an update on substance misuse at the workplace

Academy of Occupational and Environmental Medicine, Malaysia

© 2019 AOEMMAll rights reserved. No part of this document may be produced, stored in a retrieval system or transmitted in any form or by any means (electronic, mechanical, photocopying, recording or otherwise) without permission of the copyright owner.

An Update on Substance Misuse at the Workplace

Dr Abu Hasan Samad

President, AOEMM

Vision Zero Conference Malaysia 2019

PICC, 9-10 July 2019

Outline

• Introduction

• Substance of Misuse

• Local data

• Drug-Free Workplace Program (DFWP)

• Workplace Substance Misuse Testing

• Employer Responsibilities

• Legal Framework

• Daun Ketum & Kas Kas

• Conclusion

2

Introduction

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• Substance misuse is a global problem and it is a

significant issue in Malaysia and the region.

• All business sectors are affected. It is of particular

concern for oil & gas because of its potential impact on

the operations and productivity.

• PETRONAS has the Substance Misuse Policy in place,

and through MPM expects strict compliance to the

Policy by all oil & gas operators, vendors, etc. operating

in Malaysia.

• Implementation of Drug-Free Workplace Program in

other business sectors is inconsistent. Very few have

the Policy in place.

Cost of Substance Misuse


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• Increased health care costs

• Increased workers’ compensation & its premium

• Increased workplace violence

• Individuals who abuse drugs or alcohol are 3.5

times more likely to be involved in a workplace

accident compared to individuals who do not abuse

drugs or alcohol

• In US, 47% of industrial injuries are directly related

to alcohol abuse or alcoholism

Substance of Misuse


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• Alcohol

• Marijuana

• Inhalants

• Stimulants

• Depressants

• Narcotics

• Hallucinogens

• Designer Drugs

• Over the counter

(OTC)

Trending Data from AADK

Drug-Free Workplace Program

1. Definition

A structured risk based program that manage substance

misuse among employees.

2. Objective

To reduce HSE risk related to substance

misuse by employees.

3. Requirements

1. Written policy and procedures

2. Employees awareness and education

3. Supervisor training

4. Employees Assistance Program

5. Drug and Alcohol testing

6. Rehabilitation and counseling

Implementing DFWP

1. Conduct workplace health risk assessment to

identify drug and alcohol related risk

2. Develop program, strategy, targets and success

indicators

3. Establish organization and roles to manage

program

4. Establish resources and expertise

5. Implement program

a) Communicate program to employees

b) Train related personnel

c) Drug and Alcohol testing

d) Monitor and review program periodically

e) Modify program as required

Workplace Drug & Alcohol Testing

• Requirements:

– Must be error free and defensible in court

– No room for personal opinions, preferences, or biases

– Must be conducted in accordance to the Company’s

Substance Misuse Policy and procedures

– Shall comply with the applicable regulations

– Applicable to all employees including senior management

– Shall only be carried out by competent personnel

– Must use accurate method & correct equipment for

sample collection and analysis

– Does not infringe personal rights of employees

– High level of confidentiality

Substance Misuse Testing• Which substance to be tested?

– Based on company and community drug/alcohol related risk

profiles. Common substance tested;

1. Amphetamines, including metamphetamine

2. Benzodiazepines

3. Cannabinoids

4. Cocaine

5. MDMA

6. Opiates

7. Alcohol

• Samples

• Urine for drug

• Breath for alcohol

• Analysis

• IA Screening; GCMS confirmation for drugs

• EBT for alcohol

Which Substance to Test?

• Test batteries:PETRONAS

& Carigali*

ExxonMobil Shell Sapura

Kencana

Amphetamines (AMP)

Barbiturates (BAR)

Benzodiazepines (BZO)

Cocaine (COC)

Marijuana (THC)

MDMA

Opiates (OPI)

Phencyclidine (PCP)

Propoxyphene (PPX)

Methadone (MTD)

Alcohol

*Adopted by Petrofac, Talisman and Other Oil & Gas Operators

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• Fitness to Work (FTW)

– Pre-employment testing

– Pre-placement testing

• Testing for cause

– Suspected case of substance misuse

– Post-incident testing

• Random testing

• Mass screening

When to Test?

Drug Testing Process

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Donor Selection and Notification

Urine Sample Collection

Point of Collection Testing (POCT)*

Laboratory Testing+

MRO Verification

Consequence Management

Positive

Non-Negative

Negative

Negative

(Negative)

(Positive)

Notificationto Employer

*Screening test (IA method)

+Confirmatory test (GCMS method)

POCT

Kits

POCT Kits

– Drug &

Sample

Validity

Panels

POCT Kit -

Results

Alcohol Testing Process

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Donor Selection and Notification

Breath Screening Test

Breath/Blood Confirmatory Testing

Consequence Management

Positive

Positive

Negative

Negative

Notificationto Employer

Evidential

Breath

Testing

(EBT)

Breathalyser

Recommended Cut-off Values

Drug / Drug Metabolite Concentration (ng/ml)

Screening

(IA)

Confirmatory

(GC-MS)

Marijuana metabolites 50 (20)

δ-9-THC-9-carboxylic acid

(THC-COOH)

15

Cocaine metabolites (benzoylecgonine)150 150

Phencyclidine (PCP) 25 25

Amphetamines 500

Amphetamine 250

Methamphetamine 250a

MDMA, MDA, MDEA 500 250

Opiate metabolites 300

Codeine 300

Morphine 300

6-Acetylmorphine 10

Barbiturates 300 200

Benzodiazepines 300 300

a Specimen must contain at least 200 ng of amphetamine

Employer Responsibilities

1. Establish written policy and procedures.

2. Conduct employees awareness & training.

3. Provide resources to implement DFWP

• Designated Employer Representative (DER)

• MRO, AMRO, BAT

• Approved laboratories

• Equipment and consumables

4. Manage employees with D&A problems.

5. Maintain record-keeping.

6. Observe privacy & maintain confidentiality of

information.

Employee Assistance Program

• Providing employees access to professionals

and experts outside the company to help them

managing their personal health and social

problems.

• Assistance provided without having to inform

the company’s administrative channels.

• Cost is borne by the company.

• Effective in managing personal problems where

the employees may feel threatened by going

through the company administrative process.

Legal Framework

• Dangerous Drugs Act (DDA) 1952

– Dangerous Drugs Regulations 1952

– Dangerous Drugs (Forms) Regulations 2001

• Poisons Act 1952

• Occupational Safety & Health Act (OSHA) 1994

– Code of Practice on Prevention & Eradication of Drug,

Alcohol & Substance Abuse in the Workplace, 2005

• Drug Dependents (Treatment & Rehabilitation) Act

1983

• Road Transport Act, Section 45 (b)

– Drinking & Driving Law

COP on Prevention & Eradication

of Drug, Alcohol & Substance

Abuse in the Workplace, 2005

Daun Ketum

(Kratom)

• Pokok Ketum (Mitragyna speciosa)

is a native plant in many parts of Indochina & SEA

particularly Thailand, Myanmar, Indonesia, Malaysia &

Papua New Guinea.

• Leaves contain many alkaloids including mitragynine;

higher with red-vein leaves.

• It’s not an opiate but it behaves as a μ-opioid receptor

agonist like morphine, and thus is used for managing

chronic pain as well as recreationally. Adverse effects

include palpitation, seizure, myalgia, insomnia, fatigue

or chest discomfort.Academy of Occupational and

Environmental Medicine, Malaysia27

Daun Ketum (Kratom)

• Ketum leaves are chewed in raw form. They are usually

boiled or dried and pound, and then taken as a drink.

• Often used as traditional medicine, and taken by workers

in laborious/monotonous professions to stave off

exhaustion or as a mood enhancer and/or painkiller.

• Prohibited in Malaysia under Section 30 (3) Poisons Act

1952; user may be penalized with a maximum

compound of RM 10k or up to 4 years imprisonment.

Possession of kratom leaves is illegal in Thailand,

Australia & Myanmar.

Academy of Occupational and Environmental Medicine, Malaysia 28

Mitragynine is listed in the Third

Schedule of the Poisons (Psychotropic

Substances) Regulations, Poisons Act

1952. It is an offense to import, export,

manufacture, sale, and possess such

psychotropic substances.

Poppy Seeds (Kas Kas)

Poppy Seeds (Kas Kas)

• Nutty and pleasant in taste, poppy seeds are

nutritious oilseeds used as condiment in cooking.

• They are bean-shaped, light gray to dark gray,

black, or bluish depending on cultivar type.

• Obtained from the dry fruits (pods) of the poppy

plant but they are free from any sinister side effects

of other poppy plant products such as opium poppy.

• They are safe to use as food and contain negligible

quantities of toxic alkaloids of the opium poppy.Academy of Occupational and

Environmental Medicine, Malaysia31


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Opiate Interpretation


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Issues and Challenges

• Employee’s individual rights

• Medico-legal

• Information confidentiality

• Personnel competency: MRO, AMRO,

BAT, HR, DER, HSE, etc.

• Managing employees with substance

misuse problems – industry vs government

practices

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Conclusion

• DFWP can be successfully implemented.

• The focus is on prevention.

• It requires full commitment and concerted efforts by the employers and employees.

• Policy is applicable to all and implemented across the board.

• Clear process and procedures with proper organization and resources are critical .

• Addiction is life long - DFWP is to be kept alive with regular communication and drug tests.

Question?

Academy of Occupational and Environmental Medicine, Malaysia 36

an update on substance misuse at the workplace

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