Saliva Drug Testing

Prescription Drug Abuse - Oxycontin Vicodin Lortab

2009-06-05T08:57:00.000-07:00

Granted, society is 5-8 years late recognizing this serious problem, but at least it is now out in full view.

Prescribed problem Illegal use of medications a growing concern

OHIO - 2009 - The Daily Record - The stereotypical view of drug addicts buying their daily fix in small bags in back alleys is giving way to a new reality of prescription drug abuse where pharmaceuticals come in plastic bottles with a prescription pasted on the side.

Police and drug enforcement are dealing with a growing threat in the form of abuse of pharmaceutical opiates such as Oxycontin, Vicodin and Percocet. Typically prescribed for pain through legitimate prescriptions, obtained by deceptive means, or raiding medicine cabinets, the drugs are creating a new culture of addicts and dealers.

Only the OraPoint on-site drug screen effectively screens for these prescription pain relievers.

The problem with pharmaceutical opiates, according to Medway Drug Enforcement Agency Director David Smith, has grown in recent years so much it had to double its pharmaceutical diversion unit.

"If they learn there's an easy mark out there, they'll travel. Within that type of community, that word travels real fast. I'm sure they go to rural areas because they assume no one's watching, (rather) than to go to a bigger city," Smith said. "We have seen people from all over, not just adjacent counties, (but) two, three counties away."

The pharmaceutical diversion unit began May 2008, with aid of grant funding, consisting of former Wayne County Sheriff's deputy Jim Garrett. Bill Hofer, a former Wooster Police officer, came on in May to help with the caseload.

Cases investigated come from complaints filed, whether it's a doctor's office, a pharmacy, law enforcement or anonymous tips.

Medway made seven buys of Xanax in 2008, compared to two buys in 2007, and six buys of Oxycontin in 2008, compared to one buy in 2007. Other opiates purchased in 2008, not seen in 2007, include morphine, Darvocet, Lorazepam, Percocet, Klonopin and Hydrocodone.

Garrett said he has done a lot of outreach to local pharmacies, hospitals and they have been receptive and cooperative.

"They're on the front lines, they have a keen sense of observation," he said of local doctors. "Red flags will go up. They'll either question it or call us."

In 2008, Wooster Police reported 29 thefts of medication. So far this year, 11 thefts of medication were reported, Chief Steve Glick said.

"It's a tough one for us to do anything in a preventative measure because it's going to be happening inside people's homes," Glick said. "... It's kind of a wide ranging problem. Drugs like cocaine have to be imported and have to get here. Oxycontin, Vicodin, Percocet, those drugs are readily available, and it's not the health profession's fault necessarily, it's just the fact that the drugs are available because they are prescribed."

Millersburg Police detective Sgt. Roger Estill said investigations have turned up instances of trafficking as well as addiction involving opiate-based prescription drugs. The drugs are often obtained through fraudulent means from pharmacies and emergency rooms, prompting physicians and pharmacists to watch for signs that illegal activity is occurring.

"I don't think there is an increase in activity. What's happening is an increase in reporting," Estill said. "The medical community is looking for it more, were getting a lot of cooperation from pharmacies."

Two individuals facing felony charges in Holmes County Common Pleas Court are charged with using deceptive means to obtain the drugs. The cases involve a 48-year-old Millersburg man who tried to get a prescription filled twice after claiming to have lost the first prescription, and a 28-year-old Warsaw woman charged with changing the number of pills on a prescription form.

In both cases, the drugs were legally prescribed by a physician, only not in the amounts requested.

"I find that when you go talk to them, they acknowledge it's a problem, but they don't know how to address the problem," Garrett said of people addicted to opiates. "They're just embarrassed to come to their family and say 'I have a problem.' Unfortunately, it takes us to contact them to admit it."

Drugged Driving In Canada up 100%

2009-05-20T18:01:00.000-07:00

RCMP cracking down on drug impaired drivers
Officers trained to spot drivers using illegal drugs
Jim Goddard VANCOUVER (NEWS1130) | Tuesday, May 19th, 2009 3:02 pm

The RCMP have a new focus for summer time driving enforcement. Inspector Norm Gaumont says they're going to be hunting for drivers impaired by drugs or a combination of drugs and booze.

Gaumont says 100 B.C. officers have now been trained to spot a driver who has had their judgement impaired by something other than alcohol. "They can make do a set of tests. If you fail those tests, they can actually make a demand for a blood, urine or saliva, and those are then sent to the lab."

Gaumont says studies found a 100 per cent increase in the number of B.C. drivers killed with drugs in their system between 2002 and 2007. He feels those number have increased since that study was done.

www.navigent3.com
Oral Fluid Drug Screens

Teen Drug Abuse on the Rise

2009-05-16T18:32:00.000-07:00

Police say teen drug abuse is on the rise in the Desert Southwest, as the number of hospital visits for drug abuse is increasing nationwide. Police say kids are having "pharming" parties; they show up with their pharmaceutical drugs, dump them in a bowl, and have at it. Yuma Police Department School Resource Officer Erick Resendiz held a presentation Wednesday night at City Hall as part of the Yuma Education Series. His message is if you abuse drugs, you're taking your life in your hands.

"We don't want to be responding to your house for an overdose when we can be responding to your house for advice on how to stop it," says Resendiz. Drugs can take a perfectly normal person, and turn them into a zombie. Resendiz says more kids in town are potentially throwing their future down the drain. He says police are seeing "over the counter and prescription drug abuse. Kids are trying any drug, if they have a drug that affects them somehow they think well if I take it more, can it help, will it help me." Resendiz also says more kids are inhaling toxins. Why are they doing drugs? To get high, deal with problems, change their body, help with school work, and a slew of other reasons. Resendiz says kids can find information on how to abuse drugs with the click of a mouse. "There's also experiment websites; sites they (kids) can go on-line that tell them how to abuse these drugs to get better highs safer. They even have rules like they're supposed to have a watcher; someone who can standby them when they're getting high in case something goes wrong." Resendiz says once a kid starts abusing drugs, they'll become a completely different person. Signs and symptoms of look out for: "Changes in behavior, changes in appearance, drastic things that don't normally happen in juveniles. Kids are giving away their belongings, they're losing an inappropriate amount of weight."

Resendiz says you can potentially save a loved ones life by getting them help before it's too late, and also studies show that if you talk to your child about not doing drugs, they'll be more likely to stay away from them. His advice for anyone is "don't even try them, don't even abuse them, don't take them any way, you shouldn't take them unless prescribed by a doctor. If you're already taking them get help, before you get past that addiction point where you can't get help anymore." For more information on Wednesday night's presentation, or for ideas on future presentation topics for the Yuma Educational Series, contact Officer Resendiz at the Yuma Police Department.

www.navigent3.com
Orapoint Oral Fluid Drug Tests

Prescription Drug Abuse - Oxycontin / Vicodin - #1 Drug Threat p 2009 Federal Survey

2009-05-16T18:29:00.000-07:00

Prescription Drug Abuse

Despite the prevalence of prescription drug abuse, especially pain releivers such as Oxycontin and Vicodin, most organizations.. including federal mandated DOT drug testing do not monitor their use.

A recent Federal Survey* says prescription drug abuse by teens and young adults continues to be a serious problem in the United States.

Today, teenagers are not using as much marijuana, cocaine, crack, LSD, and ecstasy as the adolescents of the 1960’s. American kids have a new favorite way to get high; painkillers and other prescription drugs are being abused at record levels.

This group of young adults has been given the name “Generation Rx.”

For the first time, national studies show that today’s teens are more likely to have abused a prescription painkiller than any street drug.

Surveys shows, that kids as young as 12 years old are trying or using prescription drugs -- to get high or for "self-medicating." The pharmaceuticals are often more available to kids than street drugs because they are often found in their very own homes. Also, pills may regarded as safer because they are professionally manufactured in a lab.

The survey also shows that painkillers are the most common pharmaceutical abused by teens with stimulant abuse more common among older teens and college students than younger teens.

Many young adults think these drugs are safe because they have legitimate uses, but taking them without a prescription to get high or to “self-medicate” can be as dangerous – and as addictive – as using street any drug they find on the streets.

*The Monitoring the Future survey – now in it’s 33rd year – is a series of classroom surveys of eight, tenth and twelfth graders. It is conducted by researchers at the University of Michigan under a grant from the National Institute on Drug Abuse (NIDA), part of the national Institutes of Health (NIH), and US Dept. of Health of Human Services (HHS).

The survey indicates a continuing high rate of prescription drug abuse among teens, with little change seen in the past six years. In fact, seven of the top 10 drugs abused were prescribed or purchased over the counter. The most common drugs used were Vicodin and Oxycontin.

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Prescription Drug Abuse & Identity Theft

2009-04-22T06:07:00.001-07:00

Cedar City Rotary learns about ID theft and prescription drug abuse

[Source:thespectrum.com]

CEDAR CITY — Cedar City Police lieutenants Darin Adams and Keith Millett informed Cedar City Rotary members on Tuesday about identity theft schemes trickling in from Las Vegas, prescription drug abuse and gang issues facing Festival City, USA.
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Nevada has the nation’s third-worst identity theft problem, the Federal Trade Commission reported last week, as Nevadans filed 2,930 identity theft complaints in 2007. Adams and Millett said Southern Utah should heed that statistic as a warning to be alert to the frauds occurring about 150 miles away.

“We haven’t experienced the number of identity theft cases that Las Vegas has, but that doesn’t mean we turn a blind eye to it,” said Adams, who also announced his promotion from sergeant to lieutenant at the meeting. “We need to be aware that these scams are happening so if they do appear here we can do something about it right away.”

In 2008, 9,101 cases were reported to the Las Vegas Metropolitan identity theft and forgery task force, the Las Vegas Sun reported. A rising scam identified by Adams in Las Vegas among those cases is medical identity theft. Adams said health care information is being stolen by thieves making appointments at doctor’s offices or hospitals posing as the victim of the identity theft. This can happen to anyone with a health insurance card, he said.

The grave consequences are when the victim gets the medical bills or when records are corrupted with incorrect information, creating potentially life-threatening situations for the real patient, Adams said.

To learn more about this story, please read tomorrow's online and print edition of The Spectrum & Daily News.

Pharmascists to Fight Prescription Drug Abuse

2009-04-21T06:13:00.000-07:00

Ohio pharmacists use education to fight drug abuse

Source: COLUMBUS, Ohio (AP)

Ohio pharmacists and the Ohio State University College of Pharmacy are partnering to help educate residents about the abuse of prescription and over-the-counter drugs.

The Ohio Pharmacists Association, the college and Cardinal Health Inc. plan to soon launch pilot programs using local pharmacists to teach residents in Columbus, Mount Vernon and Chillicothe about the dangers of abusing drugs they may find at home.

The partnership was announced Friday at the association's annual meeting, focusing on targeting teen drug abuse.

It follows a recent report by the Ohio Department of Health that showed drug overdoses topped traffic crashes as the leading cause of accidental death in Ohio in 2006 and 2007. Though heroin and other illegal drugs play a big role in those figures, the department attributed the increase to the use of prescription pain medicines.

"The drug problem is moving from the streets to the medicine cabinet," said Kenneth Hale, the pharmacy college's assistant dean for professional and external affairs.

Firght Student Drug Abuse - Information for Parents

2009-04-21T06:01:00.000-07:00

Birdville district forum aims to help parents counter drug abuse
(Source: By DIANE SMITH dianesmith@star-telegram.com)

Town experiences 16 drug related deaths in three months.

Prom, graduation and summer break are important times in teens’ lives, but they are also times in which many youths make poor choices about drugs and alcohol.

The Birdville school district wants to help parents by educating them today during a forum titled "The Real Story About Drug Use."

"We want to give them some information that gives them the warning signs and things to look for," said Donna Layer, coordinator of guidance and counseling services.

The forum will include discussions on trends and concerns, emergency services and the law. It comes as law enforcement agencies have investigated several drug-related deaths in Tarrant County.

From January to mid-March, the medical examiner’s office has confirmed 16 heroin-related deaths. Four other deaths are being investigated as possibly heroin-related. One drug-related death involved an accidental overdose of the drug Ecstasy.

Layer said the recent headlines heightened the need to hold a community discussion. Another key reason for the forum, part of a federal Safe and Drug-Free Schools and Communities grant, is to remind parents that teen drug and alcohol abuse continues to be a community worry.

"None of these things ever go away," Layer said. "Just because you are not hearing about it out on the forefront doesn’t mean it’s not an area of concern."

Here are some questions and answers about the forum and drug issues.

Is teen drug and alcohol abuse still a concern?

While the issue surfaces in cycles in the news media, it is always a concern, said Layer, adding that the community can’t become blase.

"Sometimes our kids just believe they are indestructible," she said.

What are some warning signs that my teen is abusing drugs or alcohol?

The American Academy of Child & Adolescent Psychiatry states that these may be warning signs: a drop in school performance, a change in friends, delinquent behavior and deterioration in family relationships. Go to the academy’s Web site ( www.aacap.org) for more information.

Where can I get educational information about drugs?

The National Institute on Drug Abuse Web site ( www.nida.nih.gov) details drugs and how they affect the body. It also has educational materials for teens, parents and educators.

Oral Fluid Accurate vs. Urine

2009-04-20T06:27:00.000-07:00

Oral fluid testing proves comparative accuracy to urinalysis in detecting drug use
A recently published study in the December issue of Drug and Alcohol Dependence indicates that the use of oral fluid analysis may be an effective alternative to urinalysis in detecting drug use in a opiate treatment setting. Gerald A. Bennett and Eleanor Davies from the Addictions Service, Dorset HealthCare NHS Trust and Peter Thomas from Dorset Research and Development Support Unit, Poole Hospital NHS Trust, Bournemouth University studied the use of rapid oral testing to assess accuracy in detecting drugs
of abuse. The study examined specificity and sensitivity of oral screening as a viable alternative to urinalysis, which is more invasive and an often defrauded method.

Mexican Drug Cartels in America

2009-04-20T05:57:00.000-07:00

Traffic shifts from major interstate routes

Source: Alan Riquelmy - ariquelmy@ledger-enquirer.com

Atlanta area remains a major hub for moving drugs and cash

It makes sense that illegal drugs from Mexico move on interstates to Atlanta, a hub for the Southeast, and then along spokes to smaller communities like Columbus.

But drug traffickers often take detours — and make drops — in Columbus before reaching Georgia’s capital.

Interdiction teams along Interstate 85 have made plenty of busts in places such as Montgomery, Ala., and LaGrange, Ga.

Someone worried about being caught while driving through Montgomery might take state and federal highways to Dothan, Ala., then drive north to Phenix City and onto J.R. Allen Parkway on the way to either Atlanta or Macon.

“They’re taking alternate routes because of the heat on the interstate,” said Russell County Sheriff’s Lt. Heath Taylor. “That means Columbus and Phenix City are in the middle of it.”

Sgt. Rick Stinson, a Columbus police officer with the Metro Narcotics Task Force agrees. And a Columbus dealer with good contacts, he said, can convince someone carrying drugs to stop here if it works out to be easier.

Conversely, a local dealer will drive to Atlanta if that is the route of least resistance.

Agencies in Metro include the Columbus Police Department, the Muscogee County Sheriff’s Department, the Harris County Sheriff’s Department, the Russell County Sheriff’s Department and the Phenix City Police Department.

Removing Atlanta as a drug hub likely wouldn’t change anything, Stinson said. Certain people will always be willing to provide drugs, but law enforcement can make it more difficult, just as education programs such as Drug Abuse Resistance Education aim to stem the drug tide.

“You’re not going to stop a supply as long as there’s a demand,” he said. “Somebody’s going to step up and probably supply a certain portion of that demand.”

A month ago, an 18-wheeler was stopped and found to have around $1 million inside, Taylor said.

Two weeks ago, a former Phenix City police officer who’s now with the state patrol stopped an 18-wheeler near Montgomery. It had a huge amount of drugs inside, Taylor said.

“All around us there are signs of drug trafficking to Atlanta,” the lieutenant said.

Around March 1, Stinson’s eight-member, five-agency team raided a north Columbus home and found 50 pounds of marijuana, he said. It was a rental home being used for the drug trade — a trend law enforcement has seen in Atlanta as well.

Such houses are usually rented in low-traffic areas. No one would live there all the time, and neighbors would never see an endless line of drug buyers lining up. That would draw attention to the home, Stinson said.

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Oral Fluid Technology

What's an EAP ? Employee Assistance Program

2009-04-11T19:04:00.000-07:00

Employee Assistance Programs (EAPs) are designed to help identify and resolve productivity problems affecting employees who are impaired by personal concerns.

EAPs come in many different forms, from telephone-based services to on-site programs.

Face-to-face programs provide more comprehensive services for employees with substance use disorders, including screening, treatment referrals and follow-up care.

5 STEPS TO A HEALTHIER , SAFER WORKPLACE

2009-04-11T19:00:00.000-07:00

1. Establish an Employee Assistance Program that includes confidential substance abuse screening, education, treatment referral, and recovery support.

2. Develop a policy for dealing with substance abuse in the workplace: at a minimum, provide training for supervisors in recognizing and dealing with drug or alcohol problems and support treatment for and recovery from substance use disorders.

3. Offer employees health insurance that provides comprehensive benefits for substance abuse treatment, including a broad range of service options, such as therapy, medications, and recovery support.

4. Be sure that health plans require their physicians to screen patients confidentially for substance use problems.

5. Support drug-free workplace policies.

Workplace Drug-Free Workplace Policy Information

2009-04-11T18:41:00.000-07:00

Free Drug-Free Workplace Information

Save Your Company Money By Assuring Access to Substance Abuse Treatment

What You Need To Know About Older Workers and Substance Abuse

What You Need To Know About Younger Workers and Substance Abuse

What You Need To Know About Mental and Substance Use Disorders

Save Money By Addressing Employee Alcohol Problems

Save Money By Addressing Employee Drug Problems

What You Need To Know About the Cost of Substance Abuse

Save Money By Encouraging Workers To Get Help For Substance Use Problems

An EAP that Addresses Substance Abuse Can Save You Money

How You Can Support Workers in Recovery

Resources Available to Employers

What You Need To Know About Substance Abuse Treatment

Save by Providing Comprehensive Benefits for Substance Abuse Treatment

You Save When Your Health Plans Improve Substance Abuse Screening

http://csat.samhsa.gov/IDBSE/employee/index.aspx

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Drug-Free Workplace Solutions
Oral Fluid Technology

Opiate and Meth Abuse Rates Not Declining

2009-04-11T18:35:00.000-07:00

Highlights for 2007 Treatment Episode Data Set (TEDS)

The report provides information on the demographic and substance abuse characteristics of the 1.8 million annual admissions to treatment for abuse of alcohol and drugs in facilities that report to individual State administrative data systems. TEDS does not include all admissions to substance abuse treatment. In general, facilities reporting TEDS data are those that receive State alcohol and/or drug agency funds (including Federal Block Grant funds) for the provision of alcohol and/or drug treatment services.

Five substances accounted for 96 percent of all TEDS admissions in 2007:
alcohol (40 percent);
opiates (19 percent; primarily heroin);
marijuana/hashish (16 percent);
cocaine (13 percent); and stimulants
(8 percent, primarily methamphetamine.

More than two-thirds (69 percent) of all alcohol-only admissions were non- Hispanic White

For primary heroin admissions, the average age at admission was 36 years.

Just over half (53 percent) of primary non-heroin opiate admissions were male

Non-heroin opiates admissions are increasing from from 1 percent of all admissions in 1997 to 5 percent in 2007. These drugs include codeine, hydrocodone, hydromorphone, meperidine, morphine, opium, oxycodone, pentazocine, propoxyphene, tramadol, and any other drug with morphine-like effects. Non-prescription use of methadone is not included.

Methamphetamine/Amphetamine and Other Stimulants* * The proportion of admissions for abuse of methamphetamine/amphetamine and other stimulants increased from 4 percent in 1997 to a high of 9 percent in 2005. In 2006 admissions decreased to 8 percent and remained at 8 percent in 2007.

Urine Drug Screens and Potential False Positives

2009-04-04T12:40:00.001-07:00

The following have been shown to react with urine drug screens.
PHARMACEUTICAL NAME BRAND NAME USE
Amantadine Amantadine Parkinsonism
Bupropion Wellbutrin & Zyban Antidepressant&Smoking cessation
Chloroquine AralenTreats Malaria
Chlorpromazine Thorazine, Largactil Psychotic disorders
Desipramine Norpramin Antidepressant
Dextroamphetamine Dexedrine Narcolepsy "sleep
Ephedrine Ephedra and Ma Huang Amphetamines
Fenfluramine Fen Phen Diet pill outlawed by FDA Labetalol Labetalol Blood Pressure
Mexiletine Mexitil Cardiovascular
n-acetyl procainamide Procainmide Cardiovascular
Phentremine Adipex/Obenix/Oby-Trim Diet Pills
Propranolol Inderal Cardiovascular

Phencyclidine
(PCP)
Dextromethorphan Dextromethorphan Cough treatment
Diphenhydramine Benadryl Allergies
Thioridazine Mellaril RidarilinCanada Tranquilizer
Venlafaxine Effexor Antidepressant

Workplace Drug Testing Overview

2009-04-03T15:55:00.001-07:00

Drug tests in the USA can be divided into two general groups, federally and non-federally regulated testing.

Federally regulated drug testing started when Ronald Reagan enacted executive order 12564, requiring all federal employees refrain from using illegal substances in specified DOT regulated occupations. Drug testing guidelines and processes, in these areas exclusively, are established and regulated (by the Substance Abuse and Mental Health Services Administration or SAMHSA, formerly under the direction of the National Institute on Drug Abuse or NIDA) require that companies who use professional drivers, specified safety sensitive transportation and/or oil and gas related occupations, and certain federal employers, test them for the presence of certain drugs. These test classes were established decades ago, and include five specific drug groups. They do not account for current drug usage patterns. For example, SAMHSA / DOT tests exclude semi-synthetic opioids, such as oxycodone, oxymorphone, hydrocodone, hydromorphone, etc., and other prescription medications that are widely abused in the United States

Non-federally regulated or General workplace drug testing allows for far more effective drug testing procedures. While SAMHSA / NIDA guidelines only allow laboratories to report quantitative results for the " NIDA-5 " / " SAMHSA-5 " for their official SAMHSA-approve tests, many drug testing laboratories and on-site tests offer a wider, " more appropriate " set of drug screens to better detect current drug use patterns. As noted above, these tests include synthetic pain killers such as Oxycodone (Oxycontin, Percocet), Oxymorphone, Hydrocodone (Vicodin), Hydromorphone. Some also include benzodiazepines (Valium, Xanax, Klonopin, Restoril) and barbiturates in other drug panels (a "panel" is a predetermined subset of tests run). The confirmation test (usually GC/MS, or LC/MS/MS) can tell the difference between chemically similar drugs such as methamphetamine and methylenedioxymethamphetamine (MDMA or ecstasy). In the absence of detectable amounts of methamphetamine in the sample, the lab wold report the sample as negative, or report it as positive if present.

Oral Fluid / Saliva Drug Test Proven Accurate - Again

2009-04-02T16:58:00.000-07:00

A large-scale study of laboratory-based oral fluid drug testing results found that the technology is comparable to urine drug testing. Approximately 650,000 oral fluid laboratory test results analyzed were collected over a five-year period of time in the non-federally regulated workplace market.

The results of this expansive study, which was sponsored by the U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration (SAMHSA), were presented at the annual meeting of the Society of Forensic Toxicologists.

www.drugfreenavigent.com

Mines, Drug Testing, & Unions

2008-09-08T07:15:00.000-07:00

Source: September 6, 2008, Charleston Gazzette

MSHA: Test coal miners for drugs and alcohol

The White House administration will propose a rule early next week to require drug testing of miners who work in "safety sensitive" jobs in the nation's coal and non-coal mines.

U.S. Mine Safety and Health Administration ( MSHA ) officials are pushing for speedy approval of the rule, offering the mining community and the public a tight 30-day comment period - less than half the time provided for two other rules proposed by MSHA this year.

"An alcohol- and drug-free mine program as proposed in this rule will contribute to the prevention of such incidents and provide all miners, regardless of what state they work in and the size of the mine they work for, equal safety protection from working alongside miners under the influence of alcohol and/or drugs on the job,"

MSHA said in a proposal scheduled to be published in Monday's Federal Register.

The proposed rule would replace existing standards for drugs and alcohol at metal and non-metal mines with an industry-wide rule that also covers coal operations.

It would designate certain substances - alcohol and a list of controlled substances - that could not be possessed on mine property or used while performing safety-sensitive job duties, unless they were being used according to a valid prescription.

Mine operators would be required to establish an alcohol- and drug-free program, including a written policy, employee education, supervisory training and drug testing for miners in safety-sensitive jobs and their supervisors. Safety-sensitive job duties are defined as "any type of work activity where a momentary lapse of critical concentration could result in an accident, injury or death."

Company policies also must include treatment referrals for miners who violate the policy. The proposed rule also would require those who violate the prohibitions to be removed from the performance of job-sensitive duties until they complete recommended treatment and their alcohol- and drug-free status is confirmed by testing.

"Mining under the best of circumstances can be dangerous," said MSHA chief Richard Stickler, "and the use of alcohol and illegal substances creates additional, unnecessary hazards in the workplace."

MSHA's Federal Register notice did not include any mention of a public hearing on the proposal.

Department of Labor spokesman David James said the agency anticipates receiving a request for a hearing and that MSHA "is preparing to do" such a hearing.

"There will likely be a notice for public hearing published sometime during the public comment period," James said.

Coal industry officials have long sought an MSHA rule to require drug testing of miners, but the United Mine Workers union has questioned the need for such testing and worried about the specifics of how companies would carry out such testing.

Kentucky adopted its own drug-testing program for miners in 2006, and Virginia passed similar rules in 2007. West Virginia has declined to adopt drug-testing requirements for coal miners.

In October 2005, MSHA announced that it was working on such a rule, but after a string of mine disasters in 2006 and 2007, the drug-testing proposal appeared to have been put on the back burner as the agency scrambled to enact numerous safety reforms mandated by Congress.

Then, in early June, MSHA officials submitted their proposed rule to the White House Office of Management and Budget for its review. The OMB approved the proposal late last week, records show.

In its proposed rule notice, MSHA said

"a preliminary review of fatal and non-fatal mine accident records revealed a number of instances in which alcohol and drugs or drug paraphernalia were found or reported, or where the post-accident toxicology screen revealed the presence of alcohol or drugs."

MSHA cited a study that showed

more than 13 percent of full-time miners were heavy alcohol users and 7 percent admitted that they had used illicit drugs within the past month.

"Using alcohol and/or drugs can affect a miner's coordination and judgment significantly at a time when he or she needs to be alert, aware and capable of performing tasks where there is a substantial risk of injury to oneself or others," the MSHA notice said.

"Even prescription medications may affect a miner's perception and reaction time. Mining is a complicated and hazardous occupation, and a clear focus on the work at hand is a crucial component of mine safety."

During a previous comment period, UMW officials questioned whether MSHA had shown the need for a nationwide drug-testing program.

MSHA responded, "Although a subsequent internal [Department of Labor] review of accident reports failed to reveal a significant number of cases where alcohol or drugs were determined to be causative factors, it did reveal a lack of consistency in whether and how alcohol and drug tests are performed and in the investigative process used to determine whether alcohol or drugs may have been factors.

"In fact, currently accident investigations do not routinely include an inquiry into the use of alcohol or drugs and this is a failure that the proposed rule intends to address," MSHA said.

MSHA estimated that the drug-testing rule would cost the mining industry $16 million during its first year and $13 million every year after that.

Unions 1, Nevada Legislators 0

2008-08-12T09:21:00.000-07:00

Source: 2008 - August - Casino City - Las Vegas Gaming Wire

(Note: Drug Testing, including Random Drug testing is legal in all 50 States, despite political attempts to distort this fact. Furthermore, oral fluid-based on-site drug screening is the only feasible, cost-effective, and accurate method to conduct random testing at construction site. Oral fluid sceening can be directly observed, preventing the prevalent practice of drug abuser adulterating or substituting urine-based testing, and corporate security staff can administer the tests vs. relying upon $8-$10/hr third party collection personnel and sites with transient workers. Furthermore, leading on-site oral fluid tests screen for drugs commony found today on construction sites such as oxcodone and hydrocodone - tranditional NIDA-5 and/or SAMHSA-5 tests do not. )

Union rep in favor of drug test
11 August 2008

LAS VEGAS, Nevada -- Building contractors should be given authority to conduct random drug and alcohol tests of construction workers, either through legislation or through negotiations with unions, a spokesman for a construction trades group said a day after three union members were fired for entering the CityCenter job site after drinking at nearby bars.

Steve Holloway, executive vice president of the Las Vegas chapter of the Associated General Contractors, said Friday that the number of construction workers who are drinking on the job represents a small fraction of the total work force on the site.

However, "it's a large enough minority that it needs to be dealt with, probably by legislation that would allow a construction contractor to perform random drug and alcohol testing," he said.

Holloway is a member of an eight-person task force that was set up in the wake of a series of 12 construction worker deaths at Strip sites in the past 18 months. The committee is looking at possible legislation to be considered by the 2009 Legislature.

Holloway said none of the union contracts now in effect locally allow for random testing of construction workers. (NOTE: UNIONS, OWNERS, INSURERS & CONTRACTORS NEED TO ACT NOW TO ALLOW AND IMPLEMENT RANDOM TESTING VIA ALL SPECIMEN TYPES)

"That needs to be changed by statute, or by negotiations with the union," he said. "It should probably be by statute because we have just as many nonunion workers as we do union."

Steve Redlinger, spokesman for the Nevada Building and Construction Trades Council, an affiliate for 17 labor unions, said lawmakers can't legislate personal responsibility without coming dangerously close to treading on civil liberties. (NOTE: THIS STATEMENT IS COMPLETELY FALSE - U.S. SUPREME COURT HAS MADE IT CLEAR THAT RANDOM DRUG TESTING IS LEGAL AND THAT COMPANIES CAN (AND DO) IMPLEMENT RANDOM TESTING FOR SAFETY PURPOSES - IT IS FIRST AND FORMOST A FEDERAL LEGAL OBLIGATION FOR COMPANIES TO ENSURE A SAFE WORKPLACE FOR ALL EMPLOYEES... THIS IS NOT POSSIBLE AT CONTRUCTION SITES WITHOUT RANDOM DRUG TESTING (VIA OBSERVED SPECIMEN COLLECTION) IN CONCERT WITH EDUATIONAL PROGRAMS AND SUPPORT.)

Another member of the committee, state Assemblyman John Oceguera, D-Las Vegas, said he would not support giving employers "unfettered abilities" to randomly drug test employees because that would infringe on the individuals' rights. (NOTE- A PERSONAL OPINION VS. FACT)

A company should need to show there is "some indication" a worker is impaired by drugs or alcohol before it could demand a test, the state Assembly's majority leader said. (NOTE-THIS IS REPRESENTATIVE OF THE LACK OF EDUCATION ON THE TOPIC OF SUBSTANCE MISUSE-VISUAL OBSERVATION FAILS OVER 90% OF THE TIME TO DETECT SUBSTANCE MISUSE-ONLY RANDOM DRUG TESTING PROVIDES THE REQUISITE LEVEL OF DETERENCE AND DECTECTION).

Committee member and state Sen. Maggie Carlton, D-Las Vegas, sided with Oceguera in expressing concern over individual rights.

Existing union contracts already say companies can request a drug or alcohol test if an employee displays erratic behavior or is slurring speech, a union official said. Most of the current agreements also let employers demand tests before someone is hired or if they are involved in an accident.

Other committee members, Clark County commissioners Chris Giunchigliani and Rory Reid, Las Vegas Mayor Oscar Goodman and state Senate Minority Leader Steven Horsford, D-Las Vegas, did not return calls for comment. Trades Council President Rick Johnson also is on the committee.

The committee will probably reconvene in late August or early September and begin drafting a bill for next year, Holloway said.

The committee members' comments come two days after the Review-Journal reported that it had photographed 10 construction workers drinking at Strip bars before they went on to the CityCenter work site, a violation of rules set by the general contract, its subcontractors and the unions.

Dozens of additional workers were seen drinking alcohol outside convenience stores and inside bars, but they were identified as being off for the day.

On Thursday, three ironworkers members who were photographed returning to the job site were identified and fired by general contractor Perini Corp.

Perini officials said they have not identified any other workers yet, but the company will continue its investigation next week, said Doug Mure, Perini's vice president of human resources and risk management.

Chuck Lenhart, business agent for Ironworkers Local 433, said he met Friday with one of the disciplined workers, who admitted his behavior was inappropriate.

"When I spoke to one of them this morning, he got it," said Lenhart, who declined to give the workers' names or to describe their jobs. "He understood and I believe he is going to get some help."

Lenhart said the fired workers will need to go through counseling, at the union's expense, before they can be cleared to work on other jobs -- in two or three months, at the earliest. The workers won't be reassigned to another job site until they are cleared by a counselor, he added. (NOTE: AN EXCELLENT APPROACH BY THE UNION - SUPPORT, YET MONITOR)

However, each case is different and, if the workers have any prior disciplinary action on their records, they could be removed from the union.

But that is not a step the union wants to take, he said.

"When there is somebody that may have a problem they're not out the door," said Lenhart, who noted the Ironworkers local also screens workers before they join the union.

"We try to get help for them. Some people accept it and some people don't."

However, the responsibility ultimately lies with the individual worker to do the right thing for themselves and the workers around them. (NOTE: TRUE-HOWEVER, IN VIRTUALLY ALL CASES ABUSERS WILL NOT SEEK ASSISTANCE ON THERE OWN UNLESS DETECTED, OR AN INCIDENT OCCURS)

"They have free will and they can make their choices," Lenhart said. "Sometimes, they make bad choices. That's what I'm concerned about in this industry: When you have people who make these types of choices to (drink alcohol before work), there's a possibility of them hurting someone else on the job site."

Perini plans to look at what the company can do to control alcohol problems on its job site, although Mure said: "Our focus right now is the immediate identification (of the workers in the photos)."

The Perini executive did dismiss one rumor that went around the job site Thursday suggesting the company planned to "close" the job site so workers could not leave during lunch.

Mure said trying to close the 77-acre construction site, which employs 7,700 workers, would be impractical.

"That's not even really feasible on a project like CityCenter or any of the major construction projects in Las Vegas," he said. "Rumors are rumors. You've seen the site, it isn't something that could even be considered."

New Oral Fluid Technology for Cancer Detection

2008-08-12T06:41:00.000-07:00

Source: 2008 ZD Net

Sensors to detect oral cancer in saliva
Posted by Roland Piquepaille @ 10:10 am

Categories: Health & Medicine, Engineering & Innovation

Tags: University Of California At Los Angeles, Team, Researcher, Protein, Sensor, Molecule, Cancer, Protein Sensor, Dr Wong, Team Management

1 TalkBackPrintEmailThumbs UpThumbs Down+22
According to the American Cancer Society (ACS), there will be about 35,000 new cases of oral cancer in the U.S. this year. The ACS also estimates that ‘when oral cancer is identified in its early stages, patient survival rate is almost 90 percent, compared with 50 percent when the disease is advanced.’ This is why a team of University of California at Los Angeles (UCLA) researchers supported by the National Institute of Health (NIH) has developed a very sensitive optical salivary sensor. Clinical tests should start soon. A simple and fast saliva test in your dentist office might one day replace blood tests and even biopsies. But read more…

You can see on the left “Leyla Sabet, a member of the UCLA research team that built the new optical protein sensor, sits in front of the device. Based on a confocal microscope, the ultrasensitive system is being used by the researchers to detect biomarkers in saliva samples that are linked to oral cancer.” (Credit: UCLA, via MIT’s Technology Review)

This sensor has been developed by Chih-Ming Ho, a professor of engineering at UCLA and several colleagues of the UCLA Micro Systems Laboratories, including researchers Leyla Sabet and Winny Tan. David Wong, professor of oral biology, and several members of his lab were also involved in this project.

According to the NIH news release, “the sensor can be integrated into a specially designed lab-on-a-chip, or microchip assay, and preprogrammed to bind a specific protein of interest, generating a sustained fluorescent signal as the molecules attach. A microscope then reads the intensity of the fluorescent light — a measure of the protein’s cumulative concentration in the saliva sample — and scientists gauge whether it corresponds with levels linked to developing disease.”

And is this optical sensor successful? “In their initial experiments, the scientists primed the optical protein sensor to detect the IL-8 protein, which at higher than normal concentration in saliva is linked to oral cancer. Using saliva samples from 20 people — half healthy, the others diagnosed with oral cancer — the sensor correctly distinguished in all cases between health and disease. Importantly, the sensor achieved a limit of detection for IL-8 that is roughly 100 times more sensitive than today’s blood-based Enzyme-Linked ImmunoSorbent Assay (ELISA) tests, the standard technique to measure protein in bodily fluid.”

Now, let’s turn to a Technology Review article, “Spit Sensor Spots Oral Cancer” (Brittany Sauser, August 6, 2008) to learn why it has been difficult to detect oral cancer biomarkers in saliva.”Protein markers are harder to spot in saliva than in blood. To create the ultrasensitive sensor, researchers started with a glass substrate coated with a protein called streptavidin that enables other biomolecules to bind to the substrate and to one another. The researchers then added a molecule that would catch and bind the cancer biomarker — a protein in saliva called IL-8 that previous research has proved to be related to oral cancer. They also added molecules designed to keep the glass surface free of other proteins that might muddy detection of the biomarker. To visualize the target molecules, Ho’s team then added a set of fluorescently tagged proteins designed to attach to the captured IL-8 markers.”

And what was Ho’s team next step? “Because saliva has a lower concentration of proteins than blood does, the team needed a highly sensitive method to detect the tagged proteins among the background noise, stray molecules in saliva that also fluoresce. So the researchers used a confocal microscope — an imaging system that employs a laser to collect the light generated from a sample — to analyze the saliva. Ho and his team found that focusing the laser light on a specific part of the sample resulted in a lower signal-to-noise ratio, allowing them to detect lower concentrations of the cancer biomarker. Indeed, Ho says, the device is 100 times more sensitive than the standard protein-detection technique, ELISA.”

This research work has been published in Biosensors and Bioelectronics under the title “Optical protein sensor for detecting cancer markers in saliva” (Volume 24, Issue 2, 15 October 2008, Pages 266-271). Here is a quote from the abstract. “The ultra sensitive optical protein sensor presented in this paper has a wide number of applications in disease diagnoses. Measurements for detecting biomarkers in clinical sample are much more challenging than the measurements in buffer, due to high background noise contributed by large collections of non-target molecules. We used clinical saliva samples to validate the functionality of the optical protein sensor. Clinical detection of disease-specific biomarkers in saliva offers a non-invasive, alternative approach to using blood or urine.”

If you’re interested by this subject, you also should read a very good article coming from an unusual source, “On the tip of your tongue” by Anne-Marie McQueen (The National, United Arab Emirates, July 26, 2008). This article is more focused on David Wong’s research. “He and his team have already developed a saliva test for oral cancer and Sjogren’s Syndrome, a systemic disease in which the body’s immune system attacks the glands that produce saliva and tears. Dr Wong says they have promising early evidence that it will be possible – perhaps even within five years – to use saliva to detect biomarkers for more systemic diseases, like breast, lung and pancreatic cancers, as well as diabetes.”

And even if you like needles — which I don’t — “the benefits of saliva testing versus blood sampling or more invasive diagnostic tests are many, says Dr Wong. Saliva testing is easier, safer and less intrusive. Since its testing does not require specially trained personnel, there is no risk of exposing anyone to blood-born diseases. Also, oral fluids do not clot like blood, so they not require the same level of manipulation.”

Death From Prescription Drugs Soar 2008

2008-07-28T16:13:00.000-07:00

Source: CNN July 2008

Deaths from medication errors at home are up dramatically in last 20 years

Increase steepest in death rates from mixing meds, alcohol, street drugs at home

Researchers cite dramatic rise in home use of prescription painkillers

CHICAGO, Illinois (AP) -- Deaths from medication mistakes at home, such as actor Heath Ledger's accidental overdose, rose dramatically during the past two decades, an analysis of U.S. death certificates finds.

Prescription drug abuse plays a role in the rise in fatalities, but it's unclear how much, researchers said. The authors blame soaring home use of prescription painkillers and other potent drugs, which 25 years ago were given mainly inside hospitals.

"The amount of medical supervision is going down and the amount of responsibility put on the patient's shoulders is going up," said lead author David P. Phillips of the University of California, San Diego.

The findings, based on nearly 50 million U.S. death certificates, are published in Monday's Archives of Internal Medicine. Of those, more than 224,000 involved fatal medication errors, including overdoses and mixing prescription drugs with alcohol or street drugs.

Deaths from medication mistakes at home increased from 1,132 deaths in 1983 to 12,426in 2004. Adjusted for population growth, that amounts to an increase of more than 700percent during that time.

In contrast, there was only a 5 percent increase in fatal medication errors away from home, including hospitals, and not involving alcohol or street drugs.

Abuse of prescription drugs plays a role, but it's unclear how much. Valid prescriptions taken in error, especially narcotics such as methadone and oxycodone, account for a growing number of deaths, said experts who reviewed the study.

The increases coincided with changing attitudes about painkillers among doctors who now regard pain management as a key to healing. Multiple prescription drugs taken at once -- like the sleeping pills, painkillers and anxiety drugs that killed "Dark Knight" star Ledger -- also play a part, experts said.

"When we see overdoses, we're seeing many more mixed drug overdoses," said Dr. Jeffrey Jentzen, president of the National Association of Medical Examiners and director of autopsies at the University of Michigan in Ann Arbor. Jentzen said autopsies are much more likely to include toxicology tests today than 25 years ago, which would contribute to finding more fatal medication errors as cause of death.

But Phillips said there were no significant increases in other poisonings, such as suicidal overdoses or homicides, so more testing doesn't explain the huge increase. The analysis excluded suicides, homicides and deaths related to side effects.

The increase was steepest in death rates from mixing medicine with alcohol or street drugs at home; that death rate climbed from 0.04 per 100,000 people in 1983 to 1.29 per 100,000 people in 2004.

Many patients ignore the risk of mixing alcohol with prescriptions, said Cynthia Kuhn of Duke University Medical Center, who was not involved in the study.

"They think, 'Oh, one drink won't hurt.' Then they have three or four," Kuhn said.

The increase in deaths was highest among baby boomers, people in their 40s and 50s.

"We're sort of drug happy," said boomer Dr. J. Lyle Bootman, the University of Arizona's pharmacy dean, who was not involved in the research. "We have this general attitude that drugs can fix everything."

Health Library
MayoClinic.com: Get the most out of your meds
People share prescriptions at an alarming rate, Bootman said. One recent study found 23 percent of people say they have loaned their prescription medicine to someone else and 27 percent say they have borrowed someone else's prescription drugs.

Kenneth Kolosh, a statistics expert at the National Safety Council, praised the study but said improved attention to coding location on death certificates may account, in part, for the huge increases the researchers found.

Phillips countered that home deaths from any cause increased relatively little during the time period, so better coding doesn't explain the change.

Michael R. Cohen, president of the Institute for Safe Medication Practices, said more states should require pharmacists to teach patients about dangerous drugs and insurers should pay pharmacists to do so.

Unions Oppose Safety & Random Drug Testing?

2008-07-21T08:28:00.000-07:00

Some Unions just don't get it, preferring to spread misinformation and rely upon scare tactics vs. acting responsibly and in the best interests of safety.

1. Random drug testing is NOT unconstitutional, nor illegal in the United States

2. Teachers should be subject to random drug testing, just as should firefighters, police, and other individuals in occupations where drug abuse would create serious safety issues.

3. Random drug testing via observed speciment collection, has proven to be effective at both detection and deterrence.

(Source: ABC News, KITV.com)

Random Drug Test For Teachers Meets Opposition

Teachers Union Says Drug Test Unconstitutional

HONOLULU -- There are more problems with a plan to randomly drug test school teachers. The union that represents public school teachers now said it can't knowingly agree to a plan it believes is unconstitutional.

The Hawaii State Teachers Association sent a letter to the school board that revealed where the two sides were far apart. The two sides had agreed to have a drug testing plan in place at the end of June, but missed the deadline.

Those eager to begin the new school year said the start is being clouded by drug testing controversy."I hope there is some reasonable resolution to this. It just going to take away from education and that's a shame," principal Mike Haramo said.

"We are starting the school year and they are still talking about it. You just wonder how long it's going to go on for," parent Rikki Wells said.

Wells said he worries it's all about red tape and politics and not enough focus on the children.Dragging it on, going into the courts, the political fees, the arguing back and forth and the truth," Wells said.

The first day of class for most public schools is the end of July, and at some campuses, teachers are to report to work next week.

Others who get random drug tests frequently said the same should apply to teachers.

"I think everyone in the HSTA should be drug tested just for the safety of the children," a construction worker said. Gloria Chi thinks random testing a good idea, but she thinks taking classroom money to pay for it is bad. "BOE should be doing something for the kids for education but the government should really pay for it," Chi said.

And when pressed about what appears to be an about face for the teachers union...

"Random is what teachers agreed to. We agreed to random and reasonable suspicion, but when we got into procedures we found complications of constitutional issues," HSTA Executive Director Mike McCartney said.

McCartney said the latest proposal is unworkable. Both sides have appealed to the labor board to help resolve the conflict.

Drugged Driving - July 2008

2008-07-08T06:56:00.000-07:00

Police expect challenges to roadside drug test law
DOUG MACKENZIE
Source-The Cape Breton Post

SYDNEY — Drivers who operate a motor vehicle while high will no longer be able to refuse road side drug tests under new laws which came into affect last week.
Police can now require drivers to submit to roadside tests and also have the power to take suspected drug-impaired drivers to a police station or hospital to get a blood, urine or saliva sample. Under the old law, police were obliged to tell drivers suspected of being high that roadside tests weren’t mandatory.

While the new law is being heralded by law enforcement officials, they also realize there will be challenges involved with enforcement.
“To us, this is a great thing, it’s another tool in our toolbox in terms of our officers out on the streets dealing with people they believe are drug induced and driving and now we actually have the law in place which gives us the authority to deal with these issues,” said deputy chief Myles Burke, of the Cape Breton Regional Police. “I think this is a great thing for law enforcement and a great thing for the community – it’s a positive step. There will no doubt ... be challenges to the law, challenges to the constitutionality of the demand and even the expertise of the experts themselves …

“This stuff can be challenged, but that’s fine. That comes with every law we’re dealing with, but at the end of the day we will have people here who are certified experts, who will be doing the field testing that is required and will be going to court in cases where they feel someone is driving under the influence of narcotics.”

Burke said training of officers within the traffic safety unit will be the key to successful enforcement of the law and he would like to see experts on call 24/7 to help deal with situations when they arise.
“The training is very specialized and although there are funds available to train officers, it does require a significant commitment and officers have to leave the local area (for training),” said Burke. “One component of the course, the officers are actually trained at a U.S. prison doing testing of people going in and out of the prison. Their field subject testing is actually live at a prison.
“We have requested for the next training course available to have a couple of seats made available. We are very interested in having a couple of our officers trained as experts.”

Parents & Teachers Need the Education

2008-06-26T07:37:00.000-07:00

Parents & Teachers are the Problem?

The below is demonstrable of the lack of drug education on the part of many parents & teachers.

Some parents view random drug testing as a "punishment" or "lack of trust", when in reality it is a BENEFIT to students, parents,and schools. It you consider that over 20,000 people die annually due to drug overdose, and millions of students regularly abuse prescription drugs (this is the problem NOT mariujana), and illict drugs such as meth & cocaine... combined with the fact that it take 3.5 years for a parent to learn their child abuses drugs...plus, even trained DRE (drug recognition experts fail to identify a drug abuser 90% of the time... and well, you get the terrible picture.

Concerned about random drug testing

Tuesday, June 24, 2008 12:49 PM CDT

I have been following with interest the subject of Bandera ISD's policy of random drug testing at the middle and high schools.

As the mother of four children, I am concerned about my kids' health and safety when they are at school. I, like all parents, desire an educational environment which nurtures, challenges and supports my children.

However, try as I may, I cannot see how random drug testing is compatible with this goal. The only thing I see it doing is punishing both the innocent and the guilty.

As a former high school teacher, I can attest that, in my experience, it is not very difficult to identify a student who is under the influence of drugs.

Why are such Draconian measures now being proposed to do the same thing that an observant teacher could have done without disturbing the learning environment?

I applaud Mr. Zavorka's recent appeal to school board members to truly think about the implications of this policy before adopting it. He certainly gave me pause.
As C.S. Lewis wrote, "Of all tyrannies, a tyranny exercised for the good of its victims may be the most oppressive."

The citizens of Bandera should consider this before supporting the random drug testing of their children.

New Urine Test Ruling Ineffective

2008-06-25T08:57:00.000-07:00

The recent "final rule" for urine-based "Specimen Validity Testing" (outlined below) is clearly of limited value, as it does little to address the prevalent practice of drug abusers cheatig urine tests.

Observed collection is the only method to assure specimen validity.

The ODAPC / DOT / & SAMHSA must stop their "political crumbling" to private interest groups such as large urine laboratories and accept alternative specimen types - oral fluid, hair - where observed specimen collection is the norm.

While the General Workplace can develop effective drug free workplace programs, those subject to Federal Mandated Drug Testing clearly can not.

Summary of Final Rule for Specimen Validity Testing

Published in today’s Federal Register is a Department of Transportation Final Rule:

Procedures for Transportation Workplace Drug and Alcohol Testing Programs

In summary:

1. This Final Rule makes it mandatory for laboratories to test all DOT specimens for specimen validity (i.e., adulterants and urine substitutes) and for laboratories to follow all Department of Health and Human Resources (HHS) protocols for doing so.

2. Observed collections will afford less privacy in order to guard against employee use of items designed specifically to beat the testing process.

a. Directly observed collections will continue to occur only when there is a specific reason to believe that an employee may be attempting, or have sufficient reason, to evade the testing process.

b. Items such as prosthetic devices designed to carry clean urine will be checked for by observers with both male and female donors. The observer will have the employee raise and lower clothing, and then put it back into place for the observed collection.

c. Observed collections will now be required, rather than optional, for all return-to-duty and follow-up drug testing.

3. In an effort to thwart those who would manufacturer products designed to adulterate specimens, the Final Rule will no longer have easy-to-follow tables and charts outlining the adulterants for which laboratories are testing and the scientific cutoff levels at which laboratories are testing them.

4. Definitions in the Final Rule have been changed to harmonize with the HHS.

5. During an invalid result Medical Review Officer (MRO) review, an employee admission of adulterating or substituting a specimen is now a refusal to test.

6. Pursuant to MRO requests, the Final Rule will close the potentially endless loop on invalid specimen results; and employees requiring negative results [for example, pre-employment tests], when they have medical reasons for providing invalid results, will be able to obtain them through medical evaluations to rule out signs and symptoms of drug use.

7. The Final Rule will also streamline and simplify the potential myriad of complicated laboratory-confirmed and MRO-verified drug test results.

8. The Final Rule requires drug testing laboratories to report to DOT semi-annual statistical summaries on all of their DOT testing.

9. The Final Rule effective date is August 25, 2008.

Oral Fluid Best for Drug Testing - Federal Report

2008-05-14T09:55:00.000-07:00

Federal Study Compares Oral Fluid and Blood Testing for Drugs - Technical Report
National Highway Safety Traffic Administration
NHSTA - DOT

HIGHLIGHTS / SUMMARY

1. Testing included Oxycodone, Hydrocodone, Hydromorphone, as well as typical " DOT Opiates " - heroin, morphine, codeine.

2. Testing included Ecstasy ( MDMA ), MDA, MDEA, as well as typical " DOT Amphetamines

3. Comparisons made using ELIZA and GC/MS - N=639

4. Drivers selected randomly

5. 23 % POSITIVE rate overall - 15% POSITIVE for DRUGS, 8% for Alcohol only (13% Drugs only, 2% Drugs & Alcohol, 8% Alcohol only)

6. 2/3 of those TESTING POSITIVE did NOT admit to prior drug use during the prior YEAR .

7. 70% POSITIVE with oral fluid, 30% refused BLOOD sample

8. Most POSITIVES resulted from THC, Cocaine, and Opiates

9. " Strong correlation between oral fluid and blood tests

10. " Oral fluid appears to be a better specimen type for the detection of recent cocaine use."

11. " Oral fluid accounted for more total POSITIVES than blood"

Source: www.nhsta.dot.gov Oral Fluid and Blood Analysis 2008, Technical Report 2007, DOT HS 810 704

What Drugs Should I Test for ? Workplace

2008-05-12T13:04:00.000-07:00

While a complex issue, deaths directly related to drug misuse or abuse is one set of statistics worth noting. These are compiled by the U.S. Department of Health and Human Services, Substance Abuse and Mealth Health Services, SAMHSA, Drug Abuse Warning Network, DAWN

1%-2% of U.S. Population - Deaths resulting from drug misuse / abuse.
Demographics - 68% male
- 50% 35-54 year olds
- Highest percentage among 21-34 years olds
Most commonly death related - Opiates / Opiods
- 75% muliple drugs (average 2.7 drugs per case)
- Opiates and cocaine, opiate with alcohol, etc.

Unions - Drug Testing & The Boston Fire Fighters Union

2008-05-07T10:52:00.000-07:00

Random drug-testing programs are problematic for some unions.

Union leadership claims random drug testing is a violation of workers' right to privacy. Yet, this is appears to be an indefensible position.

Concerns of employee safety and public safety should be the #1 priority with union leaders. Sadly, it may not case for some.

Many non-union employees are required to have a pre-employment drug test and a random drug test. If workers refuse testing, they are terminated. If employees fail a drug test ... they are terminated - (which I don't view as best practice)-, or suspended and subsequently referred to an employee assistance program (EAP), which may or may not be funded by company insurance.

Simple... straight forward... and effective.

Random drug testing, conducted properly, is an effective deterrent to on-the-job substance abuse, as well as a detection mechanism. What an employee does at home is not the business of any employer. When employee's behaviors effect the safety of their colleagues or the public... it's not only their employers' business... it's their employers' legal obligation.

While many unions have adopted, or at least allowed random drug and alcohol testing, the Boston / Massachusetts Fire Fighters Union has failed to protect its members and the public at large.

No employee, or the public wants a drug or alcohol impaired individual in a safety sensitive position.

The Boston Fire Department had a recent tragedy in which two fatalities tested "positive" for drugs and/or alcohol. Whether this information should have been released to the public the way it was... is certainly questionable. No one should question the bravery of the individual involve, and most would not consider it.

The subsequent stonewalling of the fire fighters unions relative to drug testing is unconscionable, however, and a disgrace to everyone.

Unions & Drug Abuse - Construction

2008-05-01T07:21:00.000-07:00

"A construction work site is no place for an alcohol- or drug-impaired worker," says LIUNA General President Terence M. O'Sullivan. "To limit this risk and, also, to ensure that workers who need help get it, the Laborers support efforts to establish comprehensive drug-free workplace programs in the construction industry."

Abstract

Union stewards, general members, & senior management benefit from training on the many manifestations of substance misuse in the workplace, and their impact on working people and their children, contractors, insurers, and owners. Avitar's novel approach to workplace substance abuse management can assist in providing a framework of knowledge as well as implementation monitoring tools.

Joint development of the training curriculum, drug policy, and testing programs, would, however, require the direct involvement of union management. While Avitar can supply the technical components, to gain organization-wide commitment requires high level of participation and support of union leadership. Arguably, this leadership has been lacking in specific cases.

Unions would benefit by working with contractors, owners, insurers, and innovative drug-free workplace service providers to establish comprehensive drug-free workplace policies that include an education component to demonstrate their commitment to a drug-free workplace, support random testing via observed specimen collection, and provide employee assistance programs.

Random testing via oral is convenient, effective, non-invasive, and targets "on-the-job" drug misuse. Unlike traditional urine-based testing, oral fluid testing;

1. deters substance misuse
2. reduces accidents, workers comp claims and,
2. improves workforce image and quality.

While Construction Union may be aware of the unresolved, and epidemic problem of substance abuse in the construction sector, they may not be aware that a solution exists and the importance of their playing a leading role in mitigating the issue.

Substance abuse diminishes the ability of unions to build membership and mobilize current members.
- It erodes self-esteem and autonomy and undermines union participation, power, and leadership.
- It damages the solidarity of the union community and weakens its ability to withstand employer "attacks".

1. Unfortunately many contractors, owners, and insurers view unions as an impediment to resolution of the substance abuse in the construction sector. The lack of a comprehensive and effective occupational drug-free workplace approach by Unions contributes ineffective, ad-hoc industry practices. Similarly, the AFL-CIO program requiring urine testing and specific vendors, even further delays positive, pro-active change.

2. Unions must be proactive in efforts to deter the abuse of controlled substances and alcohol on construction sites. Laborers, management, and all related constituencies would benefit by developing and negotiating a drug and alcohol testing template programs for all contractors / owners / insurers.

3. A comprehensive drug-free workplace program MUST include:
random drug testing (via observed collection - traditional urine-based testing is relatively ineffective),
education, and
assistance.

Measurement is crucial to the recognition, treatment, and prevention of substance abuse related occupational injuries, and other negative impacts. Deterrence and identification of substance abuse benefits the individuals, their immediate coworkers, workers throughout the industry, and others exposed to the negative impacts of substance misuse. (insurers, owners, contractors, public).

4. What union members do away from work is a private affair as long as they aren't impaired when reporting to work, however, traditional urine drug testing is contrary to this notion. Neither unions nor employers should not be allowed to dictate behaviors while away from work.

5. Deterrence is the goal, however, detection and assitance are true benefits.
Union MAP's (member assistance programs) are underutilized (not used 60% of the time). MAPs serve members as well as health & MMwelfare funds, contractors, owners, alike.
- MAPs help laborers & families access to assistance most needed for personal problems/issues
- MAPs control costs (lack of care created costs far exceeding MAP cost).
Labor organizations can only offer assistance to their members on a variety of health, welfare, and safety issues, including substance use disorders, only if aware of the problem.

Sources and Additional Information:

1. 50% of abuse detected now involves prescription drugs, esp. pain relievers. The abuse / misuse of many popular prescription pain releivers is not tested via traditional DOT-based urine testing.

2. While approximately 15%- 20% of construction workers abuse drugs, the US Bureau of Labor Statistics survey significantly underestimate the incidence of work related injuries and illnesses. The United States does not have a comprehensive national surveillance system for occupational injuries and illnesses. Lacking this system, major sources of US occupational health data include the Bureau of Labor Statistics (BLS) annual survey of occupational injuries and illnesses, workers' compensation records, and physician reporting systems. Data produced by these systems have been described as fragmentary, unreliable, and inconsistent. Moreover, they have been shown to underestimate the incidence of workrelated injuries, illnesses, and even fatalities by as much as several hundred percent. (Occupational injury and illness surveillance: Conceptual filters explain underreporting; Azaroff, Lenore S; Levenstein, Charles; Wegman, David H American Journal of Public Health 09-01-2002 )

3. 77% of adults with substance abuse disorders are employed - Results From the 2004 National Survey on Drug Use and Health: National Findings. DHHS Publication No. (SMA) 05-4062. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies, September 2005, p. 72.

4. LIUNA MAPs save money - Detroit, first-quarter 2003 data indicate that the LAP saves the fund about $175,000 annually over the likely cost of service to members if no MAP existed. In Southern Illinois, drug expenditures for the first two quarters since MAP usage was mandated are running more than 50 percent below the previous year's average. In Massachusetts, since the MAP was established in 1991, the Fund has saved about $8.8 million in average length of service and per diem costs for in-patient care.

5. Substance use disorders affect people from all walks of life, workers & families. According to a 2005 Hazelden Foundation survey, more than 69 percent of employed people indicated that if a family member were struggling with abuse or addiction, it would negatively affect their ability to concentrate and be productive at work. In fact, 36 percent of people who are employed admitted that at least one of their coworkers had been distracted, less productive, or missed work because of alcohol/drug abuse or addiction within their family.

6. A key message for labor organizations to communicate to employers is that treatment for substance use disorders has substantial benefits for businesses. Reported job problems, including incomplete work, absenteeism, tardiness, work-related injuries, mistakes, and disagreements with supervisors, are cut by an average of 75 percent among employees who have received treatment for substance use disorders. Furthermore, treatment has a benefit-to-cost ratio of 7:1, with substance use disorder treatment costing $1,583 on average and having a monetary benefit to society of nearly $11,487.

7. Domestic violence is directly related to substance abuse. Despite the obvious importance of involving unions in domestic violence prevention with men, little works has been done is this area. This may reflect fears that unions would not be receptive to addressing domestic violence. Senior office holders within some unions have been hesitant to apply their leadership to this issue, for various reasons. Sometimes union leadership has not understood how widespread domestic violence is. Sometimes they have argued that it is a private matter best left to the couple affected. At other times they have expressed concern but felt pessimistic about their ability to do anything about it. And on other occasions they have felt torn between their desire to protect a worker from disciplinary action or job loss and their conviction that domestic violence is wrong.

- It is every employer's legal responsibility to ensure safety in the workplace. Domestic violence compromises the well-being, job performance, and productivity of valuable employees. Many of the attitudes and gender roles that increase men's risk of using domestic violence also predispose men to other high risk behaviors, such as drug and alcohol abuse, workplace violence, or taking unnecessary safety risks to demonstrate "toughness" to peers.
- Domestic violence is a leading cause of workplace violence; it also creates safety and health risks to everyone in the workplace:
- Since almost one in four women is affected by domestic violence, we can make a conservative estimate that 10% of employees may be affected by domestic violence.
- 24% of abused women said they were either late or missed days of work due to abuse
- 54% of abused women missed up to three full days of work per month.
- 94% of corporate security directors surveyed rank domestic violence as a high security problem at their company.
- Violence against women weakens unions and diminishes their ability to build membership or mobilize current members.
- Domestic violence is a safety and health issue for all members since perpetrators often stalk and harass women at their workplace, possibly jeopardizing co-workers as well. Additionally, domestic violence is a work/family issue, since it has devastating economic and personal consequences for the family.

8. Most union members are in support of drug testing (Discriminating characteristics of union members' attitudes toward drug testing in the workplace, Journal of Labor Research, 2007.)

Drugged Driving - A Leading Cause of Death - SAMHSA 2008 REPORT

2008-04-24T09:22:00.000-07:00

Impaired driving is the #1 cause of deaths from all other causes among persons aged 3 to 33.

5% percent (approximately 10 million drivers) of Americans drove under the influence of illicit drugs in the past year

Highest drugged driving rates
District of Columbia (7.0 percent),
Rhode Island (6.8 percent),
Massachusetts (6.4 percent),
Montana (6.3 percent), and
Wyoming (6.2 percent).

Illicit drugs, as defined above, includes marijuana/hashish, cocaine (including crack), inhalants, hallucinogens, heroin, or prescription-type drugs used nonmedically.

15% of Americans drove under the influence of alcohol.

14% of High Schools Drug Test 2008

2008-04-04T06:01:00.000-07:00

CALVERTON, Md., April 2, 2008 /PRNewswire-USNewswire/ --

A substantial proportion of the nation's public school districts have instituted random drug testing among their high school students, some possibly going beyond sanctions set by the U.S. Supreme Court, according to a study led by the Pacific Institute for Research and Evaluation (PIRE).

These sanctions limit testing to students involved in sports and extracurricular activities.

The study, funded by the National Institute on Drug Abuse, includes data collected from 1,343 drug prevention coordinators in a nationally representative sample of school districts that include high school students. Fourteen percent of the nation's school districts reported conducting random drug testing of students in high school grades in the 2004-2005 academic year.Nearly all school districts that implemented random drug testing procedures subjected their athletes to the possibility of being tested, and two-thirds randomly tested high school students who participated in other extracurricular activities.

More than a quarter of the districts that implemented random drug testing subjected all their high school students to the possibility of being tested.

The Supreme Court ruled in 1995 that testing student athletes for drugs is constitutional, even in the absence of any suspicion of substance use. In a subsequent case, the Court extended its ruling to include students participating in extracurricular activities.
"Random student drug testing will likely continue to be controversial and the practice is likely to be contested, just as we saw with the recent ruling by the Washington State Supreme Court," said Dr. Chris Ringwalt, Senior Research Scientist at PIRE. The Washington State Supreme Court ruled on March 13, 2008, based on a lawsuit that student athletes brought against a local school district, that random drug testing of student athletes is not allowed under the state's constitution, despite the U.S. Supreme Court's 1995 ruling (Supreme Court of the State of Washington. York v. Wahkiakum School District No. 200. Docket No: 99-2-00075-6, March 13, 2008).
Dr. Ringwalt concluded, "This study will provide a benchmark for monitoring the prevalence of random drug testing of high school students in the future."
Pacific Institute for Research and Evaluation

SAMHSA TO APPROVE ORAL FLUID / SALIVA DRUG TESTING

2008-03-28T06:29:00.000-07:00

(source: Forensic Sci Int. 2007 Apr 12)

Despite the lack of speed, likely due program mismangement and lobbying on the part of urine labs and large TPAs that have a vested interest in urine testing, SAMHSA will (per the below) have to approve alternative forms of drug testing in order to manage workplace drug abuse.

The U.S. Mandatory Guidelines for Federal Workplace Drug Testing Programs: Current status and future considerations.

Donna M Bush - Division of Workplace Programs, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, One Choke Cherry Road, Room 2-1033, Rockville, MD 20857, USA.

" The addition of accurate and reliable workplace drug testing using hair, oral fluid, and sweat patch specimens will complement urine drug testing, and aid in combating industries devoted to suborning drug testing through adulteration, substitution, and dilution. " - Donna M. Bush, SAMHSA

The U.S. Department of Health and Human Services (HHS) drug testing standards were published in 1988 and revised in 1994, 1998, and 2004.

In a separate notice, HHS proposed to establish scientific and technical guidelines for the Federal Workplace Drug Testing Program to:

(1) permit laboratory testing of hair, oral fluid, and sweat patch specimens in addition to urine specimens for marijuana, cocaine, phencyclidine, opiates (with focus on heroin), and amphetamines [including methylenedioxymethamphetamine (MDMA), methylenedioxyethamphetamine (MDEA), methylenedioxyamphetamine (MDA)];

(2) permit use of on-site point of collection test (POCT) devices to test urine and oral fluid at collection sites;

(3) permit use of instrumented initial test (screening only) facilities [IITF] to quickly identify negative specimens; and (

4) add training requirement for collectors, on-site testers, and MROs.

This proposal was published in the Federal Register on 13 April 2004, with a 90-day public comment period.

The Substance Abuse and Mental Health Services Administration, HHS, reviewed those comments and is preparing the Final Notice that will define the requirements for such testing, including: specimen collection procedures, custody and control procedures that ensure donor specimen identity and integrity, testing facility, initial and confirmatory test cutoff concentrations, analytical testing methods, result review and reporting, evaluation of alternative medical explanations for presence of drug or metabolite in the donor's specimen, and laboratory certification issues.

Voluntary pilot performance testing (PT) programs for each specimen type are on-going since April 2000 to determine how to prepare PT materials for specimens other than urine to evaluate laboratories' ability to routinely achieve accuracy and precision required.

Certification programs will be developed using the current urine drug testing National Laboratory Certification Program model.

Benefits of Oral Fluid / Saliva Point-of-Care Testing

2008-03-25T10:11:00.000-07:00

Protein map of human spit created
By Julie Steenhuysen 27 minutes ago

CHICAGO (Reuters) - U.S. researchers have identified all 1,116 unique proteins found in human saliva glands, a discovery they said on Tuesday could usher in a wave of convenient, spit-based diagnostic tests that could be done without the need for a single drop of blood.

As many as 20 percent of the proteins that are found in saliva are also found in blood, said Fred Hagan, a researcher at the University of Rochester Medical Center in New York who worked on the study.

"This is potentially a large field that has many clinical implications in the area of disease diagnostics," said Hagan, whose work was published in the Journal of Proteome Research.

The researchers hope saliva-based tests could be used to diagnose cancer, heart disease, diabetes and a number of other conditions.

"To be able to diagnose disease using saliva, you really have to have a comprehensive understanding of the saliva proteome," Hagan said in a telephone interview.

Like a genome, which lists all of the genes in an organism, a proteome is a complete map of proteins. While genes provide the instruction manual, proteins carry out the instructions by regulating cellular processes.

Researchers from five universities -- the University of Rochester, The Scripps Research Institute, the University of Southern California, The University of California San Francisco and the University of California Los Angeles -- sought to determine the complete set of proteins secreted by the major salivary glands.

BLOOD, SPIT AND TEARS

They collected saliva from 23 healthy men and women of several races. They tested saliva samples using some form of mass spectrometry, which determines the identity of proteins based on measurements of their mass and charge.

They compared their findings with recent protein maps of human blood and tears.

Early analysis has already turned up a number of proteins with known roles in Alzheimer's, Huntington's and Parkinson's diseases; breast, colorectal and pancreatic cancer and diabetes.

Most of the proteins were part of signaling pathways, which are key to the body's response to system wide diseases.

Hagan said the work should accelerate the development of new tools for tracking disease throughout the body.

Already there are saliva-based antibody tests to detect human immunodeficiency virus, or HIV, and hepatitis infections, Hagan said. He said this protein map will provide new targets.

"Monitoring disease as well as drug use could be more easily done with saliva as opposed to blood or urine," he said.

Other groups are working on a saliva-based test for breast cancer that would detect a protein fragment from the HER2 protein. Hagan said such tests could eventually replace uncomfortable and costly mammograms.

"We envision in the future spitting in a tube and looking for a marker like this breast cancer marker. It would be much easier to do, potentially at home," he said.

"Given that we've made this information publicly available, we fully expect a number of research groups will be picking their favorite targets and developing their own tests. That is the intent -- to create a wealth of data to stimulate more research and increase the chances of producing better diagnostic tests," Hagan said.

(Editing by Maggie Fox and Mohammad Zargham)

Prescription Pain Releiver Abuse up Nearly 40%

2008-03-18T08:11:00.000-07:00

A review of the data shows that drug abuse rates among workers have been stagnant for past decade... drug abuse is NOT declining.

Any statement that workplace drug abuse is lower, would be unsupportable by the findings.

The data does potentially indicate that that drug abusers have learned to cheat urine-based drug tests. This being supported by research recently concluded by the U.S. Government General Accounting Office (GAO) noting that cheating urine-based testing is easily accomplished and virtually undetectable.

The report also neglects to point out the opiate detection rates continue to climb. .. particularly oxycodones have gone up nearly 40% in one year!

" Use of Methamphetamine Among U.S. Workers and Job Applicants Drops 22 Percent in 2007 and Cocaine Use Slows Dramatically, Reports Quest Diagnostics"

Findings from Quest Diagnostics Drug Testing Index® also show that overall drug positivity remains at record lows

MADISON, NJ, March 12, 2008 — The percentage of positive tests for methamphetamine among U.S. job applicants and workers in the general U.S. workforce dropped more than 22 percent between 2006 and 2007.

These findings, from the Quest Diagnostics Drug Testing Index®, reflect the reversal of an upward trend in use of the drug by more than 73 percent from 2002 to 2004. These data were released today by Quest Diagnostics Incorporated (NYSE: DGX), the nation's leading provider of employment-related drug testing services.

The report also shows that positive tests for cocaine in the general U.S. workforce were down 19 percent between 2006 and 2007 and that overall drug use, among workers subject to drug testing, remains at an all-time low.

Methamphetamine, the most commonly abused type of amphetamine, increased in production and trafficking during the 1990’s to become the most prevalent illegally manufactured synthetic drug in the United States. Analysis of the Quest Diagnostics Drug Testing Index, released semi-annually, suggests that efforts to reduce illicit, clandestine production of methamphetamine may be having an impact on workplace positive tests for the drug.

"The fact that America's workers are using cocaine and methamphetamine at some of the lowest levels in years is further evidence of the tremendous success that law enforcement is having at impacting the nation's illicit drug supply," said DEA Acting Administrator Michele M. Leonhart. "DEA will continue its relentless assault on the drug supply to help keep these dangerous drugs out of our neighborhoods."

While the 2007 Quest Diagnostics Drug Testing Index shows that positive methamphetamine tests have decreased, it also indicates that the use of amphetamine in the general workforce has increased slightly, by about five percent. Testing for methamphetamine and amphetamine was conducted among employees and applicants in the U.S. workforce tested for the class of drugs called amphetamines.

"Although some may conclude that there is a reduced availability for methamphetamine, the fact that our data show an increase in amphetamines suggests that some workers might be replacing one stimulant drug for another in the larger drug class of amphetamines," said Barry Sample, Ph.D., Director of Science and Technology for Quest Diagnostics' Employer Solutions division.

Methamphetamine and amphetamine are both types of stimulants, which typically are used by individuals to increase alertness and relieve fatigue. Stimulants are also used for euphoric effects or to counteract the "down" feeling of tranquilizers or alcohol. Possible side effects of stimulants include increased heart and respiratory rates, elevated blood pressure, dilated pupils and decreased appetite. High doses may cause rapid or irregular heartbeat, loss of coordination or collapse. Indications of possible misuse may include excessive activity, talkativeness, irritability, argumentativeness or nervousness.

Cocaine Use Continues to Decline

The Quest Diagnostics Drug Testing Index shows that the percentage of positive tests for cocaine was down 19 percent among the U.S. general workforce since the first half of 2007 - the largest single-year drop since 1997. Positive tests for cocaine among the general workforce declined to 0.58 percent in 2007 from 0.72 percent in 2006.

Overall Drug Use Remains at All-Time Low

Additionally, drug use by employees remains at its lowest level since Quest Diagnostics began publishing the Drug Testing Index in 1988. Among the combined U.S. workforce, only 3.8 percent of the tests had positive results — the same level reported in 2006 — compared to a high of 13.6 percent in 1988. Further, among safety-sensitive federal workers only, the Drug Testing Index showed that drug use was at an all-time low of 1.8 percent of the tested work force.

The 2007 Drug Testing Index is a summary of results from 8.4 million workplace drug tests performed by Quest Diagnostics between January and December 2007. Results are based on tests that Quest Diagnostics performs for employers that conduct pre-employment, random or for-cause drug testing. For more information, see additional results below.

About the Drug Testing Index

The Drug Testing Index is published as a public service for government, media and industry and has been considered a benchmark for national trends since its inception in 1988. It examines positivity rates — the proportion of positive results for each drug to all such drug tests performed — among three major testing populations: federally mandated, safety-sensitive workers; the general workforce; and the combined U.S. workforce. Federally mandated, safety-sensitive workers include pilots, bus and truck drivers, and workers in nuclear power plants, for whom routine drug testing is mandated by the U.S. Department of Transportation and the Nuclear Regulatory Commission.

About Quest Diagnostics

Quest Diagnostics is the leading provider of diagnostic testing, information and services that patients and doctors need to make better healthcare decisions. The company offers the broadest access to diagnostic testing services through its national network of laboratories and patient service centers, and provides interpretive consultation through its extensive medical and scientific staff. Quest Diagnostics is a pioneer in developing innovative new diagnostic tests and advanced healthcare information technology solutions that help improve patient care. Additional company information is available at: www.questdiagnostics.com.

The statements in this press release which are not historical facts or information may be forward-looking statements. These forward-looking statements involve risks and uncertainties that could cause actual results and outcomes to be materially different. Certain of these risks and uncertainties may include, but are not limited to, competitive environment, changes in government regulations, changing relationships with customers, payers, suppliers and strategic partners and other factors described in the Quest Diagnostics Incorporated 2005 Form 10‑K and subsequent SEC filings.

The Drug Testing Index © 2008 Quest Diagnostics Incorporated. All rights reserved.

Tables Follow
Positive Prevalence Rates for Amphetamine and Methamphetamine —
Percentage of All Tests for “Amphetamines“
2007 2006 2005 2004 2003 Amphetamine 0.40% 0.38% 0.44% 0.45% 0.41% Methamphetamine 0.14% 0.18% 0.28% 0.33% 0.32% Percent Difference - Amphetamine 5.3% -13.6% -2.2% 9.8% Percent Difference - Methamphetamine -22.2% -35.7% -15.2% 3.1%

Positivity Rates for Cocaine
2007 2006 2005 2004 2003 Cocaine 0.58% 0.72% 0.70% 0.72% 0.74% Percent Difference - Cocaine -19.4% 2.9% -2.8% -2.7%

Annual Positivity Rates
For Combined U.S. Workforce
(More than 8.4 million tests from January to December 2007)
Year Drug Positive Rate 1988 13.6% 1989 12.7% 1990 11.0% 1991 8.8% 1992 8.8% 1993 8.4% 1994 7.5% 1995 6.7% 1996 5.8% 1997 5.0% 1998 4.8% 1999 4.6% 2000 4.7% 2001 4.6% 2002 4.4% 2003 4.5% 2004 4.5% 2005 4.1% 2006 3.8% 2007 3.8%

Positivity Rates By Testing Category
Testing Category 2007 2006 2005 2004 2003 Federally Mandated, Safety-Sensitive Workforce 1.8% 2.0% 2.3% 2.3% 2.5% General U.S. Workforce 4.4% 4.4% 4.5% 4.9% 5.0% Combined U.S. Workforce 3.8% 3.8% 4.1% 4.5% 4.5%

Positivity Rates By Testing Reason
For Federally Mandated, Safety-Sensitive Workforce
(More than 1.8 million tests from January to December 2007)
Testing Reason 2007 2006 2005 2004 2003 Follow-Up 2.8% 3.0% 3.1% 3.3% 3.4% For Cause 11.1% 12.5% 13.4% 14.1% 13.8% Periodic 0.75% 0.59% 0.76% 0.51% 0.75% Post-Accident 2.6% 2.7% 3.0% 2.9% 3.1% Pre-Employment 2.0% 2.3% 2.6% 2.7% 2.9% Random 1.5% 1.5% 1.8% 1.8% 1.9% Returned to Duty 3.3% 3.2% 3.0% 2.9% 2.8%

Positivity Rates By Testing Reason
For General U.S. Workforce
(More than 6.6 million tests from January to December 2007)
Testing Reason 2007 2006 2005 2004 2003 Follow-Up 7.7% 7.4% 9.6% 9.9% 9.6% For Cause 19.2% 18.1% 28.3% 27.8% 28.2% Periodic 1.4% 1.9% 2.4% 1.9% 2.2% Post-Accident 5.8% 5.7% 5.8% 5.7% 5.7% Pre-Employment 3.9% 3.9% 3.9% 4.1% 4.1% Random 5.7% 5.5% 6.6% 7.1% 6.6% Returned to Duty 5.6% 5.8% 6.0% 5.5% 5.6%

Positivity Rates By Drug Category
For Federally Mandated, Safety-Sensitive Workforce, as a percentage of all such tests
(More than 1.8 million tests from January to December 2007)
Drug Category 2007 2006 2005 2004 2003 Amphetamines 0.25% 0.28% 0.35% 0.31% 0.29% Cocaine 0.44% 0.58% 0.60% 0.57% 0.59% Marijuana 0.88% 0.94% 1.10% 1.25% 1.34% Opiates 0.18% 0.17% 0.18% 0.17% 0.19% PCP 0.04% 0.03% 0.04% 0.04% 0.04%

Positivity Rates By Drug Category
For General U.S. Workforce, as a percentage of all such tests
(More than 6.6 million tests from January to December 2007)
Drug Category 2007 2006 2005 2004 2003 Amphetamines 0.44% 0.42% 0.48% 0.52% 0.49% Barbiturates 0.24% 0.23% 0.25% 0.27% 0.29% Benzodiazepines 0.67% 0.62% 0.58% 0.58% 0.60% Cocaine 0.58% 0.72% 0.70% 0.72% 0.74% Marijuana 2.34% 2.38% 2.54% 2.88% 2.96% Methadone 0.23% 0.22% 0.23% 0.21% 0.20% Opiates 0.35% 0.32% 0.32% 0.32% 0.34% Oxycodones 0.88%1 0.64%2 0.56%3 -- -- PCP 0.02% 0.01% 0.02% 0.01% 0.03% Propoxyphene 0.58% 0.55% 0.57% 0.63% 0.67%

Positivity Rates By Drug Category
For Combined U.S. Workforce, as a percentage of all such tests
(More than 8.4 million tests from January to December 2007)
Drug Category 2007 2006 2005 2004 2003 Amphetamines 0.40% 0.39% 0.46% 0.49% 0.45% Barbiturates 0.24% 0.23% 0.25% 0.27% 0.29% Benzodiazepines 0.67% 0.62% 0.58% 0.58% 0.60% Cocaine 0.55% 0.69% 0.69% 0.70% 0.71% Marijuana 2.01% 2.04% 2.28% 2.59% 2.67% Methadone 0.23% 0.22% 0.23% 0.21% 0.20% Opiates 0.32% 0.28% 0.29% 0.29% 0.31% Oxycodones 0.88%1 0.64%2 0.56%3 -- -- PCP 0.02% 0.02% 0.02% 0.02% 0.03% Propoxyphene 0.58% 0.55% 0.57% 0.63% 0.67%

Non-Negative Rates By Specimen Validity Test (SVT)4 Category
For Federally Mandated, Safety-Sensitive Workforce, as a percentage of all such tests
(More than 1.8 million tests from January to December 2007)
SVT Category 2007 2006 2005 2004 2003 Acid-Base 0.01% 0.00% 0.01% 0.01% 0.01% Invalid 0.11% 0.12% 0.12% 0.08% 0.08% Oxidizing Adulterants 0.00% 0.00% 0.00% 0.02% 0.03% Substitution 0.05% 0.05% 0.05% 0.06% 0.06%

Non-Negative Rates By Specimen Validity Test (SVT)4 Category
For General U.S. Workforce, as a percentage of all such tests
(More than 6.6 million tests from January to December 2007)
SVT Category 2007 2006 2005 2004 2003 Acid-Base 0.00% 0.00% 0.00% 0.01% 0.01% Invalid 0.13% 0.15% 0.16% 0.10% 0.10% Oxidizing Adulterants 0.00% 0.00% 0.00% 0.01% 0.02% Substitution 0.01% 0.01% 0.01% 0.03% 0.03%

Non-Negative Rates By Drug/SVT Category
For Federally Mandated, Safety-Sensitive Workers, as a Percentage of All Non-Negatives
(More than 35 thousand non-negative test results from January to December 2007)
Drug/SVT Category 2007 2006 2005 2004 2003 Acid/Base 0.47% 0.15% 0.27% 0.32% 0.37% Amphetamines 12.7% 12.6% 14.8% 12.7% 11.4% Cocaine 22.2% 26.3% 25.4% 23.2% 22.7% Invalid 5.5% 5.7% -- -- -- Marijuana 45.2% 43.8% 47.8% 52.4% 53.6% Opiates 9.2% 7.8% 7.7% 7.1% 7.4% Oxidizing Adulterants 0.00% 0.00% 0.06% 0.42% 0.52% PCP 2.1% 1.6% 1.8% 1.4% 1.7% Substituted 2.7% 2.2% 2.3% 2.4% 2.3%

Non-Negative Rates By Drug/SVT Category
For General U.S. Workforce, as a Percentage of All Non-Negatives
(More than 315 thousand non-negative test results from January to December 2007)
Drug/SVT Category 2007 2006 2005 2004 2003 Acid/Base 0.04% 0.04% 0.06% 0.11% 0.16% Amphetamines 9.2% 8.8% 10.1% 10.0% 9.0% Barbiturates 2.8% 2.6% 2.7% 2.7% 2.8% Benzodiazepines 6.9% 6.1% 5.4% 5.0% 5.1% Cocaine 12.2% 15.0% 14.7% 13.8% 13.8% Invalid 2.8% 3.2% -- -- -- Marijuana 48.8% 49.5% 53.0% 55.0% 55.0% Methadone 2.2% 2.0% 2.0% 1.7% 1.6% Methaqualone 0.00% 0.00% 0.00% 0.00% 0.00% Opiates 7.4% 6.6% 6.6% 6.1% 6.3% Oxycodones 1.5% 0.74% -- -- -- Oxidizing Adulterants 0.00% 0.00% 0.05% 0.16% 0.48% PCP 0.35% 0.31% 0.31% 0.28% 0.51% Propoxyphene 5.6% 4.9% 4.9% 4.9% 5.0% Substituted 0.26% 0.27% 0.26% 0.49% 0.58%

Non-Negative Rates By Drug/SVT Category
For Combined U.S. Workforce, as a Percentage of All Non-Negatives
(More than 350 thousand non-negative test results from January to December 2007)
Drug/SVT Category 2007 2006 2005 2004 2003 Acid/Base 0.09% 0.05% 0.08% 0.13% 0.18% Amphetamines 9.6% 9.3% 10.6% 10.2% 9.3% Barbiturates 2.5% 2.3% 2.5% 2.5% 2.5% Benzodiazepines 6.1% 5.4% 4.9% 4.5% 4.7% Cocaine 13.2% 16.4% 15.7% 14.7% 14.6% Invalid 3.0% 3.5% -- -- -- Marijuana 48.4% 48.8% 52.5% 54.8% 54.9% Methadone 2.0% 1.8% 1.8% 1.5% 1.4% Methaqualone 0.00% 0.00% 0.00% 0.00% 0.00% Opiates 7.6% 6.7% 6.7% 6.2% 6.4% Oxidizing Adulterants 0.00% 0.00% 0.09% 0.19% 0.52% Oxycodones 1.4% 0.65% -- -- -- PCP 0.53% 0.46% 0.45% 0.38% 0.61% Propoxyphene 5.0% 4.3% 4.4% 4.4% 4.5% Substituted 0.51% 0.49% 0.45% 0.66% 0.73%

1 More than 500,000 tests

2 Approximately 400,000 tests

3 More than 200,000 tests

4 Specimen validity testing is the evaluation of a specimen to determine if it is consistent with a normal human specimen. Tests for specimen validity include tests to determine whether a specimen is adulterated or substituted.

Sometimes Unions on the Wrong Side of Drug Testing Debate

2008-02-27T06:43:00.001-08:00

Sometimes unions don't act in the best interests of their membership or the community.

THE Massachusetts Joint Labor-Management Committee has taken jurisdiction of the contract dispute between the City of Boston and the firefighters' union (Local 718). However, this step does not mean that mandatory alcohol and drug testing is any closer to becoming a reality in the Boston Fire Department.

The president of the state firefighters' union has argued that the Joint Labor-Management Committee cannot consider drug testing in arbitration.

That view should not prevail, as this contract must begin the effort to break through the imbedded culture of the Fire Department by including basic management reform measures and mandatory drug testing.

Actually, the more relevant question is why is drug testing subject to collective bargaining?

Clearly, it is in the broader interest of the Commonwealth that all uniformed public safety employees be required to annually undergo standard drug and alcohol testing.
While this contract may be settled before such change, drug testing should be a state public safety requirement, not subject to local negotiations.

Following a tragic restaurant fire in West Roxbury in August, in which two firefighters died, city officials in early October presented to Local 718 a comprehensive alcohol and drug testing policy for negotiation. The union has yet to respond in writing to the city's proposal.

The Menino administration had put drug testing on the table in contract negotiations with Local 718 in 1999 !!!!!, and 2004 but no agreement was reached.

Union resistance and the city's desire to secure other needed management reforms in the Fire Department at a reasonable cost are why drug testing has not been yet approved.

The firefighters' union maintains that the Joint Labor-Management Committee cannot consider drug testing as an issue for arbitration in the Boston dispute because the city did not list drug testing in its petition filed last August. The union would prefer to negotiate this matter separately with the city for a reported 21 percent salary increase rather than have the Joint Labor-Management Committee require drug testing in an arbitration decision.

The union's position is not supported by state law or the Joint Labor-Management Committee's case history, which shows several examples of decisions rendered in fire union cases that include issues not listed in the initial petitions, including drug testing.

Local 718 has high expectations for a new contract with drug testing and points to the 1998 police contract that provided for drug testing and also accepted the Quinn Bill. However, in that contract, the police accepted no salary increases in fiscal 2001 and fiscal 2002 when firefighters received 4 percent and 4.5 percent, respectively.

Also, drug testing was considered innovative nine years ago and not the norm that it is today. Indeed, random alcohol and drug testing is more common in major urban fire departments around the country, including Baltimore, Chicago, New York City, Philadelphia, and San Francisco.

The contract with Local 718 should include mandatory random alcohol and drug testing, but if it does not include other significant reform measures at a cost consistent with the recently negotiated public safety contracts, it should not be approved.

The stakes are too high for the welfare of the public and firefighters to settle for small incremental change in this contract.

Orignal Source: Boston Globe

Drug Testing Educators

2008-02-27T06:37:00.000-08:00

The West Des Moines school district is believed to be the first in Iowa to adopt alcohol and illicit drug testing for all potential employees.

The new policy was approved Monday and mimics private sector drug screening.

It is uncommon for public schools nationwide.

“We can say with a fair amount of confidence that this is the first such policy in Iowa,” said Lisa Bartusek, associate executive director for the Iowa Association of School Boards.The school board unanimously approved the policy, which affects all potential employees and also current ones who are suspected of drug use.

Employees who test positive for drug use or who arrive at work with a blood-alcohol concentration of .04 percent or more could be fired or forced to seek rehabilitation.

"It was surprising to me that other districts don’t do this,” said board member Susan Moritz, who helped craft the policy. “It came out of the idea that our bus drivers were already being tested, and if we felt that was important for our bus drivers, wasn’t it also important for the people who were in our buildings?”The purpose is to “help new applicants understand that we simply don’t tolerate any kind of drug abuse on the job.”

Source: Des Moines Register

Random Student Drug Testing

2008-02-27T06:16:00.000-08:00

Drug education programs and parental advice often aren’t as strong as peer pressure.

Studies show in the last year more than one in three high school seniors used illicit drugs.
Scott County Superintendent, Dr. Dallas Blankenship “We think that if we have a drug testing program it will help students to explain to their peers that they are not going to do drugs.”
Somerset High School began randomly drug testing students involved in “privileged activities”, like sports and cheerleading last fall. Their principal, Jeff Perkins, calls it “one of the best things I think we’ve done.”

The Program
Both students and parents are required to sign drug testing consent forms in order to participate in privileged activities. Curricular or academic based activities like band, debate and choir are not currently tested, even though they too are competitive extracurricular activities.
Students be tested are randomly selected and the process takes about five minutes per student. The test looks for the presence of drugs like marijuana, meth and ecstasy as well as prescription drugs such as oxycodone and hydrocodone. If a test is non-negative, a second test is sent to a laboratory for additional testing. If the confirmatory test is positive, the student receives counseling and may have to perform certain tasks such as writing a paper and performing community service. The student is also suspended from participating in the privileged activity for a short period of time.

The Intent
Overall the random drug testing program is designed to be preventative and not punitive. It’s also designed to give kids who do test positive a second chance.
“We’re getting on the other side of this now, some education and getting these kids in some type of rehabilitation program. And hopefully we can salvage that versus the other way which was throwing them away.”“The safety of students and to have a drug free environment are extremely important, so our board’s already made a commitment.”

Original Source: Chris Dietz, ABC News

2008-02-27T06:04:00.000-08:00

Kansas House approves bill to require drug testing in ‘major’ wrecks.

Drivers and passengers involved in “major” traffic wrecks in Kansas would be required to submit to drug testing, if a bill approved by the state’s House becomes law.

State law now allows law enforcement officers to order drug testing, if there is “reasonable suspicion” that the person is under the influence.

The House voted 117-5 to forward a bill to the Senate that would require truckers and other drivers, as well as their passengers, to undergo drug testing when they are involved in certain types of wrecks.

Officers would no longer need a presumption of a drug violation to force drivers to submit to the testing.

Supporters say changes are needed to make it easier to test people involved in wrecks resulting in fatalities or serious injuries. The bill would allow law enforcement to collect evidence for potential criminal prosecutions, they say.
Opponents say it is unconstitutional to force someone to submit to a blood or urine test if there is no probable cause to suspect them of a crime.
A provision added to the bill would permit people to refuse to a test. Taking that route, however, could result in loss of driving privileges.
Another change to the bill would authorize officers to waive the test requirement if they believe the actions of the driver did not contribute to the wreck.

The bill – HB2617 – has moved to the Senate Judiciary Committee.

Source: By Keith Goble, state legislative editorkeith_goble@landlinemag.com

School Drug Testing

2008-02-27T05:40:00.000-08:00

Bethlehem Schools Adopt Drug Testing Policy

Anyone looking to work in the Bethlehem Area School District will now have to take a drug test.

Monday night, the school board voted to approve a pre-employment drug testing policy. Starting immediately, new and prospective employees will have to get tested before they can work.

The policy was proposed after Nitschmann Middle School principal John Acerra was arrested on drug charges.

Loretta Leeson: "A drug test doesn't always screen everything but I think we're taking the right steps to at least protecting the children in the district and other employees in the district."

One board member has requested looking into testing all employees.

Source: http://wfmz.com/view/?id=228306

FAQs - Oral fluid / Saliva Drug Testing - Frequently Asked Questions

2008-01-18T08:45:00.000-08:00

FAQ – Oral Fluid-based / Saliva Workplace Drug Testing

What is a preliminary test?
A preliminary (qualitative) test is a single test result based on an initial screen, providing a negative or non-negative result. The technology used for the Avitar ORALscreen is lateral flow immunoassay.

Why is a confirmatory test necessary?
The purpose of a confirmation test is to eliminate any false positive test results from an initial screening. A confirmatory test provides a quantitative result through a GC/MS or LC/MS/MS instrumented process. The substance and the concentration of substance can be accurately determined.

Is there any health risk involved in placing the sample collection device in the test subject's mouth?
No. The sample collection device is stored in hygienic sealed packaging until it is used. When used correctly there is no direct contact between the sample collection foam an the test. Biocompatibility testing has been conducted on the basis of the requirements and has shown that the sample collection device can be classified as biocompatible with regard to its intended use.

How long is the shelf-life of the test kits?
The shelf-life is stated as expiration date, “Exp.” on the device packaging.

Can an opened test kit be left unused?
No. The test kit must be used immediately after opening.

How quickly must the result read once it has been developed?
Negatives can be read once all red lines (5), are visible. Non-negative results should be read at the 15 minute mark. No on-site device results should be interpreted after 15 minutes.

The test subject has a very dry mouth. Will it be possible to obtain a sufficient sample of oral fluid?
Certain drugs have an inhibitory effect on the production of oral fluid or saliva.
Prior the collection, instruct the donor to drink a glass (8 ounces) of water, and wait 5 minutes. If after three minutes of sample collection the collector foam is not completely saturated with oral fluid repeat the collection.

Which substances can be identified using the ORALscreen?
At the present time, the ORALscreen system can detect 96% or drugs typically tested for in the workplace, including the following substances or classes of substances; in samples of oral fluid: Amphetamines: METHAMPHETAMINE and MDMA / Ecstasy.
Opitates:CODIENE, HEROINEi, MORPHINE, 6-AM (heroin metabolite), OXYCODONE (Oxycontin, Peroset, etc.), OXYMORPHONE, HYDROCODONE (Vocodin, Lortab, etc.), HYDROMORPHONE, Di-hydrocodine,
Marijana: delta-9 THC,
Cocaine: COCAINE, BENZYCLONIE (cocaine metabolite)

Which prescription drugs and designer drugs can be detected?
The ORALscreen is one of the only on-site oral fluid-based devices available that can accurately dectect the commonly abused classes of prescription pain releivers. Common brand names are Oxycontin, Percoset, Vicodin, Lortab, etc.
The METH test of ORALscreen allows detection not only of methamphetamine, but also other important designer amphetamines such as methylenedioxymethamphetamine (MDMA,
"Ecstasy“).

What is the NIDA 5, SAMSHA, DOT-5 panel
This panel consists of tests for amphetamines, cocaine, morphine (heroin), PCP, and THC (marijuana). It is important to note the following:
1. PCP has a positivity rate of less that 0.3%
2. The cut-off level for OPIATES is set at 2000 ng/ml, thus making the test less effective than ORALscreen for detecting OPIATE use / abuse.
3. NIDA-5 / DOT-5, SAMSHA CAN NOT detect the commonly abuse prescription pain releivers OXYCODONE, HYDROCODONE, etc., perhaps the number one threat to workplace safety today.

Does the test show cross-reactions with other legal substances?
Because the ORALscreen system, is an immunoassay process, based on the
antigen/antibody reaction, cross-reactivity are possible. However, the antibodies used are very specific, thus cross reactivity is minimal. Confirmatory testing and MRO procedures are established to elminate false positives.

How quickly is the test result ready?
The entire on-site screen result, from the start of the sample-collection process to display of the result, takes 5 to 15 minutes on average.

Does the device have to be disposed of after analysis, or can it be sent off for a confirmation analysis?
For a negative result, the device can be disposed of. Oral fluid, without any visible signs of blood, is not considered a biohazard by the CDC.
For a non-negative result, a second sample can be collectef for confirmation analysis. Confirmation directly from the device is also available. Please discuss this option with your Avitar representative

Are there limits below which drugs cannot be detected? If so, what are these limits?
Detection windows (times) and sensitivity, cut-off values, exist for all drugs.
Thus a negative result means either that the tested saliva contains no drugs, or that they are present in concentrations below the respective cut-off value. In general detection of drugs in oral fluid ranges from within minutes of consumption up to 2-3 days. Available research indicates on that marijana (THC-delta 9) can not be detected beyond 18-24 hrs. in oral fluid at ng/ml levels, regardless of the test / test technique.

What result does the ORALscreen test window display?
The test window displays the results of the analysis, distinct for each class of drugs, in the form of a qualitative reading with either an absent line for a non-negative sample (potentially containing drugs) or a line for a negative sample (not containing drugs or drugs below the cut-off level). A control line is also visible to indicate proper operation of the device.

What is the best measure of accuracy?
Accuarcy is a comparative ratio of sensitivty and specificity. Accuracy for any device should be measured by comparing the device to a quantitative test (GC/MS or LC/MS/MS) on a “paired sample” basis using the same speciment type. Accuracy should not be measured by comparing results between two device or between different specimen types due to varying detection windows and other factors.

Sensitivity refers to the ratio of true positive (TP) samples to the total number of samples rated positive by the test kit ((TP + FP, false positive).
Specificity refers to the ratio of true negative (TN) samples to the total number of samples rated as negative by the test kit (TN + FN, false negative).

Accuracy refers to the ratio of correctly identified samples to the total number of samples.

Sensitivity:
TP
(TP+FF)

Specificity:
TN
(TN+FN)

Accuracy:
(TP+FN)
(TP)FP+TN+FN)

How were the system's key performance data determined?
By tests with spiked synthetic saliva the system's key performance data of sensitivity, specificity, and accuracy were determined, and some limited field trials were conducted by Avitar and third parties.

Can the test kits be purchased individually?
The test kits are available in boxes (containing 20 test kits), or cases (containing 5 boxes).

The test subject has just eaten or drunk something or has just been smoking. Will this affect the test result?
The test subject must have nothing in their mout for a minimum of 5 minutes berfore the test.

Can eating poppy seeds cause a false positive drug test for heroin?
Eating poppy seeds cannot turn a confirmatory drug test positive for heroin. However, poppy seeds to contain morphine. Therefore, eating poppy seeds (e.g. a poppy seed bagel) can result a in a non-negative on-site result. This effect can be mitigated by waiting 45 minutes and retesting the individuals, as it’s a very short term issues

Can passive inhalation of marijuana cause a false positive drug test?
Sometimes people who test positive for marijuana will claim it was the result of passive inhalation.
Available research show that an individual must have been in an confined space, such as an automobile, for a period of time in order for detectable levels of THC-delta 9 to be found in oral fluid. Any potential effect is also of short (45min-one hour) duration. Thus, claims of passive inhalation “over the weekend” or even “last night”, would not cause a non-negative on-site test result.

Can over-the-counter cold medications cause a false positive drug test?
No. Avitar’s methamphetamine tests are very specific, and will not react with OTC cold remedies, with the GC/MS confirmatory test also serving as a safeguard.

By the end of the sampling process, the sampling collector doesn’t appear
saturated with oral fluid . Will this affect the test result?
The device will not run (no read wash and/or no control line) without adequate sample. It is important that the foam collector is completely saturated, thus extend the collection time and provide additional water as needed.

Do the on-site results provide legal proof of drug abuse?
No. An on-site drug test can only deliver general qualitative "screening" results.
Any “non-negative” screening result should be following with a confirmatory (GC/MS or LC/MS/MS) analysis with all associated processes and documentation completed properly.

After collecting a sample, the sponge is found to contain some blood. Does this affect the test result?
No. Blood does not affect the test result, however, the specimen should be considered a bio-hazard.

How is it possible to tell which test result relates to which test subject?
By means donor ID inscribed into the device, and or chain of custody number assigned for confirmatory testing.

Can the test subject manipulate the test result?
No. Sample collection can directly observed during the entire process avoiding any type of manipulation. The subject may attempt to hold the foam collector away from any oral fluid, however, this practic is also observable. If intentional, the practice should be considered an attempt to interfere with the testing process and be handled per company policy.

.
How comparable are oral fluid / saliva and blood substance abuse readings?
Study data reveal an overall correlation / correspondence in positive oral fluid samples with positive blood samples in more than 95 percent of cases.

Which method of analysis is most suitable for a confirmation analysis?
The usual reference method is gas chromatography mass spectrometry (GC-MS) or liquid chromatography (LC/MS/MS).

How quickly can drug consumption be detected by means of an oral fluid analysis?
The individual drugs and/or their metabolites can be detected in the saliva immediately, or within minutes after oral ingestion. On average, it takes several hours for drug metabolites to be detected post-consumption in urine.

How long after consumption can the individual drugs be detected in saliva?
The time window during which drugs can be detected in oral fluid depends on various factors; e.g. the quantity consumed, the frequency of consumption, the time between the drug consumption and the test and a person's individual metabolism.
Various studies have shown that amphetamines/methamphetamines remain in the saliva in sufficient quantities for detection for up to 50 hours; cocaine can be detected for up to 12-36 hours, opiates for up to 24 hours and longer, and cannabinoids for up to 24 hours.

Do the test results provide legal proof of drug abuse?
Any on-site drug test can only deliver general "screening" results. After any non-negative screening result a confirmation analysis (e.g. with GC-MS / LC/MS/MS) should be performed.
The quantitative result is legally defensable.

On-site Oral Fluid / Saliva Drug Screens - Accurate

2008-01-18T05:34:00.000-08:00

Journal of Psychoactive Drugs

A comparison between instant and laboratory oral fluid analysis among arrestees. Yacoubian GS; Wish ED.

Research studies that collect biological measures of drug use have traditionally utilized laboratory urinalysis.

Several recent studies have also documented the utility of laboratory oral fluid (OF) analysis.
A new method of drug testing -- instant OF technology -- may offer a quicker, equally accurate alternative to laboratory OF assays.
To date, however, no field studies have compared the two methods.

In the current study, an instant OF test (Avitar ORALscreen (TM)) was administered to adult arrestees surveyed through Maryland's Substance Abuse Need for Treatment among Arrestees (SANTA) study.

Following a research interview, a second OF sample was collected (Avitar ORALconfirm (TM)) and shipped to the manufacturer's laboratory for analysis.

The Avtiar ORALscreen instant OF test was:

96% sensitive and 83% specific for cocaine,

100% sensitive and 75% specific for opiates, and

100% sensitive and 94% specific for marijuana.

Copyright 2006, Haight-Ashbury Publishing
Reference Source: Yacoubian GS; Wish ED. A comparison between instant and laboratory oral fluid analysis among arrestees. Journal of Psychoactive Drugs 38(2): 207-210, 2006. (10 refs.)

Courts Uphold Workplace Drug Testing - Once Again

2008-01-03T05:52:00.000-08:00

Alberta Court of Appeal ruling upholds construction workplace drug testing
(Source: Canadian News)

EDMONTON - Construction and energy companies are happy with an Alberta court ruling that upholds the right of employers to test workers for drugs.

The Alberta Court of Appeal's decision overturned a lower court judgment that said Kellogg, Brown & Root Co. discriminated against a man in 2002 when it fired him from an oilsands project near Fort McMurray after he tested positive for marijuana.

John Chiasson, who admitted to being a recreational pot smoker, filed a complaint with the Alberta Human Rights Commission, which ruled against him. The commission said there needs to be a balance between an individual's human rights and the needs of an employer in protecting others.
But Court of Queen's Bench Justice Sheilah Martin then ruled in his favour. She said he should have been treated the same as someone with a drug addiction, which is considered a disability in human rights case law.

The panel of three Appeal Court justices disagreed. The judges said it is legitimate for Kellogg, Brown & Root to presume that people who use drugs at all are a safety risk in an already dangerous workplace.

"We see this case as no different than that of a trucking or taxi company which has a policy requiring its employees to refrain from the use of alcohol for some time before the employee drives one of the employer's vehicles," the justices wrote.
"Extending human rights protections to situations resulting in placing the lives of others at risk flies in the face of logic."

Kellogg, Brown & Root, one of the largest construction firms in the world, was helping to build an expansion to Syncrude Canada's plant at the time of Chiasson's case and is still active in the oilsands.
Andrew Robertson, a lawyer for the company, said the Appeal Court's decision is important to energy and construction industries.

"It is refreshing to see the Alberta Court of Appeal factor in risk management in safety-sensitive workplaces in a circumstance when there had been a recent focus on human rights issues," he said.
Heather Browne, a spokeswoman for Texas-based Kellogg, Brown & Root, hailed the ruling.
"KBR is a leader in workplace safety, and maintaining that commitment is the company's top priority," Browne said Wednesday.

"The court ruling upholds that commitment and we look forward to continuing our work in that regard."
Robertson noted that the Alberta appeal justices did not follow an Ontario Court of Appeal's decision in a similar case that said employees who test positive for drugs are to be dealt with as if they have an addiction even if they don't.

He said courts in provinces outside of Alberta and Ontario hearing similar cases will now have two different precedents to refer to.
Commission lawyer Janice Ashcroft said the Court of Appeal ruling will be reviewed before determining whether to seek leave to have the case heard by the Supreme Court of Canada.
"It is important to employers and employees to clarify what is the role of human rights when it comes to drug testing," Ashcroft said.

"This affects a lot of people and it is important. The commission does have a duty to ensure that the rights of all Albertans - both employers and employees - are balanced in this respect."
During the original court case, officials with oilsands giant Syncrude testified that the company's lost-time rate from accidents has dropped in part because of drug and alcohol testing.
Syncrude, Suncor, Albian Sands and other major oilsands heavyweights test their employees for drugs before they are allowed on jobsites.

Kara Flynn, a spokeswoman for Syncrude, said that in a broad sense, the Appeal Court ruling supports the company's drug-testing policy and goals.

"Any judicial decisions that support that are greatly appreciated," she said.
The impact of the ruling is already starting to ripple beyond Alberta's boundaries.
Phil Hochstein, president of the Independent Contractors and Business Association in British Columbia, said while workplace drug testing is common on major projects in Alberta, it is the exception in B.C.
He expects that is going to change.
"I think that workplace testing of construction workers is probably an issue whose time has come," he said from Vancouver.
"I think this case is going to spur more of this jobsite testing, not only on big industrial jobs, but on commercial and institutional jobs throughout the country."

Big Rig Drivers Beat Drug Tests?

2007-12-24T07:28:00.000-08:00

Can Big Rig Drivers Beat Drug Tests?

By Robert ArnoldPOSTED: 10:03 am CST December 20, 2007UPDATED: 12:46 pm CST

December 22, 2007 HOUSTON -- Local 2 investigates potentially dangerous loopholes in federal drug testing laws. Our hidden cameras expose a flawed system that can allow drug addicts to get behind the wheel of an 18-wheeler or even a school bus. Local 2 investigative reporter Robert Arnold shows us how what we uncovered now has Congress and the industry demanding change.

We sent our hidden cameras to a Houston drug testing facility where we signed up to take an official Department of Transportation drug test. Federal law requires every driver to get a drug test before they're allowed to drive an 18-wheeler, a school bus or any kind of commercial vehicle.

But before Local 2 went for the test, we were able to order drug-free urine off the Internet.The kit Local 2 purchased came with a tube of dehydrated urine, a vial and a small heater. We mixed the powdered urine with water then used the heater to bring the sample up to the temperature of the human body.At the collection facility, Arnold was ordered to take off his sport coat and place the contents of his pockets in a secure locker. That was the extent of the search, which meant no one at the facility knew Arnold had the vial of mail-order urine hidden as he entered the bathroom.Once inside the bathroom, Arnold was allowed to close and lock the door, which allowed him to use the vial of mail-order urine as his sample for the drug test.Arnold was then sent to a bathroom to provide a urine specimen for drug test.A few days later the results of Arnold's drug test came back negative. The mail-order urine passed with no problems at all.

The facility Local 2 tested did absolutely nothing wrong. Employees followed every procedure they are required to follow when collecting a specimen for a Department of Transportation drug test. Yet, Local 2 still found it easy to beat the test."Your investigation shows how easy it is to circumvent the law," said U.S. Rep. Ted Poe, who sits on Congress' Transportation Committee."Those regulations were written based on the premise that the person giving the sample was going to be honest about it," said Poe. "That's not the world we live in."Poe said what concerns him is if Arnold had been a drug user, then that negative test would still allow him to drive an 18-wheeler, a school bus or any kind of commercial vehicle."

When it's so easy to circumvent the law, the law becomes meaningless," said Poe."Whatever needs to be done to tighten the regulations to ensure that we don't have anyone slip through the cracks like you did, then I think that needs to be addressed," said Van O'Neal, the head of Houston Community College's truck driving school.
O'Neal's program is one of the largest in the country and requires 50 percent of students and faculty to undergo random drug tests. He says that's why Congress has to tighten the regulations."Those policies must be followed, not need to be followed, but I believe must be followed to ensure that our roadways are safe," O'Neal said.Congress is promising to come up with tougher regulations because what Local 2 did was not an isolated case. A report from the Government Accountability Office shows federal investigators also circumvented drug testing laws at several facilities. The report even warns Congress it impossible to determine how many drivers have been able to beat the federally required drug test.Federal law also requires trucking companies to randomly test employees to hopefully catch those who may have beat the test the first time. But after Local 2 Investigates combed through tens of thousands of federal violations, we found not everyone is following the law.

Oxycodone & Hydrocodone Deaths Exceed Those For Heroin

2007-12-05T06:12:00.000-08:00

Tampa, Florida -

Drug related deaths for oxycodone and hydrocondone exceed those for heroin in the State of Florida.

U.S. Drug Czar John Walters again voiced concern about the abuse of prescription drugs.

Walters, National Director of Drugs Control Policy, noted that many teens and young people believe prescription pills are not as dangerous as street drugs.

12% of people between the ages of 18 and 25 report abusing prescription drugs in the past year.

CBS NEWS - WTSP - Tampa Bay's 10 News - Tampa / St. Petersburg

Urine DOT Drug Testing Not Working - New Government GAO Report

2007-11-06T06:04:00.000-08:00

Now even the US Government knows the obvious ....

Drug testing without observed specimen collection, is a waste of time and money.

Private interest groups, consisting largely of urine drug testing laboratories, urine-centric TPA's, occupational health clinics, some unions, as well as a select group of archaic government bureaucracies (DOT, FAA, etc.) continue to exclusively support urine-based testing vs. superior, user-friendly technologies - most notably oral fluid / saliva and hair-based drug screening.

Oral fluid / saliva and hair-based drug screening technologies allow for observed specimen collection and are relatively non-invasive vs. traditional urine drug testing. Oral fluid delivers information on "current" / "on-the-job" drug and/or alcohol use, while hair detects "historical drug abuse".

Oral fluid / saliva is suitable for random, post-accident, and reasonable suspicion testing, and also can be used for pre-employment testing.

Hair is most appropriate for pre-employment testing, especially for employers that wish to track drug use history for a period of up to 90 days.

The DOT and other government agencies, including "regulatory agencies" such as SAMHSA are largely to blame for the continued emphasis upon traditional urine-based testing, and ultimately serving to help perpetuate America's problem with substance abuse.

Why? Government agencies resist moving to newer technologies either due to the fear of having to "do more work", and/or are impacted by private interest groups with heavy lobbying budgets and well established "old boy networks".

In their defense, the DOT claims "success" by noting a "2% positive rate". This is a blatant misuse of statistics. Of course the is only a 2% positive rate... as most drug abusers are cheating the test!

As noted below, if drug testing involved observed specimen collection, and/or more stringent techniques the positive rate soars to 10%.

Urine-based drug testing is simply:

1. too difficult, costly, and noxious to apply consistently and on a corporate-wide / industry-wide basis,

2. prone to drug abusers "beating the test".

Several documented cases support the above facts:

For example, a recent construction site that had a low "positive rate" using tradition urine drug testing, but had several site issues and eventually discovered hypodermic needles on-site.

When they implemented Avitar's oral fluid-based testing, conducing a full site-based random screen, the positive rate registered 20%!

Urine testing laboratories, in most cases, are not able to determine if urine samples are adulterated or substituted, other than in the most basic and severe cases.

Despite this fact, they continue to spread misinformation, claiming the opposite.

The Director of Workplace Drug Testing for SAMHSA is on record, testifying before Congress, that detect adulterants, that labs can only detect a very small fraction of the many products available on the Internet available to beat urine-based drug tests, and that substituted drug free urine and synthetic urine also are undetectable.

GAO: Easy to cheat on trucker drug tests

Three-quarters of testing sites don’t provide secure conditions, report finds

The Transportation Department estimates that fewer than 2 percent of truck drivers test positive each year for controlled substances.

But when Oregon conducted its own tests, 9 percent of truck drivers tested positive.

Dozens of products on the Web are marketed to truckers as fail-safe ways to defeat the mandatory drug tests.

WASHINGTON - Undercover federal investigators discovered that it was surprisingly easy to cheat on random drug tests designed to catch truck drivers who use drugs, NBC News has learned.

Undercover investigators with the Government Accountability Office (GAO), the investigative arm of Congress, used bogus truck driver’s licenses to gain access to 24 drug-testing sites.

They found that 75 percent “failed to restrict access to items that could be used to adulterate or dilute the [urine] specimen, meaning that running water, soap, or air freshener was available in the bathroom during the test.”

The GAO team also bought drug-masking products over the Web and was able to mix them with real specimens at the drug-testing sites “without being caught by site collectors,” the agency said in a report scheduled to be made public ThursdayDrug - screening labs never realized that there was a problem.

“Every drug masking product went undetected by the drug screening labs,” said the report, a copy of which was obtained by NBC News.Rep.

Jim Oberstar, D-Minn., chairman of the House Transportation and Infrastructure Committee, said the report was “frankly astonishing and shocking and dismaying.

You can manipulate the tests, you can mask substance abuse and go undetected on the roadways.”Oberstar, who planned to hold a hearing Thursday, said the drug-testing system was broken and was placing other drivers in danger.“It fails, it is not sufficient, it is not protecting the public interest,” he said.

How many are cheating?

The Transportation Department estimates that fewer than 2 percent of truck drivers test positive each year for controlled substances in random federal tests.

But when Oregon law enforcement officials conducted their own random tests this year, 9 percent of truck drivers tested positive.

Dozens of products widely available on the Web are marketed to truckers as fail-safe ways to defeat the mandatory drug tests.

“My first reaction was total disbelief. I just felt sick,” said Kathleen Ellsbury, whose husband, Tony Qamar, was killed two years ago when a truck driver in Washington state lost his load of logs on a curve, crushing Qamar’s car.

Also killed was Daniel Johnson, a fellow seismologist at the University of Washington.Ellsbury learned later that the truck driver, who was sentenced to 4½ years in prison for vehicular homicide, had previously been convicted of possessing methamphetamines and that he had meth in his blood at the time of the crash.

“The system has big holes, let’s say that,” said Ellsbury, who said she had a message for truck drivers who might be tempted to cheat:

“I’d like to be standing right outside the bathroom and hold up a picture of my husband — remind them there's consequences.”

Truckers promise to do betterSpokesmen for the trucking industry said truck drivers were among the safest drivers on the road, with much lower rates of drug use than the general population. Still, they said, having roughly 30,000 drivers test positive each year was unacceptable.

Lisa Myers is chief investigative correspondent and Richard Gardella is an investigative producer for NBC.

" New " Building Construction and Construction Trades Department BCTD

2007-10-05T08:04:00.000-07:00

For Safety Professionals attempting to innovate and improve efforts can be frustrating, largely due to the fact that politics can easily supersede logic.

That said, while potentially well-intentioned, the "new" Building and Construction Trades Department - BCTD drug testing program ( which oddly requires outdated and relatively ineffective urine-based testing as well as the use of a specific laboratory, third party administrator, and their specific product and services ) represents a step backwards ...

not forward ,

more importantly, however, this archaic structure does NOT serve the best interests of unions, union members, contractors, insurers, or owners.

The Need for Change: Substance Abuse in the Construction Sector

We all know that a drug free workplace is a safe workplace and the union skilled trades and contractors were ahead of their time years 16 years ago, when urine-based drug testing was introduce by innovators as evidence by the MUST program, LEAD, and others.

However, times change, the drugs of choice change and the numbers of ways to “beat” the tests have changed.

It’s time again for the union skilled trades and contractors to leap ahead of the national status quo.

Recently the States of Hawaii and Georgia passed legislation to improve safety and reduce workers compensation costs through the implementation of on-site oral fluid / saliva drug screening.

The construction industry played a key role in driving these changes, especially in Hawaii. Organized labor in particular, as well as contractors, owners, and insurers recognized the following:

Drug abuse in the construction sector is as bad, if not worse than ever,

Effective drug testing, especially random drug testing is required to truly manage workplace substance abuse,

Observed specimen collection, convenience, and low cost are mandatory to ensure compliance.

It's time again for union's to put politics aside and address the issue from from a safety point of view:

Why drug test? Simple.

While 10% of employees aged 18 – 49 years abuse drugs (not including alcohol), the construction industry runs 2x-3x this rate.

With over 50% of reportable job-site accidents linked to substance abuse, it’s clear that employee safety and the corporate bottom line are sufficient reasons to implement a drug free workplace program.

A need for change

Pre-employment drug testing has become an intelligence test.

Access to the internet has made defeating drug tests an easy task. Workers are able to get information on how to “flush” their system; adulterate samples; and there are even products like the Whizinator, which uses synthetic urine undetectable by current drug testing methods, designed to defeat observed urine collection.

Random drug testing, post-incident and reasonable suspicion modes are required components of any comprehensive, effective safety program.

The goal of any drug / alcohol policy is deterrence vs. “catching” employees.

Random testing has consistently demonstrated to be singularly effective in reducing on-the-job substance abuse.

Any effective testing mode must involve direct observation of specimen collection. But observed urine collection is embarrassing and degrading to both the observed and the observer.Arguably, there are more instances of drug abusers defeating unobserved techniques, such as traditional urine-based testing, than there are “positives”.

Just look at nationwide statistics for validation. Seventy-seven percent (77%) of drug abusers are employed. Furthermore most drug testing (approx. 90%) involves traditional urine laboratory-based pre-employment testing.

Oral fluid works

Oral fluid tests are cheaper, faster and easier to use than urinalysis… and unlike urine, can not be easily defeated.

Random testing via on-site oral fluid is fast, provides results within 5-15 minutes, and averages $20 per test. It has the additional advantage of detecting current, vs. historical drug use. Oral fluid tests typically detect from within minutes of consumption up to 2-3 days for most drugs (for THC, the psychoactive ingredient in marijuana, the maximum is 24 hours.).

Urine testing can not detect drugs for up to the first several hours and is only an indicator of historical drug use. Furthermore, for THC, detection can go back as far as 30 days.

Do you as an employer really care what an otherwise dependable employee does at his/her home on the weekend?

Do you even have a right to know?

“This measure (on-site oral fluid drug testing) provides a cost effective on-the-job alternative to laboratory tests that can be costly and difficult to schedule."- Aiona, Lt. Governor, Hawaii

Also look at the true costs of urine-based random testing.

In many cases our current program requires we send our employees off site for random testing. The cost involved includes not only the hourly labor rate, probably $50/hour with benefits, but the productivity loss also. The end result is that a typical off-site urine test is truly costing a job about $300 per test, and the effectiveness is questionable at best.On-site oral fluid based testing works.

Here are actual results from a contractor who switched from urine-based to oral fluid-based drug screening:

Where do we go from here?
Occupational health, safety, and risk management professionals must assist in driving change. This groups and only this group knows what truly happens every day on our job sites.
At the end of day, they “get it”.

It’s time for safety professionals to join with all constituencies to update current drug and alcohol free workplace programs to assure compliance and effectiveness.

It’s also time for the union skilled trades and contractors to again lead the charge in effecting change.

It’s time to implement oral fluid-based testing techniques at a few “pilot sites” and demonstrate the advantage of effective drug testing programs vs. the status quo.

References:
2006 United States Department of Health – Substance Abuse and Mental Health Agency (SAMSHA) National Survey on Drug Use & Health (NHSDA)- Office of Applied Studies. (2007) Results from the 2006 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 07-4293, NSDUH Series H-32). Rockville, MD: Substance Abuse and Mental Health Services Administration.
Peter N. Cholakis and Roger Bruce (July 2007) Drug Testing in the Workplace – A look at oral fluid-based testing. Professional Safety Journal of the American Society of Safety Engineers, July 2007, 31-36

Schools Infested with Drugs

2007-10-01T09:52:00.000-07:00

New Study: Schools Infested with Drugs - 2007

A New Study from the National Center on Addiction & Substance Abuse (CASA) suggests that US Schools are infested with drugs. The survey revealed that at least once a week on their school grounds, 31 percent of high school students (more than four million) and nine percent of middle school students (more than one million) see illegal drugs used, sold, students high and/or drunk. At least weekly, 17 percent of all high and middle school students (4.4 million) personally see classmates high on drugs at school.

Construction Safety - Drug Testing - AGC - Michigan - MUST

2007-09-25T12:43:00.000-07:00

The Need for Change:Drug Testing in Construction
Lynn A. Corlett, C.S.P.

We all know that a drug free workplace is a safe workplace and the Michigan union skilled trades and contractors were ahead of their time when the MUST drug screening program was implemented 16 years ago in 1991.

However, times change, the drugs of choice change and the numbers of ways to “beat” the tests have changed. It’s time again for the union skilled trades and contractors to leap ahead of the national status quo.

Recently the States of Hawaii and Georgia passed legislation to improve safety and reduce workers compensation costs through the implementation of on-site oral fluid / saliva drug screening.
The construction industry played a key role in driving these changes, especially in Hawaii. Organized labor in particular, as well as contractors, owners, and insurers recognized the following:

Drug abuse in the construction sector is as bad, if not worse than ever,

Effective drug testing, especially random drug testing is required to truly manage workplace substance abuse,

Observed specimen collection, convenience, and low cost are mandatory to ensure compliance.

This article attempts to address this from the construction industry’s point of view:
Why should every construction site drug test?
Where do we go from here?

Why drug test?
Simple.
While 10% of employees aged 18 – 49 years abuse drugs (not including alcohol), the construction industry runs 2x-3x this rate.
With over 50% of reportable job-site accidents linked to substance abuse, it’s clear that employee safety and the corporate bottom line are sufficient reasons to implement a drug free workplace program.

A need for change
Pre-employment drug testing has become an intelligence test. Access to the internet has made defeating drug tests an easy task. Workers are able to get information on how to “flush” their system; adulterate samples; and there are even products like the Whizinator, which uses synthetic urine undetectable by current drug testing methods, designed to defeat observed urine collection.

Random drug testing, post-incident and reasonable suspicion modes are required components of any comprehensive, effective safety program. The goal of any drug / alcohol policy is deterrence vs. “catching” employees. Random testing has consistently demonstrated to be singularly effective in reducing on-the-job substance abuse.

Any effective testing mode must involve direct observation of specimen collection. But observed urine collection is embarrassing and degrading to both the observed and the observer.Arguably, there are more instances of drug abusers defeating unobserved techniques, such as traditional urine-based testing, than there are “positives”. Just look at nationwide statistics for validation. Seventy-seven percent (77%) of drug abusers are employed. Furthermore most drug testing (approx. 90%) involves traditional urine laboratory-based pre-employment testing. Oral fluid worksOral fluid tests are cheaper, faster and easier to use than urinalysis… and unlike urine, can not be easily defeated.

Random testing via on-site oral fluid is fast, provides results within 5-15 minutes, and averages $20 per test. It has the additional advantage of detecting current, vs. historical drug use. Oral fluid tests typically detect from within minutes of consumption up to 2-3 days for most drugs (for THC, the psychoactive ingredient in marijuana, the maximum is 24 hours.). Urine testing can not detect drugs for up to the first several hours and is only an indicator of historical drug use. Furthermore, for THC, detection can go back as far as 30 days. Do you as an employer really care what an otherwise dependable employee does at his/her home on the weekend? Do you even have a right to know?
Also look at the true costs of urine-based random testing.
In many cases our current program requires we send our employees off site for random testing. The cost involved includes not only the hourly labor rate, probably $50/hour with benefits, but the productivity loss also. The end result is that a typical off-site urine test is truly costing a job about $300 per test, and the effectiveness is questionable at best.
On-site oral fluid based testing works.

Where do we go from here?
Occupational health, safety, and risk management professionals must lead the charge to effect change. We know what truly happens every day on our job sites. At the end of day, we “get it”. It’s time for us to update our current drug and alcohol free workplace program.
It’s time for the Michigan union skilled trades and contractors to again lead the charge in effecting change.
It’s time to implement oral fluid-based testing techniques at a few “pilot sites” and demonstrate the advantage of effective drug testing programs vs. the status quo.

References:2006 United States Department of Health – Substance Abuse and Mental Health Agency (SAMSHA) National Survey on Drug Use & Health (NHSDA)- Office of Applied Studies. (2007) Results from the 2006 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 07-4293, NSDUH Series H-32). Rockville, MD: Substance Abuse and Mental Health Services Administration.Peter N. Cholakis and Roger Bruce (July 2007) Drug Testing in the Workplace – A look at oral fluid-based testing. Professional Safety Journal of the American Society of Safety Engineers, July 2007, 31-36.

Construction Safety / Drug Testing: Michigan AGC / MUST Drug Testing

2007-09-25T12:36:00.000-07:00

The Need for Change:
Drug Testing in Construction

Lynn A. Corlett, C.S.P.

We all know that a drug free workplace is a safe workplace and the Michigan union skilled trades and contractors were ahead of their time when the MUST drug screening program was implemented 16 years ago in 1991. However, times change, the drugs of choice change and the numbers of ways to “beat” the tests have changed. It’s time again for the union skilled trades and contractors to leap ahead of the national status quo.

Recently the States of Hawaii and Georgia passed legislation to improve safety and reduce workers compensation costs through the implementation of on-site oral fluid / saliva drug screening.

The construction industry played a key role in driving these changes, especially in Hawaii. Organized labor in particular, as well as contractors, owners, and insurers recognized the following:

Drug abuse in the construction sector is as bad, if not worse than ever,

Effective drug testing, especially random drug testing is required to truly manage workplace substance abuse,

Observed specimen collection, convenience, and low cost are mandatory to ensure compliance.

This article attempts to address this from the construction industry’s point of view:

Why should every construction site drug test?
A need for change.
Where do we go from here?

Why drug test?
Simple. While 10% of employees aged 18 – 49 years abuse drugs (not including alcohol), the construction industry runs 2x-3x this rate.
“This measure (on-site oral fluid drug testing) provides a cost effective on-the-job alternative to laboratory tests that can be costly and difficult to schedule."
- Aiona, Lt. Governor, HawaiiWith over 50% of reportable job-site accidents linked to substance abuse, it’s clear that employee safety and the corporate bottom line are sufficient reasons to implement a drug free workplace program.

A need for change

Pre-employment drug testing has become an intelligence test. Access to the internet has made defeating drug tests an easy task. Workers are able to get information on how to “flush” their system; adulterate samples; and there are even products like the Whizinator, which uses synthetic urine undetectable by current drug testing methods, designed to defeat observed urine collection.

Random drug testing, post-incident and reasonable suspicion modes are required components of any comprehensive, effective safety program. The goal of any drug / alcohol policy is deterrence vs. “catching” employees. Random testing has consistently demonstrated to be singularly effective in reducing on-the-job substance abuse.

Any effective testing mode must involve direct observation of specimen collection. But observed urine collection is embarrassing and degrading to both the observed and the observer.

Arguably, there are more instances of drug abusers defeating unobserved techniques, such as traditional urine-based testing, than there are “positives”. Just look at nationwide statistics for validation. Seventy-seven percent (77%) of drug abusers are employed. Furthermore most drug testing (approx. 90%) involves traditional urine laboratory-based pre-employment testing.

Oral fluid works

Oral fluid tests are cheaper, faster and easier to use than urinalysis… and unlike urine, can not be easily defeated.

Random testing via on-site oral fluid is fast, provides results within 5-15 minutes, and averages $20 per test. It has the additional advantage of detecting current, vs. historical drug use. Oral fluid tests typically detect from within minutes of consumption up to 2-3 days for most drugs (for THC, the psychoactive ingredient in marijuana, the maximum is 24 hours.). Urine testing can not detect drugs for up to the first several hours and is only an indicator of historical drug use. Furthermore, for THC, detection can go back as far as 30 days. Do you as an employer really care what an otherwise dependable employee does at his/her home on the weekend? Do you even have a right to know?

Also look at the true costs of urine-based random testing. In many cases our current program requires we send our employees off site for random testing. The cost involved includes not only the hourly labor rate, probably $50/hour with benefits, but the productivity loss also. The end result is that a typical off-site urine test is truly costing a job about $300 per test, and the effectiveness is questionable at best.

On-site oral fluid based testing works. Here are actual results from a contractor who switched from urine-based to oral fluid-based drug screening:

Where do we go from here?

Occupational health, safety, and risk management professionals must lead the charge to effect change. We know what truly happens every day on our job sites. At the end of day, we “get it”.

It’s time for us to update our current drug and alcohol free workplace program.

It’s time for the Michigan union skilled trades and contractors to again lead the charge in effecting change.

It’s time to implement oral fluid-based testing techniques at a few “pilot sites” and demonstrate the advantage of effective drug testing programs vs. the status quo.

References:

2006 United States Department of Health – Substance Abuse and Mental Health Agency (SAMSHA) National Survey on Drug Use & Health (NHSDA)- Office of Applied Studies. (2007) Results from the 2006 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 07-4293, NSDUH Series H-32). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Peter N. Cholakis and Roger Bruce (July 2007) Drug Testing in the Workplace – A look at oral fluid-based testing. Professional Safety Journal of the American Society of Safety Engineers, July 2007, 31-36.

Drug Testing and Return on Investment

2007-09-24T14:02:00.000-07:00

Return on Investment - Drug Testing

Employee Theft and Fraud
- Average cost Per employee involved: $650
- U.S. Chamber of Commerce estimates 30% of all business failures are due to employee theft and fraud.
- 70% of these crimes are committed by repeat offenders.
- Up to 70% of employee theft is drug related

Cost of Negligent Hiring
- Average cost per incident: $150,000
- Courts are holding companies liable in negligent hiring cases not only for what they knew about a new employee, but also what they should have known.

Employee Turnover
- Average cost per incident: $32,000
- Turnover costs average 1.5 times a person’s yearly salary

Workplace Violence
- Average cost per incident: $1,000,000
- Violence at work is a serious problem, with homicide now the #2 cause of death in the workplace.
- Up to 70% of criminal arrests are drug related

Significant Change in Substance Testing Laws

2007-09-19T05:25:00.000-07:00

Significant Changes to Substance Abuse Testing Laws

Recently the States of Hawaii and Georgia passed legislation in support of workplace drug testing, specifically relative to oral fluid-based/saliva drug on-site screening, and workers compensation premium credits. These actions highlight the need for effective drug-free workplace programs as well convenient drug screening technologies that can be applied consistently, across all modes of testing, especially, however, for random, post-incident, and reasonable suspicion.

It is critical that drug-free workplace safety initiatives are enhanced for the betterment of the American workplace as a whole: employers, employees and families, insurors, etc.
Drug abuse is as bad as it has ever been in our places of employment as well as school systems, and hopefully, these new statutes are a sign of a commitment to change.

Our society cannot continue to sweep America's drug abuse problem under the rug. Abuse of prescription drugs, especially pain-relievers, has superseded marijuana and is is a dangerous trend world-wide.

Arguably, “recreational” marijuana use outside of the workplace may have little, if any, impact to employers or employees, excluding the obvious legal issues. The non-medical use of prescription pain relievers, however, in addition to being potentially lethal, commonly leads to addiction and even escalates to heroin use. The safety and wellness aspect of prescription drug abuse is a very serious issue that must be addressed.
Hawaii
A law that became effective on July 1, 2007, now allows employers to perform on-the-job drug testing using instant, on-site oral fluid/saliva drug screening devices. Oral fluid tests are cheaper, faster and easier to use than urinalysis, hopefully leading to more widespread and consistent drug testing programs.

While it may surprise many, the construction industry and locals unions in particular strongly advocate the new legislation as a means to replace the typical, more expensive laboratory-based urine drug testing. With oral fluid, initial results are available in minutes, and observing the sample collection mitigates the prevalent practice of drug abusers “beating the test” via sample adulteration or substitution. Urine laboratory testing typically required the expensive practice of sending employees off-site to a clinic or laboratory, a process that takes at least 3-4 hours with results available for 24-48 hours. As noted by Lt. Governor Aiona of Hawaii, "Drug and alcohol abuse remain a problem in Hawaii's workforce. The law will go a long way towards helping to promote a drug-free workplace. This measure provides a cost effective on-the-job alternative to laboratory tests that can be costly and difficult to schedule."According to the U.S. Department of Labor, drug or alcohol abuse is involved in the majority of fatal accidents in the workplace. These laws represent an effort by the State Government to make the workplace safer for everyone.Although the new law permitting oral drug testing was effective on July 1, 2007, in many cases collective bargaining agreements will have to be updated before companies can start using the non-FDA approved tests. This procedure isn't expected to take long, however, since the unions - as well as management and the State Government - are in favor of the new law. According to union sources, they welcome the improved safety and working conditions that the tests will introduce.
One representative of the Pacific Resource Partnership, an alliance between contractors and the Carpenters Union Local 745, said construction workers and the industry pushed for the new tests as a way to decrease costs and save time while keeping job sites safe."This is something that I think is going to be a great asset for employers, especially in the construction industry where public safety is a huge factor," said Lt. Governor Aiona.

Georgia
In a similar bill, Governor Perdue of Georgia recently signed Senate Bill 96 into law which provides the option for companies throughout Georgia to drug test employees using an on-site rapid result oral fluid/saliva devices.

As in Hawaii, initial qualitative results are available in minutes, and if “negative” an employee goes back to work. Any “non-negative” (preliminary positive) results are sent to a lab for a GC/MS or LC/MS/MS quantitative analytical testing prior to substantive employers’ actions such as mandatory enrollment in employee assistance programs/counseling, removal from safety-sensitive duties, and/or suspension.
Per Governor Perdue, the bill which overwhelmingly passed the State Senate and House of Representatives, "had the strong support of the Georgia Chamber of Commerce and many other advocates of safe and drug-free workplaces that protect not only business owners, but employees and consumers as well.Companies using on-site oral fluid/saliva screens will now receive a 7.5 percent reduction in their worker's compensation insurance premiums. Summary

Drug testing in the workplace is not only legal, it may very well be part of an employer’s responsibility to provide a safe workplace for employees. The United Supreme Court has ruled that drug testing, including random drug testing, is legal. Furthermore, per the Department of Labor, OSHA, it is an employer’s responsibility to provide a safe workplace for all employees.

Assuming a comprehensive safety program is in place, a safe workplace is simply not possible without also maintaining a comprehensive drug-free workplace program inclusive of employee education, drug testing, and employee assistance/counseling.
Regardless of the specimen type used such as oral fluid/saliva, urine, or hair, it is critical that specimen collection be directly observed, and that drug testing is done on a regular basis. This includes; random, post-incident, reasonable suspicion, and return-to-duty mode. Pre-employment testing, while currently the most widely practiced of modes, is referred to by many experts as an “intelligence test”, and should not be relied upon exclusively.

When combined with education, and employee assistance programs, comprehensive drug-free workplace programs consistently result in a reduction in reportable site accidents of up to 50% or more, as well as multiple other safety and “bottom-line” benefits.

False Positives and False Negatives - Workplace Drug Testing

2007-09-13T08:02:00.000-07:00

False Negatives & False Positives

Qualitative Results
A qualitative drug test is one that provides a dichotomous result, that is, it indicates whether a sample is positive or negative for a specified drug. However, there are four possible results of a qualitative drug test.

A true-positive result occurs when the test correctly identifies the presence of a drug in the sample taken.

A false-positive result is one where the test incorrectly detects the presence of a drug where in fact no drug is present.

A true-negative result occurs when the test correctly confirms the absence of a drug.

A false-negative result is one where the test fails to detect the presence of a drug when it is in fact present.

Interpreting a Positive Test Result
A positive result indicates that the specific drug (or class of drug) is present at or above the designated cut-off level. Typically, the cut-off concentration is set to the lowest concentration the drug can be reliably detected following consumption.
It considers environmental and analytical variability caused by such factors as passive contamination/ingestion, technological limits, etc.

False-positives resulting from qualitative screening.A false-positive result can occur when a benign substance in the biological sample mimics the chemical effect of the targeted substance on the test. The test indicates a positive result even though the targeted drug was absent. Such results have reportedly occurred after ingestion of antihistamines, certain anti- inflammatory drugs, cold and flu medications, and poppy seeds (Selavka, 1991). Although levels are generally low, it does highlight the necessity of appropriate confirmatory testing with parent / metabolite quantification to identify and safeguard against this.

Interpreting a Negative Test Result
In the majority of cases a negative result indicates that the parent drug (typcially the active ingredient) and / or its metabolites are absent in the biological sample.
It does not mean that the person has not used the substance in the days or weeks prior to testing.
The amount of drug present in the sample at the time of sample collection, and thus whether a positive result is obtained, is determined by a number of factors which include: the cut-off level used; the testing schedule employed; the biological sample analyzed; when the drug was ingested; the amount of drug ingested; the form in which it was ingested; and physical and pharmacological characteristics of the user.

False-negatives
When an initial screen result in negative and (1.) the individual ingests a drug and the concentration of the drug in the sample is at our above the cut-off, or (2.) the individual ingests a drug and the concentration of of the sample is below the the cut-off due to sample adulteration or substitution, the result referred to as a “false-negative”.

Relative to urinalysis, there are a number of actions an individual can take, to increase the likelihood of a false-negative result. An individual can adulterate the specimen via dilution by drinking excessive amounts of water (in vivo adulteration), or by adding water or chemicals that will affect the test (in vitro adulteration) (Coleman & Baselt, 1997).
Hair testing may be susceptible to excessive washing (Rohrich, Zorntlein, Potsch, et al., 2000), bleaching (Yegles, Marson & Wennig, 2000) and other cosmetic hair treatment (Skopp, Potsch & Moeller, 1997).

There are no currently proven methods to adulterate or substitute oral fluid.

Quantitative Results
Quantitative drug testing involves the determination of the specific concentrations of a parent drug and/or its metabolite(s) in a sample, typically via GC/MS and LC/MS/MS. In addition to confirmatory testing of qualitative screening results, quantitative results quantitative results using blood or oral fluid / saliva specimens can provide additional information regarding the quantity and frequency of drug use (Cone, 1997).

Blood and/or oral fluid / saliva may also be useful when establishing impairment levels for certain drug classes.
Urine and hair specimens are generally considered effective for historical use only.

With knowledge of the drug’s pharmacokinetic parameters, including its half-life, an estimate of the frequency of new drug use can be obtained using quantitative analysis (Cone, 1997, Huestis and Cone 1998).

Urine is produced continuously by the kidneys and may be considered an ultrafiltrate of blood. During urine production the kidneys reabsorb essential substances. Excess water and waste products, such as urea, organic substances and inorganic substances, are eliminated from the body. Parent drugs (typically the active ingredient) are often present in urine in very low concentrations or not detected at all. Therefore distinguishing between codeine, heroin and morphine use, for example, can be difficult. Furthermore, inter-subject variations in urine drug concentrations, even after similar dosing, is high.

Absorption into urine is usually slow when a drug is orally administered and excretion may be delayed for several hours (approximately 6-9 hours) .Generally, a urine specimen will contain the highest concentration of parent drug and metabolite at this time period. As drug elimination usually occurs at an exponential rate, for most illicit drugs a dose will be eliminated almost completely within 48 hours.

A number of factors influence detection times including the quantity of drug administered, parent drug and metabolite half- life, cut-off level used, and a number of physiological factors.

It is also noted that for many of drugs, frequent, multiple dosing over extended periods of time can cause the drug to accumulate in the body resulting in significantly extended detection times.

ThePhysiology of Oral Fluid
Salivary gland is a term used to include any tissue that normally discharges a secretary product into the oral cavity. Thus, oral fluid refers to the mixture of fluid in the oral cavity. Saliva is a complex aqueous fluid (99% water) containing electrolytes (principally sodium,potassium, chloride and bicarbonate), proteins (mostly enzymes, including amylase) and muncin (Kidwell, Holland & Athanaselis, 1998). The mucin gives oral fluid its sticky character. Saliva also contains cell and food debris and oral microorganisms.

The composition and production of oral fluid is determined by the relative contribution of the different glands, which in turn is dependant on a variety of factors including nutritional and emotional state, sex, age, season of the year, time of day, and a variety of diseases and pharmacological agents (Höld, 1996; United Nations, 1998)

The three major salivary glands are: (1) the parotid, at the top of the mouth, (2) the submandibular, at the base of the tongue, and (3) the sublingual, at the sides of the oral cavity. The parotid gland, responsible for about 25% of the saliva produced, excretes saliva derived primarily from blood plasma (serous fluid); the submandibular and sublingual glands excrete both serous fluid and mucin and contribute approximately 71% and 4% respectively (Kidwell, Holland & Athanaselis, 1998). The volume of saliva produced by an adult ranges from 500 to 1500 ml per day. Unstimulated saliva has a pH range between 5.6 and 7. Stimulation increases the pH to a maximum of 8 (Kidwell, Holland & Athanaselis, 1998).

A thin layer of epithelial cells separates the salivary ducts from the systemic blood circulation (capillaries). The lipid membrane of these cells determines which molecules may be transferred from blood plasma into oral fluid. Three routes have been identified that may transport a drug across the lipid membrane; these include active transport (secretion), passive diffusion through the membrane across a concentration gradient, and diffusion through pores in the membrane (ultrafiltration) (Höld, de Boer, Zuidema & Maes, 1996,United Nations, 1998). Some molecules with a low molecular mass (i.e. ethanol) may diffuse through the water-filled pores in the membrane. Other small molecules are primarily transported through secretion. For larger molecules (most drugs of abuse), passive diffusion across a concentration gradient is thought to be the major factor in transport (Höld, de Boer, Zuidema & Maes, 1996; Huestis & Cone, 1998).Equilibrium occurs between plasma and saliva.In plasma a large proportion of a drug is bound to proteins.

Drug concentrations in oral vary with the free fraction of drug in plasma, and therefore mimic concentrations found in blood (Cone, 1993).

Interpretation of drug concentrations in oral fluid has been shown to be a suitable matrix for the detection of drugs of abuse, specifically cocaine and benzoylecgonine (e.g. Cone, 1993; Schramm, Craig, Smith, et al., 1993), heroin, 6-MAM and morphine (e.g. Goldberger, Darwin, Grant, et al., 1993), codeine (in Huestis & Cone, 1998b), methadone (e.g. Wolff, 1991) and amphetamines (Cone, 1993). Cannabis use is somewhat more difficult to detect in saliva though it has been shown to be possible (e.g. Menkes, Howard, Spears, et al., 1991).Saliva drug concentrations generally correlate well with the free fraction of drug in blood (Cone, 1993; Kidwell, Holland & Athanaselis, 1998).

Saliva can be used to provide both qualitative and quantitative information on the drug status of an individual undergoing testing for all drugs of abuse reviewed (Cone, 1993).

Much research into saliva testing has examined its utility as an alternative test matrix to blood and urine.

THC Detection

2007-09-07T05:56:00.000-07:00

First and forement, devices / techniques must screen for THC-delta-9 in oral fluid NOT THC-COOH and/or delta-11, etc. The latter is a metabolite found only in urine at any level that can be commonly detected, the former is the active ingreadient of marijuna and found in oral fluid.

Detection of THC-delta-9 in oral fluid has repeatedly been demonstrated to be possible from connsumption... up to 24 hours post consumption.

The following is one of several references available on this topic:

Relationship of (9)-tetrahydrocannabinol concentrations in oral fluid and plasma after controlled administration of smoked cannabis byHuestis MA, Cone EJ.Intramural Research Program,National Institute on Drug Abuse, National Institutes of Health,Baltimore, Maryland 21224. J Anal Toxicol. 2004 Sep;28(6):394-9

ABSTRACT
Understanding the relationship of (9)-tetrahydrocannabinol (THC) concentrations in oral fluid and plasma is important in interpretation of oral fluid test results. Current evidence suggests that THC is deposited in the oral cavity during cannabis smoking. This "depot" represents the primary or sole source of THC found when oral fluid is collected and analyzed. In this research, oral fluid and plasma specimens were collected from six subjects following smoking of cannabis cigarettes containing 1.75% and 3.55% THC. There was at least one week between each cannabis administration. Plasma specimens were analyzed by gas chromatography-mass spectrometry (GC-MS) and paired oral fluid specimens were analyzed by radioimmunoassay (RIA). In addition, one individual's oral fluid specimens were also analyzed by GC-MS. These data are unique in that they represent simultaneous or near simultaneous collection of oral fluid and plasma specimens in subjects following controlled cannabis dosing. The first oral fluid specimen, collected from one subject at 0.2 h following initiation of smoking, contained a THC concentration of 5800 ng/mL (GC-MS). The similarity in oral fluid and plasma THC concentrations following the dissipation of the initial "contamination" indicates the likelihood of a physiological link between these specimens. Recent studies have shown that sublingual or transmucosal administration of pure THC results in direct absorption of intact THC into the bloodstream, thereby bypassing the gastrointestinal tract. The current study demonstrates that THC is deposited in the oral cavity and remains for up to 24 h following cannabis smoking. The decline in THC oral fluid concentration over this time suggests that there may be absorption of THC into blood as previously shown with pure THC. Passive cannabis exposure studies appear to indicate that positive oral fluid tests for THC can occur shortly after cannabis smoke exposure, but results were negative within 1 h. Consequently, when very recent passive exposure to cannabis smoke can be ruled out, it is concluded that a positive oral fluid test provides credible evidence of active cannabis use.

Detection Windows vs. Specimen Type

2007-09-07T05:37:00.000-07:00

The primary goals of any drug-free workplace policy is to deter substance abuse. In order to accomplish this end, a combination of education, drug testing, and employee assistance/counseling is required.

Relative to the drug test the following elements must be present:
1. Ability to detect current / on-the-job drug abuse.
2. Convenience for both donor and test administrator.
3. Observed specimen collection.

Only oral fluid / saliva meets all three objectives.

Urine can only detect historical drug abuse and there is no relationship between drug metabolite concentration and impairment and/or time drug was ingested. Observed collection is not possible in most workplace settings.

Hair is the best method for detecting historical drug abuse, and allows for observed collection. However, is only suitable for pre-employment testing as it can not detect drug consumption within the past seven days.

Oral fluid can detect drug consumption within minutes of consumption, up to 2-3 days for many drugs. THC detection is limited to approximately 24 hours, however, the impairment period for marijuana is generally reported to be one hour (two hour maximum). Oral fluid is best for random, reasonable suspicion, post-incident testing, however, can be used for pre-employment testing.