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Chapter 4.
EDUCATION AND TRAINING
The primary objective of the controlled substances use and alcohol misuse program
is deterrence rather than detection. Public
safety is best served if drivers are aware of the
effects of alcohol and controlled substances on
health, safety, and the work environment.
Consequently, the FMCSA believes that educating drivers and training supervisors
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essential for these programs to be effective.
Employers are required to provide educational materials for drivers (see Chapter 3)
and training for supervisors prior to the start
of testing (§382.601 and §382.603, respectively).
Furthermore, the FMCSA regulations and associated DOT regulations (49 CFR
part 40) specify the involvement of professional and technical personnel in the administration
of your alcohol and controlled substances program. These personnel include the
medical review officer (MRO), the substance abuse professional (SAP), the screening
test
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technician (STT), the breath alcohol
technician (BAT), and urine collectors. Each of
these individuals must have specific training
and/or experience as described in the final section
of this chapter.
Educating your work force and supervisors is a major component of
a successful controlled substances use and alcohol misuse program. The benefits of
the program are enhanced when drivers understand your policies and procedures, why you
are implementing them, and what driver responsibilities are.
Well-trained supervisors help you achieve your safety goals and
maintain program integrity, which in turn reduce
your program costs and liabilities. The FMCSA regulations require specific training
for supervisors. In addition, many employers may choose to augment required driver
education with training programs tailored to local needs.
Section 1. EDUCATION OF DRIVERS
Employers must provide each driver subject to the regulations with
written materials as described in Chapter 3.
The appendix in Chapter 3, "Policy Development and Communication," contains
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sample form for use by drivers in
confirming receipt of the educational materials.
One effective way to distribute the educational materials is with the driver's paycheck.
Be sure to retain, in a secure location, the
signed certificate indicating that the driver has received the educational
materials (§382.601(d)).
The appendix of this chapter contains information about alcohol and the
five controlled substances tested for under part
382, which you may wish to include in your education and training materials. In
addition, table 4.1 lists other organizations that
will provide you with educational materials at
little or no cost.
Many employers offer their drivers and other employees counseling and
rehabilitation services through an employee
assistance program (EAP). As part of its
contractual obligation to the employer, the EAP should
be required to supply and distribute educational and training materials. Similarly, your
health insurance carrier may have informational
and educational materials available to distribute
to your work force.
Section 2. SUPERVISOR TRAINING
Employers must provide training to all persons who supervise drivers subject to
the regulations, in accordance with §382.603.
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Table 4-1. Sources of Educational Materials
1. National Clearinghouse for Alcohol and Drug Information (NCADI), PO Box 2345,
Rockville, MD 20852. (800) 729-6686 or (301) 468-2600. Can provide fact sheets,
films, posters, pamphlets, and brochures at no or low cost. Multilingual materials. Free
quarterly catalog available
2. Your State substance abuse clearinghouse. Each State has at least one Federally funded
clearinghouse, which can provide you with nationally and locally produced information
materials.
3. Drug-Free Workplace Helpline, Center for Substance Abuse Prevention. (800) 843-4971.
Operates from 9:00 AM to 5:30 PM Eastern time, Monday - Friday. Provides information
on policy, controlled substance testing, employee assistance program models, and
related topics. Offers literature at no cost to employers. Referrals to other information
sources and lists of consultants by geographic area are available.
Website: http://www.drugfreeworkplace.gov
4. Partnership for a Drug Free America, 405 Lexington Avenue, New York, NY 10174-
0002. (212) 922-1560. Provides high-quality, high-impact messages in the form of
posters, audio tapes, and video tapes. No charge, but a donation will be requested.
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The purpose of this training is to enable
supervisors to determine whether reasonable
suspicion exists to require a driver to undergo
testing described in §382.307. It must
include at least 60 minutes on alcohol misuse and
60 minutes on controlled substances use (120 minutes total). The training may consist
of formal classroom training, videos, written materials, online training, or other
appropriate methods. Interactive training is encouraged,
as experience has shown it is more effective than
passive methods.
The content of the training must include the physical, behavioral, speech,
and performance indicators of probable alcohol
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misuse and controlled substances use. As
with driver education, the material in this
chapter's appendix may be used as part of your supervisor education and training
materials, and the organizations listed in table 4.1
can provide additional information.
Section 3. TRAINING OF PROFESSIONAL AND
TECHNICAL PERSONNEL
Individuals who perform certain professional and technical functions in
DOT testing programs are required by 49 CFR part 40 to have specific qualifications and
recurrent
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training. These requirements apply
whether the individuals are your in-house employees
or external service agents. Before you use these types of professional and technical
personnel, you should satisfy yourself that they have
the requisite qualifications and are aware of the need for periodic refresher training. Below is
a reference list of the part 40 sections that
apply to each type of service agent subject to the training requirements:
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Urine collection personnel _ §40.31 and 33
Medical review officers (MROs) _ §40.121
Screening test technicians (STTs) and breath
alcohol technicians (BATs) _ §40.211 and 213
Substance abuse professionals (SAPs) _§40.281
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Chapter 4 Appendix
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Signs and Symptoms
of Alcohol and
Controlled Substances Use
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Detection Periods
Detection periods vary; rates of metabolism and excretion are different
for each drug and use and vary by individual. Detection periods should
be viewed as estimates. Cases can always be found to contradict
these approximations.
Drug and Detection Period
Amphetamines
Amphetamine 1 to 2 days
Methamphetamine 1 to 2 days
Cocaine
Benzoylecgonine 2 to 3 days
Cannabinoids (Marijuana)
Casual Use Up to 7 days
Chronic Use Up to 30 days
Alcohol 12 to 24 hours
Opiates
Codeine Usually up to 2 days
Hydromorphone (Dilaudid) Usually up to 2 days
Morphine (for Heroin) Usually up to 2 days
Phencyclidine (PCP)
Casual Use Up to 8 days
Chronic Use Up to 30 days
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Alcohol Fact Sheet
Alcohol is a drug that has been consumed throughout the world for centuries. It is
considered a recreational beverage when consumed in moderation for enjoyment and relaxation during
social gatherings. However, when consumed primarily for its physical and mood-altering effects, it is
a substance of abuse. As a depressant, it slows down physical responses and progressively
impairs mental functions.
Description
• Generic/Chemical Names
(Representative): Beer (about 4.5 percent alcohol),
wine (about 14 to 20 percent alcohol), distilled spirits or liquor (about 50 percent alcohol).
• Alternative Sources: After-shave lotion, cough medicine, antiseptic
mouthwash, vanilla extract, disinfectant, room deodorizer fluid, cologne, breath sprays,
shaving creams, rubbing alcohol.
• Common Street Names: Booze, juice, brew, grain, shine, hooch.
• Distinguishing
Characteristics: Pure ethanol (sold in some States as "grain
alcohol") is a colorless liquid with a distinctive odor and taste. It has a cooling effect
when rubbed on the skin. Most commonly, however, alcohol is consumed as the
component of another beverage, and grain alcohol itself is normally diluted with juices or other
soft drinks by the consumer. Depending upon the concentration of alcohol in the
beverage, the aroma of alcohol may serve as an indicator of the presence of alcohol in a beverage.
Since the sale and distribution of all products containing more than a trace amount
of ethanol are regulated by Federal and State governments, the best guide to whether
a specific beverage contains alcohol will be label information if the original container
is available.
• Paraphernalia: Liquor, wine, after-shave, or cough medicine bottles; drinking
glasses; cans of alcohol-containing beverages; can and bottle openers. Paper bags are
sometimes used to conceal the container while the drink is being consumed.
• Method of Intake: Alcohol is consumed by mouth. It is infrequently consumed as
pure (grain) alcohol. It is, however, frequently consumed in the form in which it is sold
(e.g., cans of beer, "straight" liquor, glasses of wine). Alcohol is often consumed
in combination with other beverages ("mixers"), either to make it more palatable or
to disguise from others that alcohol is being consumed.
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• Duration of Single Dose
Effect: Alcohol is fully absorbed into the bloodstream
within 30 minutes to 2 hours, depending upon the beverage consumed and associated
food intake. The body can metabolize about one quarter of an ounce (0.25 oz.roughly
half the amount in a can of beer) of alcohol per hour.
The effects of alcohol on behavior (including driving behavior) vary with the
individual and with the concentration of alcohol in the individual's blood. The level of
alcohol achieved in the blood depends in large part (although not exclusively) upon the
amount of alcohol consumed and the time period over which it was consumed. One rule
of thumb says that in a 150-pound person, each drink adds 0.02% to blood
alcohol concentration and each hour that passes removes 0.01percent from it.
Generally speaking, alcohol is absorbed into the blood relatively quickly
and metabolized more slowly. Therefore, the potential exists for alcohol concentrations
to build steadily throughout a drinking session. The table below shows some
general effects of varying levels of BAC:
| BAC |
Behavioral Effects |
| 0.02-0.09% |
Loss of muscular coordination, impaired senses,
changes in mood and personality. |
| 0.10-0.19% |
Marked mental impairment, further loss of
coordination, prolonged reaction time. |
| 0.20-0.29% |
Nausea, vomiting, double vision. |
| 0.30-0.39% |
Hypothermia, blackouts, anesthesia. |
| 0.40-0.70% |
Coma, respiratory failure, death. |
• Detection Time: The detection time for alcohol depends upon the maximum level
of BAC achieved and varies by individual. Since under FMCSA regulations
alcohol concentrations as low as 0.02 percent (under DOT testing procedures, breath
alcohol concentration is used as a proxy for BAC) require employer action, and
current technology can reliably detect this level, a driver who had achieved a moderate level
of intoxication (i.e., 0.08 percent BAC) would be detectable approximately 8 hours
after achieving that level. (Note: this is detectability after achieving this level and not
after commencing or stopping drinking.)
• Dependency Level: The chronic use of alcohol can produce dependence in
some individuals manifested by craving, withdrawal, and tolerance. Despite the fact
that many individuals consume alcoholic beverages (more than 90 percent of Americans
at some point during their lives), relatively few of them (only about 10 percent of
drinkers) develop psychological and physical dependency on it.
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Signs and Symptoms of Use
• Evidence of Presence of
Alcohol: Bottles, cans, and other containers which
alcohol-containing beverages may have been purchased and/or consumed in; bottle caps
from alcohol containers; bottle or can openers; drivers drinking from paper bags; odor
of alcohol on containers or on driver's breath.
• Physical Symptoms: Reduction of reflexes, slurred speech, loss of
coordination, unsteady gait.
• Behavioral Symptoms: Increased talkativeness, reduced emotional control,
distorted judgment, impaired driving ability, gross effects on thinking and memory.
Effects of Alcohol on the Individual
Physical Health Effects
• The liver is the primary site of alcohol metabolism and can be severely affected
by heavy alcohol use. The three primary dangers are fatty liver, alcoholic hepatitis,
and cirrhosis.
• Heavy alcohol use can also severely affect the gastrointestinal tract, contributing
to inflammation of the esophagus, exacerbating peptic ulcers, and causing acute
and chronic pancreatitis. It interferes with the absorption of nutrients from food
and contributes to malnutrition.
• Heavy alcohol use affects the heart and vascular system, contributing to heart
attacks, hypertension, and strokes.
• Either because of direct action or indirectly through the malnutrition, liver disease,
and other effects it causes, alcohol depresses immune system functioning and increases
the likelihood of infection.
• There is considerable evidence that alcohol abuse is associated with the incidence
of cancer, particularly cancers of the liver, esophagus, nasopharynx, and larynx.
• Heavy alcohol consumption causes brain damage, manifested through
dementia, blackouts, seizures, hallucinations, and peripheral neuropathy.
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Other Health Effects
• In addition to having direct health effects through physiological changes in the
drinker's body, alcohol contributes significantly to health problems indirectly. While most of
the medical consequences of alcohol use listed above result from chronic use, these
other effects can often result from a single episode of acute use:
One half of all traffic accident fatalities are alcohol-related.
The risk of a traffic fatality per mile driven is at least eight times higher for
a drunk driver than for a sober one.
Falls are the most common cause of nonfatal injuries in the U.S. and the
second-most common cause of fatal accidents. Estimates of the involvement of alcohol
in these falls range from 20 to 80 percent. A BAC between 0.05 and 0.10
percent increases the likelihood of a fall by three times. Between 0.10 and 0.15 percent,
it increases by a factor of 10, and above 0.16 percent it increases by a factor of 60.
Research indicates over 60 percent of those dying in nonvehicular fires
(fourth leading cause of accidental death in the United States) have BACs over
0.10 percent.
Approximately 38 percent of those drowning (third leading cause of
accidental death in the United States) have been exposed to alcohol at the time of
their deaths.
Between 20 and 36 percent of suicide victims have a history of alcohol abuse
or were drinking shortly before their suicides.
Alcohol also plays a significant role in crime and family violence,
including spousal and child abuse.
Effects on Driver Performance
The statistics reported above make it clear that alcohol can have a devastating effect on
driver performance. By affecting vision, reflexes, coordination, emotions, aggressiveness,
and judgment, alcohol deprives the professional driver of most of the tools he or she relies upon
to perform safely.
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Hangovers also present a risk to driving behavior, as would other illnesses. The sick
feeling associated with hangovers, including headaches, nausea, and other symptoms, can distract
a driver's attention and lead to accidents even though alcohol may no longer be detectable in
the body.
Overdose Effects
• Unconsciousness, coma, death.
Withdrawal Syndrome
Repeated use of alcohol results in tolerance, with increasing consumption necessary to
attain its characteristic effects. Alcohol at a given blood level produces less impairment in
heavy drinkers than it does in lighter drinkers. Alcohol is toxic by itself and, coupled with
the malnutrition common in alcoholics, can lead to kidney disease, deterioration of
mental faculties, and psychotic episodes (the "DTs") if the alcohol is withdrawn. The DTs
are characterized by hallucinations and extreme fear, and their presence are a clear indication
of alcohol dependence. Withdrawal and the associated DTs can be fatal.
References
Blum, Kenneth, "Handbook of Abusable Drugs," NY, Gardner Press, 1984.
Department of Health and Human Services, "Alcohol and Health: 7th Special Report to
the U.S. Congress," Washington, DC, 1990.
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Amphetamine Fact Sheet
Amphetamines are central nervous system stimulants that speed up the mind and body.
The physical sense of energy at lower doses and the mental exhilaration at higher doses are the
reasons for their abuse. Although widely prescribed at one time for weight reduction and mood
elevation, the legal use of amphetamines is now limited to a very narrow range of medical conditions.
Most amphetamines that are abused are illegally manufactured in foreign countries and smuggled into
the United States or clandestinely manufactured in crude laboratories.
Description
• Generic/Chemical Names: Include amphetamine and methamphetamine. Trade
names include: Desoxyn, Dexapex, Fastin, Vasotilin, Dexedrine, Delcobese,
Fetamine, Obetrol.
• Common Street Names: Uppers, speed, bennies, crystal, black beauties,
Christmas trees, white crosses, mollies, bam, crank, meth, ice, LA ice.
• Distinguishing
Characteristics: In their pure form, amphetamines are
yellowish crystals. They are manufactured in a variety of forms, including pill, capsule,
tablet, powder, and liquid. Amphetamine ("speed") is sold in counterfeit capsules or as
white, flat, double-scored "mini bennies." Methamphetamine is often sold as a creamy
white, granular powder or in lumps wrapped in aluminum foil or sealable plastic bags.
• Paraphernalia: Needles, syringes, and rubber tubing for tourniquets, used for
the injection method.
• Method of Intake: The most common forms of amphetamines are pills, tablets,
or capsules, which are ingested. The less frequent forms, liquid and powder, are injected
or snorted.
• Duration of Single Dose
Effect: 2 to 4 hours.
• Detection Time: 1 to 2 days after use.
• Dependency Level: Psychological dependence on amphetamines is known to be high.
Physical dependence is possible.
Signs and Symptoms of Use
• Evidence of Presence of
Amphetamines: Most frequentlypills, capsules, or
tablets; envelopes, bags, vials for storing the drug; less frequentlysyringes,
needles, tourniquets.
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• Physical
Symptoms: Dilated pupils, sweating, increased blood pressure,
palpitations, rapid heartbeat, dizziness, decreased appetite, dry mouth, headaches, blurred
vision, insomnia, high fever (depending on the level of the dose).
• Behavioral Symptoms: Confusion, panic, talkativeness, hallucinations,
restlessness, anxiety, moodiness, false sense of confidence and power; "amphetamine
psychosis" which might result from extended use (see health effects).
Effects of Amphetamine Use on the Individual
Physical Health Effects
• Regular use produces strong psychological dependence and increasing tolerance to drug.
• High doses may cause toxic psychosis resembling schizophrenia.
• Intoxication may induce a heart attack or stroke due to spiking of blood pressure.
• Chronic use may cause heart and brain damage due to severe constriction of
capillary blood vessels.
• The euphoric stimulation increases impulsive and risk-taking behaviors,
including bizarre and violent acts.
• Long-term heavy use can lead to malnutrition, skin disorders, ulcers, and
various diseases that come from vitamin deficiencies.
• Lack of sleep, weight loss, and depression also result from regular use.
• Users who inject drugs intravenously can get serious and life-threatening
infections (e.g., lung or heart disease, kidney damage) from nonsterile equipment or
contaminated self-prepared solutions.
Effects on Mental Performance
• Anxiety, restlessness
• Moodiness
• False sense of power.
Large doses over long periods can result in
• Hallucinations
• Delusions
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• Paranoia
• Brain damage.
Effects on Driver Performance
Amphetamines cause a false sense of alertness and potential hallucinations, which can result
in risky driving behavior and increased accidents. Drivers who fail to get sufficient rest may
use the drug to increase alertness. However, although low doses of amphetamines will cause
a short-term improvement in mental and physical functioning, greater use impairs functioning.
The hangover effect of amphetamines is characterized by physical fatigue and
depression, which make operation of equipment or vehicles dangerous.
Overdose Effects
• Agitation • Convulsions
• Increase in body temperature • Death
• Hallucinations
Withdrawal Syndrome
• Apathy • Depression
• Long-term periods of sleep • Disorientation
• Irritability
Workplace Issues
• Because amphetamines alleviate the sensation of fatigue, they may be abused to
increase alertness due to unusual overtime demands or failure to get rest.
• Low-dose amphetamine use will cause a short-term improvement in mental and
physical functioning. With greater use or increasing fatigue, the effect reverses and has
an impairing effect. Hangover effect is characterized by physical fatigue and
depression, which may make operation of equipment or vehicles dangerous.
Reference
Federal Motor Carrier Safety Administration, Office of Motor Carriers, "Guidelines
for Implementing the FMCSA Anti-Drug Program," Publication No. FMCSA-MC-91-014,
March 1992.
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Cocaine Fact Sheet
Cocaine is used medically as a local anesthetic. It is abused as a powerful physical and
mental stimulant. The entire central nervous system is energized. Muscles are more tense, the heart
beats faster and stronger, and the body burns more energy. The brain experiences an exhilaration
caused by a large release of neurohormones associated with mood elevation.
Description
• Generic/Chemical Names: Cocaine hydrochloride or cocaine base.
• Common Street Names: Coke, crack, snow, blow, flake, "C", toot, rock, base,
nose candy, snort, white horse.
• Distinguishing
Characteristics: Cocaine is an alkaloid (organic base) derived from
the coca plant. In its more common form, cocaine hydrochloride or "snorting coke" is
a white to creamy granular or lumpy powder chopped fine before use. Cocaine base,
rock, or crack is a crystalline rock about the size of a small pebble.
• Paraphernalia: Cocaine hydrochloridesingle-edged razor blade, a small mirror
or piece of smooth metal; a half straw or metal tube, and a small screw-cap vial or
folded paper packet containing the cocaine (used for snorting), needles, tourniquets (used
for injecting). Cocaine basea "crack pipe" (small glass smoking device for
vaporizing the crack crystals); a lighter, alcohol lamp, or small butane torch for heating
the substance.
• Method of Intake: Cocaine hydrochloride is snorted into the nose, rubbed on
the gums, or injected into the veins. Cocaine base is heated in a glass pipe and the vapor
is inhaled.
• Duration of Single Dose
Effect: 1 to 2 hours.
• Detection Time: Up to 2 to 3 days after last use.
• Dependency Level: Research indicates possible physical dependence. Although
there is insufficient evidence for humans, animal studies indicate "reverse tolerance,"
in which certain behavioral effects become stronger with repeated use of cocaine.
Psychological dependence on cocaine is known to be high.
Signs and Symptoms of Use
• Evidence of Presence of
Cocaine: Small folded envelopes, plastic bags, or vials
used to store cocaine; razor blades; cut-off drinking straws or rolled bills for snorting;
small spoons; heating apparatus.
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• Physical
Symptoms: Dilated pupils, runny or irritated nose, profuse sweating,
dry mouth, tremors, needle tracks, loss of appetite, hyperexcitability, restlessness,
high blood pressure, heart palpitations, insomnia, talkativeness, formication (sensation
of bugs crawling on skin).
• Behavioral Symptoms: Increased physical activity, depression, isolation and
secretive behavior, unusual defensiveness, frequent absences wide mood swings, difficulty
in concentration, paranoia, hallucinations, confusion, false sense of power and control.
Effects of Cocaine Use on the Individual
Physical Health Effects
• Research suggests that regular cocaine use may upset the chemical balance of the brain.
As a result, it may speed up the aging process by causing irreparable damage to
critical nerve cells. The onset of nervous system illnesses such as Parkinson's disease
could also occur.
• Cocaine use causes the heart to beat faster and harder and rapidly increases
blood pressure. In addition, cocaine causes spasms of blood vessels in the brain and heart.
Both effects lead to ruptured vessels causing strokes or heart attacks.
• Strong psychological dependency can occur with one "hit" of crack. Usually,
mental dependency occurs within days of using crack or within several months of snorting coke.
Cocaine causes the strongest mental dependency of any known drug.
• Treatment success rates are lower than those of other chemical dependencies.
• Cocaine is extremely dangerous when taken with depressant drugs. Death due
to overdose is rapid. The fatal effects of an overdose are not usually reversible by
medical intervention. The number of cocaine overdose deaths in the United States has tripled
in the last four years.
Effects on Mental Performance
• Paranoia and hallucinations
• Hyperexcitability and overreaction to stimulus
• Difficulty in concentration
• Wide mood swings
• Withdrawal leads to depression and disorientation
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Effects on Driver Performance
Cocaine use results in an artificial sense of power and control, which leads to a sense
of invincibility. Lapses in attention and the ignoring of warning signals brought on by
cocaine use greatly increase the potential for accidents. Paranoia, hallucinations, and extreme
mood swings make for erratic and unpredictable reactions while driving.
The high cost of cocaine frequently leads to workplace theft and/or dealing.
Forgetfulness, absenteeism, tardiness, and missed assignments can translate into lost business.
Overdose Effects
• Agitation • Convulsions
• Increase in body temperature • Death
• Hallucinations
Withdrawal Syndrome
• Apathy • Depression
• Long periods of sleep • Disorientation
• Irritability
Reference
Federal Motor Carrier Safety Administration, Office of Motor Carriers, "Guidelines
for Implementing the FMCSA Anti-Drug Program," Publication No. FMCSA-MC-91-014,
March 1992.
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Cannabinoids (Marijuana) Fact Sheet
Marijuana is one of the most misunderstood and underestimated drugs of abuse. People
use marijuana for the mildly tranquilizing and mood and perception-altering effects it produces.
Description
• Generic/Chemical Name: Dronabinal, marinol, nabilone.
• Common Street Names: Pot, dope, grass, hemp, weed, hooch, herb, hash,
joint, Acapulco gold, reefer, sinsemilla, Thai sticks.
• Distinguishing
Characteristics: Like tobacco, marijuana consists of dried,
chopped leaves that are green to light tan in color. The seeds are oval with one slightly
pointed end. Marijuana has a distinctly pungent aroma resembling a combination of
sweet alfalfa and incense. Less prevalent, hashish is a compressed, sometimes
tarlike substance ranging in color from pale yellow to black. It is usually sold in small
chunks wrapped in aluminum foil.
• Paraphernalia: Cigarette papers, roach clip holders, and small pipes made of
bone, brass, or glass are commonly found. Smoking "bongs" (large-bore pipes for
inhaling large volumes of smoke) can easily be made from soft drink cans and toilet paper rolls.
• Method of Intake: Marijuana is usually inhaled in cigarette or pipe smoke.
Occasionally, it is added to baking ingredients (e.g., brownies) and ingested.
Tetrahydrocannabinol (THC), the active chemical detected in urinalysis, is released
by exposure to heat.
• Duration of Single Dose
Effect: The most obvious effects are felt for 4 to 6 hours.
Preliminary studies suggest that performance impairment lasts longer. The
active chemical, THC, is stored in body fat and slowly metabolized over time.
• Detection Time: Traces of marijuana will remain in the urine of an occasional user
for up to 1 week, and, in the case of a chronic user, for 3 to 4 weeks.
• Dependency Level: Evidence indicates moderate psychological dependence.
Signs and Symptoms of Use
• Evidence of Presence of
Marijuana: Plastic bags (commonly used to sell
marijuana); smoking papers; roach clip holders; small pipes of bone, brass, or glass; smoking
bongs; distinctive odor.
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• Physical
Symptoms: Reddened eyes (often masked by eye drops); stained
fingertips from holding "joints," particularly for nonsmokers; chronic fatigue; irritating
cough; chronic sore throat; accelerated heartbeat; slowed speech; impaired motor
coordination; altered perception; increased appetite.
• Behavioral Symptoms: Impaired memory, time-space distortions, feeling of
euphoria, panic reactions, paranoia, "I don't care" attitude, false sense of power.
Effects of Marijuana Use on the Individual
General Health Effects
• When marijuana is smoked, it is irritating to the lungs. Chronic smoking
causes emphysema-like conditions.
• One joint causes the heart to race and be overworked. People with undiagnosed
heart conditions are at risk.
• Marijuana is commonly contaminated with the fungus
Aspergillus, which can cause serious respiratory tract and sinus infections.
• Marijuana smoking lowers the body's immune system response, making users
more susceptible to infection. The U.S. Government is actively researching a
possible connection between marijuana smoking and the activation of AIDS in positive
human immunodeficiency virus (HIV) carriers.
Pregnancy Problems and Birth Defects
• The active chemical, THC, and 60 other related chemicals in marijuana concentrate
in the ovaries and testes.
• Chronic smoking of marijuana in males causes a decrease in the male sex
hormone, testosterone, and an increase in estrogen, the female sex hormone. The result is
a decrease in sperm count, which can lead to temporary sterility. Occasionally, the
onset of female sex characteristics, including breast development, occurs in heavy users.
• Chronic smoking of marijuana in females causes a decrease in fertility and an
increase in testosterone.
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• Pregnant women who are chronic marijuana smokers have a
higher-than-normal incidence of stillborn births, early termination of pregnancy, and higher infant
mortality rate during the first few days of life.
• In test animals, THC causes birth defects, including malformations of the brain,
spinal cord, forelimbs, and liver, and water on the brain and spine.
• Offspring of test animals that were exposed to marijuana have fewer chromosomes
than normal, causing gross birth defects or death of the fetus. Pediatricians and surgeons
are concluding that the use of marijuana by either or both parents, especially
during pregnancy, leads to specific birth defects of the infant's feet and hands.
• One of the most common effects of prenatal cannabinoid exposure is
underweight newborn babies.
• Fetal exposure may decrease visual functioning and cause other ophthalmic problems.
Mental Function
Regular use can cause the following effects:
• Delayed decision-making
• Diminished concentration
• Impaired short-term memory, interfering with learning
• Impaired signal detection (ability to detect a brief flash of light), a risk for users who
are operating machinery
• Impaired tracking (the ability to follow a moving object with the eyes) and
visual distance measurements
• Erratic cognitive function
• Distortions in time estimation
• Long-term negative effects on mental function known as "acute brain syndrome,"
which is characterized by disorders in memory, cognitive function, sleep patterns, and
physical condition.
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Effects on Driver Performance
• The mental impairments resulting from the use of marijuana produce reactions that
can lead to unsafe and erratic driving behavior. Distortions in visual perceptions,
impaired signal detection, and altered reality can make driving a vehicle very dangerous.
Overdose Effects
• Aggressive urges • Immobility
• Anxiety • Mental dependency
• Confusion • Panic
• Fearfulness • Paranoic reaction
• Hallucinations • Unpleasant distortions in body image
• Heavy sedation
Withdrawal Syndrome
• Sleep disturbance • Irritability
• Hyperactivity • Gastrointestinal distress
• Decreased appetite • Salivation, sweating, and tremors
Workplace Issues
• The active chemical, THC, is stored in body fat and slowly releases over time.
Marijuana smoking has a long-term effect on performance.
• A 500 to 800 percent increase in THC concentration in the past several years
makes smoking three to five joints a week today equivalent to 15 to 40 joints a week in 1978.
• Combining alcohol or other depressant drugs and marijuana can produce a
multiplied effect, increasing the impairing effect of
both the depressant and marijuana.
Reference
Federal Motor Carrier Safety Administration, Office of Motor Carriers, "Guidelines
for Implementing the FMCSA Anti-Drug Program," Publication No. FMCSA-MC-91-014,
March 1992.
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Opiates (Narcotics) Fact Sheet
Opiates (also called narcotics) are drugs that alleviate pain, depress body functions
and reactions, and, when taken in large doses, cause a strong euphoric feeling.
Description
• Generic/Chemical Names: Natural and natural derivatives include opium,
morphine, codeine, and heroin (semi-synthetic).
Synthetics include meperidine (Demerol), oxymorphone (Numorphan), and
oxycodone (Percodan).
• Common Street Names: Big M, micro, dots, horse, "H", junk, smack, scag,
Miss Emma, dope, China white.
• Distinguishing
Characteristics: Because of the variety of compounds and
forms, opiates are more difficult to clearly describe in terms of form, color, odor, and
other physical characteristics. Opium and its derivatives can range from dark brown
chunks to white crystals or powders. Depending on the method of intake, they may be
in powder, pill, or liquid form.
• Paraphernalia: Needles, syringe caps, eyedroppers, bent spoons, bottle caps,
and rubber tubing (used in the preparation for and injection of the drug).
• Method of Intake: Opiates may be taken in pill form, smoked, or injected,
depending upon the type of narcotic used.
• Duration of Single Dose
Effect: 3 to 6 hours.
• Detection Time: Usually up to 2 days.
• Dependency Level: Both physical and psychological dependence on opiates are
known to be high. Dependence on codeine is moderate.
Signs and Symptoms of Use
• Evidence of Presence of Drug: In addition to paraphernalia enumerated above,
the following items may be present: foil, glassine envelopes, or paper "bindles" (packets
for holding drugs); balloons or prophylactics used to hold heroin; bloody tissues used
to wipe the injection site; a pile of burned matches used to heat the drug prior to injection.
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• Physical
Symptoms: Constricted pupils, sweating, nausea and vomiting,
diarrhea, needle marks or "tracks," wearing long sleeves to cover "tracks", loss of
appetite, slurred speech, slowed reflexes, depressed breathing and heartbeat, and drowsiness
and fatigue.
• Behavioral Symptoms: Mood swings, impaired coordination, depression and
apathy, stupor; euphoria.
Effects of Narcotics Use on the Individual
• IV needle users have a high risk for contracting hepatitis and AIDS due to the sharing
of needles.
• Narcotics increase pain tolerance. As a result, people could more severely
injure themselves or fail to seek medical attention after an accident due to the lack of
pain sensitivity.
• Narcotics' effects are multiplied when used in combination with other depressant
drugs and alcohol, causing increased risk for an overdose.
Effects on Mental Performance
• Depression and apathy
• Wide mood swings
• Slowed movement and reflexes
In addition, the high physical and psychological dependence level of opiates compounds
the impaired functioning.
Effects on Driver Performance
The apathy caused by opiates can translate into an "I don't really care" attitude
toward performance. The physical effects as well as the depression, fatigue, and slowed
reflexes impede the reaction time of the driver, raising the potential for accidents. Although
opiates have a legitimate medical use in alleviating pain, workplace use may cause impairment
of physical and mental functions.
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Social Issues
• There are more than 500,000 heroin addicts in the United States, most of whom are
IV needle users.
• An even greater number of medicinal narcotic-dependent persons obtain their
narcotics through prescriptions.
• Because of tolerance, there is an ever-increasing need for more narcotic to produce
the same effect.
• Strong mental and physical dependency occurs.
• The combination of tolerance and dependency creates an increasing financial burden
for the user. Costs for heroin can reach hundreds of dollars a day.
Workplace Issues
• Unwanted side effects such as nausea, vomiting, dizziness, mental clouding,
and drowsiness place the legitimate user and abuser at higher risk for an accident.
• Narcotics have a legitimate medical use in alleviating pain. Workplace use may
cause impairment of physical and mental functions.
Reference
Federal Motor Carrier Safety Administration, Office of Motor Carriers, "Guidelines
for Implementing the FMCSA Anti-Drug Program," Publication No. FMCSA-MC-91-014,
March 1992.
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Phencyclidine (PCP) Fact Sheet
Phencyclidine (PCP) was originally developed as an anesthetic, but the adverse side
effects prevented its use except as a large animal tranquilizer. Phencyclidine acts as both a depressant and
a hallucinogen, and sometimes as a stimulant. It is abused primarily for its variety of
mood-altering effects. Low doses produce sedation and euphoric mood changes. The mood can change
rapidly from sedation to excitation and agitation. Larger doses may produce a comalike condition
with muscle rigidity and a blank stare with the eyelids half-closed. Sudden noises or physical shocks
may cause a "freak-out," in which the person has abnormal strength, extremely violent behavior, and
an inability to speak or comprehend communication.
Description
• Generic/Chemical Names: Phencyclidine.
• Common Street Names: Angel dust, dust, peace pills, hog, killer weed, mint,
monkey dust, supergrass, Tran Q, weed.
• Distinguishing
Characteristics: PCP is commonly sold as a creamy, granular powder.
It is either brown or white and often packaged in one-inch-square aluminum foil
or folded paper packets. Occasionally, it is sold in capsule, tablet, or liquid form. It
is sometimes combined with procaine, a local anesthetic, and sold as imitation cocaine.
• Paraphernalia: Foil or paper packets; stamps (off which PCP is licked);
needles, syringes, and tourniquets (for injection); leafy herbs (for smoking).
• Method of Intake: In pill, capsule, or tablet form, PCP may be ingested. It
is commonly injected as "angel dust." It may be smoked or snorted when applied to
leafy materials or combined with marijuana or tobacco.
• Duration of Single Dose
Effect: Days.
• Detection Time: Up to 8 days.
• Dependency Level: Psychological dependence on PCP is known to be high.
Physical dependence is unknown.
Signs and Symptoms of Use
• Evidence of Presence of PCP: Packets, stamps, injection paraphernalia, herbs.
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• Physical
Symptoms: Dilated or floating pupils, blurred vision, nystagmus (jerky
eye movement), drooling, muscle rigidity, profuse sweating, decreased sensitivity to
pain, dizziness, drowsiness, impaired physical coordination (e.g., drunken-like
walk, staggering), severe disorientation, rapid heartbeat.
• Behavioral Symptoms: Anxiety, panic/fear/terror, aggressive/violent
behavior, distorted perception, severe confusion and agitation, disorganization, mood swings,
poor perception of time and distance, poor judgment, auditory hallucinations.
Health Effects
• The potential for accidents and overdose emergencies is high due to the extreme
mental effects combined with the anesthetic effect on the body.
• PCP is potentiated by other depressant drugs, including alcohol, increasing
the likelihood of an overdose reaction.
• Misdiagnosing the hallucinations as LSD-induced, and then treating with Thorazine,
can cause a fatal reaction.
• Use can cause irreversible memory loss, personality changes, and thought disorders.
• There are four phases to PCP abuse. The first phase is acute toxicity. It can last up
to three days and can include combativeness, catatonia, convulsions, and coma.
Distortions of size, shape, and distance perception are common. The second
phase, which does not always follow the first, is a toxic psychosis. Users may
experience visual and auditory delusions, paranoia, and agitation. The third phase is a
drug-induced schizophrenia that may last a month or longer. The fourth phase is
PCP-induced depression. Suicidal tendencies and mental dysfunction can last for months.
Effects on Mental Performance
• Irreversible memory loss
• Personality changes
• Thought disorders
• Hallucinations
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Effects on Driver Performance
The distortions in perception and potential visual and auditory delusions make
driver performance unpredictable and dangerous. PCP use can cause drowsiness,
convulsions, paranoia, agitation, or coma, all obviously dangerous to driving.
Overdose Effects
• Longer, more intense "trip" episodes
• Psychosis
• Coma
• Possible death.
Withdrawal Syndrome
• None reported
Workplace Issues
• PCP abuse is less common today than in the recent past. It is not generally used in
a workplace setting because of the severe disorientation that occurs.
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