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THE OFFICIAL PUBLICATION OF THE DRUG & ALCOHOL TESTING INDUSTRY ASSOCIATION
DATIA
W NTER 2015Vo. 8 Issue 1
20TPABest
Practices
Q/\ Background ScreeningOU Your Employees and
ProtectingConsumerData
A A Product Strategy;Balancing YourProduct Portfolio
fi
26
TRENDS IN
DRUG USEBY GARY F. PATRONE, ARGPOINT LABS OFTEMPE
The Deadliest Drug on the Planet
The United States is in the grips ofone of the worst heroin epidemics in its history, due in part to a
flood of cheap doses of the drug. It canbe orderedeasily and delivered right toyour front door.In someregionsof theU.S. heroin is deemed "highly available"in more than three times the number of
communities as it was just a fewyears ago.The resurgence ofheroin has sparkeda
flurry ofactionfrom governors' mansionsall the wayto the White House. Govern
ment studies estimate the number ofheroin
usersis up about 75 percent from 2009 andnearly 300 percent from 2003. It's a levelofregularusage not seen sinceheroin's peakin the mid-1970s and isgrowing faster thanallotherdrugsofabuse.
Heroin is not a new drug. It's beenaround since 1874, when chemists,working to find a less addictive form ofmorphine, created heroin. They ultimately
discoveredheroin had twice the potencyof morphine, and heroin addiction soonbecame a serious problem. So what's new?A newbreed ofheroin user is emerging.
The Transition From
Painkillers to Heroin
Thegovernment, lawenforcement andmedicalexpertsnow concur that the heroin
surgecanbe tracedto the riseofprescriptionpainkillerssuch as OxyContin*, Vicodin*
and Percocet*. Prescription painkillers areheroin's chemical sibling—containing compoundsderived from, or similar to, opium.
"Heroin is just a symptom of theprescription drug problem," saidJosephRannazzisi,deputy assistant administrator
of the DrugEnforcement Administration,duringa Senate hearing inMay2014.Doctorswrotemillions ofprescriptions foropioid painkillers, and from 1999 to 2010
sales increased 300percent, according to
Past Month Heroin Use 2007-2012The number of people (In thousands) who are 12 years old or olderand who reported using heroin in the past month if federal surveys.
400
£ 250
o 150
2007 2008 2009 2010
National Survey on Drug Use and Health, US Dept of Health and Human Services.USATODAY
Annual survey conducted by the Substance Abuse and Mental Health Services Administralion
DATIA focus
2011 2012
the Centers for Disease Control and Pre
vention.The drugsare now prescribedto12 million Americans a year with hundredsof thousandsbecomingaddicted.
With the reformulationofprescriptionopioids to make them harder to abuse com
bined with a government crackdown onprescribingthem, availability is droppingand drivingup the cost.Thoseaddictedtopillsare seen turning to heroin as a readilyavailable and cheaperoption to feedtheiraddiction. Mexican heroin, which now
dominates the American market, sells for
$4 to $10 a dose compared with $40 to$80 for an 80-milligram opiate pain pill."People aregoingto gowherethe drugsare,and right now,the cheapestand easiestway to keepthat addiction going is throughheroin," saidDEAspokesmanRustyPayne.
The'new' cheap andverypotentheroincanbe snorted or smoked,givingthesameeflfects as if injected.Thisremoves apsychologicalbarrier for some users and isleading to experimentation byyounger usersofschoolage, andothers, whohave anaversion to needles.Usingneedles isassociated with hardcore junkies while smokingheroin isregarded asbeing anactdonebyamore casual user, giving thefalse impression that addiction can be avoided.
"Now we have people openly admitting aheroin habit of20bags aday, andI haven'ttalked toasingle person who did notgetstarted byusing thepills," saidJimBaker,chiefof policein Rutland,Vermont."I'vebeen blown away bythedepth oftheaddictionproblem. I've been doing this alongtime, and I've never seen anything like this."
Ellen, anaddictinPortland, admits"Ididalot ofpills and then Imoved up here and Istarted doing heroin 'cause it's way cheaper."
Nora Volkow, director of the National
Institute onDrug Abuse, says surveys showabout 80 percent of recent heroin addictsswitched from opioid pain pills.
WINTER 2015
In the amendment, OSHAproposed thatemployers be prohibited from requiringemployees to submit to drug testingfollowing thereport ofaworkplace injury (including post-accident testing). Post-accident testing isa keycomponentof effectivedrug-free workplaces. Employees whotestpositivefor marijuanausehave55 percentmore industrial accidents and 85 percent
moreinjuries, according to the U.S. Dept.of Health and Human Services (HHS). In arecentstudyconducted byDATIA andtheSociety for Human Resource Management(SHRM), data showedthat employers withhighworkers' compensation incidenceclaims afteraccidentsdecreased by morethanhalf(57percent) after implementing adrug testing program.
DATIA has sent aU of its members the
full comments in the Oct. 23 edition of
DATLA eNews. Pleaselet us knowifyouhave anyquestions regarding those.
Reminder from DOT
to MROs RegardingVerifying an Employee'sPrescriptionAs a reminder, when a donor providesaprescription foranon-negative laboratorytest result, as the MRO, youareresponsiblefordetermining whether the medical explanation is legitimate.
Inyourrole as the"gatekeeper" inthisprocess, you must review and take allreasonable and necessary stepsto verifytheauthenticity ofall medical records theemployee provides (see 49CFR Section40.141(b)). For example:. Call the pharmacy toverify the legiti
macy ofthe prescription; and• Call thedonor's treating physician ifyou
havesuspicions or questions
In accordance vdth 49 CFR Sections40.137(c), 4Q.139(b), and 40.145(e),the donor has the burden ofproof that alegitimate medical explanation exists. Thedonor mustpresentinformation meetingthis burden at the time of the verification
WWW.DATIA.ORG
jiiimSiiL3 /;• . > Hmimfl
interview. You mayextend the time availablefor the donor to present the informationforup to 5 days. If the donor fails toprovide information youhave requested(e.g., doesnot produce a prescription ordoesnot facilitate the treating physician'scontactwithyou),youmayproceedinmakingyour determination.
Any timeyoumake thedetermination toverify a laboratory positive result negativebecause ofa legitimate medical explanation,you may have aresponsibility to raise fitness-for-duty considerations inaccordance with49 CFRSection40.137(e)(4) and40.327.Inraising these concerns, you are onlyauthorized to provide information learnedthrough your verification interview with theemployee's employer, aphysician orhealthcare provider responsible fordeterminingthe employee's medical qualifications underaDOTagency's safety regulations, aSAPevaluating theemployee as partofthereturnto duty process, aDOT agency, orwith theNational Transportation Safety Board during thecourse ofanaccident investigation.
DOT sent this reminder on Sept. 30,
2014.1
ife-
iitii nil iir mill mil uii n i.-iiil 'Ti'i
The Nov. 4 election
showed relatively
small amounts of
supportfor pro-
marijuana initiatives.
DATIAfocus 39
38 DATIA focus
WASHINGTON
REPORT BY LAURA SHELTON, CMP
V
Mixed Results for
Marijuana Initiativesat the Polls
The Nov. 4 election showed relativelysmall amounts of support for pro-marijuana initiatives. Even though more statesapproved these initiatives,they were doneby small margin.
Here aresome highlights:
Medical Marijuana
• Approved in Guam
(Proposal 14Aby56% to44%)• Rejected in Florida
(Amendment 2:43% to57%)
Legal Personal Use
• Approved inWashington D.C.(initiative 71 —64% infavor—possession)
• Approved in Oregon(Measure 91—54%approval—retail shops)
• Approved in Alaska
(Ballot measure 2—leading 52% with97% ofvotes in—retail shops)
• Approved in South Portland, ME
(52% to 48%)• Rejected inLewiston, ME (55% to 45%)
For more information on the recent
electionresultsregarding marijuana, pleasevisithttp: //learnaboutsam.org/statement-marijuana-ballot-initiatives/.
ETA Proposes RegulationEstablishing Occupationsthat Regularly ConductDrug TestingTheEmployment andTraining Administration(ETA) oftheU.S. Department ofLabor(DOL) proposes toestablish inregulation,for State Unemployment Insurance (UI)program purposes, occupations thatregularlyconduct drugtesting. These regulationswouldimplement theMiddle Class TaxReliefandJob Creation Actof2012(theAct) amendments totheSocial Security Act(SSA), permitting States toenact legislationthatwould allow State UIagencies toconductdrug testing onunemployment compensation (UC)applicants for whom suitable work(as deifined under the State law) isonly available inanoccupation thatregularly conductsdrug testing (as determined under regulationsissued bytheSecretary ofLabor). States maydeny UCto anappLcant whotests positivefordruguseunderthese circumstances. TheSecretaryis requiredunder the SSA to issue
regulations determining those occupationsthat regularly conduct drug testing.
Comments were due December 8,2014.
DATIA will provide any necessary updateson this regulation.
DATIA Comments on
OSHA NPRM to ChangeTracking of WorkplaceInjuries & IllnessesDATIAactivelysupports initiatives topromotedrug-free workplaces therebyincreasing workplace safety. Drug-freeworkplaces area key component in creating safe andhealthful working conditions,however, newchanges included in theAugust 14,2014amendment seriouslythreaten the ability ofemployers to maintaina drug-free workplace.
WINTER 2015
Lawmakers
Are Scrambling ToFind Answers
"It'sreallyon the top of everyone's radarfroma public healthperspective," saidThomasMacLellan, previousdirectorofhomeland securityand public safetyforthe National Governors Association. Even
Capitol Hill and the White House areweighingin on what's become a full-blown
healthcrisis that cutsacross geographic,social, racial and economic boundaries. At
least 18 state legislatures addressednewheroin billsin 2014,according to the National ConferenceofStateLegislatures.
"We've gotsoccer momson heroin," saidBurlington, VermontpolicechiefMichaelSchirling, whosaidherointrafficking casesthere increased500 percent in two years."This isa completely underground, behind-closed-doors phenomenon."
In the GreatLakes region, the DEA'sNational Drug Threat Assessment reportedthat9 percentoflawenforcement agenciesdeemedheroinhighly available in 2007.By2013,thepercentage rocketed to 40percent.InNewEngland, thepercentage rose from40percent to 55percent overthatsame timeand, in NewYork and NewJersey, jumpedfrom 30 percent to 45 percent.
Vermont Governor Peter Shumlin, in
January2014, devoted nearly hisentireState of the State Address to what he called
the "rising tide ofdrugaddiction and drug-relatedcrime spreadingacrossVermont....It is a crisisbubblingjust beneath thesurface thatmaybe imhsible to many, but isalready highly visible to law enforcement,medical personnel, social service andaddictiontreatment providers, and too manyVermont families."
In Massachusetts, after deaths from
heroin andopioid drugs spiked more than90percent since 2002, Governor DevalPatrickdeclared apublichealth emergency
in March 2014. "Sometimes it takes a crisis
with big numbers togetthepublic's attention," saidPublicHealth Commissioner
WWW.DATIA.ORG
HERmN
CherylBartlett."Heroin is such a harshdrugthatno onefigures that itwill beapart of theirlives eitherthroughthemselvesor someone they knowuntil it's too late,"Bartlett said.
In Kentucky, heroin abuseis "spreadinglike a cancer," Senator Mitch McConnell
told a Senate narcotics group in May 2014.
"We are losing close to 100fellow Kentuck-iansa month to drug-related deaths. This ismore lives lost than to fatal car crashes."
Overalldrug related deaths now exceed car fatalities nationwide, accordingto the Centers for Disease Control and
Prevention and the National Institute on
Drug Abuse, the federal agency that studiesdrug abuse andpolicy. In Knoxville,Tennessee, 73 people died fromdrugoverdoses in 2013, more than from ho
micides and traffic accidents combined.
Opiates ofsome sortwere involved inat least half of those deaths. "Heroin gothere later than other places, but it is herenow full-blast," KnoxvillePolice ChiefDavid Rausch said. Ginger Marshall, thevolunteer alcohol and drug treatment
coordinator for the local Lost Sheep
Ministry stated"[tjhis is just overwhelming everyone."
Previous U.S. AttorneyGeneralEricHolder acknowledged theepidemic "snuckup on us"at a national law enforcementsummit on heroin inApril2014 andreferred to the heroin resurgence as "anurgent public health crisis."
The government, lawenforcement and
medical experts now
concur that the heroin
surge can be traced tothe rise of prescriptionpainkillers such asOxyContin®, Vicodin®
and Percocel®.
DATIAfocus 27
ReferencesPagliery, Jose (2014) 90% of hospitals and clinics lose theirpatients'data. Retrieved September 16,2014. httpJ/moneyxnn.com/2014/08/20/1echnology/security/hospitals-data/
Pagilery, Jose (2014) Hospital network's failure led to massivehack. Retrieved September 16, 2014. http://money.cnn.com/2014/08/21/technotogy/security/heartbleed-hoslpital/
Better Business Bureau (2014) Community Health SystemsParlners with Kroll to offer ID Theft Protection. Retrieved
September 27,2014. httpJ/www.bbb.org/nashvilie/news-evenfs/bbb-in-the-news/2014/09/community-health-systems-partners-with-kroll-to-offer-id-theft-protection/
HireRight Employmenf Screening Benchmarking Report2014 Edition/ Health Care Spotlight httpJ/www.hireright.com/resourcelibrary/fiealth-care-spotlight-from-the-hirerighl-employment-screening-benchmarking-sun/ey-2014-edition/
Harris, Dustin (2014) Conversation with HR-Manager.Discussed September 16, 2014.
Dustin Harris Is originally from
Mt. Airy, NC—sometimes
better known as Mayberry.
Dustin graduated with honors
from Queens University of
Charlotte and received a
Bachelor of Science in Biology. Currently, he
works for HireRight in Charlotte, where he is
the Supervisor of Operations and Vendor Re
lations and he oversees a team responsible
for maintaining relations and negotiating pric
ing with occupational health vendors across
the world. His work with HireRight has made
him one of the young leaders in occupational
health. Dustin is currently enrolled at Pfeiffer
University in Charlotte, NC and Is study
ing towards his master's degree in Health
Administration & master's degree In Busi
ness Administration. Dustin is an alumnus
of the Phi Kappa Sigma fraternity and he
lives in Charlotte, NC with his fiance, Jen.
What steps is your organization taking to
respond? We want to know; email Dustin at
DATIA is Seeking Authorsand Webinar Presenters -
our "Keys To Excellence"
Would youlike to getyour name
out there as
an expert? I
share your knowledgeand expertise?
WWW.DAT1A.ORG
How would you like to gainexposure for your company?More than 2,000 industry professionals
receive DATIA focus\r\ print eachquarter and approximately 6,000 receiveit electronically. DATIA webinars attractnearly 200 participants a session. Unlockyour potential and submit your proposaltoday! For those interested in helping
DATIA maintain its "keys to excellence"please email your article and/orwebinar
topic proposal to [email protected].
^v-COHq,
DATIA focus 37 28
In 2013, the DEA
seized more than 2.3
tons of heroin at the
Mexican border.
Heroin Availability HasSkyrocketedCustomsofficers in Nogales, Arizonahaveseized more heroin in the first six months
offiscal year 2014thanduring each oftheprevious threefull fiscal years, saidJoeAgosttini, assistant port directorin Nogales."We're catching juveniles, youngkidsthatarein middleschoolor highschoolandevenpeoplewho are82yearsold,bringingnarcotics to the U.S.," Agosttini said.
In 2013, the DEA seized more than 2.3
tons ofheroin at the Mexican border. That's
more than triplethe amount seizedin
2008and theyweren't specifically targetingheroin. 'Acouple ofyears back, ifyouwouldfind apoundofheroin, thatwould beabigload," saidFinalCounty sheriffPaulBabeu."Nowadays, it'scommon tointerdict 50or60pounds, upto 100pounds, ofheroin."
Opium war#l started in 1839between China and Britain. Opium war #2spanned from 1856 to 1860.Arewe duefor our own opium war? I
References:Chasing the heroin resurgence, James Pilctier and LisaBernard-Kufin, Tfie Cincinnati Enquirer, 2014
Heroin'shiddenjourney, Paul Giblin,TheArizonaRepublic, 2014
Drugs. Inc.: Cartel City:Arizona, NationalGeographicdocumentary series
Drugs, Inc.: Heroin: The deadliest drug on the planet,National Geographic documentary series
Drugs, Inc.: Seattle. National Geographic documentary series
Drugs. Inc.: PillNation, Ha^nal Geographic documentary series
Drugs, Inc.: Dope-LarKlia (Portland), National Geographicdocumentary series
The International Heroin Market, UNODC World Drug Report2010 (United Nations Office on Drugs & Crime)
Gary F. Patrone Is CEO of
ARCpoInt Labs of Tempo
(Tempe-AZ.arcpolntlabs.
com), and is centrally
located within the Phoenix
Valley. Gary serves both
corporate and private clients in drug,
alcohol, DNA and on-site testing services,
creates workplace policies for both DOT
and non-mandated companies and man
ages consortiums and random programs
for corporate and private clients. Gary Is
an active member of the Tempe-South
Rotary Club, an Ambassador of the Tempe
Chamber of Commerce, member of the
Business Development Committee with the
Tempe Chamber of Commerce, member of
the Advisory Council for Brookline College
and PIMA Medical Institute. Gary has au
thored articles for DATIA, the Arizona Small
Business Association and writes a monthly
column for the Arizona Republic.
Heroin Availability By RegionThe percentage of police agencies reporting "high availability" of heroin in their communities in
2008, 2010 and 2013 in federal surveys.
60
2008 • 2010 • 2013
50
40
30
20
10
Florida & Great Lakes Mid-Atlantaic New England New York& Pacific Southeast Southwest West CentralCaribbean New Jersey
U.S Drug Enforcement Administration
REGIONS: Pacillc=WA, ID, OR, NV, CA(N). Soufhwesl=TX, OK, NIVl, A2, CA(S). Southeasf=AR, LA, MS, AL, GA, SC.NC, TN. West CentralsMT, SO, ND, lA, UT, CO, WY, KS. MO, IL(S). GreatLakes=MN,Wl, Ml, OH, KY IL(N). MidAtlantic=PA, VA, WV.DE. DC. Northeast=ME, NH, VT, MA, CT.
DATIA focus WINTER 2015
