Welcome to the Federal Transit Administration's Drug Awareness Video for Safety-Sensitive Employees.
As the FTA's National Drug and Alcohol Program Manager, I want to ensure all safety-sensitive
employees fully understand how drugs can adversely affect their personal health, personal life, job performance, and safety.
This video is designed to meet the requirements of 49 CFR Part 655. It will educate you about
the five types of drugs for which you will be tested.
You will learn about the effects and consequences of the use of these drugs on your personal
health, your safety and the safety of others, and your work environment.
This video will also teach you about the signs and symptoms that may indicate prohibited drug use.
It is important for you to know how to recognize these indicators and know who to contact if
you suspect a coworker may have an issue with substance abuse.
Our priority is to ensure the safety and the protection of the traveling public.
Drugs can have acute impacts on our brains specific to the chemicals in different drugs.
These chemical interactions impact our psychology, or the way we think, and our physiology, or
the way our bodies function.
What is an example of a psychological impact?
Someone who has used or abused an illegal drug or controlled substance may
begin to process what is happening around them more slowly and interpret what people
say differently.
Physiologically, their heart rates may increase and they may feel a lot of energy.
In addition to the immediate psychological and physiological effects, drug use, especially
regular drug use and abuse, can lead to addiction.
Drug addiction is a complex disease that is affected by a person's genetics or biology,
their environment, and the stage of life when their drug habit developed.
Because drug use can change the way the brain functions, quitting can be very difficult.
Some of the five drugs we'll discuss have similar psychological and physiological effects
on users and abusers.
Drugs affect neurotransmitters, the brain chemicals that communicate information throughout
the brain and body.
One neurotransmitter, dopamine, is a chemical in the brain that regulates the feelings of
happiness or pleasure.
Drug use and abuse changes the way neurotransmitters, such as dopamine, are released by the brain.
When a drug is abused, the brain is less likely to continue this release process on its own
and will begin to require the drug to maintain equilibrium.
In addition to changes in brain chemistry, people addicted to certain drugs usually develop
a physical dependence on that drug.
With some drugs, users may have a strong desire for the drug's physical effects, in addition
to the psychological ones.
Physical addiction results in a compulsion to take a drug to feel normal.
A user will experience symptoms of withdrawal when the drug is not present in the body.
In many cases, withdrawal can be dangerous and extremely painful.
As with other chronic diseases, such as diabetes or asthma, addiction may not be curable, although
it is treatable.
Addiction can be managed with medical and behavioral treatments, which can be effective
in both inpatient and outpatient settings.
As an employee performing safety-sensitive functions in the transportation industry,
you are responsible for providing a safe work environment for your co-workers and the traveling
public.
Creating a safe work environment not only means following established work rules but
also following the DOT's rules on drug use.
Safety-sensitive employees perform duties such as:
Operating a revenue service vehicle, including when not in revenue service;
Operating a nonrevenue service vehicle, when the vehicle is required to be operated
by a holder of a Commercial Driver's License; Controlling dispatch or movement of a
revenue service vehicle; Maintaining a revenue service vehicle or equipment used in revenue service.
This includes repairs, overhaul and rebuilding.
Carrying a firearm for security purposes.
If you or someone you work with is addicted to or abuses illegal drugs, help is available.
Now let's talk about the five types of drugs for which you, as a Safety-Sensitive transit
employee, will be tested.
The five drugs include marijuana, cocaine, phencyclidine or PCP, opioids, and amphetamines.
Consumption of these products is prohibited at all times.
We'll describe each drug, and discuss its impacts on users, and how they affect workplace performance.
Marijuana, referred to as weed or pot, is the nation's most commonly used drug
that is illegal at the Federal level.
The primary psychoactive ingredient in marijuana is THC, which is short for tetrahydrocannabinol.
There are medical uses for other component chemicals of marijuana, such as cannabidiol,
or CBD, which does not produce the psychoactive effects or high that THC produces.
In this segmant, we discuss recreational use and abuse of marijuana, not medical applications of CBD.
Marijuana includes the dried leaves, stems, and flowers of the cannabis plant.
It can be green, brown, or gray.
Other marijuana products include hashish and extracts.
Hashish is cannabis resin that is dried and pressed into bars, sticks, or balls, then smoked.
Extracts are resins from the marijuana plant that are rich in THC.
Use of these extracts is also called dabbing.
Extracts can be liquid hash oil, a soft solid budder, or a hard solid shatter.
Extracts deliver a strong concentration of THC into the body.
The most common use of marijuana is through inhalation.
The plant products, hashish, or extracts are heated and smoked in rolled papers, pipes,
or water pipes, also known as bongs.
Mooking is when a mixture of tobacco and marijuana is smoked.
Some marijuana users may wish to avoid inhaling smoke and they may use the drug through a process
known as vaporizing or vaping.
Vape pens pull the THC and other active ingredients into water vapor, which the user then inhales instead
of smoke.
Another method of using marijuana is ingestion.
The drug is mixed into food or brewed as a tea, then the user ingests the food product.
Dabbing involves smoking or vaporizing THC that was extracted into a liquid or solid.
The extracted THC is heated quickly on a hot surface, vaporizing the drug, which is then inhaled.
The THC content of the inhaled vapor ranges from 60% to 90%, which is a very high concentration
compared to other methods of use.
But how does marijuana affect the user?
The high that a user experiences comes from the chemical THC and leads to mind-altering effects.
The naturally occurring neurotransmitter, anandamide, binds to THC receptors already in the brain, causing
similar effects to THC.
When marijuana is used and THC is inhaled, the drug passes from the lungs into the bloodstream.
The blood then carries the THC into the brain and other organs.
THC is absorbed more slowly when eaten or consumed as liquid.
THC attaches to molecules on neurons in the affected brain areas, activating or disrupting
those neurons.
Perhaps most important for safety-sensitive transit employees, THC affects parts of the
brain that are responsible for memory, coordination, perception, and judgment.
When inhaled, THC enters the bloodstream quickly and causes these effects within minutes.
The high generally peaks within the first thirty minutes and lasts for a few hours,
but higher dosage and/or potency of THC can lead to longer-lasting effects.
Though users might enjoy a temporary heightened sense of pleasure, there are also many undesirable
short- and long-term effects of marijuana use.
Short-term negative effects may include increased heart rate and appetite, slowed reaction time,
decreased coordination or impaired body movement, a dream-like or foggy state of mind, drowsiness,
impaired memory and thought processes, and anxiety or paranoia.
When taken in higher doses, a marijuana user may also experience hallucinations, delusion,
psychosis, and/or insomnia.
Some of the symptoms of marijuana use may be a laissez-faire attitude, or just that nothing's really important.
That employee may not be adhering to rules
or trying to bend rules somewhat
because it's just really not that important to them. It's not striking them as necessary.
Long-term use of marijuana leads to adverse changes to the brain, particularly if marijuana
is used during brain development.
Several studies have shown that impaired brain function depends on the degree and duration of marijuana use.
In studies, marijuana users did not function as well on learning and memory tasks, and
had decreased impulse control in comparison to non-users.
Users who frequently inhale marijuana smoke may also develop a chronic cough and other respiratory issues.
Marijuana use can also lead to dependence and addiction.
When a user cannot stop using the drug despite its interference in other aspects of the user's
life, this is called a use disorder.
It is possible to be dependent on marijuana without being addicted.
Data suggests that 30% of marijuana users have some degree of use disorder.
Marijuana dependence can result in withdrawal symptoms including irritability, adverse mood,
sleep difficulties, decreased appetite, cravings, restlessness, and physical discomfort.
Whether a user is addicted, dependent, or neither, there are many adverse effects of
marijuana use in the work environment, particularly for safety-sensitive transit industry positions.
From the moment the employee is on property
during their new hire orientation,
we introduce them to the policies and the regulations so they know marijuana
is not going to be a part of a safety sentive employee's career.
We then have ongoing drug training, and then for those who rise to the ranks of
supervisors, they participate in reasonable suspicion training.
Marijuana's effects on memory and cognitive abilities can last for days or weeks after
the immediate effects have worn off.
These effects can become more pronounced over time.
For example, an individual who uses marijuana daily may perform work functions less efficiently
and effectively than when he or she is not using.
Other work-related impacts of marijuana use may include low motivation, difficulty learning
new skills and recalling learned ones, low productivity, and increased risk of injury
or accidents.
When these impacts affect the user's ability to perform his or her job, they may lead to
disciplinary action or job loss.
Adverse health impacts stemming from marijuana use may cause a user to expend health benefits
and sick leave.
Signs and symptoms of marijuana use include unusually giddy or uncoordinated behavior;
red, bloodshot eyes, or frequent use of eye drops; difficulty remembering; clothing that
emits the smell of marijuana; and possession of drugs or drug paraphernalia such as pipes
or rolling papers.
Other indicators include excessive hunger, or heavy use of incense, cologne, perfume,
or deodorizers.
Marijuana can increase your sense of well-being followed by a dreamy state of relaxation.
It decreases your ability to concentrate, reduces coordination and reflexes, and affects
judgment, impairing your ability to operate transit vehicles or other machinery.
Marijuana use dulls one's attention span, delays decision-making, affects short-term
memory, and impairs signal detection.
Marijuana use impairs your ability to track, or follow moving objects with your eyes, and
limits visual distance measurements.
And we just let employees know that prescription marijuana does not trump
either the drug and alcohol policy of the company or the federal regulations.
If you or a coworker uses marijuana, know that it can have dangerous impacts on the safety of the traveling public.
Next, we'll discuss the drug cocaine.
Cocaine is also referred to as, blow, coke, crack, rock, or snow.
Cocaine is a powerful stimulant made from the leaves of the coca plant.
As a street drug, cocaine appears as a fine, white powder that may look similar to flour
or baking soda.
In fact, many street dealers often dilute or "cut" cocaine with other substances that
look similar, such as cornstarch, talcum powder, flour, or baking soda.
Typically, cocaine users snort the drug, which is then absorbed into the bloodstream
through the nasal tissues.
But cocaine can also be ingested or rubbed into the gums; or dissolved into water and injected
with a needle, which then releases the drug directly into the bloodstream, intensifying the effects
and substantially increasing the risk for overdose.
Cocaine can also be inhaled by heating the cocaine crystal to produce vapors that are
then inhaled into the lungs.
This form of cocaine is called crack, which refers to the crackling sound of the
rock as it's heated.
This method of absorption into the bloodstream is almost as rapid as injection.
When a person uses cocaine, the brain is flooded with dopamine.
Remember, dopamine is a neurotransmitter present in regions of the brain that regulate movement,
emotion, motivation, and feelings of pleasure.
When a person uses cocaine, the drug prevents the neurotransmitter dopamine from being reabsorbed
by the body.
Instead, dopamine accumulates in the brain and causes the euphoria commonly experienced
immediately after taking cocaine.
Cocaine has both short and long term effects on users personal lives and workplace performance.
Let's talk about these.
Cocaine is a nervous system stimulant, so short-term effects include increasing alertness
and attention, as well as elevating blood pressure, heart rate, and breathing pace.
After a single dose of cocaine, the effects appear almost immediately and then disappear
within a few minutes to an hour.
The duration of the drug's effects depend upon how the person takes the cocaine.
The faster the drug is absorbed, the more intense the high, but also the shorter the duration.
For example, a high from smoking crack is more immediate but may last only 5 to 10 minutes.
In contrast, snorting cocaine produces a relatively slow onset of the high, but it may last from 15 to 30 minutes.
Small amounts of cocaine can make users feel euphoric, energetic, alert, talkative,
confident, and hypersensitive to their senses, including sight, sound, and touch.
The drug can also temporarily decrease the need for food and sleep.
Large amounts of cocaine can intensify the user's high, but can also lead to erratic, bizarre, and violent behavior.
Some cocaine users report feelings of restlessness, irritability, anxiety, panic, and paranoia.
Users may also experience tremors, vertigo or dizziness, and muscle twitches.
As users come down from their cocaine high, some experience temporary, unpleasant reactions,
which may include restlessness, anxiety, agitation, irritability, and insomnia.
A long-term cocaine user becomes progressively tolerant to the increase of dopamine, needing
more to produce a similar effect.
After sustained use, people may be more susceptible to negative side effects, such as paranoia,
confusion, and depression.
There are many drugs out there, and often, like I said, we don't know what we're
coming in contact with, but we can have, we have clues - if somebody is excited, or
very energetic, aggressive - it could be cocaine for instance, which is a stimulant.
Long term use may lead to emergency medical visits for chest pain or palpitations, psychiatric
complaints, and neurological problems, including seizures and delirium.
Long term use can also lead to adverse effects on the respiratory, cardiovascular,
and central nervous systems.
Research has found that cocaine can cause movement disorders, including Parkinson's
disease, after many years of use.
Snorting cocaine may cause a loss in the user's sense of smell, nosebleeds, breakdown of nasal
tissue, frequent runny nose, and problems swallowing.
Consuming cocaine by mouth can cause severe bowel decay.
Intravenous injection of cocaine with dirty or shared needles can cause a higher risk
of contracting HIV, hepatitis C, and other blood borne diseases.
The use of cocaine may result in overdose and death.
Cocaine is a highly addictive drug.
Its effects on the brain's reward pathways are immediate, so taking it even once may
trigger addiction.
Addiction may also develop from repeated usage.
Once cocaine begins to wear off and dopamine is absorbed, users experience depression,
exhaustion, mood swings, and other early withdrawal symptoms.
To avoid these feelings, a person may take another dose of cocaine in a process that
is called reinforcement.
The brain's reward circuits eventually adapt to the excess dopamine made available by the drug.
As a result, people take stronger and more frequent doses to achieve the same high and
feel relief from initial withdrawal.
Withdrawal symptoms include: depression;
fatigue; increased appetite and slowed thinking.
It also can create an intense feeling of euphoria or agitation and people don't usually think of that
as being part of a symptom of cocaine use because agitation they think oh they're angry
when we all know that cocaine makes people feel great - well it does right up until it doesn't.
Paranoia is also frequently a symptom of that and during withdrawal, the user experiences
an insane craving for more of the drug because of the
neurotransmitters being used to having cocaine - they stop creating the good feeling stuff
over time.
So again, long term it can decrease the
serotonin in the brain, and therefore depression becomes the norm.
Often, a cocaine overdose leads to a heart attack, stroke, or seizure.
First responders and emergency medical personnel will attempt to restore blood flow to the
heart, restore oxygen-rich blood supply to the affected part of the brain, and stop the seizure.
There are no medications approved by the FDA to treat cocaine addiction, though researchers
are exploring a variety of neurobiological targets.
Many behavioral treatments for cocaine addiction have proven to be effective in both inpatient
and outpatient settings, such as rehabilitation or rehab centers.
Cocaine use negatively impacts workplace performance in a number of ways including impairing your
driving performance and ability to concentrate.
It also can lead to changes in sensory perception, which may make it more difficult to interact
with and respond to the environment around you.
This can pose a serious threat to the safety of transit system activities.
Some behavioral effects include poor and impulsive decision-making, mood swings, lack of focus,
distraction, aggressiveness, and paranoia.
All of these will limit the drug user's effectiveness in the workplace and may pose a real
danger to the traveling public.
Remember, it is your responsibility to provide a safe work environment for the traveling public.
Providing a safe work environment not only means following established work rules, but
also following FTA's rules on drug use.
Next, we'll discuss the drug Phencyclidine or PCP.
PCP is most commonly known as angel dust.
PCP is a white, crystalline powder that quickly dissolves in water or alcohol.
PCP can also be found in capsule or tablet form.
PCP is a synthetic dissociative drug that causes a person to become disconnected from
reality and hallucinate.
Because PCP carries a high potential for abuse and may lead to severe addiction, this substance
is illegal in the U.S. Typically, PCP users smoke the drug; leafy
plants such as mint, parsley, or marijuana are often sprayed with the chemical, or a
rolled joint is dipped into a PCP solution and the vapors produced are inhaled.
Users can also snort, ingest, or inject it.
A user may snort PCP and absorb the drug into the bloodstream through nasal tissues or ingest
it by swallowing the powder or tablet.
A person uses PCP intravenously by dissolving it into water and injecting it with
a needle, which releases the drug directly into the bloodstream.
PCP is a psychoactive drug.
It blocks neurotransmitter receptors governing pain sensation, emotions, learning, and memory functions.
PCP also inhibits the brain's absorption of dopamine, norepinephrine, and serotonin.
As we discussed, dopamine regulates movement, emotion, motivation, and feelings of pleasure.
Norepinephrine is referred to as a stress hormone, causing increases in heart rate,
breathing, glucose or sugar release, and more.
Serotonin is a neurotransmitter that regulates emotions, such as depression and anxiety,
and impacts motor functions.
When PCP inhibits the absorption of dopamine, norepinephrine, and serotonin, users may feel
euphoria and disconnected from their bodies.
Now let's discuss the effects of PCP - both short and long term.
Often, the experience of the PCP user is unpredictable - the short-term effects of PCP may vary based
on the amount and the way in which the drug was taken.
After a PCP user takes a smaller dose of the drug, he or she may experience a rise in blood
pressure, body temperature, and heart rate.
However, a larger dose will have the opposite effect, reducing blood pressure, heart rate,
and breathing pace.
Along with the physiological response, a person taking PCP may experience a range of psychological
responses.
These include euphoria, sound, image, and body distortion, feelings of detachment, loss
of balance, the inability to feel pain, acute anxiety or mood swings, confusion, amnesia
or memory loss, chills and sweating, and more.
Phencyclidine, angel dust, back in 1978, 60 minutes did a story on PCP and called it the number one
drug problem in America. Then came cocaine in the 80's and PCP sort of went out,
but there are still users of PCP. It's a very small circle
typically. PCP can come from unhealthy, unclean surroundings like where it's being made so it's
it's even more dangerous because people don't know what's in it, they don't how it was made, and obviously there could be other
ingredients that aren't good for you. PCP is a dissociative drug and what that means is that
and what that means is it takes the person outside their body. We've all heard the stories of
people jumping out of second floor windows, running down the street being shot five times...
it's because one of the things PCP does is it numbs the extremities so you're not feeling part of your body.
There are many drugs out there and often like I said we don't know what we're coming in contact with
if they are asleep and we do not suspect that it is an opiate, it could be
PCP, which was created to be
an anesthetic, so it has a numbing effect.
They could have a blank stare something like that it looks
like it can cue us into PCP. For those drugs we
we go by appearance. We may not know what's going on and for treatment wise, it's just
supportive measures with those. We don't have an antagonist for those drugs like we do for
a narcotic. So, we just support
anything that we need to, whether it's their breathing, their heart, any other symptoms they might be having.
In very high doses, a person who has used PCP may experience seizures,
damage to the skeletal muscles, coma, or death.
PCP use can also have substantial long term effects including stuttering or difficulty
speaking, problems with reasoning and memory, anxiety and depression, suicidal thoughts,
social isolation and withdrawal, flashbacks, and hallucinations.
Toxic psychosis can also develop as a long-term effect of PCP use, causing hostility, paranoia,
and delusions.
PCP use can develop into addiction as a user develops tolerance and needs higher doses to feel desired effects.
A PCP user may experience cravings and feel that they need the drug to function
in daily life.
The treatment for PCP addiction begins with a safe detoxification off the drug or detox.
PCP withdrawal can lead to seizures, therefore detoxing under medical supervision is important.
An inpatient rehab center is often recommended for a safe and supervised environment to detox.
Once the withdrawal process is complete, addiction treatment therapy begins at either an inpatient
rehab center or as part of an outpatient treatment program.
PCP use can significantly reduce the effectiveness of safety sensitive transit employees
and poses real dangers to the traveling public.
The use of PCP may cause hallucinations, mood swings, confusion, memory loss, violent or
suicidal tendencies, and other effects that can endanger the employee, co-workers and
the traveling public.
These extreme effects of PCP make the operation of vehicles or machinery extremely dangerous,
because often the employee's perception of the world has diverged greatly from reality.
PCP use not only poses risks for you, but also puts coworkers, transit users, and the public in danger.
Now, let's talk about opiates and opioids, a growing problem in the United States.
You can go virtually anywhere and find someone that's impaired
or is using opioids. I don't think it's anymore
something that you just see down dark allies or in
sort of sketchy hotels. I think we're
seeing the effects of opioid use and prescription drug
misuse really broadly within our communities.
We're dealing with a very large opioid crisis.
Prescribed opioids to heroin, fentanyl, and now carfentanil.
It's not a media created thing that opioid overdoses
or opiate use, is increasing.
Over the last decade, we've seen a large increase in the numbers
of overdoses in the city, the number of deaths
in the city. It was pretty
constant, the numbers, for a long time, and in the last 10 years it's spiked.
Opiates are a category of natural substances derived from opium plants.
Opium is extracted from opium poppies that contain the chemical compounds of morphine and codeine.
These compounds are used for medical purposes to induce sleep and alleviate pain.
In the past, opioids referred to medications possessing some of the characteristics of
opiates but were not derived from opium.
Now, however, the term opioid is used to define the entire group of drugs, including those
produced synthetically and semi-synthetically, and those occurring naturally.
In terms of the semi synthetics, it's very interesting
that oxycodone is
one and a half times stronger than
morphine, yet, oxymorphone
is ten times stronger than morphine.
You know, these are used for severe pain management.
Synthetic opioids, like fentanyl and methadone, are manufactured in a lab setting.
Semi-synthetic opioids, like oxycodone and hydrocodone, are a hybrid resulting from chemical
modifications to natural opiates.
These synthetic and semi-synthetic drugs affect the same receptors as opiates.
Opioids resemble chemicals in your brain that attach to nerve cells called opioid receptors.
There are a few different types of receptors: mu receptors, delta receptors, and kappa receptors.
The mu receptors are responsible for producing the pleasurable effects of opioids and providing pain relief.
Opioids can act on many different parts of the brain and in turn affect your body in different ways.
When the drug interacts with the brainstem, it can slow breathing, stop coughing, and reduce pain.
When opioids affect the spinal cord, they can also decrease pain, even after serious injury.
Depending on how the drug is taken, the effects can be intensified, making the drug more dangerous.
If pills are ingested, the drug takes longer to reach the brain.
If the drug is injected, it acts much more quickly and intensely, increasing the risk of overdose or death.
Let's discuss why opioids are dangerously addictive and how they may impact your job.
As we discussed earlier, opioids affect the mu opioid receptors that trigger the same
biochemical processes that reward people with feelings of pleasure.
I think for transit employees it's important to recognize that often times they
are in control of so many lives and that they are behind the wheel of some type
of vehicle. And they could be someone who is has been prescribed a medication,
that has some type of psycho-active impact, and that could be something like an opioid pain medication or it could be
stimulant medication. The concerns around dosage with substances
and impairment are really kind of hard to draw the guidelines of. So somebody
could struggle with substance use and could take the same dose everyday and not be impaired and then randomly one day could be
significantly impaired. And if they've had that history of using it could be very complicated.
And obviously, no one should be operating any type of vehicle or
heavy machinery and be impaired.
Typically, opioids are prescribed to relieve pain, but when opioids activate the brain's
reward processes in the absence of significant pain, they can motivate repeated use of the drug for pleasure.
As use continues, people develop tolerance and require more of the drug to achieve the same sense of pleasure.
So opioids are used for management, which is a beautiful thing to alleviate pain or to get someone through a surgery or
even a toothache, even a minor incident - minor injury, but the problem with it
all opioids are highly addictive. Not only do they manage your pain,
but they also create a feeling of euphoria and relaxation, which is where the addiction can come into play.
If a student athlete has been prescribed some sort of opioid to get through an injury,
even someone that is having their wisdom teeth pulled are prescribed opioids to get through the
pain. Up to larger surgeries - open heart surgery. You're going to be given morphine, and unfortunately,
for some patients that can become very addicting. They get addicted to that feeling of euphoria and relaxation.
Chronic use of escalating dosages of opioids alters brain chemistry
so that the brain begins to require the drug to function more or less normally, and will function abnormally
when the opioids are not present.
This abnormal functioning, called withdrawal, is one of the most powerful factors in opioid
dependence and addictive behavior.
So signs of withdrawal, include
a sort of
hay fever allergy type response so
the person would have really dry
eyes, watery eyes, maybe sneezing a lot and
in early withdrawal. And then in full blown withdrawal, the person would look like they have a very severe flu so
they'd be complaining of really significant
bone, muscle, ligament pain, they'd have
vomiting, nausea, diarrhea,
they would potentially be very
itchy. So, itching and scratching themselves, particularly the
hands, arms, and face.
And they could be really anxious, depressed,
agitated, and they could be
displaying any of those signs. So, if you're talking about an employee
who is reporting flu like symptoms multiple times in a month, and that's the reason that they can't come into work, potentially it could be
is struggling with opioid addiction and they are withdrawing on a regular basis.
Opioids are available under a wide range of names including:
Morphine, a prescription pain medicine, Codeine, which acts as pain reliever,
cough medicine, and anti-diarrheal, Oxycodone or OxyContin, which is used
to treat moderate to severe pain,Oxymorphone, which treats moderate to
severe pain and can help improve the effectiveness of anesthesia,
Hydrocodone or Vicodin, which is used to treat chronic or acute pain,
Methadone, which is used as a pain reliever or as a part of drug addiction detoxification
and maintenance, Heroin, an illegal street drug made from
morphine; and, Fentanyl, which is up to 100 times more potent than heroin.
Often, opioid use begins when a doctor has prescribed prescription drugs for pain management.
However, if the drugs continue to be used over a prolonged period, a person may become dependent, leading to an opioid addiction.
As the addiction develops, users may turn to heroin or fentanyl when the prescription
drugs become too expensive or less effective.
If you see something, it could be, even as simple as a belt, that could be used to actually
help them with creating that blood vein and having it more raised surface.
You could have a bent spoon that is used for cooking heroin, you could have different types of syringes that are available,
another interesting way that they've come up with is having tin foil, where they put the substance on the tin foil,
light it from underneath, and use a straw to inhale that smoke. There's different apparatuses they can make
with different bottles - making different hydration, filtration systems, that allows them to
transport that drug from within the bottle into the body.
The opioid crisis is ever increasing and the impact that it has on individuals,
in communities, and employers - and really everyone.
Opioids have a very high addiction risk.
Some of the potential factors that may lead to opioid dependence and addiction include:
Having overlapping opioid prescriptions from multiple providers
Taking a high daily dose of the prescription; A history of alcohol or substance dependence;
and; a history of mental illness.
Some of the effects of the use of opioids include constipation, nausea, vomiting, dry mouth,
sleepiness, dizziness, itching and sweating, watery eyes, runny nose, and heightened sight and sense of touch.
Longer term effects of opioid use can include an increased tolerance to the medication requiring
larger or more frequent amounts to produce the same effect, physical dependence, increased
sensitivity to pain, depression, low levels of testosterone leading to low energy and
strength, weight loss, and slow shallow breathing.
Some of the things you can notice right off the bat is their detachment, from not only the community, but from their every day living.
Things that they have found interesting at one point that they just have no interest in any longer.
You could see, especially with a student, which is usually what I come across, is maybe a decline
in their grades, their attention span, things if you start
looking closely in - more of their slurred speech - that you could attest to being
adolescent drinking, but it's a little more noticeable once you know what to recognize - it could be that they're nodding off,
they are profusely sweating - looking that clammy kind of look to their skin. If they're nodding off it could be a complete
passing out and not being responsive. Then some of the signs and symptoms from that point would be the pin point
pupils, abnormal breathing - things that you will notice that would prompt you to hopefully call
911 and get us on scene to start facilitating them.
In terms of use indicators, one of the most obvious signs is a pinned pupil
which is really easy to identify the lighter the color the eye is
and I'm talking about teeny tiny pinned pupil
and that would be regardless of lighting. So whether the person was in a darkened room or in a bright sunlight,
the pupils would remain pinned. Also, within the eyes,
you typically would find a droopy, smooth looking eyelid. The response to that
individual would typically be very delayed. They would have a very sedated nodding type of appearance. They could have sort of
a slow dream-like response. It could look like they are sleeping. It's important to be able to recognize in a really concrete way
what the signs of use look like, then what the withdrawal look like, because you'll often see that with individuals - particularly employees,
and then the signs of overdose those obviously all create a very clear line. And one of the positive things about it is if you can recognize
that someone is under the influence of opioids, or in withdrawal, or overdosing - it's very clear. And really, we have the
baseline of signs that we can definitively, through looking at an individual,
really concretely identify that person is using opioids.
Now that we've gone over many of the effects of opioid use,
let's spend more time discussing the specifics of heroin use.
Heroin is an illegal, non-prescription derivative of morphine.
It occurs as either a white or brownish powder or as a black, sticky substance.
The drug is typically diluted with other drugs, or sugar, starch, powdered milk, or quinine.
It is usually injected, smoked, or snorted.
The short terms effects of heroin use include euphoria, drowsiness, respiratory depression,
constricted pupils, nausea, and dry mouth.
Injecting heroin subjects users to an increased risk of HIV and Hepatitis-C because of unclean and shared needle usage.
Like all opioids, heroin use comes with the potential of accidental overdoses.
Signs of a heroin overdose may include slow and shallow breathing, blue lips and fingernails,
clammy skin, convulsions, coma, and death.
The United States is experiencing an opioid epidemic.
High levels of opioid prescriptions have led to widespread prescription dependence,
which often lead to the use of highly addictive, dangerous, and illegal versions of the drug.
Each year, there is a significant number of deaths due to opioid overdoses.
Opioids in particular are prescribed by doctors so you could be
someone who receives an injury related their vocation, who are injured on the job, and then becoming dependent on substances.
The interesting thing about my position being the public education officer is that we push
education at the earliest ages where we could possibly get out to. The average age
right now for opioid introduction is 14 years old. So through the education
that we advocate for on the junior high school, high school, college level, not only do we
advocate for fire safety, but now we are starting to educate on opioid related incidences and
how to recognize some of the different things such as paraphernalia, different drug types,
that they might come in contact with and how to not only recognize those signs, but how to react to them using 911.
Any time there's any type of mishap, with any type of transit employee
I think it's apparent. When you talk about
substance usage, it could be one
driver, one person who is irresponsible for moving a vehicle, can have a
bad experience and that's going to impact other people's willingness to get on a train, or a bus,
or a subway, a car, because you don't know what you're going to get and unfortunately,
particularly with the opioid crisis, use is so widespread and so significant, that that's a realistic fear that people have.
Because opioids are highly addictive, they represent a significant danger for transit employees.
Like the drugs discussed earlier, the changes opioids create in neurochemistry can have
costly and life-threatening impacts on transit operations.
Opioid use causes poor motor coordination, impairs general mental functioning and alertness,
depresses reflexes, reduces vision, and causes drowsiness and physical fatigue.
These effects are extremely dangerous for anyone operating motor vehicles, including
transit vehicles or associated machinery.
Amphetamines are a synthetic stimulant that excites the central nervous system.
Amphetamines are legally prescribed for treatment of narcolepsy or ADHD.
Examples of pharmaceutical amphetamines include Ritalin, Adderall, and Dexedrine.
However, when these drugs are used without a prescription, or used improperly with a
prescription, their use is illegal.
Methamphetamine, also known as meth, is an illegal amphetamine.
Meth is manufactured in informal laboratories with common household chemicals.
These chemicals can be very dangerous and cause fires and explosions.
Meth is made in powder form or can take the form of glass- or rock-like fragments, which
are known as crystal meth.
This particular form of meth is highly addictive because of the drug's potency.
Meth can be used orally, or through snorting, injection, or smoking.
The method of use impacts how quickly the user feels the effects of meth.
Regardless of method, effects typically last six to eight hours, or as long as 24 hours.
Oral use of meth typically involves swallowing a pill, which produces effects within fifteen to twenty minutes.
Snorting meth generally involves crushing pills or crystals and snorting the resulting powder.
This method produces effects within three to five minutes.
Injecting meth allows the drug into the bloodstream and brain almost immediately.
To inject meth, the user dissolves the crushed pill or crystal powder into water, then injects the resulting solution.
Smoking meth is another way for users to feel the effects of the drug very quickly.
Some users claim that smoking meth increases the effects of the substance overall.
Meth metabolizes slower than other stimulants and has a substantially longer half-life than other amphetamines, leading to a longer high.
Withdrawals resulting from stopping meth use are also significantly more intense than other
drugs within the amphetamine class.
Short-term effects of amphetamines include increased attention and decreased fatigue,
increased activity and wakefulness, and decreased appetite.
Users of amphetamines may also experience a euphoric, rushing feeling and increased energy and hyperactivity.
Physically, users experience increased respiration, rapid and irregular heartbeat, and hyperthermia.
Long-term effects of amphetamines include memory loss, aggressive behavior, and psychosis,
including paranoia, hallucinations, and repetitive motor activity, such as rocking back and forth.
Effects can also include violent behavior and severe mood disturbances.
Long-term use can lead to heart and brain damage, as the drug changes the brain's structure and function.
This damage can lead to deficits in thinking and motor skills, including impaired or reduced motor speed and verbal learning.
Other physical effects include weight loss, severe dental problems, which include tooth decay and tooth loss, and skin issues.
Sores may result when users experience a hallucination that insects are crawling on or under their
skin, leading to scratching and bleeding.
These short- and long-term effects all have significant negative impacts on
an individual's ability to function appropriately in the work environment.
Feelings of euphoria, hyperactivity, and aggressiveness, can cause safety sensitive employees to
perceive reality in an extremely altered way and take risks while working that could put
themselves, their coworkers, and the public in danger.
Amphetamines while highly dangerous
often give the user a perception of increased
concentration, wakefulness, attention to detail,
that they're hyperfocused. So they think
think that's a good thing - right up until they become addicted and then
they're abusing amphetamines, using more, higher doses
than prescribed - or higher doses than necessary.
Negative effects of amphetamines can include depression,
and intense fatigue during a
withdrawal period.
These short and long term effects can all have significant negative impacts
on an individual's ability to function appropriately in the work environment.
Feelings of euphoria, hyperactivity, and aggressiveness,
can cause safety-sensitive employees to perceive reality
in an extremely altered way and to take risks while working
that may put themselves, coworkers and the public in danger.
Amphetamines, especially meth, are highly addictive.
Individuals who suffer from addiction may stay in a cycle of trying to chase their next
high, and may skip or avoid work.
Individuals may also exhibit erratic behavior, poor decision-making skills, and lack of self-control.
These, in combination with the need to find more of the drug to maintain the high,
can result in dishonest behaviors and constant reward seeking.
Finally, lowered inhibitions may result in unsafe behaviors, increasing the risk of accident
or injury and leading to more frequent use of sick time and expenditure of health benefits.
Using and abusing drugs in the workplace and out of it is a serious problem that far
transcends the individual user.
This training is intended to ensure that all safety-sensitive employees fully understand
how drugs can adversely affect their health, personal life, job performance, and safety.
It is not always easy to tell if someone is using drugs in the workplace or is affected
by drug abuse outside of working hours.
A person may show subtle or overt behaviors as a result of drug use that affect workplace
health, safety, and performance.
Drug abusers are more likely to: Endanger themselves, co-workers and passengers;
change jobs more frequently; be late or absent from work regularly;
be less productive employees; be involved in a workplace accident;
file a worker's compensation claim; steal from fellow employees;
use health benefits; and use sick time.
It is important to keep in mind that drug use has the potential to negatively affect
how you do your job.
Remember that, as a safety-sensitive employee, the safety of the traveling public is in your hands.
Drug use not only poses risks for you, but also puts coworkers, transit users, and the public in danger.
For the employee, they're a distracted employee, because using is a full time job. they are thinking about
getting their drugs, suffering the effects of withdrawal and trying to avoid that,
taking time from work possibly to answer phone calls, make phones calls, even disappearing from the work site,
and then there are coworkers who don't want to work with that guy
out of their own necessity for safety and productivity. Coworkers also
can frequently create a decreased morale throughout the department
because they are seeing supervisors who aren't doing anything - they're not seeing what's going on -
and that creates frustration and why should I do anything? Joe doesn't.
Drug use can directly impact your work as a safety-sensitive employee.
Using drugs can impair your driving, which can lead to increased risk-taking.
It also can cause changes in sensory perception, meaning that it may be more difficult to interact
with and respond to the environment around you.
You've taken in a lot of information about the five types of drugs for which you, as a safety
sensitive transit employee, will be tested. This is a quick recap of the effects and consequences of these drugs.
Marijuana can increase your sense of well-being followed by a dreamy state of relaxation.
It decreases your ability to concentrate, reduces coordination and reflexes, and affects
judgment, impairing your ability to operate transit vehicles or other machinery.
Marijuana use dulls one's attention span, delays decision-making, affects short-term
memory, and impairs signal detection.
Marijuana use impairs your ability to track, or follow moving objects with your eyes, and
limits visual distance measurements.
Cocaine use can have significant work place impacts as well.
Extreme mood and energy swings can cause emotional instability.
Loud or sudden noises can cause violent reactions in users and addicts.
Lapses in attention and ignoring warning signals can increase the potential for accidents.
Paranoia and withdrawal symptoms can create unpredictable and sometimes violent behavior.
PCP use causes loss of muscular coordination, severe disorientations, hallucinations, and
violent or suicidal tendencies, making it extremely dangerous to operate vehicles or machinery.
Opioid use impairs driving ability, causes poor motor coordination, impairs general mental
functioning and alertness, depresses reflexes, reduces vision, and causes drowsiness and physical fatigue.
These effects are extremely dangerous for anyone operating motor vehicles, including
transit vehicles or associated machinery.
Gone are the days when folks
have to suffer silently and full of shame
because either themselves or a family member
is addicted. The treatments
spectrum ranges from all kinds of different things
from self help meetings
all the way up to long term halfway houses
and everything in between.
Amphetamines are highly addictive drugs, which can cause erratic behavior, poor decision
making, and lack of self-control.
This drug use may lead to unsafe behavior, increasing the risk of accidents and endangering the travelling public.
Drug abusers are more likely to endanger themselves, coworkers, and passengers,
change jobs more frequently, be late or absent from regularly, be less
productive employees, be involved in a work place accident, file a workers compensation
claim, steal from fellow employees, use health benefits and use sick time.
One thing that all drugs have in common is they affect your brain, whether it decreases function or increases functions, it's
changing the way your brain thinks and comprehends. So if you're overexcited or you have a decreased level of consciousness
either way, it's going to affect your judgement, your reflexes, and how you react to something, so
somebody like a bus operator certainly should not be on drugs. Anybody driving a car should
not be on drugs or anybody operating heavy equipment, or anything that could endanger others or themselves
should not be using drugs when using equipment like that.
You know - use different modalities of treatment.
I think that some of the most important things to understand about treatment is there's no quick fix, you know, once you've
gotten the drug out of your system, you have to address the underlying causes of why did you use in the first place?
And, really what we know about substances, is there's three main reasons that people use drugs. They use
drugs to feel good, they use drugs to feel better,
and they use drugs to do better. So those are things like I want to feel good, it's a Friday night and I want go out and really
party and use drugs recreationally or drink recreationally; I want to feel better, I'm not feeling good, things are hard in my life,
I don't want to feel this way any more. And to do better are things like those performance
enhancing drugs or I want to stay up all night so I'm going to take a stimulant.
So those are the three primary reasons that people use substances. There's no quick fix. You have to address
all of those underlying feelings of why you used in the first place and then you also have to address any negative consequences
that have come as a result of your use. And that's a really frightening thing if your primary coping skill has been to drink or
to use a drug. So it's an enormous amount of work for that individual and for the people around them who love them to
support them and to get the help that they need, you know, and understand
the system of care and understand how they can support that individual.
Early identification and support really help to make a difference. Recognizing that no one is immune to this,
and this really impacts everyone is I think really part of the battle in being able to support employees and individuals.
Transit employers have different policies regarding illegal drug use; however, in general,
employees who use or abuse the five drugs discussed in this video can expect discipline or termination.
Whenever there's an incident where drugs have found to be a part of
or caused the accident, it reverberates
throughout the nation and our industry reflecting that, hey is public transportation safe? How could this have happened?
You know, clearly, with the federal mandates for a drug free workplace, that's operationally sound
makes sense to everyone, increases public trust, but at the end of the day - it's saving lives.
It is the responsibility of transit employers and those who work for them to ensure the
safety of the traveling public.
Drug use and abuse does not fit into this equation.
Now that we've gone over the effects and consequences of prohibited drug use for safety sensitive transit employees,
let's take a moment to review what's we've learned through a quick quiz.
Question one: what are the short term effects of cocaine use?
A. Increased alertness and attention
B. Elevated blood pressure C. Elevated heart rate and breathing pace or D. All of the above
The answer is D. All of the above, cocaine use by transit employees
could have significant negative impacts on workplace performance and could gravely endanger the travelling public.
Question 2: True or false? A long-term cocaine user becomes progressively
tolerant to the increase of dopamine, needing more to produce a similar effect. After sustained use, people may be more susceptible
to negative side effects, such as paranoia, confusion, and depression.
True, long term cocaine users become progressively tolerant to the drug and need more of it to produce a similar effect.
Question 3. What is the nation's most commonly used drug?
Marijuana, referred to as "weed" or "pot," is the nation's most commonly used drug that is illegal at the federal level.
Question 4. Marijuana use can do which of the following?
A. Dull your attention span B. Delay decision-making or C. Affect short term memory
D. Impair signal detection or E. All of the above
The answer is E all of the above. Marijuana use decreases your ability to concentrate, reduces coordination
and reflexes, and affects judgement, impairing your ability to operate transit vehicles or other machinery.
Question 5: true or false?
Using drugs can impair your driving, which can lead to increased risk-taking.
It also can cause changes in sensory perception, meaning that it may be
more difficult to interact with and respond to the environment around you.
True. Drugs can have significant impacts on workplace performance.
Question 6: true or false?
Often, the experience of a "PCP" user is unpredictable -- the short-term effects
of PCP vary based on the amount and way in which the drug was taken.
True. PCP use causes loss of muscular coordination, severe disorientations, hallucinations,
and violent or suicidal tendencies making it extremely dangerous to operate vehicles or machinery.
Question 7: what is the street name for PCP?
A. Snow B. Angel dust C. Powder or D. Coke
The correct answer is B Angel Dust.
Question 8: true or false?
Amphetamines are a synthetic stimulant that excite the central nervous system. Amphetamines are legally prescribed for
treatment of narcolepsy or ADHD.
True. Long term effects of amphetamines include memory loss, aggressive behavior, and psychosis
including paranoia, hallucinations, and repetitive motor activity.
Question 9: What kind of prescriptions have led to widespread prescription dependence?
The United States is experiencing an opioid epidemic.
High levels of opioid prescriptions have led to widespread prescription dependence,
which often leads to the use of highly addictive, dangerous, and illegal versions of the drug.
Each year, there is a significant number of deaths due to opioid overdoses.
Question 10. Opioids have a very high addiction risk.
Some of the potential factors that lead to opioid dependence and addiction include:
A. Having overlapping opioid prescriptions from different providers
B. Taking a high daily dose of the prescription
C. A history of alcohol or other substance dependence
D. A history of mental illness
Or E. Sleeping 8 hours a day
A, B, C, and D are all correct.
This video has reviewed five types of drugs that you will be tested for as a safety-sensitive
transit agency employee.
These drugs, marijuana, cocaine, phencyclidine or PCP, opioids, and amphetamines, have
immediate and long-term effects on the way a person thinks and the way their body functions.
Using and abusing drugs may negatively affect how a transit operator performs their job.
When a transit operator uses or abuses drugs, he
or she puts themselves at risk, and risks the health and safety of coworkers, transit
users, and the general public.
It is important to remember that you are an integral part of many people's commute each
day, and every person that you help to get from point A to point B relies on you to help
them get where they are going safely.
On a personal level, the use of drugs can be a catalyst for addiction, which can become a lifelong battle.
Drug abuse may lead to the loss of one's job, relationships, and sense of self.
Without the context of a person's life situation, it is irresponsible for anyone to suggest
it is easy to just say no to drugs.
However, we hope this information has helped to highlight the negative impacts of drug use and abuse.
As a safety-sensitive employee, your day-to-day decisions can impact the lives of many people.
It is your responsibility to make responsible choices that show respect for yourself, your
coworkers, and the traveling public.
FTA is strongly focused on protecting the safety of the traveling public.
We want to make sure that people whose jobs affect not only their own safety, but that
of everyone else who travels or can be affected by transportation systems, are alert, able
to exercise good judgment in potential emergency situations, and committed to compliance
with safe practices and safety rules.
Substance abuse creates serious effects across our society: people die, families are devastated,
and livelihoods are ruined.
Substance abuse affects your mind and body, your community, and your future.
If you or someone you work with is addicted to or abuses drugs, help is available.
For additional information visit FTA's Drug and Alcohol Program website.
For information specific to your agency, check your agency's website, speak with your manager,
or contact your Drug and Alcohol Program Manager.
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