Seeing The Forest AND The Trees

The Role of the Substance Abuse Professional (SAP)

Jeannie James, LPC/S, NCACII, SAP

1st Group ActivityThe Macarena:

1. It is a 16 step dance – turning clockwise each sequence.

2. 1st 4 moves – right hand straight out palm down,now the left; then right hand palm up and then the left.

3. Next, cross right hand to grab inside of the arm and same with the left hand; then place right hand on right side of neck and left hand on left side of the neck (moves 5-8).

4. Next take right hand and place on left @ waist and left hand on right @ waist then place right hand on right glute and left hand on left glute (moves 9-12).

5. Finally shake, shake, shake (your bootie) 3 times, turn and clap (moves 13-16).

6. REPEAT until you return to starting position (ideally 4 times)… :]7. *IT IS OPTIONAL TO LIST THIS SKILL ON YOUR RESUME.

WHAT does the Macarena have to do with being an SAP?

SAP – what does that really mean? Substance Abuse Professional• This is NOT someone who has just started in the field of

addiction. This person MUST be someone who is alicensed physician; licensed or certified social worker;licensed or certified employee assistance professional;

• alcohol and drug abuse counselor certified by the NAADAC Certification Commission (NCC) or the International Certification Reciprocity Consortium/Alcohol and Other Drug Abuse (ICRC).

• To even qualify for those licenses/certifications, one must have years of experience.

• IN ADDITION, a SAP must receive qualification training and pass a test administered by a nationally recognized professional or training organization.

SAP – What do they do?

• The GATEKEEPER of the return to duty process.• The responsibility of the SAP is tremendous,

and at every step in the process, the SAP must be aware of the impact his/her decisions make on the employee, the employer, and the general public.

• Public safety is the first and foremost priority.

When are SAP services needed?

• An employee comes to the SAP because of a verified positive drug test, a refusal to test (this includes a substituted or adulterated urine specimen), a breath alcohol test of .04 or higher, or a violation of the prohibitions on the use of alcohol or drugs under a DOT agency regulation.

Role of the SAP in the Returnto Duty Process

The SAP must perform the following functions:• Conduct a face to face initial evaluation/assessment.• Provide a recommendation for either education or

treatment.• Conduct a face to face follow-up evaluation.• Provide continuing treatment/aftercare

recommendations when appropriate once the employee has returned to a safety-sensitive position.

• Provide a follow-up testing plan.

Initial evaluation/assessment – Step 1

• Should be a comprehensive psycho-social-bio assessment using interview questions, standardized testing tools and collateral contacts.

• SAP is responsible for appropriately assessing for any co-existing mental health problem.

**Initial evaluation MUST include a diagnosis, treatment recommendation(s) and a treatment plan.

Group Activity #2 – Part 1

• Put yourself in the place of the client in scenario #1. What is your feedback about this experience?

Group Activity #2 – Part 2

• Put yourself in the place of the client in scenario #2. What is your feedback about this experience?

Level of Care Recommendation and Referral – Step 2

• Should be based on OBJECTIVE data and clinical history; for example – ASAM Placement Criteria for the Treatment of Substance Related Disorders.

• Per DOT, ALL employees must be given some recommended course of education or treatment.

Follow-Up Evaluation – Step 3

• The clinically based question to be answered is whether or not the employee has successfully complied with the initial treatment plan.

• The employer is dependent on the SAP’s evaluation at this stage in the process to gauge the employee’s ability to return to a safety-sensitive position.

• The follow-up evaluation is clinically based on the face-to face meeting and information received from the treatment resource.

Continuing Treatment/Aftercare (When Appropriate)• It is permissible for the SAP to recommend additional services

to ensure an employee returning to a safety-sensitive position remain clean and sober, as part of the return-to-duty agreement.

• If the follow-up evaluation indicated the employee did not comply with the SAP’s initial recommendations, the SAP must write a letter to the employer or designated rep indicating dates for further follow-up evaluations and the clinical reasons for determining the employee has not demonstrated compliance to the initial recommendations.

• The employer may take personnel action per their policies/procedures and must not return the employee to a safety-sensitive position.

Follow-Up Testing – Step 4

• SAP is sole determiner of the number/frequency of the follow-up tests and whether these tests will be for drugs, alcohol, or both.

• SAP MUST recommend a minimum of six unannounced follow-up tests within the first 12 months following the employee’s return to a safety-sensitive position and can recommend up to 60 months follow-up testing.

• Employer is responsible for determining the actual dates of the testing and may not impose additional requirements that go beyond the SAP’s plan.

SAP Consultation

• S

• SAP can act as consultant to DOT regulated companies – should know the limits of their knowledge and should refer employers directly to the appropriate operating administration for regulation questions.

References• The Substance Abuse Professional’s U.S. DOT Alcohol and Drug

Testing Regulation Qualification Course, January 2003, NAADAC.• Federal Motor Carrier Safety Regulations, Management Edition,

October Revisions, Label Master.• La Macarena by Los Del Rio.

• Acknowledgements:• -THANKS to Terry Turner, my co-worker and amateur actor.• -THANKS to Bill Gilmer, my co-worker and IT consultant for my

presentation.• -THANKS to Randy Cole, my supervisor/CEO for letting me

attend this conference.

QUESTIONS???

THANKS SO MUCH FOR YOUR TIME AND

ATTENTION!