420 - When You Suspect an Employee Is Impaired at Work

0:00Ten years ago, I thought people came to conferences for information. I was wrong. You can Google almost any answer in 30 seconds while hiding in a supply closet. What you can't Google is skill. Skill is having hard conversation when you're exhausted, short-staffed, and the person across from you is upset. And that only comes from practicing with people who will tell you the truth when you miss. That's what Uncharted is. On Friday, January 15th in Orlando, the day before VMX opens, we're celebrating 10 years with a one-day conference built around leaders practicing hard things together. You'll get Dr.

0:37Peter Weinstein, the Uncharted team, and about a dozen mic drop talks from people in the community, people you know like Dr. Phil Richmond and Dr. Caitlin DeWild. I'm not going to tell you it'll be easy because it won't. But if you want to do the work alongside people who get it, come and join us. Details are at unchartedvet.com. Register today. Don't miss your chance. Welcome back to a very special episode of the Uncharted Veterinary Podcast. Y 'all, I am so excited to be bringing you this episode because this is our 420 episode and I am covering a topic that a lot of practice managers have personally asked me about, especially in 2020 when marijuana became recreational legal in my state in Illinois.

1:22But in general, we got a mailbag from a practice manager who is struggling with this very situation. She flat out said that she had a team member come in who she thought might've been under the influence of marijuana. And she's still struggling with whether she made the right decision or not. And so of course I had to bring in an expert because I was like, this is very interesting. And the laws keep changing around marijuana use. So I got in contact with the incredible Joe McGuire from the National Drug and Alcohol Screening Association. And she brought forth just so much knowledge. You cannot miss this episode.

1:57I know that it has been so hard to know what to do in these situations because the laws change and they keep changing. And we want to be compassionate with our teams. But at the same time, we have a responsibility to keep our patients safe. And so I came prepared with plenty of questions with Joe. I tried to keep it under an hour. I don't even think we're going to be able to. But you guys are going to not want to miss a single part of this, especially at the end where she goes through some of the new tests that are going to be available pretty soon when it comes to marijuana screening. So make sure to saddle up, tune in, and let's get into this episode.

2:31And now, the Uncharted Podcast.

2:38You show up for pets every day. It's because care is your calling. And it's ours, too. We know it's what drives you to make a difference in the health and well-being of every pet. That's because at Zoetis, hundreds of veterinarians are part of our team too, working with you to provide science-backed medicines, technology, and practical support to help elevate your standard of care. Learn more at careisyourcalling.com. All right. Welcome back to the Uncharted Veterinary Podcast. I am so excited. You'll have no idea. I get to sit down today to talk to you, Joe. Joe McGuire, tell us a little bit about who you are.

3:19We start that. Okay, great. Sure. I'm with National Drug and Alcohol Screening Association, and I did found that with several work colleagues eight years ago. We're coming up actually on our ninth anniversary here pretty quickly. It's so hard for me to believe that. But I have been in all kinds of prevention work, community prevention, whether it was youth violence, drug prevention, prevention of risk behaviors, promotion of positive behaviors, you know, anti-bullying, this and that, for pretty much my whole entire career for about 25 years. And the problem with a lot of those programs is they're always nonprofit grant funded.

3:59And so they kind of tend to change around a little bit, merge here and there, whatever. And about, gosh, 17 years ago now, the one that I thought I would be with for the rest of my life lost all of their funding. And I put my resume out to my board members. And one of them lived in my community, meaning I didn't have to commute from Colorado Springs up to Denver, which is always a plus. And I thought, oh, this is cool. I got to keep doing what I'm doing in my local community. I didn't quite pick up and realize that part of the job was the drug testing. I would have missed that. And I knew that she did that, but I didn't know that would be my job.

4:38So she did come to me after sitting in my beautiful little office for a couple of weeks and be like, you know, you also have to do that too. It was very awkward conversation because I really, I think my face said, are you serious? when my mouth said, sure. But I will tell you, it really did change the course of my life because I realized really quickly that it is such an important tool for maintaining workplace and community safety, family safety for those who are struggling with substance use. And, you know, I know there's a lot of pushback on this topic out there. That's fine. I don't ever shy away from that.

5:17I really love what I do. But over the years, a lot of things, of course, changed in our world with the advent of legal marijuana. And what do you do with that in the workplace? And then policies and how does that matter? And just because I'm kind of a jump in there and figure it out and learn it and I'm a communicator and I really feel like people need to know when nobody else is talking about it, it's just kind of propelled me to even the global stage. I mean, I do a lot around the U.S., of course, but at the federal level and even on the global stage, I talk so much about safety policies, workplace policies, and I'm really trying to come at this from the point of view of how do we help people because very early into this, like right into it, I came to understand that my son was also struggling with substance use disorder.

6:13And I didn't know a lot about that. And I was missing all the signs as a mom while entering into this career was part of what inspired me to try to learn everything I could to help him. So that journey has gone hand in hand. And I'm always looking at this from how do we help people and how do we, yeah, we need boundaries for safety, but we have to do that through compassion. And we have to do that through understanding that there is an opioid epidemic and there's these things happening around us. How do we all do that together and make the world a better place? And so that's where I come from.

6:47I love so much of what you just said, honestly, like you have such passion for it. And honestly, I believe so much of what you just said. One of the ways in which I found you specifically and the administration was back in 2020 when it had just become legal in Illinois, in my state, And in the clinic that I was overseeing, it had just become legal. And I was like, what do I even do? How do we approach this? And you had had a great podcast at that point. And you had said how it kind of had become legal at this point already in Colorado. And it was like, right, you kind of got there right in the beginning where it became legal.

7:21And you were like, well, it doesn't mean that we necessarily have to allow it. There's differences in work policies and government policies. And I think that what you had said back then kind of inspired me so much that it helped me create my own internal policy around it as things were changing. And we are seeing so much of that change. And still continuously, there's some states in which there's still completely, you know, a big issue where, you know, it's completely illegal. And then there's states where it's a different issue because it's completely legal and we're seeing the repercussions of that too, right?

7:48Right. So whether you stand on the spectrum of the political sense of whether it's legal or not, we still have a very reality in which it's going to affect the workplace. Right. And so how do we manage our workplaces in a way where we stay true to who we are, but we also stay true to the fact that this is a real problem in the United States? And I'm sure not just in the United States. This podcast reaches other areas, but obviously we are in the U.S. And so I got a mailbag actually for the podcast. And that's one of the main reasons why I was like, I know who to talk to about this mailbag because it was, it's around drugs.

8:22It's around this issue that we're talking about. And also I feel like in veterinary medicine too, we have learned that we have access to drugs. And so it's an especially tough topic. It is very easy to get access to certain drugs because we work in veterinary medicine. And so I love that somebody submitted this in and perfect timing because this is going to be our 420 episode also. I think we're perfectly timed out for everything. So if you don't mind, I'd love to read the mailbag for you and the audience. Sure. All right. So they said, I had a veterinary assistant who returned from lunch with red or glossy eyes and seemed quieter than usual.

8:58During one team meeting, she was noticeably drowsy and even nodded off. At some point, I thought I smelled marijuana, but I couldn't confidently say for certain. So I pulled her aside privately and explained that I was concerned about her well-being, more importantly, patient safety. I shared the behaviors I observed and asked her whether she felt impaired or needed to go home. She denied being under the influence, but I sent her home anyway. I explained that if I continued to observe these behaviors, I would have to send her home regularly for a drug test. Interestingly, I never saw the behavior again after this, but it has always stuck in the back of my mind and I've always wondered, what if it had happened again?

9:32What if she continued denying everything? At what point is observation enough? What am I legally even allowed to do? And is this something that other practices are running into? What are their policies around this? I was like, there's a lot of questions all at once. I think we can definitely attack the majority of them. I always love for people to share their policies. And so I think some of this is going to be dependent on the clinic itself. But just to start kind of on a high, high level space for you, what do you think about this mailbag? Do you think that the practice manager essentially did the best thing?

10:05Should she have done something differently? What are you seeing in this situation? It is such a great question. And I'm so glad that all of the components are in the question that we can point to. So first of all, did she do the right thing? I cannot answer that question unless I know what is in their drug and alcohol testing policy. so every company if you have one employee you know if you are not the only one walking into that job every day one employee you need to have a safety policy that safety policy should include what is your stance on drug and alcohol testing when will you do it why will you do it what will that look like because you cannot test someone you should not let me just say that you should not test anyone without prior notice.

10:55I say you cannot, and I use that strong language because you can get sued in a second, you will lose instantly if you try to test someone without advance notice. It is not a good thing to do. So please don't do that because that puts you in a very vulnerable position. So, you know, if you're listening to us today and you need that policy, there's some great sample policies on the SAMHSA website. They've got a workplace drug testing, resource area because they're kind of the keepers of the original safe and drug-free workplace program. And so they have templates. It's really simple. I can also refer you to people who do that.

11:33I used to. I don't anymore. But we have great colleagues who do that in our industry. It does not have to be overly complicated. It can be pretty simple. But the thing is, every employee that works for you needs to understand that that's something that you reserve the right to do at some point. You can pre-employment test them random post-accident, test them for cause, which is what this falls under, but it just needs to be very clear that you will either absolutely certainly be doing that or you reserve the right to do that if it's not something that you want to be doing on the regular. Just to clarify, because I want to make sure that I got this right, you're saying that we cannot test them for drugs unless we have explicitly said in our handbook or in our policies that random drug testing is a possibility in your workplace.

12:22That's what you're saying. Absolutely. And the reason that I say that is because collecting a bodily fluid specimen could fall under the constitutional amendment for search and seizure of personal property without notice. Yeah. So if you have notified them in policy and they've said, yes, I want this job and I agree I should be safe at work, I don't want to do any harm, then now you have not just a social contract, but an actual contract that says, this is how we're going to proceed because we agree that this is a matter of safety. You're not trying to invade their privacy, but what you are trying to do is say, we can't cause harm here.

13:05We have life in our hands every day. And so we're going to proceed, you know, in the safest possible manner. So as long as you've notified them and they've agreed to that with you. We have no problem on the constitutional freedom front. But this is why I say if you do it without notice and someone says, hey, this is illegal search and seizure, I have a constitutional right to not be drug tested here. That's why I said you can lose a court case very, very quickly, as long as there's advanced notice. And also the Supreme Court has ruled in many cases that employers have the right to do this. We have the Safe and Drug-Free Workplace Act, while it's required for federal workers, it also can, we have protections for non-federal workers.

13:49So we have these things in the U.S. that say these are safe and responsible practices and employers have the right to do it, but you have to have to give notice. And that's just the corporates love it. If we imagine that this practice manager did have a policy in place where they could do random drug testing, do you think that sending them home for the day is the right call there? Or would you have recommended going immediately for drug screening? Because I think that that's where this person is struggling the most. It feels like at least. Right. So she did mention in her question a policy. What am I legally allowed to do?

14:24Let's see. There was some place where she did say the word policy and I'm like, okay, it sounds like maybe she has a policy. So there's two important things here that we want to talk about. First of all this situation is a reasonable cause situation not a random so we can get into that later we can put a little place marker by that because i go down like a whole path of this is what constitutes a random versus this is a reasonable suspicion or for cause test and this is where this falls under like we saw signs and symptoms now we need to take action what she can do should have done and did do depends on what her policy says if her policy says hey we noticed this we're going to send you home for the day, but the next time we're going to test you, she did the right thing.

15:06If her policy says, hey, we noticed this, those are documentable signs and symptoms. We're going to have to test you in this case. She should have had the drug test performed. So it really depends on what the policy said. Now, if she really doesn't have a policy, she absolutely did the right thing. But now she probably understands, I better get that policy in place because if this ever, I've got to have that before I can do this. The way she approached it, I think, was quite wonderful. However, every employee, to my experience, every employee in the world is going to say, no, I'm not a parent at all.

15:43Yeah, when asked that, and I kind of struggled with that myself too, you know, because I was like, well, I don't know how many would openly admit it. And if she went home and sent her home anyway, it gave her the option. Does that tell us anything? Yeah. Some people may say, oh my gosh, I had a crown put in. This happened to me last week. I had a crown put in. They gave me the local anesthesia. Now, I didn't have anything stronger than that. But if I, you know, I had a Rook now a few months ago and I came to work and I'm like, I really should not be in this meeting right now. I'm struggling. If she had said something like, yeah, I had a dental procedure and I felt like I could work.

16:21But now that I'm here, I probably shouldn't be working. That's a whole different thing, right? Yeah. But she suspects marijuana use, that's something that you would not feel like someone could probably work safely under the influence of that. She could say, might you be under the influence? But what is really the best approach? I have no problem with what she did do. I just want to say that. But what do you think might be a more positive outcome often? And to not get yourself into any weird situations with expressly trying to indicate that someone may be using a drug or under the influence of a drug to say, I'm noticing this behavior.

16:55I'm concerned for your safety. So because I'm concerned for your safety and I just want to make sure that you're safe to work and the work environment is also safe, we're just, you know, you can either say at that point, we're going to do a test just to make sure everything's okay. It may or may not tell us anything. That's fine. Or we're going to send you home or we're going to do both. But just approach it from a safety point of view, because that's what our policy says we need to do. It's not personal. We love you. Hope everything's okay. We want you back tomorrow. We hope you're feeling better tomorrow.

17:26If you're not, we need to talk. And so try to keep it there because if you start getting into, and she did this great, but not all of us might approach it the way she did. We would be prone to say, are you using a drug? Did you use a drug? Are you under the influence of a drug? Are you impaired? Are you intoxicated? Are you whatever? And it goes nowhere and it can create conflict. Fortunately for her, this worked out well because the employee didn't get combative with her. if she had approached it this way and the employee would have started getting combative. I have a feeling she might not have known what to do, perhaps, or just said leave.

18:02It could have escalated. It doesn't always escalate, but she had an employee who it sounds like, I went too far. I'm not going to do that again. I'm from here on out, I'm going to not maybe consume before I come into my shift. Yeah. Which is what we want people to do. We want them to understand there's boundaries here. Yeah. We're not asking you what you did last night, but we might need to ask you, hey, were you waking and baking this morning? Yeah, that's not cool. Yeah. No, I'm trying to really approach this from a point of view of, I get it, it's legal. Okay. We're not going to, you know, and you can say in your policy, maybe they won't terminate if you have a positive marijuana test, but they want to send a message.

18:42We're going to expect you to come into work prepared to work. So that test that they're going to do, if they're going to drug test, it's not going to tell the employer, are they impaired? It is not. It's just a test that says it's in your system. However, coupled with the signs and the symptoms that she observed, you know what's going on. You have a confirmation through the signs and the symptoms that this person was very likely impaired. And in that case, take the next steps. But I got to be clear as well here. A lot of state laws have changed around legal marijuana, and many of them have addressed the employer situation.

19:20Now, those state laws are going to primarily impact the ability to pre-employment test and conduct random testing. There's really only a smattering that do that. But like if you're in California, they're going to even dictate what type of test you are allowed to do. Wow. I don't know if you want me to get into that very much, but I do want to say, don't just write a policy on your own without consulting someone that can help you navigate that stuff. And really make sure that you never call a suspicion case a random, because random tests have to be conducted in a truly randomized fashion. All of your employees have to be in like a scientifically generated random pool.

20:01And you have to be able to prove that you ran that pool through a random generator and the person you want to test came up. And that's typically statistically not going to happen magically in this case. So also understand that testing for cause has been upheld by the Supreme Court as an employer's right. And you don't have to correct in your assumption, but you have to be able to document what you saw, what she did right here. so she has documentable evidence the u.s supreme court backs her up so employers please understand you have the right to do that i personally want to just say and advocate because i think we have a few other things to talk to you about this situation i personally want to say that i think that you've got the signs and symptoms you do the drug test it comes back positive here we already see an example of an employee who went, whoop, not going to do that again.

20:59Does it mean she never will? No. But we've got pretty good evidence to show that this is a person that's probably a one-time offense. I really advocate for allowing people a second chance and let's see where we go. If someone continues to violate your policy, you know, you may have to ask them to go work somewhere else because you're caring, like I said, you're caring for life every day and And we don't want to interrupt the good care that we provide. But if it's truly a one-time mistake, you don't want to get rid of a really good employee who really cares and will learn from that lesson. So let's have reasonable policies.

21:36Yeah. I love so much of what you just said because you could tell that for this practice manager, it's weighing heavily on them because they question whether they did it the right thing. and you can tell that they care about their team member. And that's likely why they even gave that option of, I'm going to send you home, but just know that the next time that we're in the situation, we're likely going to have to send you for a drug test. And if it comes back positive, you already know what the policy is, right? So it sounds like there's some sort of policy here that they're kind of playing back.

22:02And I love this piece about compassion because there are so many times when, I think you're right, sometimes people make a mistake. Maybe this person had something to eat the night before and the next day it was still in their system and it was visible and they thought they could be okay, but turns out they can't. We know that those situations have happened with alcohol, for example. You know, a lot of practice managers are in a situation where they're like, hey, this is not okay. And so I do think that there is an area here where we need to balance that compassion with the employee, but also our responsibility to protect the patients, the clients, and the rest of the team.

22:35And so I guess that's kind of my question to you right now is what are some of the other ways that people can balance this compassion. Like for example, in my situation, I remember being a practice manager and it was in a very similar situation as this one, except for we were doing training on this. I hadn't caught anybody, you know, there wasn't any symptoms or anything, but marijuana had recently gotten legalized in the state of Illinois. I was trying to read up on what's real and what's not real, but I wanted to set the standard early up front. Like I want you guys to know, I know that the laws are changing in the state of Illinois.

23:08I still want you to know this is what our policy is. This is how we handle things. So it was very clear if you came in to the clinic with any symptoms, we were going to look into it and we were going to terminate employment if that was happening. So trying to put that standard there. But I remember when I was talking to them about this and kind of having this meeting and making sure that everybody was on the same page, it was very important for me to let them know, like, I want you guys to know that this is really important to me because it is very easy to think that, oh, today's going to be an easy day.

23:38Maybe we don't have a lot of appointments in the schedule. Maybe we have a day of training, but things can turn very serious, very quickly in a clinic setting. At any point, could an emergency come in through that door? And if we lose a patient and you are under the influence of something, even if I did not notice, you are going to question yourself for years to come, whether it was the right thing to do. And I don't want that on you because I know that you guys care about your patients. I know you care about your team. And so it's not just the reality of not only can it affect your work in general and lead to the loss of a life, that's also something that you yourself are going to have to live with, knowing that you put yourself under the influence while you were caring for animals.

24:17And so I think that that's something that really showed the team, like you could see it in their eyes that affected them because they were like, wow, I hadn't really thought about that. You know what I mean? But that's part of the compassion that I think I was trying to show them is it's like, this is a policy that it's meant to protect our team. It's meant to protect our patients. But I want you to know it's meant to protect you also, because this is a very serious thing that we have lives in our hands. And so I guess in my brain, that's something that we kind of did to try and balance the compassion for the employee, but also the responsibility to the patients.

24:46What are some other things that managers or leaders can do when they're put in a situation that shows that compassion, like beyond that even? It's such a great question. And I have so much to say here. But I do want to, before we fully move on, I want to take one half a tiny step back. Yeah. The employee in this situation was sent home. Yeah. If we had a feeling that she may have been under the influence, did we put her in her car and send her driving? That's a good question. Yeah. I didn't even think about that. Yeah. Well, next time, let's call an Uber. Yeah. And have her transported home in case she's not safe to drive.

25:26And I was just teaching on this yesterday. And I said, you know, so many times I present to HR managers. And when I get to this point, and I say that usually there's someone that goes why and raises their hand before I get a chance to finish my sentence. but when I explained that it's not just about the care and compassion because that's a part of it but it's also about your own liability and culpability and putting someone that you thought was under the influence behind the wheel so what I see is a lot of light bulbs come on around the room so I've come to understand that it's just something we don't think about the what after they walk out of our office right yeah um so let's not encapsulate that fully and care all the way to the end of safe in their home.

26:10So with that having been said, I love what you did, Maria, because to me, that education is so valuable. Something that we have seen trending for about the last maybe 10 or 12 years or so is substance use education of any kind is not always present in our high schools these days. Even when it was, they were usually offering it like in fifth and sixth grade, not That's what I remember taking it, yeah. Always in high school. Right? And even through college. So I'm finding that employers say we've got people coming in that really don't even understand the impact of substance use to the safety aspect of work.

26:50Okay, some of us might go, hey, Joe, that's just common sense. Why do we have to even think about that? Unfortunately, and this has become one of my favorite go-to things that I say lately. Unfortunately, in the workplace, employers are now sort of forced into becoming a drug and alcohol testing expert sometimes. just to make sure that safety is protected. That's not what they're there to do every day. Certainly not what you're there to do every day. But if it's not a part of your safety conversation, your practices and protocols at some point, you're failing your employees because they just may not know.

27:24Pop culture is not going to tell them, right? They're not getting it on Instagram or TikTok or whatever. So please take the time to have that conversation that you talked about, and it's best to have it at the pre-employment phase, whether that's in the interview phase, the employee orientation, which I think is really where it should be when you go over the policies. Don't just think, I'm going to shove the employee handbook at them. Ha ha, you signed the policy, which you need to do. They need to sign the policy. You signed the policy so you knew, so we're going to go. I have sat in a room in new employee intake meetings.

28:03I hand in the policy and say, I need you to read this carefully. This is what happens. Flip through and find the holiday schedule, which days are we? Some of them will flip through and go, no yoga pants, no flip flops. Okay. Flip through, you know, and then they sign it and they go. And that's a legal document. If you went to big court on a case like this, the employer has to bring that to the judge and say they signed this policy, so they were aware of it, they agreed to it, and I'm covered. So employees need to understand you need to know what you're signing and what you're getting into and why.

28:40So I started going super boring, sorry to do this. I know you're not a first grader, but we're going to read through this together. And I'm just going to explain to you what everything says, because you're going to be signing that you're informed, and I'm going to make sure that you're informed. So employee orientation is good. Put it in your schedule for your staff meeting once a quarter or twice a year. You don't have to beat people over the head with it. But that education is so valuable. Because even I have a lot of nieces and nephews and cousins that are in like between that 25 and 35 range in there.

29:14And we've had some very enlightening conversations. Those are kids where I live in Colorado that marijuana has been medically legal since they were in elementary school and then it's been recreational since they were in high school. Some of them, yeah, middle school. And they don't know a world that is not that. And it's been so normalized in the culture around them that the safety boundary isn't always clear. And we don't even do a good job when we sell to consumers of saying, hey, there are safety concerns. And that can go for any drug. It can also go for alcohol because you know what? I'm clearly older than you.

29:55In my era of the high school and college experience, MAD, Mothers Against Drunk Driving, they were very new on the scene. And we were getting MAD commercials and information and literature and education constantly, constantly. So I came in to the world as a young adult in the workplace. I knew what one drink would do to me. I knew what drugs would do to me. I knew how long I had to stop drinking before I drove. I knew that because I just had been able to absorb it in the media around me. I don't think young people are getting that today. You know, I think you're so right about that. I remember doing the D.A.R.E.

30:35program in like fifth or sixth grade, and that was about it. I don't think you're trying to remember that as an adult. Yeah. And you are speaking my love language, talking about bringing your handbook out more regularly because I think you're so right. That was something that I immediately saw is if you just hand them the handbook for them to sign, they're going to exactly flip through the pages that they want and then sign it. And it was something that I noticed early on. And that's why I was like, all right, we're going to sit there and go through the policies and we're going to do a questionnaire afterwards to make sure you understand the policies.

31:06But I have always said that your handbook needs to be a living, breathing document, meaning that about once a month, you should grab a policy that's pertaining to whatever's going on and go over the policy. because how many times do they not ask you anything about the holidays until it's the holiday? And all of a sudden they're like, wait, what's the rule? Am I allowed to take the day off before the holiday? And it's like, well, it's in your handbook. You know, like just go check your handbook. But at the same time, that's why we have that. So right before the holidays, before Thanksgiving, I'm going over the holiday policy, right?

31:34We're going over sexual harassment training. We're doing OSHA training. We're doing all of these things that pertain to their job. And I think that there's a lot that they learn because even some things like the fact that the night after drinking, is actually more likely for you to still get into car accidents because the alcohol is still in your in your system right so like even stuff like that people are not always aware and there are some employees who go home and they have their glasses of wine after work and then they go to work the next day and so making sure that they are aware that like hey if you have too many glasses of wine it could impede you for the next day right like the way that you work or where they function they don't always know that and so I do I'm with you on that I feel like training ahead of time is something that we can keep the policy alive and real, remind them that it's happening, but also a good opportunity for us to teach them of the dangers of what really happens when you are impaired.

32:25I think a lot of employers really miss that education piece. And then let me just interject really quickly that recovery-friendly workplace is a thing. Like it's a movement across the country. Right now, it's still rather grassroots, but I think in the next five years, It will be the way that we do policy. In fact, I'd love to see legislation mandating it, to be honest with you. Because what it says is we approach with compassion. We approach with dignity and respect. We give second chances where possible. We are trying to change the mindset of thinking of people as addicts to understanding substance use disorder.

33:07And how can we accommodate that? And that is a medical condition. Is there ADA? Is there HIPAA? Is there what goes along with that? Even marijuana becoming a schedule through drug soon, that's going to have some HIPAA and ADA protections if someone has a valid marijuana card in their state. So there's things that people really need to take a step back and think about. And I'd love to be a resource because that sounds complicated. It's not as complicated as you think. You just have to know the parameters and act accordingly. And so I'm happy to be a resource, but I think people would feel a lot better about couching these safety policies properly if they understood.

33:46They don't just have to terminate everyone. They don't have to become a judge of your character or your moral failure because that's not what this is about. Oh, my goodness. I love that you said so much of this. I need to ask you something. Let's take a break right here, and then I'll come back and get to some action steps. you believe that uncharted is turning 10 that's right uncharted veterinary conference is celebrating 10 years and you're gonna want to be there it is happening on january 15th 2027 and registration is open right now uncharted vet.com hope to see you there all right let's get back into this because i love what you just said and i for those that are interested in becoming like a recovery friendly workspace, where can they go to find out like what to do in order to be that?

34:35Yeah, just Google Recovery Friendly Workplace Initiative. And they have a wonderful website. A lot of states have a Recovery Friendly Workplace initiative in their state. So you can search your state or you can search the national movement. Try your state first, because I think now over half of the states are running their own initiatives. They've got toolboxes that kind to give you some ideas. They don't all offer sample policies yet, but I'm working on that. I did a three-day recovery-friendly policy workshop just over the last couple of weeks with the state of Michigan, and they are really trying to get out there and help people with some sample policy tips.

35:16But Google what is happening in your state, and you can kind of see some good examples of that. And yeah, there's a lot of information. Like I said, it's grassroots, but we're already getting some great data and I'm really excited about it. Yeah, that's amazing. I love so much of that. I mean, I have somebody who's been affected by the general pieces of it. So to me, it feels like such a great way to move forward, especially because I think for most of us as managers and leaders, that is where we struggle, right? Like we want to be compassionate to our teams. A lot of times these are excellent technicians, excellent receptionists, excellent doctors, and we don't necessarily want to lose them.

35:52We want to help them. And you're right. Like this is a medical condition and like how can we help protect them in these spaces? It can be such a powerful thing. Now, there were so many things that we talked about in this particular case when it came to whether they did the right thing. I love that you called out the fact that, well, if you did believe that they might have been under the influence and you sent them home, did they drive? They didn't tell us whether they made them drive or not, but I feel like that's such a good thing to point out that something that I didn't even think of when I read the mailbag.

36:19What are some other mistakes that you see managers making when they are put in this situation? We're going to make sure that we have a policy and we're going to try and stick to the policy. But what are some other major mistakes that you see managers kind of do when they're put in the situation? Things that we should avoid. Avoid judging. Avoid assuming. You know, impairment can be caused by a lot of different life circumstances. Lack of sleep, going through a divorce, a sick child, problems with child care, mental health issues, physical health issues. Impairment can be caused by so many things.

36:50Maybe she's still taking college courses and so exhausted she can't stay awake. Now, there were other things that led the employer to go, yes, something else is going on here. However, don't come out of the gate hot because a lot of things can cause impairment. So what we're looking at and what we are really talking about in a word that we don't use much is intoxication. You can be impaired by a lot of things. You cannot be intoxicated without substances. so we just need to kind of think about our mindset shift on that but no judging no harsh like i said coming in hot i have witnessed employers dragging an employee into the drug testing center and really just verbally berating them in front of people and one that has stuck with me for many years is a gentleman that the supervisor was like he's drinking he's drinking on the job i can't believe he did this.

37:42It was just being like cruel to him to a point that even if the man was just down drunk, he should not have been being treated that way. No one should have. Our whole staff was like, what do we do about this guy? And I do believe our receptionist finally said, could you step out into the hallway for a minute? Because we'll handle him. He wanted to charge in the back, observe the drug test, not allowed to do that. This individual has autonomy and privacy. Turned out the alcohol test was negative because this man was in diabetic keto acid dose like he was in a and luckily we had a physician's assistant there on the site and she goes run a quick sugar test if you would and we did which a drug test company normally doesn't do that we were a clinic right so we did a sugar dip really quick and she called 9-1-1 and he was transported So we have to take a step back and understand that, yeah, we got to know about this stuff and address it.

38:44But you are not a medical expert. You are not a substance abuse professional. You do not have the right to try to evaluate this person. There's a spectrum of substance use disorder. Some people just need to be educated. Other people need help, and we want to help them. We want education over here. And then on the whole spectrum, we want, is it inpatient treatment? Is it outpatient treatment? How can we accommodate that? Can they get family medical leave? Can they, do we have an EAP program? What are we going to do to help return someone to health, wellness, and safety? Because we care about the full person.

39:19And sometimes that accommodation, because look, I know a lot of veterinary practices, my niece is in a veterinary practice as a tech. I know a lot of these are small business owners and there's expense with having employees and all of this. So we can't always make all of the benefits available, but maybe we can say, you know, family medical leave or sometimes these things qualify for temporary disability. Job will be here when you get back or we will try or we, you know, whatever. There's paid leave, there's unpaid leave. There's a lot of ways to approach this without termination. and you're out of here.

39:56And not that termination is never warranted when someone is a repeat, repeat, repeat by later and they respect the boundaries. Boundaries have to be in place. But there's ways that we can support and care and keep our team intact. And sometimes the person has to go in a timeout for a little while before they can come back in. And that can be a hardship. You might have to hire a temp to replace them for a minute, but we can do this. We can do this, right? And so the approach, a lot of how we even implement recovery friendly policies is in the approach and the response. Yeah. I just love in the mailbag.

40:35I love how her verbiage comes across. I know we're looking at words on a typed page, but it comes across in a very caring manner. I didn't see accusation. Now, of course, you probably would not have told us I chewed them out. but really truly take a step back and think about every human deserves dignity and respect even those who are struggling even those who just screwed up maybe they don't have a substance use disorder let's re-educate them let's bring them back to the team so yeah I think for a start there we are yeah I know what you mean in the mailbag I felt that too you could hear the compassion in her voice of she was trying to help this team member and I think that that's why she did the whole I'm gonna send you home anyway because you're denying all this and so I am such a big fan of everything that you just said, because I think that at some point you're right, there are those people who just need to be educated, who just need, and there's some people who also need more help, right?

41:28And this could be something that breaks them, right? If they now all of a sudden are in this situation and now they've lost their job too. And like, it doesn't help them necessarily in the long run to simply have this, this barrier of, no, you're completely gone now. This is where we do. And you're right. There's still repeat offenders. Like there's some people who at some point you can't help. So I guess maybe that's where I want to bring this question to you. At what point do we go from that? So say that we've got a situation where this person admitted, yes, I made a mistake. I think I need some help.

41:57And I know that sometimes when they come to you and they're like, okay, I think I have, you know, an alcohol problem, or I think I have a drug abuse problem. At this point, it does become technically protected in some cases by ADA. So what are, what do those steps look like? Because I'm more of a fan of like, I think you should talk to your employment lawyer and make sure that everything is probably nice and squared away because the state is going to matter. And also I'm a fan of, obviously we're going to document as much as we can, like document, document, document. But beyond that, what is that appropriate approach here so that we want to help them and we want to stay true to the law and the rules.

42:30And we also obviously are in the situation where it's becoming a medical issue too. What is the appropriate thing here? This was such a great question. And I know I keep saying that to you, but you are like the awesome person to kind of ask the questions in this way and think it through. ADA on substances typically, and a lot of these are state-based, but even I think federally, ADA typically says it's protected if you're in a treatment program and following the steps. Not that you can't mess up, but if you are actively in treatment, ADA protects you. If someone has entered treatment and then they're coming to you and saying, I need my schedule adjusted because this is a day program and I have to be there during these hours or whatever have you.

43:19I need you to make some accommodations for me. You need to accommodate that because they have protections because they're in a program. ADA doesn't always protect the person that self-reports that has never even been evaluated. But take a step back to the recovery-friendly workplace. One of the things we suggest in the recovery-friendly model is that we allow self-reporting without punity. So our punitive action is what I want to say. So that's something that, I mean, in my association, we have a weekly town hall and everybody comes and just chats about this stuff. And we have experts every week that talk us through it.

43:53And I hear employers heard when I think it was just last week, might have been the week before, who said this guy self-reported. So he immediately stated that it was a positive drug test and put him in a violations program. And we're like, no, no, no. He did not have a violation. What are you doing? Get that out. Like you have to get this reversed immediately because he self-reported. He did not have a violation of your policy. He didn't fail a drug test and then self-report. He came and reported first and now you're being punitive against him. Self-reporting needs to be able to be handled without any punishment.

44:28So when someone comes and says, I think I have a problem, I don't know, or I do, how are we going to work together? What's going to be in their best interest. Now, maybe we might suggest to them maybe a random drug testing program throughout the year that will help them to be accountable to you, that they're staying in treatment. Often people that are in recovery will agree to that because they want that boundary there. That's an option. But also, what are we going to agree to for checks and balances to know that we're supporting their recovery, but they're also working their plan? Don't want to go too far into that because some of that can cross the bounds, but we also want to help set them up for success.

45:10So what will they agree to? What can we agree to? But self-reporting should not be handled with the punitive approach. And I just want to repeat that. But a lot of policies don't allow for that. And that's something that I would like to see people change. Yeah. It's such an easier way to come from that compassion standpoint, right? Of like, I'm going to feel more comfortable self-reporting if it's in the policy that, you know, it's not going to lead to my termination just because they tell you that I'm struggling with something. And I'm more likely than to do it. One final question, because I almost feel like we might need to do a part two to this episode.

45:42I still have so many, and I know people are going to send us questions after this too. So I may have to reach out to you for a part two, but one final thing, just because I was wondering this myself, as far as marijuana testing itself, and we talked a little bit about marijuana being legalized. Have there been any advancements as far as, I know that like we're looking at somebody who has the symptoms. I know there's been some states that will say like, oh, they have to have three symptoms at minimum and report positive on their drug screening test. Is there anything else that will tell us, I guess, sooner?

46:12Because as of what I remember when I was in Illinois and it was legal, when you did a drug screening test, it wouldn't tell you whether that person was in the moment under the influence of something. They would only tell you if they had within the last like week. And so it was like people would argue, well, that's not enough to prove that I am. And so at what point is it enough to prove that you are? Can we go based on just the three symptoms? Is it two symptoms? What are we looking at here? Like, how do we? Well, the Supreme Court system says it has to be one. Okay. Okay. The Supreme Court says one.

46:46It says something more than a hunch. If you can articulate it, if you can document it, you have a symptom. I'd have to look at what other state laws have said But this is a super hot topic You're in drug testing It takes about 24 hours to metabolize It is saying, did you have presence in the system It is not an impairment test I don't know that you'll ever find an impairment test In an actual drug test Because it's just metabolites in your body There are some tools that can be used However, advancements, yes Lab-based oral fluid detects use within a few hours and most of them cut off at about 24 hours some are 36 but you're at least narrowing the window there is a new product out called the cannabis bix and there's a great lab that i love friends of mine that is in ohio but the cannabis tool it's still a lab-based test you blow into it like a breathalyzer you still send that to the lab but that's supposed to be like within minutes to a cutoff of, I think it's four to six hours.

47:49So we're getting better. We're getting closer to recent use, not a week ago, three weeks ago, all of that stuff that people say, that's not really how the urine drug test works. But those tools are better. But what really holds up is the signs and symptoms. She put her eyeballs on it. She saw that. That's really what holds up in court. So that's what matters more than the test. The test is a tool. It's a piece of the puzzle. It can help you figure out the story of what's happening, but never rely on that alone. You've got to be looking at what are you seeing? What are the eyes telling you? The speech, the ability to understand what you're saying right now.

48:30Do you multivite a detention task? The gate, all of those things play a role in whether or not someone is functioning safely. But at the end of the day, this all boils down to going back to the very first core step. She did not feel this person was operating safely. We cannot continue operating right here in this manner. Yeah. The safety call is the call that the employer always has the right to make no matter what. I love that so much. Thank you so much for sharing that. I knew you would know about advancements. I just knew it. Is there anywhere people can find you where they can look for more information from you specifically?

49:03Because I know that they are going to want to. Where can people learn more about you? Yeah, they can find me at www.indesa.com. And that's N-D-A-S-A.com. I'm also at joe at joemcguire.org or joemcguire at indesa.com. And that's J-O-M-C-G-U-I-R-E. So yeah, be happy to hear from people and help them out. Yeah, we'll make sure and put the links in the show notes. So thank you so much for being here. We genuinely appreciate it so much. And I'm sure you're going to hear more from me. I promise. Wonderful. Thank you so much. Bye. And that's it. That's what we got. Yo, I hope you enjoyed this episode.

49:41I had so much fun talking with Joe. I think there are so many questions here when it comes to the changing laws around substances, around trying to be compassionate. We have all been somewhere in a situation where a family member or a friend has been affected by a drug substance abuse disorder. And so how do we approach this from a place where we can be compassionate for our teens, but also responsible for the lives that are very much in our hands every single day. And so I'm just so glad we were able to do this episode. Thank you so much to Joe McGuire from the National Drug and Alcohol Screening Association for doing this episode.

50:15Thank you for listening to this episode and trying to be more educated around this topic. And thank you to obviously the Uncharted Veterinary Team who is always working so hard. shout out to Dustin Bays. I'm sorry I don't shout you out more often. He is such an excellent editor for our podcast. Thank you so much, Dustin. And I will catch all of y 'all next time. Bye, everyone. A brand new course is now available from the Uncharted Veterinary Conference team. Don't Get Sued is an on-demand eight-module course that we've created in partnership with HR expert Debbie Hill. To help you answer the question, why do veterinary practices get sued in the first place and what can I do to protect my team.

50:54This course is available now for$2.99 and is free for Uncharted members. You can find out more now at unchartedvet.com.