A Presentation by Bill Current and Judy Swartley

Making a Case for Lab-based Oral Fluid Drug Testing In the Construction Industry
A Presentation by Bill Current and Judy Swartley Sponsored by OraSure Technologies CurrentSwartleyWebinarInterceptConstruction0113 Item# INT0236 rev. 01/13

Our Webinar Sponsor: OraSure Technologies
OraSure Technologies is the maker of the Intercept Oral Fluid Drug Test, a lab-based oral fluid testing system that was ranked as the #1 recognized brand name in oral fluid testing in a national drug testing industry survey. For More Information go to: Or Call: 800-ORASURE CurrentSwartleyWebinarInterceptConstruction0113

Bill Current Founded WFC & Associates, LLC in 1998
Author of 10 books, including: “Why Drug Testing?” Publisher of the On-Line Ultimate Guide to State Drug Testing Laws at StateDrugTestingLaws.com and the publisher of the e-newsletter “State Drug Testing Laws Monthly” Director of the Annual Survey of Drug Testing Industry Trends (now in its 15th year) Former Executive Director of the American Council for Drug Education, Director of the Institute for a Drug-Free Workplace, and Vice President of Consulting for a national third-party administrator CurrentSwartleyWebinarInterceptConstruction0113

Judy Swartley Judy Swartley is the president of Red Plant Substance Abuse Testing, Inc., a leading provider of drug and alcohol testing services to many industries, including the construction industry. She has been involved with substance abuse testing since 2000. Served as the Safety Director at a mid-size contracting business, worked in heavy manufacturing as the QC Manager of a 4,200 person facility of Honeywell, Inc., Has taught at Lehigh University and Penn State University. CurrentSwartleyWebinarInterceptConstruction0113

Substance Abuse In the Construction Industry
There are more than 5.5 million workers in the Construction Industry as of December 2012. (Source: In , the federal government estimated that 13.7% of full-time Construction Workers were current substance abusers... That was more than 840,000 full-time employees which today reflects approximately 750,000 employees. (Source: Nearly 16% of the full-time workers in the Construction Industry admitted to being heavy alcohol users... approximately 874,000 in today’s industry. CurrentSwartleyWebinarInterceptConstruction0113

A study conducted by a Cornell University graduate student found that construction laborers between 25 and 34 years of age who have been treated for substance abuse have a time-loss injury rate of 23.6 per 100 full-time equivalent workers (FTEs). That’s nearly double the rate of non-substance abusers, who had a rate of 12.2 FTEs. The study concluded that the difference between the known substance abusers and the non-substance abusers is “likely understated.” The study observed that: “Injuries were counted as related to substance abuse only after substance abuse was diagnosed, yet 1/3 of the substance abusers’ work-related injuries occurred before diagnosis.” The study only tracked workers on union jobs and only substance abusers treated in programs paid for by union health insurance.” (Source: Pollack, E. etal. Risk of Job-Related Injury Among Construction Laborers With a Diagnosis of Substance Abuse, Journal of Occupational & Environmental Medicine; June 1998, Vol. 40(6), pp ) CurrentSwartleyWebinarInterceptConstruction0113

Consider the undercover study by the GAO (GAO T) that revealed significant vulnerabilities in DOT’s urine drug testing program. What the GAO found was that: The DOT’s urine drug testing program is vulnerable to manipulation by drug users, especially given the wide availability of products designed to defeat drug tests. Products could easily be brought into a collection site and used during a test. Investigators were able to substitute synthetic urine for their sample. Every drug masking product went undetected by the drug screening labs CurrentSwartleyWebinarInterceptConstruction0113

Drug Testing Works! Drug testing has proven to be a powerful weapon in the war on workplace drug abuse. After implementation many companies experience a decrease in the key indicators of employee substance abuse such as accidents, workers’ compensation claims filed, usage of health care benefits, lost productivity due to absenteeism and excessive tardiness, and incidents of employee theft and workplace violence. Drug testing deters drug use and helps identify people who need help. But there are many different ways to conduct drug testing. There are alternatives available worth considering. Which is right for you? CurrentSwartleyWebinarInterceptConstruction0113

Alternative to What? Traditional lab-based urine testing…
Collect a urine specimen Transport it to a lab The lab conducts a preliminary screen of the sample If the result is non-negative the lab conducts a confirmation test If the result is confirmed positive a medical review officer (MRO) attempts to verify it Once the result is verified one way or the other it is reported to the employer according to applicable law CurrentSwartleyWebinarInterceptConstruction0113

Lab-based Oral Fluid Testing
Lab-based oral fluid testing is growing in popularity for several reasons: It’s not urine It’s nearly impossible to cheat on It reduces the time it takes to conduct a drug test It renders an accurate lab-based result CurrentSwartleyWebinarInterceptConstruction0113

What the Experts Are Saying About Oral Fluid?
“I am seeing an increase in oral fluid testing but not hair testing.” “We’re seeing more interest in oral fluids because it addresses collection costs and logistical issues… we have to look at profits, not revenue.” “Yes, and it has been going on for the last 5 years… clients care more and more about what will work for them.” “We’re seeing more combinations… oral fluid for post accident and urine for pre-employment.” Source: Annual Drug Testing Industry Report by WFC & Associates CurrentSwartleyWebinarInterceptConstruction0113

Common Myths Related to Lab-based Oral Fluid Testing
Lab-based Oral Fluid Testing Is Not Accurate The Window of Detection Is Too Short to Detect Drugs Marijuana Cannot Be Detected with Lab-based Oral Fluid Testing Lab-based Oral Fluid Testing is Just As Susceptible to Cheating as Urine Lab-based Oral Fluid Testing Is Illegal In Most States Lab-based Oral Fluid Testing Is Too Expensive Lab-based Oral Fluid Testing Is Not As Efficient As Urine Testing Lab-based Oral Fluid Testing is not FDA Cleared Making the Switch Is Too Complicated CurrentSwartleyWebinarInterceptConstruction0113

Common Myths Lab-based Oral Fluid Testing Is Not Accurate
The Window of Detection Is Too Short to Detect Drugs Marijuana Cannot Be Detected with Lab-based Oral Fluid Testing Lab-based Oral Fluid Testing is Just As Susceptible to Cheating as Urine Lab-based Oral Fluid Testing Is Illegal In Most States Lab-based Oral Fluid Testing Is Too Expensive Lab-based Oral Fluid Testing Is Not As Efficient As Urine Testing Lab-based Oral Fluid Testing is not FDA Cleared Making the Switch Is Too Complicated CurrentSwartleyWebinarInterceptConstruction0113

Is Lab-Based Oral Fluid Testing Accurate?
The results of lab-based oral fluid testing may have greater relevance to understanding the effects of drug abuse and assessing an individual’s behavior, job performance, and safety risk than the results from urine testing. The presence of drugs in oral fluid is usually related to the amount of drugs in the bloodstream at the time of the sample collection. Oral Fluid provides a blood equivalent result Oral Fluid tests for the parent drug and not just a metabolite, making it possible to detect recent drug use more accurately than urine, which typically detects only metabolites Advances in oral fluid testing and collection technology are making it possible to more accurately quantify drug test results Source:E.J. Cone. Oral fluid testing: New technology enables drug testing without embarrassment. CDA Journal. 34: (2006). CurrentSwartleyWebinarInterceptConstruction0113

Accuracy… How to know if a product is accurate…
Independent, empirical data (publications) FDA cleared (for lab-based products) History of satisfied customers (ask for referrals) Your own internal research Put the package insert information to the test Know who you’re doing business with CurrentSwartleyWebinarInterceptConstruction0113

Detection Times Drug transfer to oral fluid from blood occurs as long as the drug is in the bloodstream, thus detection times start within minutes of ingestion and continue for as long as the drug remains in the bloodstream. Drug detection by lab-based oral fluid testing is as effective as urine testing over a comparable time period. Window of detection is affected by many factors regardless of the specimen being tested Every drug has its own unique window of detection Each specimen type has its own unique ability to reveal the presence of a particular drug Source:E.J. Cone. Oral fluid testing: New technology enables drug testing without embarrassment. CDA Journal. 34: (2006). CurrentSwartleyWebinarInterceptConstruction0113

Common Myths The Window of Detection Is Too Short to Detect Drugs

WOD for Various Matrices
Source:E.J. Cone. Oral fluid testing: New technology enables drug testing without embarrassment. CDA Journal. 34: (2006). CurrentSwartleyWebinarInterceptConstruction0113

Is the Window of Detection Too Short?
Generally, lab-based oral fluid and urine provide comparable positivity rates. Oral fluid can pick up drugs early on which urine will miss; urine can sometimes pick up positive results longer which oral fluid will miss… but on balance, cut- off levels developed for oral fluid produce similar positive rates when compared to urine. Source:E.J. Cone. Oral fluid testing: New technology enables drug testing without embarrassment. CDA Journal. 34: (2006). CurrentSwartleyWebinarInterceptConstruction0113

Is the Window of Detection Too Short?
Source:R.H.B. Sample, L.B. Abbott, B.A. Brunelli, R.E. Clouette, T.D. Johnson, R.G. Predescu, and B.J. Rowland. Positive prevalence rates in drug tests for drugs of abuse in oral-fluid and urine. Society of Forensic Toxicologists (SOFT) Annual Meeting (2010). CurrentSwartleyWebinarInterceptConstruction0113

Common Myths Lab-based Oral Fluid Testing Is Not Accurate The Window of Detection Is Too Short to Detect Drugs Marijuana Cannot Be Detected with Lab-based Oral Fluid Testing Lab-based Oral Fluid Testing is Just As Susceptible to Cheating as Urine Lab-based Oral Fluid Testing Is Illegal In Most States Lab-based Oral Fluid Testing Is Too Expensive Lab-based Oral Fluid Testing Is Not As Efficient As Urine Testing Lab-based Oral Fluid Testing is not FDA Cleared Making the Switch Is Too Complicated CurrentSwartleyWebinarInterceptConstruction0113

Can Marijuana Be Detected In Oral Fluid?
The short answer is YES! But there’s a little more to it than that. CurrentSwartleyWebinarInterceptConstruction0113

Factors to Consider… Typically, marijuana is detectable through oral fluid testing within an hour, if not immediately, after the use of the drug. Cut-off levels being used have a huge impact on the detection of marijuana. Testing method also plays a role: lab-based vs. POCT Lab-based oral fluid testing provides a longer window of detection than current POCT devices on the market, especially with respect to marijuana. This is due to cut- offs for POCT devices being higher than lab-based oral fluid tests. CurrentSwartleyWebinarInterceptConstruction0113

THC and the Window of Detection
Source: Quest Diagnostics. Data on File. CurrentSwartleyWebinarInterceptConstruction0113

Common Myths Lab-based Oral Fluid Testing Is Not Accurate
The Window of Detection Is Too Short to Detect Drugs Marijuana Cannot Be Detected with Lab-based Oral Fluid Testing Lab-based Oral Fluid Testing is Just As Susceptible to Cheating as Urine Lab-based Oral Fluid Testing Is Illegal In Most States Lab-based Oral Fluid Testing Is Too Expensive Lab-based Oral Fluid Testing Is Not As Efficient As Urine Testing Lab-based Oral Fluid Testing is not FDA Cleared Making the Switch Is Too Complicated CurrentSwartleyWebinarInterceptConstruction0113

Is Lab-based Oral Fluid Testing Just as Susceptible to Cheating as Urine Testing?
Lab-based oral fluid is very difficult to adulterate Lab-based oral fluid collections take place in the presence of both the donor and the administrator of the test Typical cheating methods such as switching samples or adding something to a sample are virtually impossible to successfully pull off… even if a product existed that could mask the presence of drugs in saliva A search of the Internet will find thousands of hits for cheating on a urine drug test… only a handful for oral fluid testing CurrentSwartleyWebinarInterceptConstruction0113

Advice for cheating an oral fluid drug test…
One of my favorite websites for oral fluid drug test cheating is wikihow.com/pass-a-drug-test. Quoting directly from the website: “Try to avoid the test. If one is being tested and has used in the past 3 days you will need to overcome the saliva collection. To do this you will have to avoid submitting saliva and perform the steps requested of you by the instructor.” Another offers this advice: “To pass this [an oral fluid test] you should always know the detection time of the drug you have taken. Marijuana can be detected via saliva drug testing from an hour after ingestion up to 24 hours depending on use. Between these periods of time, you must avoid being screened or you will surely test positive.” CurrentSwartleyWebinarInterceptConstruction0113

Cheaters Love Urine Testing?
Drug test cheating is a major concern because urine testing is particularly susceptible to adulteration, tampering and substitution. Efforts to combat drug test cheating in urine add to the cost of drug testing, infringe further upon the privacy of donors, and can further reduce the efficiency of drug testing thus reducing the ROI hoped for from drug testing. Lab-based oral fluid testing virtually eliminates concerns about drug test cheating. Every oral fluid collection can be observed, thus making it impossible for someone to tamper with the specimen. CurrentSwartleyWebinarInterceptConstruction0113

Case Study: Iowa DOC CurrentSwartleyWebinarInterceptConstruction0113

Common Myths Lab-based Oral Fluid Testing is not FDA Cleared

Is Lab-based Oral Fluid Testing FDA Cleared?
FDA clearance means the FDA has examined a product to ensure it is “substantially equivalent” to a device that is already legally marketed for the same use. FDA clearance is a critical issue when considering any testing method that involves self-administering collections and especially analysis as in the case of POCT. You should consider both the collection device and the lab testing system when looking for FDA clearance… in other words, has the FDA cleared each of the assays you’re testing for in the lab? The OraSure Intercept® device is the only FDA-cleared, lab- based testing system that can detect Amphetamine, Methamphetamines (including Ecstasy), Cocaine, THC, Opiates, PCP, Methadone, Barbiturates and Benzodiazepines Source: Data on File at OraSure Technologies, Inc. CurrentSwartleyWebinarInterceptConstruction0113

Common Myths Making the Switch Is Too Complicated
Lab-based Oral Fluid Testing Is Not Accurate The Window of Detection Is Too Short to Detect Drugs Marijuana Cannot Be Detected with Lab-based Oral Fluid Testing Lab-based Oral Fluid Testing is Just As Susceptible to Cheating as Urine Lab-based Oral Fluid Testing Is Illegal In Most States Lab-based Oral Fluid Testing Is Too Expensive Lab-based Oral Fluid Testing Is Not As Efficient As Urine Testing Only FDA Cleared Devices Can Legally Be Used Making the Switch Is Too Complicated CurrentSwartleyWebinarInterceptConstruction0113

Is It Too Difficult to Switch to Lab-based Oral Fluid Testing?
Identify drug testing objectives Update policy Determine method of collection Train supervisors Ensure vendors are set up Set up confirmation testing Announce the program to all employees CurrentSwartleyWebinarInterceptConstruction0113

Source: Case Study, Data on File at OraSure Technologies, Inc.
One Company’s Story Grocery store chain (good correlation to the construction industry) Distribution facilities and manufacturing plants plus 30+ stores 1,500 oral fluid test results were compared with 1,500 urine test results Source: Case Study, Data on File at OraSure Technologies, Inc. CurrentSwartleyWebinarInterceptConstruction0113

Lab-based Oral Fluid Positives
One Company’s Story Drug Urine Positives Lab-based Oral Fluid Positives Cocaine 7 19 Methamphetamines 1 4 Marijuana 23 56 Overall rate 2.06% 5.27% Source: Case Study, Data on File at OraSure Technologies, Inc.

Cost Savings Collection (costs range from $8-$25) Negotiating collection fees varies (but with lab-based oral fluid testing professional services are not needed and the expense can be eliminated) Retesting rate is high when challenged because the collection site is not typically well known Low creatinine policy… led to1,677 retests in one year at a cost of $35,284 Source: Case Study, Data on File at OraSure Technologies, Inc. CurrentSwartleyWebinarInterceptConstruction0113

Cost Savings Time Away from Work (TAFW) 52% were away from work between minutes and 38% were away more than an hour 6.5 minutes of management time involved in coordinating each test 5 more minutes of staff administrative time for each test Source: Case Study, Data on File at OraSure Technologies, Inc. CurrentSwartleyWebinarInterceptConstruction0113

Cost Savings Total administration time for each test equaled 11 minutes Cost per area of operation: Retail $7.73 Facilities $13.73 Manufacturing $12.43 Warehouse $12.90 Source: Case Study, Data on File at OraSure Technologies, Inc. CurrentSwartleyWebinarInterceptConstruction0113

Cost Savings 98% of 776 employees with random lab-based oral fluid tests were away from the job less than 15 minutes. Admin time away from the job averaged 5-10 minutes Source: Case Study, Data on File at OraSure Technologies, Inc. CurrentSwartleyWebinarInterceptConstruction0113

Cost Savings Lab-based oral fluid versus urine savings of… $5.57 per test saved in retail stores $9.90 per test saved in in facilities $8.96 per test saved in in manufacturing plants $9.30 per test saved in in warehousing locations Total savings of $32,473 in payroll expense from 776 tests Extrapolate out….~$250K per year savings Source: Case Study, Data on File at OraSure Technologies, Inc. CurrentSwartleyWebinarInterceptConstruction0113

Who Might Consider Lab-based Oral Fluids?
Construction companies that do not currently conduct drug testing because lab-based urine testing has always been unacceptable for a variety reasons including high turnover volume, large single-event hiring situations, worksites without secured rest rooms, cost, etc. CurrentSwartleyWebinarInterceptConstruction0113

Construction companies that have conducted drug testing for several years and must now justify the expense of maintaining a program. As a result, they are searching for ways to streamline their programs and improve their overall return on investment. CurrentSwartleyWebinarInterceptConstruction0113

Companies located in rural areas, that operate late night and weekend shifts, or that work in safety- sensitive industries where the use of conventional off-site collection services is impractical, inconvenient, too expensive or non-existent all together. CurrentSwartleyWebinarInterceptConstruction0113

Industries That Like Lab-based Oral Fluid Testing…
Construction Manufacturing Hospitality Retail Staffing Occupational health centers …as well as probation and parole institutions, prisons, drug courts, schools and other non-workplace markets. CurrentSwartleyWebinarInterceptConstruction0113

Advantages of Lab-based Oral Fluid Testing
Takes just 5 minutes to conduct the test Results are available within 24 hours via the Internet Virtually adulteration proof Eliminates shy bladder issues or dilution issues Flexible….sample can be collected anytime, anywhere Legal in 48 states Legally defensible as technology is widely considered reliable Scientifically accurate A more accurate method to measure “recent” use CurrentSwartleyWebinarInterceptConstruction0113

Advantages of Lab-based Oral Fluid Testing
Easy to administer and often preferred by those who administer tests Gender collector issues are eliminated Observed collections can occur with every test creating trust in the process Collection process is not embarrassing for the donor Eliminates the need for the myriad precautions needed with urine testing Eliminates the “yuck” factor commonly associated with urine testing CurrentSwartleyWebinarInterceptConstruction0113

Return on Investment Comparing traditional lab-based urine testing with lab-based oral fluid testing reveals some very interesting contrasts. For example: One method takes less time to conduct than the other One method does not require professional collection services One method costs less overall CurrentSwartleyWebinarInterceptConstruction0113

Lab-based Oral Fluid vs. Lab-based Urine
Let’s compare some “hard” costs associated with drug testing for both methods: Lab-based Urine Drug Test Cost Per Test Price End-User Pays for Collection $15.00 $0.00 Price End-User Pays for Lab Analysis $18.00 $25.00 Confirmation Price Built Into the Lab Analysis Fee MRO Fee (positive & negative) $5.00 Price Paid by Customer for Lab-base Urine Test $38.00 $30.00 CurrentSwartleyWebinarInterceptConstruction0113

Now, let’s look the “soft-dollar” costs directly related to each drug testing method: Lost-Work Time (Worker Hourly Rate x 1.5 Hours for Urine and .25 Hours for Oral Fluid) $10.10 $15.15 $2.53 Lost-Work Time (Fringe Rate of 40% x 1.5 Hour) $0.00 Lost Work Time (Supervisor Hourly Rate x 1.5 Hours for Urine and .25 Hours for Oral Fluid) $24.00 $36.00 $6.00 Lost-Work Time (Fringe Rate 40% x 1.5 Hour) Total Cost of Lost Work Time $51.15 $8.53 CurrentSwartleyWebinarInterceptConstruction0113

When we add worker time and/or supervisor time (lost productivity) we discover the true cost of a drug test: Even if the buyer is receiving aggressive pricing on lab-based urine testing, the cost is close to, or even lower when all parameters of testing are factored in for oral fluid testing comparisons. Total Cost of Lost Work Time $51.15 $8.53 Price Paid for Drug Test $38.00 $30.00 Actual Cost of Lab-based Urine Drug Test $89.15 $33.53 CurrentSwartleyWebinarInterceptConstruction0113

OraSure… Intercept ® Intercept® Oral Fluid Collection Device
Oral Fluid Drug Assays Used in laboratory CurrentSwartleyWebinarInterceptConstruction0113

Benefits of OraSure Technologies’ Intercept®
10+ Years Proven Performance More than 15 million samples tested with a proven track record of reliability, accuracy and quality service. The ONLY lab-based saliva test on the market with this much history. #1 recognized brand name for oral fluid drug testing. Scientifically Proven The ONLY oral fluid collection device that is FDA-cleared for 9 assays. Legally Proven Intercept has been upheld in multiple court cases in workplace, criminal justice and family courts. CurrentSwartleyWebinarInterceptConstruction0113 52

Benefits of OraSure Technologies’ Intercept®
Direct Observed Collections Very difficult to cheat on the result. No third party collection site. Quick and Convenient The oral fluid collection takes no more than 5 minutes to complete, and it also eliminates the ‘shy bladder’ challenge. Negative results are reported by the next afternoon if the specimen was shipped the prior evening, positive results within hours No Special Training or Certification OraSure provides training; there is no regulatory certification required. CurrentSwartleyWebinarInterceptConstruction0113 53

Intercept® Lab-based Oral Fluid Drug Testing
For More Information on the Intercept Oral Fluid Drug Test and how it can help in your drug testing program go to: Or Call: 800-ORASURE CurrentSwartleyWebinarInterceptConstruction0113

A Presentation by Bill Current and Judy Swartley

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