Drugs In the Work Place

Drugs

In the Work Place

Editor’s Note: In view of the fact that many states have now legalized Marijuana for recreational use, I decided to reprint this article which was written by Roger Pilotti and was first published in the May/June 2000 issue of The National Dipper. Roger was a Narcotics Agent for 28 years. The statistics have been updated with current information. I have also added descriptions of the signs and symptoms of abuse of each drug.

Employees who engage in heavy alcohol or illicit drug use are 33 percent less productive then their coworkers and on average cost their employers $7,000 annually. In total, substance abuse costs American’s employers more than $160 billion per year in accidents, lost productivity and related problems.

According to the Substance Abuse and Mental Health Services Administration it is estimated that 75 percent of adults who admit to current illicit drug use (at least once per month) are actively employed either full-time or part-time. This number represents more than 12.4 million individuals. Although those statistics are eye-opening, the problem of substance abuse is particularly distressing within the context of workers’ compensation because several studies have shown that a disproportionately large percentage (approaching 50%) of workers’ compensation claims are related to the use of alcohol or illegal drugs in the workplace. Furthermore, the National Institute on Drug Abuse reports that employed drug abusers cost their employers about twice as much in medical and workers’ compensation claims as their drug-free coworkers.

Work place problems are magnified by the use of drugs and alcohol. Employees are tardy or absent, the employee turnover rate is greater, their attitude is bad, they are problem employees, they cause product defects, decreased productivity, crime and violence.

As the larger corporations make in-roads with stricter policies and better drug testing, drug using workers detour to smaller companies, that perhaps cannot afford to have future employees tested for drug use. Most Fortune 500 companies now conduct pre-employment drug testing. Most U.S. workers however, work for small to mid-size companies, many do not do drug testing.

According to the National Council on Alcoholism and Drug Dependence (NCADD), more than 70% of those abusing illicit drugs in America are employed; most binge drinkers have jobs as well. Word circulates about which employers test for drugs and which employers do not test for drugs. Those who do not, become the employer of choice for substance abusers.

According to the National Survey on Drug Use and Health, 9.7 million people misused prescription pain relievers, 4.9 million people misused prescription stimulants, and 5.9 million people misused prescription tranquilizers or sedatives. Roughly 11% of high school seniors reported prescription drug misuse during the past year, and of those, 44% used multiple supply sources. Drugs like vicodin, a pain killer, is a drug of choice. Tylenol with codeine, Zoloft, Valium and stimulants. Prescription drugs are as addictive, impairing and destructive as the common street drugs.

Someone misusing a prescription for percodan or vicodin can be just as high as someone on heroin. Today you can find doctors who will prescribe any drug for a fee.

Among teenagers, who most of you employ, there is no gender gap in alcohol and drug abuse. Girls are 15 times more likely than their mothers were to engage in using illegal drugs by age 15. Teenage boys and girls are equally likely to drink or use illegal drugs. Young employees tend to be more comfortable with drug use. Most of these young drug users will be moving into the work force within the next few years, bringing with them a life style that includes unprecedented comfort with drug use. College graduates who develop a drug habit on campus are less likely to quite using drugs once they enter the work force.

Drugs in the Work Place

Drug sales have moved from the streets to the work place. It’s a myth that substance abusers are street people. The work place makes an ideal place to sell drugs. A dealer who sells on credit to a co-worker on Monday knows where to find them for payment on Friday. Often users, trying to support their own habits tell their dealers they can help them sell drugs to coworkers.

Employers should prohibit all drug use, period. Don’t get into whether they do it on their days off at home.

One of the biggest mistakes employers make is writing a drug policy that prohibits drug use on the job or coming to work impaired. That may require a judgment call. There is no legally protected right to use illicit drugs at home. Then there is the issue of liability. As employer, you need to know and you need to do something about drugs in the work place, because if you don’t, you are ignoring a major safety issue. If an employee on drugs causes an accident, and you didn’t do anything to stop it, there are issues of negligent hiring. You also need to protect yourself if you know of drug dealing or drug use at your business property. Call the police and make a record of it.

In Pennsylvania a business was padlocked by the District Attorney’s Office because of the excessive amount of drug dealing that took place within that business and property. That business was considered a nuisance and was padlocked for a year. How many of us could be padlocked for a year and remain in business? That’s certainly something to think about.

Just as we have conventions to talk about ice cream related issues, District Attorneys and U.S. Attorneys or prosecuting attorneys in general hold conventions and also meet. Once the word gets around that Pennsylvania was able to padlock a business under some of the statutes that were enacted, it’s a matter of time before that becomes common place in most states.

It is something we need to be aware of, having reason to know can be used against you, and is something that could cost you your business. Often times I hear people say, “Yes, I know he’s using drugs, but he’s a good employee. I wish I had two or three more like him.” I’m not so sure he’s a good employee. But remember reason to know can be used against you.

Now, we’ll talk about some of the drugs people are taking.

Prescription Drugs

One of the things that employers and parents need to know is that some people who abuse drugs try to legitimize it by carrying illegal drugs in legitimate prescription containers. The mere fact that a drug is in a prescription container doesn’t make it legal. If you look at the label very closely, most states require the name of the drug on the label and if the drug that’s name and description is on the label is not the drug in the container, at least in some states statutes that drug would be misbranded and of course it would be carried illegally.

One of the first drugs I chose to talk about all the time are the cough syrups or cough elixirs which contain codeine, which in many states can be purchased without a prescription over the counter, according to Federal law by the person merely being 18 years of age and signing for that drug. There are a few other details such as an address and the pharmacist must make the sale and it must be recorded in a book. The point is, in some states you can buy an elixir with codeine over the counter with merely a signature, a prescription is not needed.

People who abuse this particular type of drug build a tolerance to it. It takes more and larger quantities of the same drug to give them the same affect they received when they first started using it. So consequently it takes more and more of that drug to get the person high. So someone who sits down with a 4-ounce bottle today must gradually consumer two 4-ounce bottles to get that same effect, and then three, four and five and so on.

I arrested a young man who was a short order cook at a diner who had a tolerance of sixteen 4-ounce bottles per day. This was one of those restaurants where nothing was written down and the waitress shouted the orders to the cook. This gives you the idea that someone could be consuming that amount of drug and still function in a job such as that.

When we talk about someone who has a dependency of this type, we are talking about using a drug, in this case a drug to reduce cough due to colds. If you used that drug according to the physician’s directions, you would take a teaspoon every four hours. So you see how the medical use of that drug, one teaspoon every four hours, to consuming sixteen 4-ounce bottles a day shows the medical use and abuse of the same drug.

The person who has this type of dependency has a dual dependency because this drug contains not only alcohol (40%), but also codeine. If you remember your high school chemistry, to get the proof you merely double the amount of alcohol, so we are talking about 80 proof alcohol. For those of you who drink, you know that the average bar whisky is 84 to 86 proof. So we are talking about 80 proof alcohol and about one gram of codeine per ounce. So someone who consumes a 4-ounce bottle would be consuming 80 proof alcohol and four grams of codeine, not to mention the other ingredients of that drug. Sometimes people will use any drug with codeine in order to cause withdrawal not to be as painful or not to happen at all.

One of the most common signs of an addiction to codeine is nausea, especially in higher doses. “It’s also a common side effect of withdrawal,” Michael Damioli, LCSW, CSAT, clinical director at Colorado Medication Assisted Recovery, says. “Users are more likely to take even more codeine to alleviate their nausea, worsening their addiction cycle.”

Other signs of a codeine addiction

are: • Mood swings • Decreased appetite • Itching • Drowsiness • Constipation • Abnormal heart rate • Feeling tired and weak • Isolating from friends and family

Barbiturates

The next drug we want to talk about are barbiturates. Barbiturates have a very definite place in the practice of medicine. Barbiturates are commonly known as sleeping preparations or sedatives. They are drugs that a doctor can prescribe to get a patient needed rest which is very important in convalescing or prior to certain procedures that are being done in order to facilitate the anesthesia.

Generally a gram and a half to three grams of barbiturates is going to make someone go to sleep. Barbiturates are the drug of choice for those individuals who wish to commit suicide. They do a very fast and clean job in taking one’s life. A person who is addicted to barbiturates is considered

to have a dependency, which can be more dangerous, than someone who has a dependency towards heroin. The reason we say this is that someone who is on heroin detoxifies and withdraws within three to five days. But someone who has a dependency on barbiturates it can take from 15 to 30 days and we must gradually administer a barbiturate over that 15 to 30 days to bring that individual down because if we abruptly stop giving the drug, the individual can go into a coma or respiratory arrest and death will ultimately result.

Barbiturates are very deadly when used in combination with alcohol. Alcohol and barbiturates do not mix and that’s how many people have lost their lives. Sometimes it is considered accidental death because someone who is on a prescribed barbiturate will take his or her medication after drinking. What usually happens within an hour or two of falling asleep, they will wake up and because they think they are not getting a good night’s sleep, they’ll take a second dose of barbiturates and that in combination with the alcohol is usually enough to prohibit breathing and the person dies.

There are a variety of symptoms that are commonly experienced by an individual who is using and abusing these substances. The type of symptom and the severity will depend upon an individual’s genetic makeup, the length of time an individual has been abusing these drugs, and the dosage an individual has taken. Common symptoms of barbiturate abuse include: • Depression • Sleepiness • Slowed pulse • Slow breathing • Respiratory arrest • Mood swings • Agitation • Irritability • Impaired judgment • Dependence • Hallucinations • Delusions • Decreased anxiety • Unusual excitement • Slurred speech • Decreased motor control • Poor concentration • Lack of coordination • Reduction of REM sleep • Respiratory depression • Visual problems • Unable to urinate • Dilated pupils • Tolerance • Slowed brain function • Confusion • Sluggishness • Hypotension • Dizziness • Bradycardia

Amphetamines

Amphetamines are drugs that have a place in medicine. They are the drug of choice for a condition known as narcolepsy where people can fall asleep very rapidly. One minute they are awake and the next minute they are sound asleep.

Amphetamines are used in the field of weight control. Again if a doctor were to prescribe an amphetamine, he usually prescribes no more than 50 milligrams per day. People who are using amphetamines are using upwards of 150 milligrams. Again, we can see the relationship between the medical use of the drug and the abuse of the drug.

Many of us have seen the billboard that says, “Speed Kills”. When you talk about speed, you are talking about a drug known as methamphetamine. This drug is usually injected directly into the blood stream. This drug causes sever problems for some individuals because of aneurysms or strokes because of the sudden influx of blood pressure.

There are multiple ways of recognizing amphetamine abuse, including physical and mental symptoms and changes in behavior: • Increased heart rate and blood pressure • Decreased appetite and weight loss • Insomnia • Digestive upset • Mood swings • Aggression • Paranoia and anxiety • Visual, auditory, or tactile hallucinations • Inability to keep up with work, school, or home responsibilities

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• Much of the person’s time spent seeking or using the drug • Missing pills from a prescription • Changes in groups of friends and difficulties with relationships • Loss of interest in previous activities

Marijuana

Marijuana is another drug which is misunderstood by many people. No one can tell you exactly how harmful marijuana is and no one can tell you how harmless marijuana is. What we do know is marijuana grown in different parts of the U.S. and in various foreign countries have different levels of tetrahydrocannabinol (THC). THC is the active ingredient that causes things to happen with the body. We know that a person who ingests through inhalation about 200 micro grams of THC can hallucinate and they can hallucinate as great as one who uses the drug LSD.

Some common signs and symptoms that may indicate Marijuana use include: • Bloodshot eyes • Increased appetite • Lack of motivation • Weight gain • Nervous or paranoid behavior • Impaired coordination • Slowed reaction time • Dry mouth • Memory impairment • Anxiety • Impaired judgment • Distorted perception • Relaxed state/sleepiness • Feeling “high” or euphoric

LSD

The next drug we’ll talk about is LSD. LSD is lysergic acid diethylamide, a drug which affects the mind. People say they take LSD for a religious type experience. They talk about good trips and bad trips. When they talk about a good trip, they talk about hallucinating about something they found pleasurable. When they talk about a bad trip they talk about hallucinating about something that causes them fear or paranoia within that individual which they relate to as a bad trip.

Again, we don’t know all there is to know about LSD, but people use it because they want a religious type experience or to turn on or “drop some acid”. We know that a person can become catatonic or schizophrenic or psychotic through the use of LSD.

LSD is a totally unpredictable drug. An individual could experience a good trip today and tomorrow take the very same LSD and experience a bad trip. Their emotional status at the time they take the drug often decides the outcome.

One of the most frightening things about LSD is that up to two years after taking the drug the person could have an after-flash. You could trip again without taking any more of the drug. That’s very frightening because you talk about an individual who has taken a drug today and six months from today, think of that individual piloting an air plane or driving a school bus or just a driver in another vehicle coming toward you as you drive down the highway on your way to work and he or she suddenly starts to hallucinate again.

LSD is known for the profound changes it causes in consciousness and perception. During a “trip,” users experience a wide variety of effects. These most often include visual and other sensory distortions, changes to thought processes, intense emotions, and, for some people, surprising new insights and life revelations. LSD’s effects typically last around 8-10 hours, with peak effects occurring 4-6 hours after ingestion. Common side effects include: • Sensory enhancement • Delusions • Sweating • Alienation • Dry mouth • Visual hallucinations • Tremors • Synesthesia (e.g., “hearing” colors and “seeing” sounds) • Dissociation • Anxiety • Impaired depth perception • Panic attacks • Flashbacks • Depression

Tolerance to LSD develops quickly; if a specific dose is taken every day for 3 consecutive days, no reaction will occur by the third day. Users who abuse the drug regularly must take progressively higher doses to achieve the same state of intoxication that they have previously experienced. This practice is particularly dangerous; when the dose amount increases, so do the chances of the user experiencing a “bad trip” and negative psychological side effects.

Heroin

The next drug we’ll talk about is heroin. Heroin is a total cerebral depressive. A drug which has no use in the practice of medicine. It’s like taking the cortex of the brain and incasing it in a shell, very few impulses reach the brain and very few impulses are coming back. It’s a drug we build a tolerance to so someone who starts out with a $5 a day habit will graduate to a $25 to a $50 to a $100 to astronomical sums per day in order to get the same effect the day when they first started using it.

Heroin is a drug which can be snorted through the nostrils, it can be injected into a fleshy part of the body, which we call “skin popping”, or it can be main-lined, injected directly into the blood stream. In order to get the full effects of the drug, it is almost always injected directly into the blood stream. They want the biggest bang for the buck.

An individual who is on heroin has pin-pointed eyes and they can be in a stupor or semi-stupor, they can lose muscle coordination of the limbs and again the central nervous system is depressed.

Heroin is derived from the opium poppy, which is legally grown in a country such as Turkey. When opium poppies are mature, the farmers go out into the field and with a razor, split the pod and return a short time later and collect the sticky substance which is secreted from the poppy pod. This is then collected, put into bricks, which weigh a kilo or 2.2 pounds. The Turkish government will pay the farmer a fair price which is about $9 for every kilo of heroin delivered.

However, there are some who will skin the cat the other way and will hold some back by putting little pebbles or little stones in the bricks in order to have a kilo to sell on the black market where they can get anywhere from $35

to $75. And of course, when it’s purchased on the black market it’s sent to a country such as France and the residue is turned into morphine base and then the morphine base is turned into heroin.

It takes 10 kilos of opium residue to produce one kilo of heroin, so for an investment of about $350 when the heroin is brought into this country and sold at individual doses they can net from that one kilo of heroin, hundreds of thousands of dollars. And of course, when vast sums of money can be made, our young people will be targeted for heroin use.

The signs and symptoms of heroin addiction will vary among users based upon genetic makeup, amount of drug used, frequency of use, and dependency on the drug. The most common symptoms of heroin addiction include the following: • Depression • Euphoria • Mood swings • Anxiety • Hostility toward others • Agitation and irritability • Lying about drug use • Avoiding loved ones • Weight loss • Scabs or bruises as the result of picking at the skin • Delusions • Disorientation • Hallucinations • Paranoia • Decreased attention to personal hygiene • Possession of burned spoons, needles or syringes, missing shoelaces, glass pipes • Stashing drugs in various places around the home, car, and work • Periods of hyperactivity followed by periods of exhaustion • Inability to fulfill responsibilities at work or school • Increased sleeping • Apathy and lack of motivation • Decline in occupational or academic performance • Slurred speech • Shortness of breath • Frequent respiratory infections • Dry mouth • Wearing long pants and shirts, even in warm weather • Going “on the nod” during conversations • Forced, pressured speech • Track marks on arms and legs • Warm, flushed skin • Constricted pupils • Extreme itching

Fentanyl

Fentanyl is a synthetic opioid that is 50-100 times stronger than morphine. Pharmaceutical fentanyl was developed for pain management treatment of cancer patients, applied in a patch on the skin. Because of its powerful opioid properties, Fentanyl is also diverted for abuse. Fentanyl is added to heroin to increase its potency, or be disguised as highly potent heroin. Many users believe that they are purchasing heroin and actually don’t know that they are purchasing fentanyl – which often results in overdose deaths. Clandestinely-produced fentanyl is primarily manufactured in Mexico. v