See DOT’s web site at www.dot.gov/odapc/sap.html for the definition and job responsibilities of an SAP.
The Montreal Cognitive Assessment (MoCA) may be used in identifying potential cognitive impairment among substance use disorder patients. (Using a cut-point score of 25, the sensitivity for substance use disorder is 83% and the specificity is 73%.)
Examples include the Patient Health Questionnaire-9 (PHQ-9) for major depressive disorder, and the GAD-7 for generalized anxiety disorder.
Physicians certified by the American Society of Addiction Medicine (www.asam.org) or the American Board of Addiction Medicine (www.abam.net)
Following a comprehensive substance use disorder evaluation, either the assessing clinician or the police physician may have a strong clinical suspicion of substance dependence (see Appendix B, section B-3, regarding denial), but only the DSM-IV criteria for substance abuse may have been formally met. Then, they may adjust the treatment to the dependence level and request additional evaluation in the future. With individuals working in law enforcement, as in other safety sensitive positions, if there is doubt with respect to the diagnosis, it may be considered appropriate to err on the side of safety at least during a defined period of further ongoing evaluation. Notably, individuals with substance dependence can be unaware of the magnitude of their problem because of denial or alternatively may simply under-report symptoms and substance use-related adverse consequences.
Testing mandated in recovery is intended to assist the LEO in maintaining abstinence. At a minimum, it should be targeted at the specific substance(s) of abuse, and commonly abused members of the same class. If an agency has a written post-offer or random workplace drug testing program, the routine tests, which are aimed at primary prevention, may not be properly targeted.
Since there is significant safety risk associated with relapse in LEOs and because inpatient treatment may have better outcomes with decreased risk for relapse, inpatient treatment should be strongly considered in treating LEOs with substance dependence. The period in residence may count toward the documented abstinence period. (Consideration should be given, however, to avoiding substance abuse treatment programs with high criminal offender participant rates.)