11 October 2006

Adelaide Conference on drugs/alcohol in work place. Summary by Richard Hallinan (part 4 of 4)

Work-related Alcohol and Drug use - A National Forum.

30th June 2006.

Session 1 on the second day of this important forum dealt with Industrial Coalface Issues in five different workplaces.

Trevor Sharp, Executive Officer of The Construction Industry Drug and Alcohol Foundation, had to summarise 14 years experience in 15 minutes. The CIDAF story is how a union recognised problems in its own workforce, in a blokey culture of 'work hard and play hard', where almost half of apprentices had used drugs or alcohol before going to TAFE or work in the previous year, a quarter in the previous week. A union Workers Compensation officer, "being an old socialist and liking a glass of wine herself", asked the guys on the job about the problem: the short answer was, they wanted the union, not the bosses, to do something about it.

What Trevor Sharp didn't want was a programme that ended up in the filing cabinet.

The union's approach was based on peer intervention: "people trust their peers". The appeal was very simple, as shown on a poster: "What you do in your time is your business. If you do it at work, it becomes our business. If you've got a problem, maybe we can help." The intervention targeted the 85% of workers who didn't have a problem, to reach the minority who did.

Dedicated officers keep the issues alive by ongoing education and peer intervention and providing referral where needed. CIDAF has a residential rehabilitation centre in Sydney, "Foundation House", with funding contributions from employers. The programme has been successful because they "got the jump on everyone else", and CIDAF is doing consultancy work for other industries (eg New Zealand Post; National Football league).

What credentials and qualifications do the people need who work for CIDAF? Commitment, not merely interest, and identification with the target group: Mr Sharp contrasted the guy who turned up wearing a tie, to the guy who turned up on a Harley Davidson. No contest.

The union is simply opposed to drug testing of workers, and as Mr Sharp pointed out, they are well placed to reject it because they have a well-functioning alternative in place.

Mr John Sargaison, Chief Health and Safety Adviser of Santos Limited, described the 3 year time frame for the consultation and implementation of their Health and Wellbeing Program. The programme is based on 1. standards for well-being (looking at not just alcohol and drugs, but nutrition, fitness, managing/preventing fatigue) and 2. strategies for when problems arise ie, a remedial function.

Santos has a zero tolerance of illicit drugs at the workplace, including random urine testing. Depending on the nature of the work involved, acceptable BAL is set at 0.05 or 0.00. Infractions lead to a 3-month 3-stage disciplinary process.

Asked whether the low threshold set for urine cannabinoids meant that Santos expected its workers to abstain from using cannabis in their free time (on weekends and periods of leave) Mr Sargaison said that the ability to abstain was a sign of a lower level of cannabis dependence. Urine testing could be moderated in various ways, for example by waiting a couple of days after return to work.

Superintendent Peter Martin, of Brisbane West District Police spoke on "Policing the Police" and the development of a Drug and Alcohol Policy for the Queensland Police Service.

An important difference from other workplaces is "What we do in our private lives should reflect what we do as an organisation", and reflect the reality that the police force is a 24 hour/day service. The balance of guidelines is achieved by a focus on licit as well as illicit drugs, on education and training, the idea that testing must have a clear rationale and intent, and is most useful in combination with other measures. Regarding testing, he said - "We need to think about the positive test plus one day". "What do you do when the dog actually catches the car?"

The police work in a range of settings, including remote areas where the officers work alone and are on 24-hour call. Is it reasonable to expect these officers never to have more than 2 glasses of alcohol, for the life of their tenure, say 3-5 years? Therefore a range of BALs apply: nil for the SERT squad, generally 0.02 for police on duty, and 0.05 for police on call.

Currently alcohol testing is random, but testing for illicit drugs is only performed as a targeted measure - this is set down in legislation, not in enterprise bargaining.

Peter Shaw, of Queensland Rail spoke about "what is left after the brass band leaves".

QR had 26,000 workers in 1967, and 13,000 now, in a range of settings from office work to camps settings, with a historical motto: "work 12, drink 6, sleep 5". Tea breaks used to be timed to coincide with pub opening. QR's strategy focuses on fatigue, general health, as well as Alcohol and Drug use, and aims not to "catch and sack", but develop awareness and allow for rehabilitation.

Their was growing peer intolerance of as Alcohol and Drug use at work, but we must recognise that expecting workers to confront this in their workmates could have costs, especially in small communities where everyone knew each other, and where there might be little else to do by way of recreation. Also, telling a workmate to go and sit in the corner to sober up could mean more work for everyone else.

Air Vice Marshal Tony Austin of the Defence Health Service, RAAF, reminded us that their had been historically a strong and even essential role of alcohol in the military. An example was the practice of rewarding submariners on their return from a period away with a "piss-up" in the canteen.

Work in a peacekeeping or disaster relief setting was as stressful as combat, and in some ways more, with the loss of control involved.

The military has a zero tolerance policy for illicit drugs. In the evolving role of drug testing, one principle was supreme: "nothing erodes an organisation like hypocrisy" so testing would have to be for all staff, from the highest officer down.

There were positive signs of work of the ADF's Alcohol Tobacco and Other Drug Services with the personnel attrition rates (due to accident, suicide, marital breakdown etc) dropping by 75% in the last 4 years.

Session 3 of the day was about systems responses: "What's happening, and What should we be doing differently?"

Donna Bull, CEO of ADCA, spoke on the theme "Not My Job... the benign neglect of workplace AOD issues". She noted that the 5 workplace models presented in the morning session showed that programmes should be uniquely tailored (not off-the-shelf), developed in partnership, be equitable, comprehensive, evidence-based, and integrated in the normal activities of the business. Also it was important to market them.

AOD workers have the expertise for designing and implementing workplace interventions. In failing to do so (and viewing with suspicion colleagues who cross to the other side in working in partnership with employers and industry), we neglect an opportunity for reaching pre-dependent users. Key elements are policy, workplace culture, education, early and brief interventions, and access to specialist care services, which she suggests ought to be accredited (contrast with the sorts of referrals commonly made by government agencies such as Centrelink). She suggested drug screening tools (such as AUDIT and SDS) might be more useful than drug testing.

Associate Professor Jeremy Davey, of the Centre for Accident Research and Road Safety at Queensland University of Technology, observed that our history of avoidance in this area was such that "Best practice is ANY practice". "Show me your education programme first", he said. Industry was quick to start drug testing programmes, reflecting the need "to be seen to be doing something, and now".

In this field everyone is an expert, change is driven by emotion, is reactive and poorly thought out and reflects, he says, a historical approach dominated by the USA - not a matter of rancour, just a fact of history, reflecting the differing ways we look at our communities. The American philosophy, literature and approach to testing have been Reaganesque Zero Tolerance, not aimed at reducing harm associated with use, nor even at stopping drug use, but at detecting and excluding drug users. The drug test identifies the User, but tells us little about the Use of the drug.

For most industries, the focus has been on testing, which is akin to the tail wagging the dog. Testing should instead be the end of a line of strategies. Industry generally had not learned from our AOD successes in Australia. Roadside Breath Testing is all about getting negative test results, not positives.

Industry focus has been on liability rather than safety, with AOD programmes usually written by lawyers and accountants. Drug testing fits this approach of "inoculation" of the business. In this environment drug-test suppliers may drive the field.

He applauds the cases where unions and employers have worked together for a safe and fair workplace. Observing that no other workplace policy has the potential to reach this way into the lounge room at home, he asks "How important is it for employers to know about their workers behaviour on holidays?" However, in workplaces such as the police force, there are imperatives of preventing corruption, of public perception and credibility and the oath of office.

Commissioner Mal Hyde of the South Australian Police referred to a survey of NSW police showing a perception that drug and alcohol use was "officers' private business". In SA, the average recruitment age is 28, and the views of officers probably reflect those of the wider community in this age group. Police were at risk as a result of workplace stress, but also due to their work providing access to drugs and the drug scene.

The SA Police need their officers to be mature, calm and objective, to show leadership, and at times they must be involved in high risk situations with firearms and driving. AND "we want them to obey the law". Therefore they have a policy of zero tolerance of illicit drug use.

With 50 one-officer units in remote areas, the situation of the on-call officer was a significant issue. For pursuit and firearm situations, there is a BAL = 0.00 requirement. Officers must always be "fit and available". If not alternative arrangements needs to be made. Officers would be referred to an Employee Assistance Programme if there were problems, and would not be subjected to disciplinary procedures if they self-identified.

Drug testing is mandated after incidents, but there has been no random testing hitherto. As this was now in place for drivers in SA, the question of random versus targeted drug testing was one for discussion with the police union. A question came from the floor (from the Transport Workers Union): how can "catch and sack" be legitimised when police don't accept random testing in their ranks? Another question for consideration is drug testing of recruitment or induction into the service.

The final session of the NCETA Forum was led by Keith Evans, Director of Drug and Alcohol Services South Australia.

Mr Evans knitted together some of the paradoxes that emerged from the Forum:

At a time when employers show less long-term commitment to their workers than ever before, is it fair to require commitment from their workers in their private lives - which is an inevitable consequence of workplace drug testing?

Workplace testing may fit well with a corporate desire to control from the top down. Mr Evans contrasted a well-known corporation which used to lock up all work projects at night (the writer once heard its corporate anthem sung by hundreds of identically-suited male executives, praising their "founder's glorious name"), with a smaller company which let workers take projects home, where even the kids would work on them and sometimes came up with the best ideas. However in both scenarios we might ask "How much of my time are you paying me for?".

A corollary strikes to the heart of issues of workplace fatigue, "If you take up enough of my time, you are liable...". Given a corporate expectation of "getting more for less" from their workers, this may be opening a Pandora's box.

Where is the idea of mutual obligation? Mr Evans gave the example of the well-supplied executive bar. Does anyone really believe that "the workers won't know if we drink"? Issues of equity arise, but also of the framework of trust needed for partnership - where does drug testing do to that framework of trust?

Do we aim to catch (and sack) the drug addict or alcoholic? - or do we want to reach everybody in the workplace? Are we interested in workplace performance? If so, we must look at all the other issues, like stress, bullying, fatigue.

Is our aim to "keep the mad and bad off the streets"? If so, quipped one from the floor "Put them back to work!".

Congratulations to NCETA and ADCA for organising this Forum. One couldn't help but wish more occupational physicians and specialists in addiction medicine had been there.

The transcripts of these presentations will be available from NCETA in the Proceedings of the Forum. For more details contact NCETA on 08 8201 7535 or nceta@flinders.edu.au or www.nceta.flinders.edu.au.

The forum presentations can be viewed at: www.nceta.flinders.edu.au/events/twenty_four_seven.html#Presentations

Summary by Richard Hallinan