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DRUG TESTING 101: CONDENSEDDRUG TESTING 101: CONDENSEDJeff Sims, C-SAPA, C-SIJeff Sims, C-SAPA, C-SI

Past President, Substance Abuse Program Past President, Substance Abuse Program Administrators AssociationAdministrators AssociationPresident, a’ TEST consultants, inc.President, a’ TEST consultants, inc.

OVERVIEW

1. The Drug Testing Industry 2. Why drug test? 3. How and When do You Test? 4. Specimen Types: Traditional vs Alternative 5. Drug Testing Panels: Not one size fits all! 6. Validity Testing and Adulterant Products 7. Reporting Requirements 8. Current Federally Mandated Programs 9. Pending Drug Testing Legislation and Current

Industry Issues 10. Questions and Answer

1. THE DRUG TESTING INDUSTRY1. THE DRUG TESTING INDUSTRY

DRUG TESTING INDUSTRY PLAYERS AND THEIR ROLE

Laboratories Third-party administrators (TPAs) and

background screening retailers Collection sites and collectors Medical Review Officers Manufacturers / Distributors

2. WHY DO COMPANIES DRUG 2. WHY DO COMPANIES DRUG TEST?TEST?

HOW DID WE GET TO THIS POINT?

Most aggressive actions occurred since the late 1980’s:

- The Anti-Drug Abuse Act of 1986 (directed U.S. Secretary of Labor to initiate efforts to address the issue)

- President Reagan’s Executive Order 12564, Drug-Free Federal Workplace (made it a condition of employment to refrain from using illegal drugs)

- Drug-Free Workplace Act of 1988 (required federal contractors and grantees to have drug-free workplaces)

- Drug-Free Workplace Act of 1998 (establish grant programs that assist small businesses in developing drug-free workplaces)

- Omnibus Employee Testing Act of 1991 (required transportation industry employers to conduct alcohol and drug testing for employees in “safety sensitive” positions) It created a model for non-regulated employers now follow.

THE U.S. DRUG AND ALCOHOL PROBLEM

In 2006, estimated 20.4 million Americans were current illicit drug users, which is a rate of 8% among all Americans. No significant changes in recent years.

About 57 million people, or more than one-fifth (23.0 %) of the population age 12 and over, participated in binge drinking (having five or more drinks one the same occasion at least once in the past 30 days).

DRUG ABUSERS AS EMPLOYEES

More likely to be involved in an accident and file a workers’ compensation claim

More likely to quit or get fired More likely to steal from workplace More likely to miss work More likely to be in a confrontation Less productive

THE IMPACT ON SAFETY

Substance abusers are: 3.6 times more likely to be involved in a

workplace accident 5 times more likely to file a workers’

compensation claim As many as 50% of all workers’ compensation

claims involve substance abuse

THE IMPACT ON SAFETY

80% of those injured in “serious” drug-related accidents at work

are not the drug abusing employees… but innocent co-workers

and others.

BOTTOM LINE

On average it cost an employer On average it cost an employer almostalmost

$7000.00$7000.00

per substance abusing employee per substance abusing employee

5 KEY COMPONENTS

A comprehensive drug-free workplace program includes:

1. Policy2. Supervisor training3. Employee education4. Employee assistance5. Drug testing (Alcohol testing)

3. HOW AND WHEN DO YOU TEST?3. HOW AND WHEN DO YOU TEST?

HOW TO TEST? Traditional laboratory based urine testing using:

• Screen

• Confirmation

Alternative specimen Rapid result or also known

as POCT using professional collectors Medical review officer verification

When to TestsWhen to Tests

Pre-Employment

Random

Post-Accident

Reasonable Cause/Suspicion

Return-to-Duty

Follow-Up

4. SPECIMEN TYPES: 4. SPECIMEN TYPES: TRADITIONAL VS TRADITIONAL VS ALTERNATIVEALTERNATIVE

SPECIMEN TYPES

Which specimen meets your needs? Urine (lab and rapid result analysis) Hair (on-site collection; lab analysis

required) Oral Fluids (rapid result and lab analysis) Sweat Testing (rapid result and lab analysis) Blood Testing (lab analysis)

SPECIMEN TYPES

Urine? Legally sound Federally endorsed Most common Invasive Subject to adulteration Split Testing

ALTERNATIVE SPECIMENS

Hair? Window of 90 days minus recent 7-10 days Legally still being tested Lacks federal endorsement About 1-2% usage Invasive Scientifically questionable? Pre-employment tool

ALTERNATIVE SPECIMENS

Oral Fluid?

Window 4-24+ hours Limited legal exposure Getting federal endorsements (alcohol

only) Least invasive Comparable to blood Adulteration resistant “Under the influence” indicator

5.5. DRUG TESTING PANELS AND DRUG TESTING PANELS AND PRICE: PRICE:

NOT ONE SIZE FITS ALL!NOT ONE SIZE FITS ALL!

FEDERALLY MANDATED TESTING PANEL

Marijuana Cocaine Opiates Amphetamines Phencyclidine (PCP)

The primary drugs of abuse

ADDITIONAL DRUGS BEING TESTING

Hydromorphone   Oxycodone   Oxymorphone Hydrocodone Propoxyphene Ecstasy Benzodiazepines Barbiturates Methadone

6. VALIDITY TESTING AND 6. VALIDITY TESTING AND ADULTERANT PRODUCTSADULTERANT PRODUCTS

ADULTERATED, SUBSTITUTED SPECIMEN

Internet provides a list of suppliers with information on beating drug, alcohol or hair testing

Bleach, soap, Visine, other substances

Purging with water, other liquids

“Rapid” on-site drug test are the most vulnerable Innovative Resources, Inc.

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ADULTERANTSADULTERANTS

7. REPORTING REQUIREMENTS7. REPORTING REQUIREMENTS

FEDERAL VS NON FEDERAL TO BE COMPLETED BEFORE REPORT

If it is a Federally mandated test (This would include US DOT)a. Must receive certifying scientist signed copyb. Must have MRO copy of CCF

Non Federal? Any other requirements?a. State Laws (Arkansas Law Rule 36, Act 750) b. Safe Harbor

TRANSMISSION OF RESULTS

Typical Typical Reporting:Reporting:

1. Web1. Web2. Text 2. Text message message with with reference to reference to webweb3. Fax3. Fax4. Mail 4. Mail (yuck!)(yuck!)5. Phone 5. Phone (yuckier!)(yuckier!)

BACK OFFICE SUPPORT APPS

STORAGE OF RESULTS

Subject to audit and must be stored in a secure environment

Must maintain in accordance with state or federal requirements

Under federal rules, subject to release and must be forwarded upon termination of clients agreement to new MRO (FAA example)

8. CURRENT FEDERALLY 8. CURRENT FEDERALLY MANDATED PROGRAMSMANDATED PROGRAMS

REGULATORY SCOPE OF WHO IS IMPACTED REGULATORY SCOPE OF WHO IS IMPACTED THROUGH US DEPT. OF TRANSPORTATIONTHROUGH US DEPT. OF TRANSPORTATION

INDUSTRY DOT MODE # EMPLOYERS # EMPLOYEES

Highway FMCSA 650,000 10,941,000

Railroad FRA 650 97,000

Aviation FAA 7,200 525,000

Transit FTA 2,600 250,000

Pipeline PHMSA 2,450 190,000

Maritime USCG -DHS 12,000 132,000

TOTAL 674,900 12,135,000

WHO ELSE IS FEDERALLY WHO ELSE IS FEDERALLY MANDATED?MANDATED?

Nuclear Regulatory CommissionDepartment of Defense

NASATransportation Security Administration

And other federal agencies covered under the Drug-Free Workplace Act of 1988.

What’s on the horizon?????Don’t rule out new safety sensitive industry groups

(electricians, construction, miners, etc..)

9. PENDING DRUG TESTING LEGISLATION AND CURRENT INDUSTRY ISSUES

MANDATORY POSITIVE DRUG TEST REPORTING TO STATES

Several states have created databases Specific to commercial drivers license Result transmission straight from the MRO and

employer, or severe penalties Positive alcohol test, employer reports Great idea, but why don’t they work at this

point?

NATIONAL DRIVER DATABASE

Congress funded a study in 1999 Report released to in 2004 In early 2007, FOXNews Minnesota

5 Collection sites Inspected Congress is involved, GAO investigation with testimony by

SAPAA, ATA, IOOA, FMCA, ODAPC, Oregon State Police Working with House Transportation and Infrastructure

Committee to tighten programs

NEW ACTION ITEMS

Revisit the Drug Testing Integrity Act Implementation of the Driver Database, but

include a drug testing repository Have MRO’s, Consortia, and TPA’s do the

reporting Hire more agents to inspect employers AND

collection sites New NPRM’s issued, by SAMHSA, US DOT, and

operating modes.

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THANKS!THANKS!

Contact Jeff @ 800.837.8648, Ext 117, or by email @ jpsims@atestinc.com

10. Any Questions / Discussion10. Any Questions / Discussion