Drug Testing Best Practices

PRESENTED BY:

BEN JOHNSON

VICE PRESIDENT

FLEET SCREEN, LTD.

Identifying and responding to substance abuse:

Helps prevent the hiring of illegal substance abusers when pre-employment drug testing is required.

Helps deter current employees from on-the-job substance abuse.

Provides assistance in helping employees recover from abuse.

Provides a safer workplace for all employees and customers.  

Reduces workers compensation premiums.

Statistics to Support Testing

You can’t afford not to drug test

According to the 2010 National Survey on Drug Use and Health

8.4 percent of full-time employees (10.2 million) and 10.1 percent of part-time employees (3 million) aged 18 or older reported using illicit drugs within the prior month of the study.

• Employees who use drugs are 2.5 times more likely than other non-abusing co-workers to be absent for 8 or more days.

• Drug abusers are 3.6 times more likely to be involved in an accident at work and 5 times more likely to file a workers’ compensation claim.

• 44 percent of abusers have sold drugs to other employees, and 18 percent have stolen from co-workers to support their habit. Studies suggest that substance abuse—which includes drugs and alcohol—costs the United States an estimated $276 billion a year, with much of the cost resulting from lost productivity and increased healthcare spending.

Statistics (Continued)

Studies suggest that substance abuse—which includes drugs and alcohol—costs the United States an estimated $276 billion a year, with much of the cost resulting from lost productivity and increased healthcare spending.

Studies have shown that substance abusing employees function at about

67% of their capacity.

BOTTOM LINE:

Substance use can pose significant risks to workers’ health and productivity, which in turn, costs you more

Check the Statistics

It is untrue that most drug users are poor or unemployed.

About 10 million regular drug users went to work this morning in the US.

Results from the 2010 National Survey on Drug Use and Health

Alcohol Abuse Statistics

Benefits of Drug Testing

Drug testing programs aim to filter out drug users from your workforce as well as to deter drug use on the job.

According to data from the National Survey on Drug Use and Health, past-month illicit drug users said: They would be less likely to apply for a company that conducted pre-employment drug testing than one with no testing program.

Reported they would be far less likely to work for employers that conduct random drug testing compared to those reporting no current illicit drug use (29.1 percent of past-month illicit drug users versus 6.9 percent of non-users).

More Benefits

Drug testing programs improve employee morale and productivity; decrease absenteeism, accidents, downtime, turnover and theft; and lead to better health among employees and family members as well as decreased use of medical benefits.

Organizations with drug-free workplace programs sometimes qualify for state government incentives or workers’ compensation insurance premium discounts.

Company Policy as the Cornerstone of your Testing Program

At a minimum, an effective corporate drug and alcohol policy should include the following:

An opening statement that effectively describes the reason for testing “a Drug Free Workplace is essential for the safety of our employees”

Identify the Program Administrator.

Identify the employees subject to testing. (Safety Sensitive or all)

Employee compliance with policy is mandatory for continued employment.

Identify the drugs that will be tested.

Company Policy (Continued)

Describe what is considered prohibited conduct (i.e. showing up for work under the influence or having drugs on their person)

Types of Tests (Pre-employment, Random, Post Accident, etc.)

Testing Procedures that will be utilized. (Specimen Collection, Lab Testing, Medical Review).

What constitutes a Refusal to Test.

Disciplinary Action.

Review of state laws.

Signed Acknowledgement of Receipt.

Drug-Free Workplace Policy

Policy exists to:

- Protect the health & safety of all employees, customers and the public

- Safeguard employer assets from theft and destruction - Protect trade secrets - Maintain product quality, company integrity

and reputation - Comply with the Drug-Free Workplace Act of

1988 and/or any other applicable laws

Testing Procedures

Drug Testing (Urinalysis)

Urine is the most common testing method. It detects recent or new drug use, typically in the previous one to three days.

Urine testing is suitable for all testing reasons— from pre-employment to random to post-accident — and can be used to detect a wide variety of illicit and prescription drugs.

Both Lab Based and Rapid Test cup methods.

Currently, urine testing is the only method approved for federal, safety-sensitive workers.

Urine Drug Testing Pro’s & Con’s

ADVANTAGES EXTENSIVE SCIENTIFIC BASE AND RESEARCH

ACCURATE AND RELIABLE

TECHNOLOGY HAS BEEN IN PLACE FOR YEARS

GC/MS Testing has been upheld in Supreme Court case

DISADVANTAGES EASY TO ADULTERATE

SUBSTITUTION & DILUTION IF COLLECTION PERSONNEL NOT VIGILANT.

COLLECTION ISSUES

TESTING MAY NOT CORRELATE WELL WITH LEVELS OF IMPAIRMENT

Drug Testing (Oral Fluid)

Oral fluid is the second most utilized screening method and it detects recent drug use in the previous 24-36 hours.

Employers typically collect a oral fluid specimen under the direct observation of the test administrator which reduces the likelihood of donor tampering.

Can be used as Lab based testing or Rapid Drug Test Swab.

Oral Fluid Test Advantages

ADVANTAGES

EASY SPECIMEN TO OBTAIN SPITTING OR SWABBING

EASILY OBSERVED COLLECTION DIFFICULT TO ADULTERATE OR DILUTE CORRELATION BETWEEN DRUG CONCENTRATION AND IMPAIRMENT

MAY BE USEFUL IN DETECTING VERY RECENT DRUG USE

Oral Fluid Test Disadvantages

DISADVANTAGES

INDIVIDUAL VARIATIONS IN THE RATE OF SALIVA PRODUCTION

REQUIRES CLOSE ATTENTION DURING COLLECTION PROCESS TO ENSURE SAMPLE COLLECTION

NARROW WINDOW OF DETECTION

LIMITED NUMBER OF DRUGS FOR TESTING.

Drug Testing (Hair)

Has been around since 1979.

Hair testing continues to gain broader appeal as it provides a longer detection window, giving a drug-use history that shows a pattern of repetitive use as far back as 90 days.

Hair testing yields the benefit of an observed collection that is not easily adulterated.

With hair testing, a candidate’s efforts to prepare for a drug test, either by stopping their drug use or cheating with adulterants or substitution, are not as effective.

Hair Testing Advantages

ADVANTAGES LONG TIME WINDOW FOR DRUG DETECTION

EASY TO COLLECT, HANDLE AND STORE

SAMPLE IS CUT, GROUND UP THEN WASHED WITH WATER AND/OR SOLVENTS. EXTRACTION AND PURIFICATION PROCESS PRECEDES ASSAY

STORAGE IS AT ROOM TEMPERATURE (NO NEED TO REFRIGERATE OR FREEZE PATIENT SAMPLES)

SECOND COLLECTION CAPABILITY

NONINVASIVE

BEATING THE TEST MAY BE DIFFICULT

Hair Testing Disadvantages

DISADVANTAGES

WILL NOT DETECT RECENT USE

ENVIRONMENTAL CONTAMINATION IS A POSSIBLE PROBLEM

DOSE/TIME RELATIONSHIPS ARE NOT WELL ESTABLISHED

LIMITED NUMBER OF DRUGS TO TEST.

INFLUENCE OF HAIR COLOR AND TEXTURE ON TEST RESULTS

STUDY BY GYGI ET AL IN 1997 FOUND THAT PIGMENTED HAIR IN VARIOUS SPECIES OF RATS INCORPORATED 3 – 44 TIMES THE AMOUNT OF CODEINE THAN NON-PIGMENTED RATS,EVEN IN THE SAME RAT. THERE WERE LARGE DIFFERENCES SEEN FOR MORPHINE AND NORCODEINE. HOWEVER, PHENOBARBITAL WAS FOUND IN THE SAME CONCENTRATION IN PIGMENTED AND NON-PIGMENTED HAIR.

9-Panel Drug Test

Amphetamines(dexedrine, adderall)

Cocaine

Cannabanoids (marijuana)

Opiates (heroin)

Phencyclidine (PCP)

Barbituates (seconal)

Benzodiazepines (valium, xanax, klonopin)

Methadone

Propoxyphene (narcotic pain relievers)

URINE SPECIMEN 9-PANEL TEST

Analyte Cutoff Cutoff

Amphetamines 1000 ng/mL 500 ng/mL

Cocaine Metabolite 300 ng/mL 150 ng/mL

Marijuana Metabolite 50 ng/mL 15 ng/mL

Opiates 2000 ng/mL 2000 ng/mL

Phencyclidine 25 ng/mL 25 ng/mL

Barbiturates 300 ng/mL 300 ng/mL

Benzodiazepines 300 ng/mL 200 ng/mL

Methadone 300 ng/mL 200 ng/mL

Propoxyphene 300 ng/mL 200 ng/mL

Post Accident Drug Testing

Studies have shown drug dependent workers have 200-400% more accidents on the job!

47% of all serious workplace accidents have drug or alcohol involvement!

Drug dependent workers use twice the amount of healthcare benefits!

Drug dependent workers are 5 times more likely to file a worker’s comp. claim!

Drug dependent workers are 16 times more likely to be absent from work!

Post Accident Testing (Con’t)

Post-accident testing immediately following an accident can help determine whether drugs were a factor.

Employers should establish objective criteria for performing post-accident testing.

It is recommended that post-accident testing be done appropriately with urine or oral fluid testing within 12 hours of the incident, since substances remain in a person’s system for different amounts of time.

Testing after an Accident, proceed with caution.

If you are not required by law or contractual Agreement it is recommend to carefully reconsider testing under the following conditions:

When there is bodily injury to someone outside of your organization.

When there is property damage to a third party.

Alcohol on the Job

Most workplace alcohol policy violations do not involve actually drinking at work.

Usually, someone has used alcohol too close to reporting to work.

BAC LEVELS EXPECTED, BASED ON THE NUMBER OF DRINKS CONSUMED IN A ONE-HOUR PERIOD

body weight in pounds

1drink

2drinks

3drinks

4drinks

5drinks

6drinks

7drinks

8drinks

90 - 109               

110 - 129               

130 - 149               

150 - 169               

170 - 189               

190 - 209               

210 - 229               

230 & up               

Alcohol Testing

In workplace testing programs, testing for alcohol may be accomplished using a variety of specimen types – urine, saliva, blood and breath.

The selection of the specific specimen type for alcohol screening should be based on the goals of the drug testing program and how the results will be used.

There are four (4) methods for collecting a specimen to test for Alcohol.

Alcohol Testing (Urinalysis)

As stated previously, Urine is the most commonly used specimen for testing for a wide variety of drug substances, both illicit and prescribed (i.e., prescription drugs, for which their use or misuse could impact workplace safety) drugs. However, it is less commonly utilized for alcohol screening – especially in post-incident or reasonable suspicion testing.

Urine testing detects recent use of a substance, but a positive urine test does not necessarily mean that an individual was “under the influence” at the time of the collection/test, nor can it indicate how frequently a substance was used or when it was last used.  Consequently, one of the other testing methods is recommended for alcohol testing, especially in post-incident or reasonable suspicion testing situations.

Alcohol Testing (Saliva)

Saliva is commonly used in screening for workplace alcohol use and saliva screening is one of the methods recognized by the Department of Transportation (DOT) for alcohol testing.

Saliva alcohol screening devices (ASDs) that are approved for use in DOT mandated testing programs are listed on the National Highway Traffic Safety Administration (NHTSA) Conforming Products List (CPL). While there is a high degree of correlation between blood and saliva alcohol levels, any presumptive positive saliva test would need to be confirmed – either through blood or breath – and Federal rules require confirmation using breath alcohol.

One advantage of saliva ASDs is that they may be easily utilized by the employer at the employer’s location by a trained screening test technician (STT), eliminating the need to transport the employee/applicant to a third-party collection site, unless there is a non-negative screen result requiring confirmation.

Alcohol Testing (Blood)

There are a number of studies that correlate blood alcohol levels to performance and impairment.

Most States use a cutoff of 0.08 % as presumption of impairment for operation of a motor vehicle. However, collection of the blood specimen is considered to be more invasive due to the need for venipuncture. Consequently, blood alcohol testing is less commonly used for workplace screening purposes and is more likely to be used for confirmatory purposes when there a presumptive positive screening result.

Alcohol Testing (Breath)

Evidential breath testing (EBT) for alcohol is utilized in both DOT-mandated and company-policy alcohol testing.

EBTs are used for both screening and confirmatory purposes and the test may be performed at a third-party location or “on-site” at the employer location by a trained breath alcohol technician (BAT).

EBTs approved for DOT testing programs also appear on the NHTSA-CPL. The correlation between breath and blood alcohol results is well documented and the results of these tests are commonly used as evidence of impairment or “fitness for duty”.

Point of Collection Testing (POCT)

POCT Testing Advantages

CONVENIENT QUICK NEGATIVE TEST RESULTS INEXPENSIVE IF TESTING IN LARGE VOLUME MULTIPLE TEST OPTIONS, CUPS, CARDS, SWABS. AVAILABLE IN URINE AND SALIVA BASED TEST

DEVICES

POCT TESTING DISADVANTAGES

NOT LEGAL IN ALL STATES REQUIRES ADDITIONAL STEPS IF NON-NEGATIVE PURCHASED IN CASE LOTS SO NOT PRACTICAL FOR

SMALL VOLUME LIMITED SHELF LIFE (12-14 MONTHS) REQUIRES INTERPRETATION BY COLLECTOR.

Does marijuana “legalization” affect workplace drug testing?

Marijuana Legalization and Workplace Testing

23 states and the District of Columbia (D.C.) have legalized marijuana for medical purposes and five of these jurisdictions – Colorado, Washington, Oregon, Alaska and D.C. – have legalized marijuana for recreational use.

However, the federal government still classifies marijuana as a Schedule I drug – meaning it has a high potential for abuse and no currently accepted medical use. This disparity between federal and state regulations has caused confusion for employers who want to continue to screen their job candidates and employees for marijuana use.

Marijuana (State impact)

While some states may provide employee protection for medical marijuana users, many do not. And no state currently offers employee protection for recreational users.

That said, in many jurisdictions, employees can be fired for using marijuana – even if the user has a medical marijuana card or resides in a state where recreational use is “legal.” If in Arizona, research the AMMA prior to implementing policy.

Just because a drug is considered “legal,” does not mean that it doesn’t impair the user.

Marijuana (Schedule I Controlled Substance)

Marijuana is a schedule I drug. Under federal law, its cultivation, possession, sale and use are illegal.

In all 50 states, including the five states that have removed state criminal penalties for recreational use – employers can test their job applicants and employees for marijuana.

Since a positive drug test for marijuana is indicative of the donor’s use of an illegal drug under current federal law, these results continue to provide employers with the information they need to make proactive decisions based on state law and their company policies. Employers with employees in “medical” marijuana states should consult an attorney to find out how state laws may affect their ability to take action when there is a positive test for marijuana.

Defining Under the Influence

While alcohol impairment levels are well-established and recognized, the same cannot be said for drugs of abuse.

At this time, there isn’t a consensus for drug concentration levels that indicate impairment as the studies have not been widely conducted.

Lacking these studies and an agreed upon drug concentration that indicates impairment, any drug testing that seeks to determine ‘under the influence’ will be a challenge.

COATS V. DISH NETWORK: MARIJUANA AND ZERO-TOLERANCE DRUG USE POLICIES

The Colorado supreme court recently held that under the plain language of section 24-34-402.5, 13 C.R.S. (2014), Colorado’s “lawful activities statute,” the term “lawful” refers only to those activities that are lawful under both state and federal law. Therefore, employees who engage in an activity such as medical marijuana use that is permitted by state law but unlawful under federal law are not protected by the statute. The Court therefore affirmed the Colorado Court of Appeals’ opinion that Dish Network can terminate employees who test positive for THC, in violation of the Company’s drug policy.

Case Overview

In Coats v. Dish Network, an employee sued for wrongful termination after he tested positive for marijuana. The plaintiff is a quadriplegic who used medical marijuana outside of working hours. Mr. Coats was a registered medical marijuana user, accessing the product in a manner consistent with state constitutional guarantees and state statute.

Conclusion

In short, until the federal government removes marijuana from the list of Schedule I controlled substances, an employer in Colorado may terminate employees who test positive for THC, even if the use of marijuana is off-duty, for medical purposes, and consistent with state laws.

A Safer, Drug-Free Workplace

• Recognize the impact of alcohol and drug abuse on the workplace • Understand and follow the Drug-Free Workplace Policy

• Know your employees and look for changes in behavior. Be proactive in identifying substance abuse and alcohol misuse.

• For additional information, Visit www.samhsa.gov, the website for the

Substance Abuse and Mental Health Services Administration (SAMHSA), maintained by the US Department of Health and Human Services

Thank you!

QUESTIONS?