego, California

2015 OPSC Annual Convention. syllabus. February 4-8, 2015 Hyatt Regency Mission Bay San Diego, California 2015 OPSC Annual Convention syllabus February 4-8, 2015 Hyatt Regency Mission Bay San Diego, California FRIDAY, FEBRUARY 6, 2015: 9:30am - 10:30am Opioid Addiction and Buprenorphine Use * Presented by

More information

MOSAIC DES MOINES Alcohol/Drug Free Workplace Policy

MOSAIC DES MOINES Alcohol/Drug Free Workplace Policy MOSAIC DES MOINES Alcohol/Drug Free Workplace Policy Purpose: To help safeguard employee health, provide a safe and productive workplace, and supply our people served with high quality service, Mosaic

More information

Chapter 16 DRUG & ALCOHOL TESTING

Chapter 16 DRUG & ALCOHOL TESTING Chapter 16 DRUG & ALCOHOL TESTING Chapter 16 Table of Contents Chapter 16 DRUG & ALCOHOL TESTING... 16-1 DRUG AND ALCOHOL TESTING... 16-3 Testing Program... 16-3 Guidelines and Procedures for Drug/Alcohol

More information

X. SUBSTANCE ABUSE/DRUG-FREE WORKPLACE POLICY

X. SUBSTANCE ABUSE/DRUG-FREE WORKPLACE POLICY X. SUBSTANCE ABUSE/DRUG-FREE WORKPLACE POLICY GENERAL POLICY It is the policy of Scott County to provide safe, dependable and efficient services to the public which it serves. Scott County is committed

More information

DRUG AND ALCOHOL TESTING OF SCHOOL BUS DRIVERS ADMINISTRATIVE PROCEDURE

DRUG AND ALCOHOL TESTING OF SCHOOL BUS DRIVERS ADMINISTRATIVE PROCEDURE DRUG AND ALCOHOL TESTING OF SCHOOL BUS DRIVERS ADMINISTRATIVE PROCEDURE The RSU 83/M.S.A.D. #13 School Board, hereinafter referred to as the Board, is committed to the establishment of an alcohol and controlled

More information

guideline for identification and treatment of alcohol abuse/dependence in primary care

guideline for identification and treatment of alcohol abuse/dependence in primary care guideline for identification and treatment of alcohol abuse/dependence in primary care This guideline is informational in nature and is not intended to be a substitute for professional clinical judgment.

More information

F 416 Willmar Public Schools ISD 347

F 416 Willmar Public Schools ISD 347 F 416 Willmar Public Schools ISD 347 ATTACHMENTS TO DRUG AND ALCOHOL TESTING POLICY Attachments A through C are to be used in conjunction with the drug and alcohol testing of bus drivers and driver applicants.

More information

DRUG AND ALCOHOL TESTING POLICY

DRUG AND ALCOHOL TESTING POLICY DRUG AND ALCOHOL TESTING POLICY Policy This policy applies to all persons who are applicants for or who are employed in positions with duties or activities that involve the requirement of a commercial

More information

Opiate Abuse and Mental Illness

Opiate Abuse and Mental Illness visited on Page 1 of 5 LEARN MORE (HTTP://WWW.NAMI.ORG/LEARN-MORE) FIND SUPPORT (HTTP://WWW.NAMI.ORG/FIND-SUPPORT) GET INVOLVED (HTTP://WWW.NAMI.ORG/GET-INVOLVED) DONATE (HTTPS://NAMI360.NAMI.ORG/EWEB/DYNAMICPAGE.ASPX?

More information

PATIENT TREATMENT AGREEMENT

PATIENT TREATMENT AGREEMENT PATIENT TREATMENT AGREEMENT Patient Name: : As a participant in buprenorphine treatment for opioid misuse and dependence, I freely and voluntarily agree to accept this treatment agreement as follows: I

More information

Screening Patients for Substance Use in Your Practice Setting

Screening Patients for Substance Use in Your Practice Setting Screening Patients for Substance Use in Your Practice Setting Learning Objectives By the end of this session, participants will Understand the rationale for universal screening. Identify potential health

More information

Kanawha Valley Fellowship Home

Kanawha Valley Fellowship Home Kanawha Valley Fellowship Home Client Assessment Form Date: Time: Assessment Taken Caller s Name: Agency (if applicable) Address: County: Relationship to Patient: Phone # Client s Name: Age: D.O.B.: Current

More information

Teen Misuse and Abuse of Alcohol and Prescription Drugs. Information for Parents

Teen Misuse and Abuse of Alcohol and Prescription Drugs. Information for Parents Teen Misuse and Abuse of Alcohol and Prescription Drugs Information for Parents Terminology Misuse: Using a drug in a way in which it was not intended Example: Using a higher dose of medication than was

More information

Naltrexone Pellet Treatment for Opiate, Heroin, and Alcohol Addiction. Frequently Asked Questions

Naltrexone Pellet Treatment for Opiate, Heroin, and Alcohol Addiction. Frequently Asked Questions Naltrexone Pellet Treatment for Opiate, Heroin, and Alcohol Addiction Frequently Asked Questions What is Naltrexone? Naltrexone is a prescription drug that effectively blocks the effects of heroin, alcohol,

More information

OMNIBUS TRANSPORTATION ACT- ALCOHOL AND CONTROLLED SUBSTANCES

OMNIBUS TRANSPORTATION ACT- ALCOHOL AND CONTROLLED SUBSTANCES CATEGORY: POLICY STATUS: University Policy Approved POLICY TITLE: POLICY NUMBER: POLICY ADDRESS: POLICY PURPOSE: APPLIES TO: SUB-SECTIONS: POLICY STATEMENT OMNIBUS TRANSPORTATION ACT- ALCOHOL AND CONTROLLED

More information

Educational Support Personnel

Educational Support Personnel Burr Ridge Community Consolidated School District #180 Policy Manual 5:285 Educational Support Personnel Drug and Alcohol Testing for School Bus and Commercial Vehicle Drivers 1 The District shall adhere

More information

SUBSTANCE ABUSE POLICY AND PROCEDURAL DIRECTIVE

SUBSTANCE ABUSE POLICY AND PROCEDURAL DIRECTIVE Page 1 of 7 700 Kipling Street, Suite 1000 Lakewood, CO 80215 SUBSTANCE ABUSE POLICY AND PROCEDURAL DIRECTIVE PURPOSE To maintain a safe, healthful, and efficient work environment for the Colorado Department

More information

CHAPTER 2 Board of Trustees Approval: 06/14/89 POLICY 2.08 Revised: 03/12/97

CHAPTER 2 Board of Trustees Approval: 06/14/89 POLICY 2.08 Revised: 03/12/97 2.08 DRUG FREE WORKPLACE Cabinet Approval: CHAPTER 2 Board of Trustees Approval: 06/14/89 POLICY 2.08 Revised: 03/12/97 I. PURPOSE To provide: (1) an alcohol / drug free workplace for all employees, (2)

More information

COMMERCIAL DRIVER S LICENSE DRUG AND ALCOHOL TESTING POLICY and IMPLEMENTATION PROCEDURES

COMMERCIAL DRIVER S LICENSE DRUG AND ALCOHOL TESTING POLICY and IMPLEMENTATION PROCEDURES COMMERCIAL DRIVER S LICENSE DRUG AND ALCOHOL TESTING POLICY and IMPLEMENTATION PROCEDURES I PURPOSE The Purpose of this policy is to establish programs designed to help prevent accidents and injuries resulting

More information

Appendix to Tennessee Department of Health: Tennessee Clinical Practice Guidelines for Outpatient Management of Chronic Non- Malignant Pain

Appendix to Tennessee Department of Health: Tennessee Clinical Practice Guidelines for Outpatient Management of Chronic Non- Malignant Pain Appendix to Tennessee Department of Health: Tennessee Clinical Practice Guidelines for Outpatient Management of Chronic Non- Malignant Pain Division of Workers Compensation 04.01.2015 Background Opioids

More information

Drug & Alcohol Policy RELIABLE TRUCKING, INC. COMMERCIAL DRIVER PROGRAM

Drug & Alcohol Policy RELIABLE TRUCKING, INC. COMMERCIAL DRIVER PROGRAM Drug & Alcohol Policy RELIABLE TRUCKING, INC. COMMERCIAL DRIVER PROGRAM 1 2 I. Purpose Statement The purpose of Reliable Trucking, Inc. s Drug & Alcohol Policy is to create, encourage and enforce a safe

More information

Opioid Prescribing for Chronic Pain: Guidelines for Marin County Clinicians

Opioid Prescribing for Chronic Pain: Guidelines for Marin County Clinicians Opioid Prescribing for Chronic Pain: Guidelines for Marin County Clinicians Although prescription pain medications are intended to improve the lives of people with pain, their increased use and misuse

More information

Driver DOT Drug Free Guidelines Mackay School District #182

Driver DOT Drug Free Guidelines Mackay School District #182 Driver DOT Drug Free Guidelines Mackay School District #182 In recognition of the harmful effects that the use of illegal drugs and the misuse of the alcohol can have on drivers engaged in the transportation

More information

SUBOXONE /VIVITROL WEBINAR. Educational Training tool concerning the Non-Methadone Medication Assisted Treatment Policy that is Effective on 1/1/12

SUBOXONE /VIVITROL WEBINAR. Educational Training tool concerning the Non-Methadone Medication Assisted Treatment Policy that is Effective on 1/1/12 SUBOXONE /VIVITROL WEBINAR Educational Training tool concerning the Non-Methadone Medication Assisted Treatment Policy that is Effective on 1/1/12 WEBINAR INTRODUCTIONS Cynthia Parsons- Program Manager

More information

Last Reviewed: November 25, 2014 WOOD COUNTY BOARD OF EDUCATION. Policy 5160.3 Transportation Employees Alcohol and Controlled Substance Policy

Last Reviewed: November 25, 2014 WOOD COUNTY BOARD OF EDUCATION. Policy 5160.3 Transportation Employees Alcohol and Controlled Substance Policy WOOD COUNTY BOARD OF EDUCATION Policy 5160.3 Transportation Employees Alcohol and Controlled Substance Policy Last Reviewed: November 25, 2014 Next Review: November 25, 2016 Section 1.0 Introduction The

More information

Update and Review of Medication Assisted Treatments

Update and Review of Medication Assisted Treatments Update and Review of Medication Assisted Treatments for Opiate and Alcohol Use Disorders Richard N. Whitney, MD Medical Director Addiction Services Shepherd Hill Newark, Ohio Medication Assisted Treatment

More information

ST. CLAIR COUNTY COMMUNITY MENTAL HEALTH Date Issued: 07/09 Date Revised: 09/11;03/13;06/14;07/15

ST. CLAIR COUNTY COMMUNITY MENTAL HEALTH Date Issued: 07/09 Date Revised: 09/11;03/13;06/14;07/15 ST. CLAIR COUNTY COMMUNITY MENTAL HEALTH Date Issued: 07/09 Date Revised: 09/11;/13;06/14;07/15 WRITTEN BY Jim Johnson Page 1 REVISED BY AUTHORIZED BY Jessica Moeller Debra Johnson I. APPLICATION: THUMB

More information

Salt Lake Community College Policies and Procedures Manual 2.08 Personnel Policy Committee Approval:

Salt Lake Community College Policies and Procedures Manual 2.08 Personnel Policy Committee Approval: 2.08 Personnel Policy Committee Approval: DRUG FREE WORKPLACE Senate Approval: CHAPTER 2 Board of Trustees Approval: 6/14/89 POLICY 2.08 Revision: 3/12/07 I. PURPOSE To provide: (1) an alcohol/drug free

More information

ALCOHOLISM, ALCOHOL DEPENDENCE AND THE EFFECTS ON YOUR HEALTH.

ALCOHOLISM, ALCOHOL DEPENDENCE AND THE EFFECTS ON YOUR HEALTH. ALCOHOLISM, ALCOHOL DEPENDENCE AND THE EFFECTS ON YOUR HEALTH. Alcoholism also known as alcohol dependence is a disabling ADDICTIVE DISORDER. It is characterized by compulsive and uncontrolled consumption

More information

Chapter 7. Screening and Assessment

Chapter 7. Screening and Assessment Chapter 7 Screening and Assessment Screening And Assessment Starting the dialogue and begin relationship Each are sizing each other up Information gathering Listening to their story Asking the questions

More information

9.3 Alcohol and Drug-free Workplace (Corporate Policy)

9.3 Alcohol and Drug-free Workplace (Corporate Policy) 9.3 Alcohol and Drug-free Workplace (Corporate Policy) Purpose Xcel Energy has a commitment to its employees, customers, shareholders and the public to promote a safe work environment and to provide energy

More information

Appropriate Use of UDT to Improve Patient Care

Appropriate Use of UDT to Improve Patient Care Published on OpioidRisk (http://www.opioidrisk.com) Home > Urine Drug Testing Urine Drug Testing This guide provides: Download Entire Guide [1] Appropriate use of Urine Drug Testing (UDT) to improve patient

More information

Triage, Assessment & Treatment Methadone 101/Hospitalist Workshop

Triage, Assessment & Treatment Methadone 101/Hospitalist Workshop Triage, Assessment & Treatment Methadone 101/Hospitalist Workshop Launette Rieb, MSc, MD, CCFP, FCFP Clinical Associate Professor, Dept. Family Practice UBC American Board of Addiction Medicine Certified

More information

SOUTH CAROLINA DEPARTMENT OF ADMINISTRATION DRUG AND ALCOHOL TESTING POLICY AND PROCEDURE

SOUTH CAROLINA DEPARTMENT OF ADMINISTRATION DRUG AND ALCOHOL TESTING POLICY AND PROCEDURE SOUTH CAROLINA DEPARTMENT OF ADMINISTRATION DRUG AND ALCOHOL TESTING POLICY AND PROCEDURE THE LANGUAGE USED IN THIS DOCUMENT DOES NOT CREATE AN EMPLOYMENT CONTRACT BETWEEN THE EMPLOYEE AND THE AGENCY.

More information

Buprenorphine/Naloxone Maintenance Treatment for Opioid Dependence

Buprenorphine/Naloxone Maintenance Treatment for Opioid Dependence Buprenorphine/Naloxone Maintenance Treatment for Opioid Dependence Information for Family Members Family members of patients who have been prescribed buprenorphine/naloxone for treatment of opioid addiction

More information

Ever wish you could... Quit using heroin? Protect yourself from HIV infection? Get healthier?

Ever wish you could... Quit using heroin? Protect yourself from HIV infection? Get healthier? Ever wish you could... Quit using heroin? Protect yourself from HIV infection? Get healthier? Good News: Medical treatments called opioid (oh-pee-oyd) maintenance can help you! Injecting heroin puts you

More information

Table of Contents. I. Introduction... 2. II. Summary... 3. A. Total Drug Intoxication Deaths... 5. B. Opioid-Related Deaths... 9

Table of Contents. I. Introduction... 2. II. Summary... 3. A. Total Drug Intoxication Deaths... 5. B. Opioid-Related Deaths... 9 Table of Contents I. Introduction... 2 II. Summary... 3 III. Charts A. Total Drug Intoxication Deaths... 5 B. Opioid-Related Deaths... 9 C. Heroin-Related Deaths... 11 D. Prescription Opioid-Related Deaths...

More information

CITY OF WICHITA SUBSTANCE ABUSE POLICY PURPOSE

CITY OF WICHITA SUBSTANCE ABUSE POLICY PURPOSE CITY OF WICHITA SUBSTANCE ABUSE POLICY PURPOSE The City of Wichita has a public trust to provide a variety of services to the community. An efficient and productive workforce is vital to fulfill that responsibility.

More information

ALCOHOL AND DRUG-FREE WORKPLACE 6.65

ALCOHOL AND DRUG-FREE WORKPLACE 6.65 ALCOHOL AND DRUG-FREE WORKPLACE 6.65 I. Legislative Intent It is the intent of the School Board of Seminole County, Florida (SBSB) to establish a policy that ensures all employees remain drug free as a

More information

Methadone. Buprenorphine 10/9/2015

Methadone. Buprenorphine 10/9/2015 Medication Assisted Treatment for Opioid Addiction Tanya Hiser, MS, LPC Premier Care of Wisconsin, LLC October 21, 2015 How Did We Get Here? Civil War veterans and women 19th Century physicians cautious

More information

SEEKING DRUG ABUSE TREATMENT: KNOW WHAT TO ASK

SEEKING DRUG ABUSE TREATMENT: KNOW WHAT TO ASK National Institute on Drug Abuse SEEKING DRUG ABUSE TREATMENT: KNOW WHAT TO ASK U.S. Department of Health and Human National Institutes of Health SEEKING DRUG ABUSE TREATMENT: KNOW WHAT TO ASK The goal

More information

PROCEDURES FOR BUS DRIVER DRUG AND ALCOHOL TESTING

PROCEDURES FOR BUS DRIVER DRUG AND ALCOHOL TESTING PROCEDURES FOR BUS DRIVER DRUG AND ALCOHOL TESTING District bus drivers are subject to a drug and alcohol testing program that fulfills the requirements of the federal regulations. The School District

More information

FAQ' s on Alcohol Abuse and Alcoholism

FAQ' s on Alcohol Abuse and Alcoholism FAQ' s on Alcohol Abuse and Alcoholism It is important to understand that these answers are not meant to provide specific medical advice, but to provide information to better understand the health consequences

More information

A Growing Problem. Substance Abuse In The Eldery 1

A Growing Problem. Substance Abuse In The Eldery 1 A Growing Problem Substance Abuse In The Eldery 1 A substantial and growing percentage of older adults misuse alcohol, prescription drugs, or other substances. The number of older adults in need of substance

More information

Substance Abuse Prevention Program

Substance Abuse Prevention Program Planning, Design and Construction 14528 S Outer Forty Suite 100 Chesterfield, MO 63017 (314) 628-3494 (314) 628-3715 Substance Abuse Prevention Program REFERENCES: In an effort to create a safe workplace,

More information

Federal Motor Carrier Safety Administration Mandated Drug and Alcohol Testing Program

Federal Motor Carrier Safety Administration Mandated Drug and Alcohol Testing Program Federal Motor Carrier Safety Administration Mandated Drug and Alcohol Testing Program Definitions: Accident, for purposes of this policy, is as an incident involving an employee whose job responsibilities

More information

DOUGLAS COUNTY GOVERNMENT POLICY FORM. To ensure a drug-free work environment within Douglas County Government.

DOUGLAS COUNTY GOVERNMENT POLICY FORM. To ensure a drug-free work environment within Douglas County Government. DOUGLAS COUNTY GOVERNMENT POLICY FORM SUBJECT DRUG-FREE WORKPLACE TITLE DRUG-FREE WORKPLACE POLICY NO. HR.6.10 APPROVAL DATE 1/1/11 REVISION DATE 9/1/12 PURPOSE: DEPARTMENT RESPONSIBLE: DEPARTMENT(S) AFFECTED:

More information

Alcohol Overuse and Abuse

Alcohol Overuse and Abuse Alcohol Overuse and Abuse ACLI Medical Section CME Meeting February 23, 2015 Daniel Z. Lieberman, MD Professor and Vice Chair Department of Psychiatry George Washington University Alcohol OVERVIEW Definitions

More information

Appendices to Interim Report on the Baltimore Buprenorphine Initiative. Managed Care Organization Information Pages

Appendices to Interim Report on the Baltimore Buprenorphine Initiative. Managed Care Organization Information Pages Appendices to Interim Report on the Baltimore Buprenorphine Initiative Appendix A Managed Care Organization Information Pages Appendix B Buprenorphine Online Physician Training Information Packet Appendix

More information

HACH COMPANY DRUG AND ALCOHOL POLICY

HACH COMPANY DRUG AND ALCOHOL POLICY HACH COMPANY DRUG AND ALCOHOL POLICY I. Purpose Hach Company is committed to a safe, healthy, and productive work environment for all Associates free from the effects of substance abuse. Abuse of alcohol,

More information

Procedure 5202P Personnel

Procedure 5202P Personnel FEDERAL HIGHWAY ADMINISTRATION MANDATED DRUG AND ALOCHOL TESTING PROGRAM Definitions: Accident, for purposes of this policy, is as an incident involving an employee whose job responsibilities require a

More information

CITY OF CRIPPLE CREEK DRUG AND ALCOHOL TESTING POLICY AND PROCEDURE MANUAL

CITY OF CRIPPLE CREEK DRUG AND ALCOHOL TESTING POLICY AND PROCEDURE MANUAL CITY OF CRIPPLE CREEK DRUG AND ALCOHOL TESTING POLICY AND PROCEDURE MANUAL I. Purpose The City of Cripple Creek is committed to a safe, healthy, and productive work environment for all employees free from

More information

SUBSTANCE ABUSE POLICY (NON-DOT)

SUBSTANCE ABUSE POLICY (NON-DOT) Health, Safety and Environmental Manual SUBSTANCE ABUSE POLICY (NON-DOT) 1 SUBSTANCE ABUSE POLICY (NON-DOT) Table of Contents Topic Page 1.0 Objective 3 2.0 Scope 3 3.0 References 3 4.0 Training 3 5.0

More information

SAMPLE DRUG AND ALCOHOL POLICY

SAMPLE DRUG AND ALCOHOL POLICY SAMPLE DRUG AND ALCOHOL POLICY (MISSISSIPPI) DRUG AND ALCOHOL POLICY DISCLAIMER WARNING!!! The attached Drug and Alcohol Policy is being furnished to you as a courtesy. Stonetrust Management Services highly

More information

Electronic Access to Publication This publication can also be accessed electronically through the internet at www.dot.gov/odapc.

Electronic Access to Publication This publication can also be accessed electronically through the internet at www.dot.gov/odapc. Disclaimer This publication was produced by the U.S. Department of Transportation (DOT) to assist safety-sensitive employees subject to workplace drug & alcohol testing in understanding the requirements

More information

CHARLES & SUE S SCHOOL OF HAIR DESIGN DRUG AND ALCOHOL POLICY DRUG AND ALCOHOL POLICY; SUBSTANCE ABUSE RESOURCES:

CHARLES & SUE S SCHOOL OF HAIR DESIGN DRUG AND ALCOHOL POLICY DRUG AND ALCOHOL POLICY; SUBSTANCE ABUSE RESOURCES: CHARLES & SUE S SCHOOL OF HAIR DESIGN DRUG AND ALCOHOL POLICY DRUG AND ALCOHOL POLICY; SUBSTANCE ABUSE RESOURCES: At Charles & Sue s School of Hair Design, the illicit use of drugs and/or alcohol by staff

More information

DRUG AND ALCOHOL TESTING FOR SCHOOL BUS DRIVERS

DRUG AND ALCOHOL TESTING FOR SCHOOL BUS DRIVERS FILE: GDQ-PC DRUG AND ALCOHOL TESTING FOR SCHOOL BUS DRIVERS A. Generally The Omnibus Transportation Employee Testing Act of 1991 requires alcohol and drug testing of safety-sensitive employees in the

More information

Pain and problem drug use

Pain and problem drug use Pain and problem drug use Information for patients Prepared by the British Pain Society in consultation with the Royal College of Psychiatrists, the Royal College of General Practitioners and the Advisory

More information

Non medical use of prescription medicines existing WHO advice

Non medical use of prescription medicines existing WHO advice Non medical use of prescription medicines existing WHO advice Nicolas Clark Management of Substance Abuse Team WHO, Geneva Vienna, June 2010 clarkn@who.int Medical and Pharmaceutical role Recommendations

More information

(Updated: 10/12/2015)

(Updated: 10/12/2015) DRUG TESTING & BACKGROUND CHECK Pfizer s Drug Testing and Background Check Requirements for Contingent Workers and Suppliers, Including Criminal and MVR Record Checks, FDA Debarment Database and DEA Controlled

More information

Contractor compliance with the Alcohol & Drug Program. Rigorous. Respectful. Ready.

Contractor compliance with the Alcohol & Drug Program. Rigorous. Respectful. Ready. Contractor compliance with the Alcohol & Drug Program Rigorous. Respectful. Ready. Table of contents Cenovus s commitment 1 Expectations of our contractors 2 Prevention 5 Impaired driving 6 Testing and

More information

Driver indicated a loss or impairment of consciousness within last: 6 months 12 months or more Date: / /

Driver indicated a loss or impairment of consciousness within last: 6 months 12 months or more Date: / / PHYSICIAN S STATEMENT OF EXAMINATION Michigan Department of State Driver Assessment and Appeal Division P.O. Box 30196, Lansing, Michigan 48909-7696 Phone: (517) 335-7051; Fax: (517) 335-2189; E-mail:

More information

Office-based Treatment of Opioid Dependence with Buprenorphine

Office-based Treatment of Opioid Dependence with Buprenorphine Office-based Treatment of Opioid Dependence with Buprenorphine David A. Fiellin, M.D Professor of Medicine, Investigative Medicine and Public Health Yale University School of Medicine Dr. Fiellin s Disclosures

More information