1. TPS Alert – D&A Program Management January 2019

2. Agenda Drug & Alcohol Statistics TPS Alert Overview
Program Management & Benefits
Q & A

3. The US Opioid Epidemic

4. What are Opioids? Where do Opioids come from? Oxycodone Meperidine
Opioids are a class of drugs that include the illicit drug heroin, as well as prescription pain relievers like oxycodone, hydrocodone, codeine, morphine, fentanyl and others.
Where do Opioids come from?
Some opioids, such as morphine and codeine, occur naturally in opium. Opium is a substance collected from the seed pod of the opium poppy.
Other opioids, such as heroin, are made by adding a chemical to morphine. Today, many drugs in the opioid category don’t actually come from opium. Instead, they are made synthetically from chemicals.
Examples of opioids produced by pharmaceutical companies include:
Oxycodone
Meperidine
Hydrocodone
Hydromorphone
Percodan/Percocet
Demerol®
Tussionex®
Dilaudid

5. What are Opioids?
Prescription opioids come in various forms – tablets, capsules, syrups, solutions and suppositories. Opium comes in dark brown chunks or powder and is usually eaten or smoked. Heroin is usually a white or brownish powder.

6. Affects of Opioid Use How Soon do Opioid Drugs Start Affecting People?
Euphoria
Relaxation
Confusion
Drowsiness
Difficulty Concentrating
Constricted Pupils
How Soon do Opioid Drugs Start Affecting People?
The speed and intensity of the effects of opioids vary depending on how the drugs are taken. When taken orally, the effects come on gradually and are usually felt in about 10 to 20 minutes. When injected into a vein, the effects are most intense and are felt within a minute.
Although there are many factors, a single dose of opioids have symptoms that last for four to five hours.

7. Affects of Opioid Use on Drivers
Studies link opioid use to increased risk of driver fatalities, driver injury, crash risk and unsafe driver actions.
Impairment impacts tasks related to pertinent driving skills such as attention, vision, auditory perception and reaction time.
There is evidence to support the contention that use of opioids increases the risk of a motor vehicle crash.

8. 400% Opioid Prescriptions
80% of all opioids dispensed in the world are dispensed in the US.
Opioid use in the U.S. has increased 400% since 1999.
Almost 175 people die every day in the US from opioid-related deaths.

9. 2018 Federal Regulations Update

10. 2018 DOT Updates
The Department of Transportation added 4 semi-synthetic opioids to the required drug testing panel: hydrocodone, oxycodone, hydromorphone and oxymorphone.
Drugs Included in the DOT Panel:
Marijuana
Cocaine
Opioids
Amphetamines
PCP
The PHMSA random testing rate was increased to 50% for 2018.
As described in the Code of Federal Regulations, the increase for 2018 is a result of the 2017 positive rate being greater than one percent.
The positive rate would have to be lower than 1% for two consecutive years for the random percentage rate to be lowered back to 25%.

11. +141.7% Outcome of 2018 DOT Updates Marijuana +5.4% Cocaine -18.5%
The DOT Annual Percentage Change for MRO Positives from 2017 to 2018 by Drug:
Marijuana
+5.4%
Cocaine
-18.5%
Amphetamines
-14.9%
PCP
-54.2%
Opioids
+141.7%

12. Outcome of 2018 DOT Updates Operator Requirement Changes
Updated Non-DOT drug testing panel requirements to include expanded opioids.
Increased Non-DOT random drug testing percentage to 50%.
FMCSA Random Drug Testing Percentage Increase
Based on the increase of DOT Non-negatives seen in 2018, it is projected that the FMCSA random drug testing rate will be increased to 50%.
Drug Testing Price Increase
Drug testing panels that include expanded opioids (DOT and Non-DOT) are more expensive due to increased Lab and MRO fees.

13. Opioid Use in the Workplace and How to Handle

14. Abuse in the Workplace
Approximately 23% of the U.S. workforce has used opioids non-medically.
When people are injured on the job, approximately 75% are prescribed an opioid.
The National Safety Council polled 1,014 adults and 427 reported having been prescribed an opioid painkiller within the last three years.
Nearly half of users participated in a potentially unsafe activity while using an opioid:
39% went to work on opioids
35% drove a vehicle for work on opioids
14% operated heavy machinery on opioids

15. Employee Education
Work to educate your employees about the substantial risks associated with opioid use.
Medication education policies should be communicated repeatedly at orientation, training and safety meetings.
Take the time to educate your employees about how these drugs can affect them, their body, mind, workplace, family and community.
Encourage your employees to work with their doctors to use non-opioid pain medicines whenever possible.
Medications & Safety Training for Employees
Drug & Alcohol Awareness for Employees
Drug-Free Workplace Training for Employees
DOT Awareness Training for Employees

16. Supervisor Training It’s important for managers to:
Understand the state and federal laws regarding prescription drug use at work.
Be current on your workplace policies for prescription drug use.
Understand potential signs of impairment.
Understand your organization’s definition of reasonable cause for drug testing.
Know your company’s policies and processes for workplace drug testing.

17. Drug & Alcohol Statistics

18. Drug & Alcohol Statistics
Workforce drug positivity at highest rate in a decade
Prescription opioid testing implemented for workers covered under DOT
Cocaine positivity increased 11% in federally mandated, safety-sensitive workforce
Heroin declined in the general U.S. workforce to a three-year low
Marijuana positivity increased 8% in the safety-sensitive workforce

19. Drug & Alcohol Statistics

20. Drug & Alcohol Statistics

21. TPS Alert Overview

22. About Us Our Beginnings: Our Locations:
Our company was founded over 20 years ago by a regulatory attorney who specialized in managing DOT-mandated drug & alcohol testing for transportation clients.
Our services evolved to also include full drug & alcohol program management, which is still conducted today by our sister company, TEAM Professional Services.
We began monitoring contractor drug & alcohol compliance through TPS Alert based on TEAM client needs.
Our Locations:
Headquartered in Tulsa, OK and an additional office in Oklahoma City, OK with clients and contractors nationwide.

23. Services
TPS Alert provides comprehensive audits and ongoing monitoring to confirm your contractors are:
Completing drug testing at the required intervals (i.e. pre-employment, post-accident, random, return-to-duty, reasonable suspicion)
Testing in accordance with federal (DOT) and Client-specific (Non-DOT) requirements including drug panel and random testing percentages
Using an HHS certified lab
Using a certified Medical Review Officer (MRO)
Prohibiting employees with positive test results from accessing your jobsites or following necessary protocols for employees allowed to return

24. Program Management & Benefits

25. Contractor Benefits Proactive Program Management
Access to experts in drug testing, policy development and program management
Visibility on year-to-date testing progress and compliance
Centralized location to review and manage operator requirements
Efficient roster management
DOT audit information
Reasonable Suspicion training
Simplified Process
Electronic enrollment & document management
No requirement for specific Third Party Administrator (TPA)
Competitive Advantage
Ability to export compliance status
Established compliance leads to increased operator exposure
Contractor Support
Operator-specific account managers provide dedicated customer service

26. TPS Alert – D&A Program Management January 2019