1. Workplace Drug and Alcohol Testing
Kim Hanlon, M.D., MRO; Medical Director
Corporate Care; Conemaugh Health System
Duke Lifepoint

2. Workplace Drug and Alcohol Testing:
What it does for the employer…
What it does not do for the employer…

3. Brief History of Testing
What is an MRO?
Federal Testing
Non-Federal Testing
Still with the state, local and worker’s compensation law must be considered

4. Employer Responsibilities
A solid policy and procedure
Employee and supervisor training
A Designated Employer Representative (DER)
“Standing Down”
Recordkeeping
Consortiums and Third Party Administrators (TPAs)

5. Specimen Collection: Types of Testing
Pre-employment
Random
Reasonable Suspicion/ “For Cause”
(DOT mandated Supervisor Training)
Return to Duty
Follow-up
Post Accident (recent OSHA guideline)

6. Specimen Collection: Types of Specimens
Urine to lab for drug testing
Hair to lab for drug testing
Urine (instant drug test at collection site)
Saliva (instant drug test at collection site)
Alcohol (breath or saliva at collection site)

7. The Collection Process
Workplace testing requires
ID verified
Chain of Custody
Urine drug sample validity testing
Temp. at site
PH, Specific Gravity and identification of adulterants by lab
Shy Lung/ Shy Bladder

8. What Can a Donor Do to Their Urine?
Dilute It
Adulterate It
Substitute It

9. Urine Drug Test Results Prior to MRO Review
Instant-False Positives
Lab Results
Positive (Scheduled Prescriptions and Illegal Drugs)
Dilute
Adulterated
Substituted
Invalid
Rejected for Testing
If you aren’t going to use an MRO, know what to do with each of these.

10. Urine Drug Test Results After the MRO Review
Negative/Negative Dilute
Positive/Positive Dilute
The drug can be listed
Adulterated/Substituted
These are both refusal to test
Cancelled
Invalid or Fatal Flaw on collection
Negative but recommend a fitness for duty evaluation for safety sensitive work, new DOT five day rule.

11. THE DRUGS
Stimulants
Depressants (Alcohol)
Hallucinogenic

12. STIMULANTS; Amphetamines Bath Salts Cocaine
Methamphetamine, MDMA, MDA, MDEA
Bath Salts
Cocaine

13. DEPRESSANTS; Alcohol Barbiturates Benzodiazepines Marijuana
Synthetic Cannabinoids (K2, Spice)
Methaqualone
Opioids: Codeine, Morphine Heroin
Synthetic Opioids: Oxycodone, Oxymorphone, Hydrocodone, Hydromorphone, Methadone, Buprenorphine and Fentanyl

14. HALLUCINOGENICS
LSD
Most of the drugs listed as stimulants and depressants can have hallucinogenic effects depending on the dose and the situation!

15. What To Do With A Non-Negative Test Result?
Termination (Non-Federal)
Referral to Substance Abuse Professional (SAP)
Return to Work
Follow-Up Testing

16. Medical Marijuana in Pennsylvania