5.4 Drug Effects, Substance Abuse Recognition & Paraphernalia
Key Takeaways
- A security guard records observable indicators such as slurred speech, unsteady gait, pupil size and odour, and never records a diagnostic conclusion that a subject was drunk or under the influence of a named drug.
- Pupil response is the fastest field discriminator between drug families: opioids constrict pupils to pinpoints while stimulants and hallucinogens dilate them.
- Hypoglycaemia, stroke, head injury and the post-seizure state all mimic intoxication, so an apparently intoxicated person who cannot be roused or is breathing abnormally is a 911 medical emergency and must never be ejected.
- Section 25.2 of the Occupational Health and Safety Act requires an employer aware of a risk of worker opioid overdose in the workplace to provide and maintain a naloxone kit in the charge of a trained worker in the vicinity.
- Discarded sharps are never recapped or handled by hand: use puncture-resistant gloves and tongs, deposit point-first into an approved sharps container, and report a needle-stick injury the same day because post-exposure prophylaxis is time-sensitive.
Drug Effects, Substance Abuse Recognition and Paraphernalia
Core Principle: Section 3 of the ministry syllabus requires guards to discuss drug effects, substance abuse, and related paraphernalia, including the physical and psychological signs of use and of withdrawal. The purpose is not diagnosis — a guard is not a physician and never states in a report that someone "was on meth." The purpose is observation, safety, and articulation: recognizing behaviour that changes your tactical approach, spotting a medical emergency that needs an ambulance rather than an ejection, and recording what you actually saw.
The Golden Rule: Describe, Never Diagnose
Write "the subject's speech was slurred, his eyes were bloodshot, he was unsteady on his feet, and there was a strong odour of an alcoholic beverage on his breath." Never write "the subject was drunk" or "the subject was high on cocaine." The first is admissible observation you can defend under cross-examination; the second is an opinion you are not qualified to give, and it hands defence counsel an easy attack on your entire report.
The same rule protects the subject. Many conditions mimic intoxication and are frequently mistaken for it, with fatal consequences:
- Diabetic hypoglycaemia — confusion, sweating, slurred speech, aggression, staggering.
- Stroke — sudden facial droop, one-sided weakness, garbled speech.
- Head injury — a subject who was assaulted, fell, or was struck may look "sleepy drunk" while bleeding intracranially.
- Post-ictal state after a seizure — disorientation, combativeness, no memory of events.
- Hypoxia, sepsis, or dementia — all can present as apparent intoxication.
Exam Trap: The safest reflex when a person appears intoxicated and is losing consciousness, breathing abnormally, or cannot be roused is to call 911 and treat it as a medical emergency, not to eject them into the cold or lock them in an office to "sleep it off." Ejecting an unconscious or semi-conscious person creates a direct duty-of-care exposure.
Drug Categories and Their Observable Effects
| Category | Common Examples | Typical Observable Effects | Withdrawal Signs |
|---|---|---|---|
| Depressants (CNS) | Alcohol, benzodiazepines, GHB, barbiturates | Slurred speech, poor balance and coordination, slowed reactions, drowsiness, disinhibition, sometimes belligerence | Tremor, sweating, anxiety, insomnia, nausea; alcohol and benzodiazepine withdrawal can cause seizures and can be fatal |
| Opioids | Fentanyl, heroin, oxycodone, hydromorphone, morphine | Pinpoint (constricted) pupils, drowsiness or "nodding," slow shallow breathing, itching, low, raspy voice | Yawning, runny nose, watery eyes, goosebumps, cramps, vomiting, diarrhoea, muscle aches; intensely unpleasant but rarely fatal |
| Stimulants | Cocaine, crack, methamphetamine, MDMA, prescription amphetamines | Dilated pupils, rapid pressured speech, sweating, elevated body temperature, restlessness, grinding teeth, hypervigilance, paranoia | Crushing fatigue, depressed mood, increased appetite, agitation, strong cravings |
| Hallucinogens / Dissociatives | LSD, psilocybin, ketamine, PCP | Dilated pupils, disorientation to time and place, responding to stimuli that are not there, unpredictable emotional swings, apparent insensitivity to pain | Generally no physical withdrawal syndrome; persistent perceptual disturbance possible |
| Cannabis | Dried flower, edibles, concentrates, vapes | Red eyes, distinctive odour, delayed reactions, impaired short-term memory and time perception, increased appetite; edibles peak late and unpredictably | Irritability, poor sleep, reduced appetite, restlessness |
| Inhalants | Solvents, aerosols, nitrous oxide | Chemical odour on breath or clothing, paint or residue around the mouth and nose, dizziness, slurred speech, sudden euphoria then collapse | Headache, tremor, irritability |
The single most operationally useful contrast to memorize is pupil size: opioids constrict, stimulants and hallucinogens dilate. Confirm it against ambient lighting before you record it.
Paraphernalia a Guard May Encounter
Guards find paraphernalia in washrooms, stairwells, parkades, dumpster enclosures, and vacant units. Recognizing it drives the correct response — containment, sharps safety, documentation, and notification — not amateur investigation.
- Injection: syringes and needles, spoons or bottle caps with burn marks, cotton filters, tourniquets, sharps containers.
- Smoking: glass stems and bulb pipes, blackened foil, cut straws, torch lighters, rolling papers, grinders, bongs.
- Snorting: rolled bills or cut straws, razor blades, small mirrors or cards, folded paper "bindles."
- Packaging: small zip bags, corner-cut baggies, gel capsules, digital scales, unlabelled vape cartridges.
Sharps protocol on every Ontario site: never recap a needle, never sweep with bare hands, never pinch a syringe between fingers. Use puncture-resistant gloves and mechanical tongs or a scoop, place the item point-first into an approved sharps container, note the exact location and time, and report it. A needle-stick injury is a critical workplace incident: wash immediately, report to the supervisor, and seek medical assessment the same day, because post-exposure prophylaxis is time-sensitive. Under the OHSA the exposure must be reported and the incident recorded.
Opioid Overdose: The Emergency a Guard Is Most Likely to Face
Recognize the classic triad: unresponsiveness, very slow or absent breathing, and pinpoint pupils, often with blue or grey lips and fingertips, and a gurgling or snoring sound.
Response sequence: ensure scene safety and glove up → shout and apply a trapezius pinch to check responsiveness → call 911 immediately → give naloxone if trained and available → open the airway and give rescue breaths, or begin CPR if there is no pulse and no normal breathing → stay and monitor, because naloxone wears off before many opioids do and the person can re-enter overdose → hand over to paramedics with the time of onset, the number of naloxone doses given, and anything found at the scene.
Two legal facts belong with this:
- OHSA Section 25.2 requires an employer who is aware, or ought reasonably to be aware, that there may be a risk of a worker having an opioid overdose in the workplace to provide and maintain a naloxone kit there, ensure it is in the charge of a trained worker in the vicinity whenever workers are present, and provide the prescribed training. Guards at such sites must know where the kit is before the emergency, not during it.
- The federal Good Samaritan Drug Overdose Act amended the Controlled Drugs and Substances Act to protect a person who seeks emergency help for an overdose — and anyone else at the scene — from charges for simple possession. Telling a frightened bystander this is often what keeps them from fleeing before paramedics arrive.
Tactical Adjustments When Impairment Is Suspected
- Increase reactionary distance. Impaired subjects have unpredictable balance and delayed comprehension. Stand outside arm-plus-reach, at a slight angle, with an exit behind you.
- Slow everything down. Speak in short sentences, one instruction at a time, and repeat calmly. Alcohol and stimulants both destroy the ability to process complex directions.
- Never take an intoxicated subject somewhere private and alone. Keep a witness, keep the interaction on camera where possible, and keep the door open.
- Do not use pain compliance as a first tool. Dissociatives and stimulants blunt pain response, so pain techniques often escalate rather than resolve.
- Treat extreme agitation with hyperthermia, incoherence, and superhuman exertion as a medical emergency — this is the excited-delirium presentation covered in Section 4.3, and prone restraint here is potentially lethal.
- Never search for, taste, field-test, or "identify" a suspected substance. Fentanyl and its analogues are dangerous in trace quantities. Isolate the area, restrict access, and hand it to police.
- Document only what you sensed. Behaviour, speech, gait, odour, pupils, and what was found and where.
A guard finds a man slumped in a parkade stairwell. He does not respond to a shout or a trapezius pinch, his breathing is roughly four shallow gasps per minute, his lips are grey, and his pupils are constricted to pinpoints. What do these findings most strongly indicate, and what is the immediate priority?
During a washroom sweep a guard finds a used syringe on the floor beside a sink. What is the correct handling procedure?
A guard at a commercial office tower approaches a woman who is sweating heavily, slurring her words, staggering, and becoming argumentative. A colleague says she is obviously drunk and should be walked out. What is the most defensible course of action?