A Drug-Free

WORKPLACE

Ricardo T. Balagot, MD, FPCOM

CONTENTS

DEALING WITH DRUG ABUSE

 Global facts:
•  Substance use and abuse occur in
virtually all branches of industry and
among all types of people.
•  Studies have shown that men, young
workers, and workers in certain sectors/
occupations are more likely to be
associated with workplace substance
abuse.
 Rates of alcohol and drug use are
higher among workers who:
•  Work in high stress jobs: e.g. managers, sales
staff, physicians, lawyers, bartenders,
entertainers;
•  Work in unsupervised situations: e.g. long
distance drivers, travelling salespersons;
•  Work under extreme conditions: e.g. army
personnel, mining industry workers;
•  Work round the clock across different time zones
in call centers and information technology
services
•  Methamphetamines Hydrochloride
–  Sniffing (snorting)
–  Ingesting
–  Inhaling (Chasing the dragon)
–  Injecting
•  Cannabis
–  Smoking
•  Benzodiazepine/Cough Preparation
–  Oral Intake

•  Solvent
–  Inhaling

•  Nubain/Demerol
–  Injecting

•  Nicotine
–  Inhaling

•  Alcohol
–  Ingesting
•  Mean Age: 27 years
•  Male to female ratio: 13:1
•  Single
•  Employed
•  Place of Residence: Urban
•  Duration of Drug use: More than
2 years
•  Employed individuals comprise the
largest proportion of those admitted
to rehabilitation and treatment
centers.

Source: Dangerous Drugs Board Center-Based Report, 2000

 Drug and Crime
•  Statistics from the Dangerous Drugs
Board and other law enforcement
agencies show that 75% of crime
committed are drug-related or were
carried out under the influence of
drugs.
Common Crimes that are
Drug-Related

•  Robbery / Theft
•  Murder
•  Rape
Adverse Effects of Substance
Abuse
 General Signs and Symptoms
•  Sudden changes in work attendance, work
quality and productivity

•  Unusual flare-ups or inappropriate

outbreaks of temper over minor situations.

•  Withdrawal or escape from

responsibilities.
 General Signs and Symptoms
•  Changes in attitude: becomes less
sociable with known and usual circle of
friends.

•  Associates with persons who are known to

use drugs/ substances.

•  Deterioration of physical appearance and

grooming.
 General Signs and Symptoms
•  Wearing of sunglasses at inappropriate
times (i.e. at sundown, night time or
indoors).

•  Wearing of long sleeved clothing.

•  Unusual borrowing of money from family

and friends.
 General Signs and Symptoms
•  Becoming secretive particularly regarding
actions and possessions.
•  Poorly concealed attempts to avoid attention and
suspicion
–  (i.e. frequent trips to the restroom, or
elsewhere to get hold of the drug/ substance)
•  Stealing which starts with small items and
graduate to more valuable things from the home,
office, friends, coworkers and family.
 General Effects of Substance Abuse

These adverse effects have direct importance

and outcome to the workplace and work
performance at all levels.
•  Reaction time
•  Motor performance
•  Vision
•  Emotion and mood
•  Learning and memory
•  Intellectual performance
 Effects of Substance Abuse on the
Individual or the User
•  Substance abuse/chemical
dependency affects a person in many
different ways:
– Mentally
– Physically
– Emotionally
– Behaviorally
 Emotional Effects
•  Another term for drugs or alcohol is
"mood-altering chemicals" (MACs).
– significant effect on the user's
emotional state
– Feeling "high" is an emotional
state.
 Emotional Effects
•  withdrawal symptoms affect emotions.
•  Examples:
– Irritability
– Anger
– Aggression
– Loneliness
– Mood swings
– Suicidal and homicidal thoughts
 Behavioral Effects
•  Outward manifestations of emotions
•  The behavioral effects of substance abuse
include:
– Loss of self-control
– Preoccupation with use
– Stealing
– Destructive behavior
– Neglecting responsibilities
 Mental or Psychological Effects
•  Denial
•  the inability to see the adverse effects of
alcohol and substance abuse
•  Paranoia (“praning’)
•  Trouble concentrating, difficulty thinking
•  “Amotivational" Syndrome
–  giving up doing important or pleasurable
activities
•  Delusions, illusions and hallucinations.
 Physical Effects
•  Short-term effects include
–  Bloodshot or glassy eyes
–  Drowsiness
–  Slurred or rapid speech
–  Drastic weight loss or gain
•  Alcohol or drugs can contribute to many physical
illnesses.
•  Interferes with the function of the immune
system.
Physical Effects of High Risk Drinking
•  Aggressive irrational behaviour-
arguments, violence, depression,
nervousness
•  Alcohol Dependence-memory loss.
•  Cancer of the throat and mouth
•  Premature Aging-drinker’s nose.
•  Reduced resistance to infection-frequent
colds, increased risk of pneumonia
•  Weakness of heart muscle-heart failure,
anemia, impaired blood clotting, breast
cancer (for women)
•  Liver damage
•  Vitamin deficiency-bleeding, severe
inflammation of the stomach, vomiting,
diarrhea, malnutrition
•  Painful nerves-trembling hands, tingling
fingers, numbness
•  Impaired sensation-leading to falls
•  Numb, tingling toes, painful nerves
•  Inflammation of the pancreas
•  GI Ulcer
•  In men-impaired sexual performance
•  In women-risk of giving birth to deformed,
retarded babies or low birth weight babies

Source: ILO 2012

Philippine Data: Cigarette Smoking
Among those who work indoors, 65.4% of
their worksites have policies “disallowing”
smoking in any closed area; yet 13.9 were
exposed in the past 30 days.

•  66.7% of workers are exposed to second

hand smoke in worksites where smoking is
allowed:

–  75.7% are exposed where there is no anti-

smoking policy

Source: ILO 2012

•  28.3% among adults 15 years or older
were current tobacco smokers,
representing 17.3 million Filipinos.
•  13.8 million or approximately 22.5%
Filipinos smoke everyday
•  14.6 million men and 2.8 million women
currently smoke tobacco.
•  38.2% of men and 6.9% of women are
currently daily smokers

Source: ILO 2012

Mixing Substances and Work
•  Alcohol
•  Marijuana
•  Inhalants
•  Cocaine
•  Shabu
•  Hallucinogen (Ecstasy)
 SHABU (Methamphetamine
hydrochloride, Ice, bato, shabs)
•  Produces temporary mood elevation or
exhilaration (high)

•  “Increased” mental alertness

•  An “upper” – increase wakefulness

•  Extremely addictive - sometimes with just one

use.
 SHABU (Methamphetamine
hydrochloride, Ice, bato, shabs)
•  Can cause convulsions, heart irregularities, high
blood pressure, depression, restlessness,
tremors, and severe fatigue.

•  An overdose can cause coma and death.

•  Withdrawal may cause deep depression.

•  Causes a very jittery high, along with anxiety,

insomnia, and paranoia.
 SHABU (Methamphetamine
hydrochloride, Ice, bato, shabs)
•  Physical Effects:
–  Regular use of shabu is damaging to the body
– constricting the blood vessels, and
increasing body temperature, heart rate, and
blood pressure.
–  Diminish appetite
–  Disrupt sleeping pattern.
 SHABU (Methamphetamine
hydrochloride, Ice, bato, shabs)

•  Psychological Effects:
–  False sense of exhilaration and increased
energy
•  Followed by anxiety and irritability.
–  Paranoia, hostility and rapid mood swings
are also common in people who use shabu
regularly.
 HALLUCINOGENS
•  Some types of hallucinogens:
– Ecstasy (designer drug),
– LSD (Acid, Red/Green Dragon),
– PCP (Angel Dust, Loveboat)

•  Used during parties and gatherings

•  Causes stimulation or depression
 HALLUCINOGENS
•  One use of LSD or PCP can cause multiple and
dramatic behavioral changes.

•  Large doses may cause convulsions, ruptured blood

vessels in the brain and irreversible brain damage.

•  Unpleasant and potentially dangerous "flashbacks,"

long after the drug was used.

•  Most hallucinogens cause "hallucinations" i.e.,

changes in perception of time, smell, touch, etc.
 HALLUCINOGENS
•  Physical Effects:
–  Designer drugs are certain drugs that are similar in
structure (analogs) to other drugs and are
designed (hence, the term “designer”) to mimic
their effects.
–  Ecstasy is an amphetamine analog and its effects
are similar to amphetamines.
•  May cause chills, nausea, excessive
perspiration, blurring of vision, and fainting.
–  A single dose can cause brain damage.
•  Psychological Effects:
–  Can cause hallucinations, illusions, poor
perception of time and distance, poor insight, and
panic reactions.
 MARIJUANA
(Pot, Grass, Damo, Mary Jane)
•  Sometimes classified as a “hallucinogen” due
common effects
•  Causes euphoria
•  impaired short-term memory, a shortened
attention span and delayed reflexes.
•  During pregnancy, marijuana may cause birth
defects.
•  Fast heart rate and pulse.
•  Repeated use of marijuana may cause
breathing problems.
•  Relaxed inhibitions, disoriented behavior.
 TRANQUILIZERS/DIAZEPINES
(Valium, Tranxene and Ativan)

–  Used to induce sleep, relieve tension and

anxiety
–  People who take depressants rapidly get used
to low doses.
• People tend to increase the dose
–  Physical addiction can occur after 2-3 weeks
 TRANQUILIZERS/DIAZEPINES
(Valium, Tranxene and Ativan)
•  Physical Effects:

– Effects are slurred speech,

dizziness, disorientation,
impaired balance and poor
judgment.
 TRANQUILIZERS/DIAZEPINES
(Valium, Tranxene and Ativan)
•  Psychological Effects:
– A person’s long-term use of
depressants makes him/her
moody.
– Experiences apathy, a lack of
interest in the things and events
around her.
 ALCOHOL (Alak, Booze, Toma)
•  Consumed for relaxation
•  Socially acceptable
•  Cheap source of euphoria/excitement
•  Often used by substance abusers to
enhance the effects of other drugs.
•  Most frequently abused substance among
young adults
 ALCOHOL (Alak, Booze, Toma)
•  Physical Effects:
–  Low doses of alcohol can cause excitation;
–  higher doses
•  muscular incoordination, dizziness,
slurring of speech, lack of coordination,
and diminished reflexes.
–  death can occur due to respiratory and
circulatory failure.
–  Chronic alcohol intake
•  liver, kidney and brain damage.
•  nutritional deficiencies
ALCOHOL (Alak, Booze, Toma)
•  Psychological Effects:

– Intake of small amounts of alcohol

causes an excited state.

– Larger amounts can lead to

forgetfulness, confusion, lack of
concentration, nervousness
 MULTIPLE DRUG USE
•  drugs that may counteract or
enhance the actions of other
drugs already present in the body

•  more dangerous than use of a

single substance of abuse
 MULTIPLE DRUG USE
•  Marijuana and Alcohol

–  Alcohol is used with marijuana to make the

marijuana "high" last longer.

–  When used together, the body's craving for

marijuana is much stronger.
 MULTIPLE DRUG USE
•  Shabu and Alcohol

–  Since shabu causes such an intense "high"

and "low", alcohol is often used to mellow the
low or deep depression.

–  When used together, the paranoia, fatigue,

depression and loss of control are likely to be
more intense.
 MULTIPLE DRUG USE
•  Inhalants and Marijuana

–  Marijuana and inhalants used regularly may

cause severe irritation of the nose and throat.

–  Use of this combination of drugs can lead to

use of stronger drugs to achieve a more
intense "high."
 MULTIPLE DRUG USE
•  Amphetamines (shabu) and Sedatives

–  Use of "uppers" and "downers" to counteract

the highs and lows of drug use causes an
addictive cycle of dependence.

–  When used together, overdoses are

sometimes difficult to detect and may be fatal.
 Pertinent Workplace
Provisions of RA 9165

•  Article III – Dangerous Drugs Test and Record

Requirements.
•  Article V – Promotion of a National Drug-Free
Workplace Program with the participation of
Private and Labor Sectors and the DOLE.
•  Article VI – Participation of Private and Labor
Sectors in the Enforcement of this Act.
 Article III

•  Dangerous Drugs Test and Record

Requirements.
•  The following shall be subjected to undergo
drug testing:
–  Officers and employees of public and
private offices, whether domestic or
overseas,
•  random drug test as contained in the
company’s work rules and regulations,
•  shall be borne by the employer, for purposes
of reducing the risk in the workplace.
 Article V
•  Promotion of a National Drug-Free
Workplace Program with the participation
of Private and Labor Sectors and the
Department of Labor and Employment.
 Article V
•  Section 47: Drug-Free Workplace:
–  Use tripartite approach.
–  Pursuant to the functions of the Board under
Section 81(a) of the Act, the existing Civil
Service rules and policies needed to respond
to drug abuse in the public sector shall be
adopted.
 Article V
•  Section 48. Guidelines for the National
Drug-Free Workplace Program.
–  The Board and the DOLE shall formulate the
necessary guidelines
–  The amount necessary for the
implementation of which shall be included in
the annual General Appropriations Act.
 Article VI
•  Section 49. Labor Organizations and the
Private Sector.
–  include in their collective bargaining or any
similar agreements, joint continuing programs
and information campaigns for the laborers
similar to the programs
 Article VI
•  Section 50. Government Assistance.
–  The labor sector and the respective partners
may secure the technical assistance, such as
but not limited to, seminars and information
dissemination campaigns of the appropriate
government and law enforcement agencies.
 D.O.L.E.
Department Order 53-03
•  Guidelines for the Implementation of a
Drug-Free Workplace Policies and
Programs for the Private Sector
•  In accordance with the provisions of
Republic Act 9165
 D.O.L.E.
Department Order 53-03
•  Drafted by the multi-sectoral Task
Force on the Prevention and Control
of Substance Abuse in the Workplace
and reviewed by the Tripartite
Industrial Peace Council (TIPC).
 D.O.L.E.
Department Order 53-03
•  mandates all companies with 10 or more
workers to formulate its own drug abuse
policies and programs jointly prepared by
management and employees
•  encourages companies with less than 10
workers to participate in the campaign.
 D.O.L.E.
Department Order 53-03

•  Components:
–  information and education
–  implementation of drug testing
–  Treatment, Rehabilitation & Referral
–  Monitoring & Evaluation

•  Coverage
–  All private establishments, including
contractors and concessionaires
 Components of Policies &
Programs

•  Advocacy, Education, and Training

–  Awareness and education of officers and
workers
•  Relevant features of RA 9165
•  The company’s rules and regulations
•  Drugs and their effects
•  Services available for officers and workers
 Components of Policies &
Programs

•  Advocacy, Education, and Training

–  Posting of banner
“THIS IS A DRUG-FREE WORKPLACE;
LET’S KEEP IT THIS WAY!”
–  Adapt curricula drafted by the Task Force
 Components of Policies &
Programs
•  Advocacy, Education, and Training
–  Training on prevention, clinical assessment,
counseling, and other activities for OSH
personnel, HR, employer’s, and worker’s
representatives.
•  Shall form part of the Assessment Team
•  DOLE shall assist small companies w/o
adequate resources
 Components of Policies &
Programs

•  Advocacy, Education, and Training

–  Companies are encouraged to extend drug
education to officer’s/worker’s family and the
community
 Components of Policies &
Programs

•  Drug Testing Program

–  Employers shall require their officers and
workers shall undergo random drug testing
–  Drug testing for teaching and non-teaching
staff in private schools shall be provided by
DepED, CHED and TESDA.
 Components of Policies &
Programs

•  Drug Testing Program

– Shall conform to the protocol set by
the DOH
– Only drug testing centers
accredited by the DOH shall be
utilized
 Components of Policies &
Programs

•  Drug Testing Program

–  Drug testing:
•  Screening
•  Confirmatory
 Components of Policies &
Programs

•  Drug Testing Program

–  Positive drug test results shall be forwarded to
the Assessment Team for evaluation:
•  Level of care needed
•  Administrative interventions
 Components of Policies &
Programs

•  Drug Testing Program

–  Drug testing for “just cause”:
•  After workplace accidents or near misses
•  Monitoring during and after treatment and rehab
•  Upon clinical recommendations
 Components of Policies &
Programs

•  Treatment, Rehabilitation and Referral to

be provided by the company
–  The Assessment Team shall determine the
need for referral (for 1st time offenders)
–  After rehabilitation, the Assessment Team may
evaluate the status and may recommend
resumption of employment
 Components of Policies &
Programs

•  Treatment, Rehabilitation and Referral to

be provided by company
–  Repeat offenders shall be dealt with according
to the penalties under the Act
–  List of treatment and rehabilitation centers will
be posted at the OSHC website
(www.oshc.dole.gov.ph)
 Components of Policies &
Programs

•  Monitoring and Evaluation

–  The OSH Committee or any similar committee
–  To ensure the implementation of the policies
and programs
 Rights, Roles and
Responsibilities
•  Employer
–  Disseminate the policies and programs to
all officers and employees
•  a written acknowledgment shall be
obtained from everyone
–  Shall maintain the confidentiality of the
drug test results; unless, otherwise
required by law.
 Rights, Roles and
Responsibilities

•  Workers
–  Unions, federations and other similar
organizations are enjoined to take an active
role in the education and advocacy within the
organizations
 Rights, Roles and
Responsibilities

•  All officers and employees shall enjoy the

right to due process
 Enforcement
•  DOLE Regional Offices shall monitor the
compliance to this DO
•  RO shall also provide basic information
during advisory visits
•  DOLE may delegate monitoring to the
local government units, if necessary and
appropriate
Frequently Asked Questions

•  Is mandatory or random drug testing a

violation of human rights?

Although there are questions being raised on the

constitutionality of mandatory and random drug
testing, as long as the Supreme Court has not
decided on this issue, the Law stands as it is.
 Frequently Asked Questions

•  Are expatriates and foreigners employed

in a local company covered by the Order?

They are included in the Order.

 Frequently Asked Questions

•  What is “for just cause”? Are companies

required to implement “for just cause” drug
testing?
The Law requires only random drug testing.
However, it is an option for companies to
implement testing for justified causes such as
part of accident investigation or as testing to
follow-up workers who already underwent
treatment and rehabilitation.
•  What penalties can a company impose
on an officer or a worker caught in
illegal possession of dangerous drugs?

Illegal possession is a criminal act. The Law

has provisions to deal with these
circumstances. The company policy should
clearly state the sanctions for these types of
offenses.
 Frequently Asked Questions

•  A company has already its own drug abuse

policy but is not in consonance with the Order.
The company terminates all those found to be
positive for drug use the first time. Is the
company required to revise its policy?

The Department Order is part of the bigger Law,

the Republic Act 9165. Any ordinances, orders, and
company policies that is not in consonance with the
Law should be revised.
 Frequently Asked Questions

•  How will confidentiality be assured within a

company?

Confidentiality of drug test results and

treatment and rehabilitation should be
maintained on a “need to know basis”. The
company policy should include sanctions for
any intentional violation of confidentiality of
records.
 Frequently Asked Questions

•  Who will shoulder the expenses of

rehabilitation?

This will depend upon the agreement within the

company.
 Frequently Asked Questions

•  If a worker is referred for rehabilitation,

is he/she entitled to leave benefits?

The grant of leave benefits will depend on the

agreement of employers and workers.
 Frequently Asked Questions

•  Are companies allowed or required to have

job applicants undergo mandatory drug
testing as part of their requirement? Who will
shoulder the expenses?

It is the prerogative of the company if they

would require job applicants to undergo drug
testing. However, it is encouraged that the
companies require only short-listed candidates
to lessen the financial burden on the applicants.
 Frequently Asked Questions

•  Can a company conduct on its own the

screening tests?

The company can conduct it’s own screening test as

long as it is accredited by the Department of
Health. However, many prefer third-party service
providers to avoid technical legalities that may
arise.
 Frequently Asked Questions

•  What if a worker/officer refuses to undergo

random drug testing? What sanctions can
be imposed on the worker/officer?

Refusal to undergo drug testing is tantamount to

refusal to follow company rules and regulations.
The worker may be guilty of insubordination and
may be dealt with other pertinent policies of the
company.
 Frequently Asked Questions

•  What sanctions await companies which do not

have drug abuse policies and programs?

Refusal to formulate and implement policies and programs

will be considered violation of the Labor Standards.

Some local government units (Muntinlupa City) are

implementing a “NO POLICY, NO BUSINESS PERMIT”
ordinance to supplement existing laws.
 Art. V. RA 9165 - Promotion of a National Drug-Free Workplace Program with the
Legal Basis Participation of Private and Labor Sectors and the Department of Labor and
Employment
Mandatory to all establishments in private sector employing 10 workers
Coverage and above including contractors and concessionaires, and those with
less than 10 workers are encouraged to formulate its drug-free policy

Minimum Requirement Drug-Free Workplace Policy and Programs

CRITERIA Consequences of Policy

1. Jointly prepared by MGT & COMPONENTS Violations
Labor Rep. and made an integral part of the 1.Advocacy, Education & Training 1.  ART. II, RA 9165
OSH and related workplace programs 2. Drug Testing Program for Officers (Unlawful Acts & Penalties)
2. In organized establishments – included as and Employees 2. ART. 282, Book VI LCP
part of CBA 3. Treatment, Rehabilitation Referral (Termination by Employer)
Note: In formulation of policies, seek assistance 4. Monitoring and Evaluation 3. Co. Rules & Regulations
from Task Force
RO – Focal center in providing information EMPLOYER – information dissemination and maintain
confidentiality
Roles, Rights & Responsibilities UNION/ FEDERATION – education/ training
DUE PROCESS must be observed

Enforcement DOLE INSPECTORS – monitor, disseminate info

Consequence of No Policy Violation of Labor Standards

Effectivity March 7, 2004

 World Health Organization

≈ 200,000 people died because of

drug abuse in the year 2000,
equivalent to 0.4 per cent of all deaths
worldwide.
Substance abuse knows no
boundaries, race, age or
position. Everyone is
vulnerable to drugs,
including those in the
workplace.