"Dramatic weight loss"...It's often cited as a symptom of drug abuse on those checklists you can find online. Most addiction treatment professionals will tell you dramatic weight loss, when considered a symptom, is due to the effect of some "speed like" drug -- cocaine, amphetamine abuse, using other forms of diet pills, etc.  

Of course, many medical conditions can cause weight loss. This symptom therefore is not typically given a lot of weight when it comes to counting on it as a document-able "contemporaneous" symptom of potential drug or alcohol abuse.

Let's be honest. You are not likely to ever observe this symptom with an employee in your career as a supervisor. If you do, it will probably not be from drug abuse, but from some other medical condition or side effect of treatment.

So, let's discuss and play pretend, because you just never know.

What about that one employee of yours--you know, the one who is losing weight and looks sickly. Is that any of your business?

Most experts in reasonable suspicion training for the DOT who happen to also be addiction treatment knowledgeable folks in workforce management would say "no." This is because you can't diagnose and link weight loss to substance abuse without more information. And you aren't like to get it.

But wait, let's examine this symptom a bit closer.

An employee who looks weak and skinny, or appears without much strength, could be a safety risk, right?

Generally, most jobs require essential functions at lifting about 50 lbs if they have functional capacity requirements. Adults, when necessary, are supposed to be able to carry 50lbs if the need should ever arise. If they can't it can be a sign of other physical problems.This is true teachers, janitors, and many white collar jobs--who need to lift boxes of books or files, a table, or some other lifting object commonly found in the workplace but weighing 50 lbs. 

Many organizations don't have a functional capacities test or exam for their positions, but many should because if an employee ever becomes sickly looking, and is still on the job, a fitness for duty exam can remove that worker until cleared by a medical doctor with the help of an assessment offered by the EAP who can spot other diagnostic conditions like drug and alcohol abuse. 

A fitness fro duty can save the worker's life, prevent injury, reduce financial loss, or get a worker into the proper treatment for a medical condition This may be an addiction treatment program. This is also why management should have a good working relationship with the EAP -- for a fitness for duty, go through the EAP and let them manage the medical clearance so they can also expertly review the employee to spot a substance abuse problem.

 Fitness for duty referrals save lives, and essentially that is what a drug test - removal from work until cleared by a medical doctor -- an MRO.

Continuing, employees in weak condition risk injury if they attempt to lift a reasonable amount of weight, or perhaps risk a fall, which is the most common reason for injury or death.

So requesting a fitness for duty based on "dramatic weight loss" over a period of time, could lead to a substance abuse/addiction upon closer examination. This is also a good reason for having an effective employee assistance program.

Getting an employee to the EAP can help ensure that the drug and alcohol issue won't be glossed over or ignored entirely by the medical doctor -- and some doctors avoid confrontation -- hint-- get doctors who will work with your company and not avoiding asking employees tough questions about workplace drug and alcohol abuse.

So it is not totally off the grid -- weight loss. In fact, it can signal an employee who is physical at risk of injury or injuring others. 

Or other signs and symptoms of drug abuse may corroborate the weight loss as a likely reason for it. The issues is this: "What role does dramatic weight loss play in reasonable suspicion, and can it be considered as a contemporaneous, articulate-able, and document-able issue for purposes of justifying reasonable suspicion.

Standing alone this symptom does not do much good for documenting purposes -- so NO.

Reasonable Suspicion Training for Supervisors: Two Applications of Intervening (Sort of) with Dramatic Weight Loss

Here's what dramatic weight loss should signal you to do in the game or reasonable cause for being under the influence, and what DOT supervisors should consider as reasonable steps.

1) Ask what's going on. If something looks like a problem it is obvious and, then it is okay to ask. It's not prying at that point.

2) Don't ignore other signs and symptoms. When an employee is losing weight and it is associated with drug abuse, then there are almost always signs and symptoms of substance abuse that the DOT Supervisor (or any supervisor for that matter) will be able to see.

There is nothing wrong with increasing your suspicion level -- thinking about attendance, attitude, behavioral issues, quality of work, quantity of work, availability, and conduct on the job. All of these performance dimensions can be influence by drug and alcohol use by employees.

Many companies make the mistake of telling supervisors that not employee can be referred for drug testing unless there are clear, here-and-now "articulate-able" contemporaneous signs and symptoms exhibited by the worker that could be associated, possibly, with being under the influence of alcohol or other drugs/substances.

Is there a balance between this and other signs and symptoms are clearly associated with drug abuse, but aren't necessarily proof of using substances on the job at the moment? I have just shown you how there is.

DOT Drug and Alcohol Education/Training for Supervisors includes a discuss of many symptoms and signs of using. The weight loss symptom is strictly about context to aid the supervisors resolve to be suspicion in a healthy and appropriate way, and make the referral based upon other symptoms that appear to demonstrate themselves on the job.

You can purchase or participate in our DOT Supervisor Training Course on Drug and Alcohol Abuse by clicking the link below: DOT Supervisor Training for drug awareness and alcohol training.