Effects of Psychoactive Chemicals on Commercial Driver Health and Performance: Stimulants, Hypnotics, Nutritional, and Other Supplements (2011)

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INTRODUCTION AND METHODOLOGY A structured interview questionnaire for use with CMV stake- holders (e.g., predominately truck carrier fleet managers, safety advocates, and other company officials) was designed to elicit key information about current commercial motor carrier company applications, policies, and programs involv- ing the use, or restriction of use, of chemical substances by commercial drivers. The survey questionnaire asked specific questions about a carrier’s knowledge base regarding various chemical substances sometimes ingested by their drivers. It also asked them about current company policies regarding driver use of stimulants, hypnotics, and nutritional supple- ments. The questions on the survey were open-ended enough to gather information about company officials’ experiences with current approaches and procedures, and safety policies in place, to identify problems and to elicit proposed solutions regarding the use of chemical substances in the commercial transportation industries. Survey questions were specifically designed to cover the scope and objectives outlined for the purpose and intent of this synthesis study. The ATRI distributed the survey questionnaire to motor carrier company officials through: (1) the American Trucking Associations (ATA) Safety and Loss Prevention Management Council; (2) to a health and wellness working group within the council; and (3) to several wellness clinics located at travel centers that target over-the-road drivers. Respondents were solicited by e-mail, accompanied by an Internet URL link on the ATRI’s website, where the respondents could access the online version of the Chemical Effects Survey. QUESTIONNAIRE SURVEY RESULTS The participants consisted of safety and human resource personnel within the trucking industry, including motor carriers and allied professionals (e.g., motorcoach and health and wellness clinics). Thirty-one company responses were collected. These companies employed a range of from a min- imum of 10, to a maximum of 6,200 drivers, with an average of more than 800 drivers (816) per company. Most respondents were representatives of truck carrier firms. The survey netted responses from one commercial driver training company and from one charter-bus company. The specific questions posed in the survey are depicted in the context of the presentation of the results (here) along with summary statistics for the surveys. Carrier Survey on Chemical Substance Use among Drivers 1. What sector of the trucking industry do you primarily operate in? (Check all that apply.) Sector Total For-Hire 16 Private 7 Truckload 7 Less-than-Truckload 5 Specialized 2 Other 3 Open-Ended Responses: Total Other Charter Bus 1 Medical and Wellness Clinics 1 Training 1 2. How many drivers does your company employ (by type)? Driver Type Total Company Drivers 24,490 Leased/Owner–Operators 4,225 3. Do you have company policies or guidance (written or verbal) for drivers on drugs, medications, or other chemical substance use? Company Policies or Guidance Total Yes 29 No 2 If you answered yes to Question 3, please answer Question 4 below. If no, please proceed to Question 5. 4. For which of the following chemical substances does your company provide drivers with policies or guidance? (Check all that apply.) Type of Policy or Guidance Total Prescription Medications 24 Over-the-Counter Medications 12 Legal Stimulants 6 Sleep Aids 8 Nutritional Supplements 3 Alcohol 24 Illegal Drugs 23 CHAPTER SEVEN MOTOR CARRIER POLICIES ON DRIVER USE OF CHEMICAL SUBSTANCES 62

63 If yes, please briefly describe your Health and Well- ness efforts here: Open-Ended Responses Training materials developed in-house and through Novartis Just brought the program in with a fund that is awarded by the Chamber of Commerce in our business area. It covers checks for cholesterol, triglycerides, etc. Blood pressure, diabetes. Associated counseling for any problems discovered. We perform basic awareness. Evaluating options for starting a wellness program. Company provides guidance regarding good nutrition to employees and ongoing awareness regarding health to the employee. Health fairs, driver wellness training with practical discussion over the ideas, drivers trained in Drug and Alcohol use. We provide an onsite workout facility (weight machines, treadmills, free weights). We mail out a monthly health newsletter to drivers’ homes. We are developing a program. Presentation on exercising and healthy eating. Weight watchers program. Health care staff comes in once a year to review additional options and to complete minor health care diagnostic work. Company healthcare. Our program is just starting, so initially we address diet and smoking. Primarily promoting healthy life style through messages and handouts. Nondriver employees have sack lunch health meetings. Roadside Medical (RSM) Driver Wellness Program is designed specifically for the professional driver based on testing from the current state of driver health. RSM is also in the process of creating a line for its employee’s monthly wellness program; Introducing the Roadside Medical Driver Wellness Program . . . the most innovative program designed to travel with you! Roadside Medical’s Driver Wellness Program provides simple and easy-to-follow tools and materials to get us on the road to better health (and keep us there!). Key features include: unlimited one-on-one telephone health coaching, a wellness kit, a free 30-day health check, exercise and nutrition guides, and more. New driver 30-day meal supplements kits, designed for the professional truck driver. Currently they fall under the corporate Wellness Program. We are tailoring this program to be driver- specific, and keeping them under the corporate program. Annual screenings, preventative testing paid 100% through insurance 7. If chemical substances are included in your Health and Wellness program, please elaborate: Open-Ended Responses We offer Employee Assistance Program for all staff Health coaching We follow the DOT regulations for hazmat endorsed drivers Open Ended: Type of Policy or Guidance Total Prescription Medications Over-the-Counter (OTC) Medications Legal Stimulants Sleep Aids Nutritional Supplements Alcohol Illegal Drugs 5. Do you have an employee Health and Wellness program? Health and Wellness Program Total Yes 19 No 12 6. Does the Health and Wellness program include drivers? Health and Wellness Program Including Drivers Total Yes 19 No 9 No Response 3 Advise safety of all prescription meds As a CDL driver if this medica- tion could cause a problem with your driving do not use if it causes you to test positive; you could be terminated. Prohibited as they cause adverse effects Must report any prescribed drug usage Guidance on effects, guide- lines for use when off duty first to evaluate effects before performing safety- sensitive functions, fact sheets on common OTC meds provided As a CDL driver if this medication could cause a problem with your driving, do not use, if it causes you to test positive you could be terminated. Prohibited if they cause adverse affect Discourage use by providing education on health effects and through wellness fatigue education Awareness communication Prohibited if they cause adverse effects No responses received Firm written policy Assistance if employee steps forward Firm written policy Zero tolerance if busted, assistance if employee comes forward

64 8. How are company policies regarding driver substance communicated? (Check all that apply.) Communication Method Total Health and Wellness Program 13 Written Company Policies 31 Safety Meetings and Training 29 Reminders in Employee Newsletters 14 Other Means 2 9. What issues or problems regarding commercial driver chemical use need to be addressed or resolved in our trucking community? (Please identify and elaborate.) Open-Ended Responses Education on OTC and prescription medications and their effects. There needs to a better way to control what drivers are doing once they are out on the road. As far as being mandatory, there should be no more regulations required of the companies. All illegal drugs, abuse of legal drugs, and alcohol are already covered in our DOT Drug and Alcohol policies. Sleep Designer drugs None we have Drug database for carriers to reference Expand to additional drugs and testing processes Most of our problems with drugs or alcohol are drinking and driving in the driver’s personal vehicle (DUI) resulting in loss of CDL. Need to reduce the number of drivers that need to be randomly tested each year. Specific guidelines of what is acceptable and what is not. The drug testing standard needs to move to hair testing. Providing health/wellness health coaching and counseling. Once you start to help drivers achieve results and their minds become clearer, they need support in recognizing dependencies and how to deal with them LONG-TERM! Prescription drugs and legal stimulants Accurate method to determine a driver’s alcohol and drug history prior to hiring. Over-the-counter aids should have warning labels when taken with prescription medications. Need to make sure all companies are in compliance. We need a national database showing when and where drivers tested positive. This database should be accessible to all trucking companies so they know a driver’s prior history before hiring him or her. 10. Do you have adequate access to chemical substance resources? If yes, what information sources did you find useful? Adequate Access to Chemical Substance Resources Total Yes 22 No 9 Open-Ended Responses Internet and Internet updates; online information if needed (5 responses) Seminars sponsored by main health facility we contract with to do our DOT physicals and drug tests. Employee awareness through J. J. Keller Through our Medical Review Provider National Safety Council Close relationship with our clinics, Employee Assistance Program line J. J. Keller Health care programs, Employee Assistance Program network Our Third Party Administrator (TPA) for health insurance, etc. Coaching and counseling Consolidated Drug and Alcohol Compliance, Inc., Kenner, LA We use DOT regulation notices and have a medical staff that keeps our organization informed Tapes, written programs, and online tools If no, on what topics would you like more infor- mation? Open-Ended Responses Information on over-the-counter meds and their effects Industry best practices Federal database Specific information for generic drug names Easy reference to prescribed and over-the-counter drugs that are restricted or problematic for driver alertness Providers of testing nationwide