The Changing Face of Drug Testing PITTSBURGH, PA ~ CLEVELAND, OH ~ PARAMUS, NJ

Transcription

1 The Changing Face of Drug Testing

2 Today s Session Decades of Drug Use Legislation Trends Testing Methods Best Practices Policy Development Third Party Administration

3 Psychedelic 60 s Hallucinogens, Marijuana and LSD Recreational Drug Use Becomes Fashionable among Young, White, Middle Class Americans

4 70 s Nixon Declares War On Drugs Becomes Public Enemy #1

5 70 s Drug Explosion

6 Nixon Administration Established 1970 The Controlled Substances Act 1970 Narcotics Treatment Administration 1972 The Office of Drug Abuse Law Enforcement 1973 The Drug Enforcement Administration (DEA)

7 Controlled Substances Act (CSA) Schedule I most dangerous to Schedule VI least dangerous Schedule I most dangerous & addictive. High potential for abuse and/or dependence with no accepted medical use i.e. Synthetic Cannabinoids, Ecstasy/MDMA, Bath Salts, Marijuana, Heroin, LSD Schedule II accepted medical use with potential for abuse and the ability to produce dependence i.e. Cocaine, Propoxyhene, methadone, Oxycodone, Oxymorphone, Ritalin, PCP, Morphine Schedule III Barbiturates, Marinal, Hydrocodone, Codeine, Steroids Schedule IV- Xanax, Librium, Klonopin, Valium, Ambien Schedule V- Contain limited quantities of certain narcotic drugs i.e.. Prescription cough syrups Schedule VI Over the Counter Drugs (OTC) Canada & Europe also have schedules. Europe is closer to the USA s

8 80 s Public Panic & Federal Testing Programs

9 Crack Cocaine The Social Problem of the Decade Organizations developed to deal with drug abuse : World Youth Against Drug Abuse Partnership for a Drug-Free America College Challenge Just Say No Club RRIDE STOPP

10 80 s Legislation 1986 The Anti-Drug Abuse Act 1986 Executive Order Federal Drug Testing Begins 1989 Federal DOT requires PRIVATE Employers to Test *US Supreme Court upholds drug testing *12 state laws exist for private workplace testing Federal funding for the war on drugs reached $17.1 billion dollars

11 90 s A Resurgence of Illicit Drug Use METH, HEROIN, ECSTASY & POT Mom and Pop Meth Labs Heroin Chic GLAMORIZED BY FASHION INDUSTRY Ecstasy Club Drugs

12 Prescription Abuse This Millennium's War on Drugs Leading Cause of Unintentional Injury Death Americans ages 25-64

13 Commonly Abused Prescription Drugs opioids/pain relievers depressants/sedatives and tranquilizers stimulants

14 Prescription Painkillers Vicodin Percocet Oxycotin USA 5% of Worlds Population Consumes 80% of Worlds RX Pain Medications Consumes 99% of Worlds Hydrocodone Vicodin Nearly 1 in 20 Americans age 12+ report using recreationally in last year 45 Americans die each day from unintentional RX pain medication overdoses 2011 leading cause of unintentional death, surpassed motor vehicle crashes Painkiller & Heroin usage have become integrated

15 NEW TRENDS Designer Drugs Synthetics Mimic other drugs but are hard to detect with standard drug test Fake Cannabinoids / POT Bath Salts / COCAINE

16 Imminent Hazard to Public Safety aka Fake Marijuana What is it- Mixture of herbal compounds and chemicals No Quality Control Sold in tobacco shops, convenience stores and internet for $15 - $45. Over 400 brands readily available Symptoms: Include hallucinations, vomiting, high blood pressure, heartbeat, loss of consciousness, anxiety attacks rapid Laws - Banned in 41 states and Puerto Rico (Schedule I) Problem- 20 types currently listed on CSA, over 470 variations identified Economically testing labs cant keep up with manufacturers altering of active ingredients. Difficult to drug test

17 Bath Salts Product Names: Ivory Wave, Bliss, White Lightning, Hurricane Charlie, Vanilla Sky Use: Snort, smoke, injest - alternative to cocaine and meth, inexpensive, $10.00 Side effects: increased blood pressure and heart rate, agitation, hallucinations, extreme paranoia and delusions, violent and combative behavior, even suicides Laws: 43 states and Puerto Rico have outlawed (Schedule I) Problems: Not detected in standard drug screen, expensive

18 Sample Policy Language Synthetics Designer and Synthetic Drugs: Such as, but not limited to China White, Synthetic heroin, MDA, Adam, Eve, Love Drug and any other drugs that are made in clandestine laboratories where the chemists alter the molecular structure of both legal and illegal drugs to create a drug that is not explicitly banned by federal law, but may be illegal under state law. Unauthorized (or prohibited) Drugs: Such as, but not limited to, medical & recreational marijuana, non-prescription inhalants, stimulants and amphetamines or any other tablets, capsules and powders containing controlled over-the counter ingredients whose physical appearance mimics various prescription drugs products which contain popular substances of abuse and are regulated under the provisions of the Controlled Substances Act.

19 ZOHYDRO The Next OxyContin FDA approved to treat chronic pain Available March x more potent Hydrocodone based ER- Extended Release Easy to crush capsule #1 Massachusetts Governor announced their state has banned ZOHYDRO. He cited a public health emergency stemming from opioid abuse #2 Vermont Becomes Second State to Take Action Against Zohydro

20 E-Cigarettes Smokers Are Using E-Cigarettes to Get High Difficult to Detect Odorless Marijuana - Hash Crack Cocaine

21 BEST PRACTICES Substance Abuse Policy Policy Review Supervisor / Employee Education Qualified Third Party Administrator (TPA)

22 Policy 5 Basic Components Required: 1. A written substance policy 2. Employee educational awareness 3. Supervisor skill-building training 4. Drug and alcohol testing under specified circumstances 5. Employee assistance

23 Policy Development & Review WHO WHAT WHERE WHEN HOW WHY Are you & who to test? to test for? on-site? test events? test methods? safety, mandated?

24 WHO 40 Million Workplace Drug & Alcohol Tests 32 Million Non-Federal 8 Million Federal U.S.S PITTSBURGH, PA ~ CLEVELAND, OH ~ BALTIMORE, MD ~ SACRAMENTO, CA ~ ASTORIA, NY ~ PARAMUS, NJ

25 WHAT Drug Test Panel DOT Panel (Fed) Additional Panels (NF) * Marijuana Cocaine Amphetamines MDMA Ecstasy Opiates 6-AM (heroin) Phencyclidine (PCP) Methadone Expanded Opiates Oxycodone & Hydrocodone Barbiturates Benzodiazepine Synthetics Propoxyhene (OWO) Methaqualone (1985) PITTSBURGH, PA ~ CLEVELAND, OH ~ BALTIMORE, MD ~ SACRAMENTO, CA ~ ASTORIA, NY ~ PARAMUS, NJ

26 WHERE One Policy Does or Doesn t Fit All

27 600 State Workplace Testing Laws Limit or prohibit random testing Limit discipline Prohibit post-accident tests Prohibit observed collections Require MRO review Require split-sample

28 State vs Federal Law Marijuana Still Dangerous, Still Illegal in the Workplace Medical Marijuana

29 Medical Marijuana Legal in 20 States and DC 13 States with pending legislation in 2014: FLORIDA KANSAS KENTUCKY MARYLAND MINNESOTA MISSOURI NEW YORK OHIO PENNSYLVANIA SOUTH CAROLINA TENNESSEE WEST VIRGINIA WISCONSIN

30 Recreational Marijuana 2 States 12 States with pending legislation 2014 Alaska Vermont New Mexico New Hampshire Maryland Ohio* * also has legislation for MM Arizona Oregon New Jersey Delaware Washington, DC Missouri*

31 How does state Marijuana laws impact employers? 1. State laws dictate whether an employer will incur liability for refusing to hire or discharging an employee who has a positive drug test due to MM 2. Currently, most state statues say that employers do not have to accommodate the use of MM 3 The use of MM by any safety-sensitive employee subject to drug testing under the DOT regulation is not permissible. Court Cases: Employer Community Has Won Most Cases - Walmart vs. Casias private employer allowed to take action even if a registered MM users. 4. Address in your policy: Basis of Policy, Prohibited Conduct, Consequences

32 Sample Policy Language BASIS OF POLICY: Company recognizes some state laws permit the use of marijuana either for medical or recreational purposes. However, the federal government continues to classify Marijuana as a Schedule I Controlled Substance, thereby making it illegal to use for any purpose under federal law.

33 Sample Policy Language PROHIBITED CONDUCT: Employees are prohibited from being under the influence of marijuana while at work or on company time as exhibited by a positive drug test result. Employees are prohibited from bringing marijuana or any marijuana- related paraphernalia to work or using marijuana while at work, including lunch breaks and other timeoff during an official work schedule.

34 Sample Policy Language CONSEQUENCES: Employees who test positive for marijuana, regardless of the reason for the use or the source from which the employee acquired the drug, will be considered in violation of this policy and subject to possible adverse employment action as outlined in the Disciplinary Procedures section of this policy.

35 HOW Test Methods Hair Urine Oral Saliva Sweat Blood Breath

36 Urine Instant/Rapid or Laboratory INSTANT / RAPID Pro s Negative result in 5+ minutes Lower cost Can be administered on-site INSTANT / RAPID Con s Quality of Device, False + / - Interpretation/Skill of Collector State Laws may prohibit Not accepted for DOT testing LABORATORY Pro s SAMHSA certified labs Results accurate Legally Sound DOT acceptable LABORATORY Con s Cost Results 24 hours + Only # of certified labs

37 Oral Saliva (rapid & lab) PRO s Non-invasive Can test anywhere Not expensive Great for Post Accident Testing or reasonable suspicion testing *Window of detectionimmediate CON s *Not accepted for federal testing or by BWC *Prohibited use by certain states *Limited window of detection (Immediate 32hours) *Small collection specimen limited drug detection

38 PRO s: Detects up to 90 days Can t be adulterated Tests for five + Panels Non-invasive CON s: Cost is higher than other methods Takes 4-7 business days for result Isn t approved for Federal Guidelines Hair Follicle (Lab)

39 New Drug Test Method Breath Journal of Breath Research, March 2013 Swedish researchers Detects 12 Substances: cocaine, amphetamines and marijuana High accuracy rate as compared to blood and urine Non-invasive Years of further development

40 UPDATE: What s Ahead for Federal Drug Testing Programs Written recommendations for Mandatory Guidelines: 1. Include lab-based oral fluid drug testing 2. Add additional Schedule II drugs (e.g. synthetic opiate/opioids) 3. Evaluation of the scientific supportability of the hair specimen Comment periods and review and evaluation of all comments Revised Guidelines 2014/2015 Implementation dates 2015/2016 DOT must go through its own rulemaking process in order to adopt/modify/implement DHS changes in the DOT-regulated testing programs

41 WHY The construction industry accounts for 5% of the gross national product but 20% of workplace accidents According to AGC and 14% of illicit drug users and heavy drinkers work in this Industry According to the US. Dept. of Labor 15% of all worker s compensation costs are spent on construction injuries According to NIOSH 65% of all work-related accidents involve substance abuse According to OSHA Absenteeism rate: 6 times higher Health According to 2006 National Survey on Drug Use &

42 Employee Education Tool Box Talks * Health Fairs * Drug Free Work Week

43 Supervisor Training on the Signs & Symptoms For Cause / Reasonable Suspicion Testing Drug and Alcohol Step 1 - OBSERVE Step 2 - DISCUSS Step 3 - DOCUMENT Step 4 - TAKE TO COLLECTION SITE

44 Employee Referral / Assistance The Mental Health Parity and Addiction Equity Act of 2008 Voluntary Confirmed Non-Negative Education/Meetings AA & NA * Out Patient (IOP) * * In Patient (detox) *

45 Third Party Administrator -TPA Not Labor Not Management Neutral Party Provides Credibility & Confidentiality

46 A TPA Will Support your organization by providing: * A dedicated Program Coordinator * On-line test Verifications 24/7 * Data exchange with Owners/TPA * SAMHSA certified laboratories * Certified Medical Review Officer * National network of testing facilities * Consolidated billing

47 Questions to Ask HR 1. When was our Substance Abuse Policy last reviewed? - Is it a single or multi-state policy - Is the drug panel current - Does it discuss synthetics, medical and/or recreational marijuana? 2. What type of employee / supervisor training is available? 3. What type of substance abuse treatment is available? 4. Who accepts our policy?

48 Q & A Thank You! mkarg@mobmed.com