1. Drug Testing Best Practices
Presented by:
Ben Johnson
Vice President
Fleet Screen, Ltd.

5. Identifying and responding to substance abuse:
Helps prevent the hiring of illegal substance abusers when pre- employment drug testing is required.
Helps deter current employees from on-the-job substance abuse.
Provides assistance in helping employees recover from abuse.
Provides a safer workplace for all employees and customers.  
Reduces workers compensation premiums.

6. Statistics to Support Testing
You can’t afford not to drug test
According to the 2010 National Survey on Drug Use and Health
8.4 percent of full-time employees (10.2 million) and 10.1 percent of part-time employees (3 million) aged 18 or older reported using illicit drugs within the prior month of the study.
• Employees who use drugs are 2.5 times more likely than other non-abusing co-workers to be absent for 8 or more days.
• Drug abusers are 3.6 times more likely to be involved in an accident at work and 5 times more likely to file a workers’ compensation claim.
• 44 percent of abusers have sold drugs to other employees, and 18 percent have stolen from co- workers to support their habit. Studies suggest that substance abuse—which includes drugs and alcohol—costs the United States an estimated $276 billion a year, with much of the cost resulting from lost productivity and increased healthcare spending.

7. Statistics (Continued)
Studies suggest that substance abuse—which includes drugs and alcohol—costs the United States an estimated $276 billion a year, with much of the cost resulting from lost productivity and increased healthcare spending.
Studies have shown that substance abusing employees function at about
67% of their capacity.
BOTTOM LINE:
Substance use can pose significant risks to workers’ health and productivity, which in turn, costs you more

8. Check the Statistics
It is untrue that most drug users are poor or unemployed.
About 10 million regular drug users went to work this morning in the US.

9. Results from the 2010 National Survey on Drug Use and Health

10. Alcohol Abuse Statistics

11. Benefits of Drug Testing
Drug testing programs aim to filter out drug users from your workforce as well as to deter drug use on the job.
According to data from the National Survey on Drug Use and Health, past- month illicit drug users said: They would be less likely to apply for a company that conducted pre-employment drug testing than one with no testing program.
Reported they would be far less likely to work for employers that conduct random drug testing compared to those reporting no current illicit drug use (29.1 percent of past-month illicit drug users versus 6.9 percent of non- users).

12. More Benefits
Drug testing programs improve employee morale and productivity; decrease absenteeism, accidents, downtime, turnover and theft; and lead to better health among employees and family members as well as decreased use of medical benefits.
Organizations with drug-free workplace programs sometimes qualify for state government incentives or workers’ compensation insurance premium discounts.

13. Company Policy as the Cornerstone of your Testing Program
At a minimum, an effective corporate drug and alcohol policy should include the following:
An opening statement that effectively describes the reason for testing “a Drug Free Workplace is essential for the safety of our employees”
Identify the Program Administrator.
Identify the employees subject to testing. (Safety Sensitive or all)
Employee compliance with policy is mandatory for continued employment.
Identify the drugs that will be tested.

14. Company Policy (Continued)
Describe what is considered prohibited conduct (i.e. showing up for work under the influence or having drugs on their person)
Types of Tests (Pre-employment, Random, Post Accident, etc.)
Testing Procedures that will be utilized. (Specimen Collection, Lab Testing, Medical Review).
What constitutes a Refusal to Test.
Disciplinary Action.
Review of state laws.
Signed Acknowledgement of Receipt.

15. Drug-Free Workplace Policy
Policy exists to:
Protect the health & safety of all employees, customers and the public
- Safeguard employer assets from theft and
destruction
- Protect trade secrets
- Maintain product quality, company integrity and reputation
- Comply with the Drug-Free Workplace Act of and/or any other applicable laws

16. Testing Procedures

17. Drug Testing (Urinalysis)
Urine is the most common testing method. It detects recent or new drug use, typically in the previous one to three days.
Urine testing is suitable for all testing reasons— from pre-employment to random to post-accident — and can be used to detect a wide variety of illicit and prescription drugs.
Both Lab Based and Rapid Test cup methods.
Currently, urine testing is the only method approved for federal, safety- sensitive workers.

18. Urine Drug Testing Pro’s & Con’s
ADVANTAGES
EXTENSIVE SCIENTIFIC BASE AND RESEARCH
ACCURATE AND RELIABLE
TECHNOLOGY HAS BEEN IN PLACE FOR YEARS
GC/MS Testing has been upheld in Supreme Court case
DISADVANTAGES
EASY TO ADULTERATE
SUBSTITUTION & DILUTION IF COLLECTION PERSONNEL NOT VIGILANT.
COLLECTION ISSUES
TESTING MAY NOT CORRELATE WELL WITH LEVELS OF IMPAIRMENT

19. Drug Testing (Oral Fluid)
Oral fluid is the second most utilized screening method and it detects recent drug use in the previous hours.
Employers typically collect a oral fluid specimen under the direct observation of the test administrator which reduces the likelihood of donor tampering.
Can be used as Lab based testing or Rapid Drug Test Swab.

20. Oral Fluid Test Advantages
EASY SPECIMEN TO OBTAIN
SPITTING OR SWABBING
EASILY OBSERVED COLLECTION
DIFFICULT TO ADULTERATE OR DILUTE
CORRELATION BETWEEN DRUG CONCENTRATION AND IMPAIRMENT
MAY BE USEFUL IN DETECTING VERY RECENT DRUG USE

21. Oral Fluid Test Disadvantages
INDIVIDUAL VARIATIONS IN THE RATE OF SALIVA PRODUCTION
REQUIRES CLOSE ATTENTION DURING COLLECTION PROCESS TO ENSURE SAMPLE COLLECTION
NARROW WINDOW OF DETECTION
LIMITED NUMBER OF DRUGS FOR TESTING.

22. Drug Testing (Hair) Has been around since 1979.
Hair testing continues to gain broader appeal as it provides a longer detection window, giving a drug-use history that shows a pattern of repetitive use as far back as 90 days.
Hair testing yields the benefit of an observed collection that is not easily adulterated.
With hair testing, a candidate’s efforts to prepare for a drug test, either by stopping their drug use or cheating with adulterants or substitution, are not as effective.

23. Hair Testing Advantages
LONG TIME WINDOW FOR DRUG DETECTION
EASY TO COLLECT, HANDLE AND STORE
SAMPLE IS CUT, GROUND UP THEN WASHED WITH WATER AND/OR SOLVENTS. EXTRACTION AND PURIFICATION PROCESS PRECEDES ASSAY
STORAGE IS AT ROOM TEMPERATURE (NO NEED TO REFRIGERATE OR FREEZE PATIENT SAMPLES)
SECOND COLLECTION CAPABILITY
NONINVASIVE
BEATING THE TEST MAY BE DIFFICULT

24. Hair Testing Disadvantages
WILL NOT DETECT RECENT USE
ENVIRONMENTAL CONTAMINATION IS A POSSIBLE PROBLEM
DOSE/TIME RELATIONSHIPS ARE NOT WELL ESTABLISHED
LIMITED NUMBER OF DRUGS TO TEST.
INFLUENCE OF HAIR COLOR AND TEXTURE ON TEST RESULTS
STUDY BY GYGI ET AL IN 1997 FOUND THAT PIGMENTED HAIR IN VARIOUS SPECIES OF RATS INCORPORATED 3 – 44 TIMES THE AMOUNT OF CODEINE THAN NON-PIGMENTED RATS,EVEN IN THE SAME RAT. THERE WERE LARGE DIFFERENCES SEEN FOR MORPHINE AND NORCODEINE. HOWEVER, PHENOBARBITAL WAS FOUND IN THE SAME CONCENTRATION IN PIGMENTED AND NON-PIGMENTED HAIR.

25. 9-Panel Drug Test Amphetamines(dexedrine, adderall) Cocaine
Cannabanoids (marijuana)
Opiates (heroin)
Phencyclidine (PCP)
Barbituates (seconal)
Benzodiazepines (valium, xanax, klonopin)
Methadone
Propoxyphene (narcotic pain relievers)

26. URINE SPECIMEN 9-PANEL TEST
Analyte Cutoff Cutoff
Amphetamines ng/mL ng/mL
Cocaine Metabolite ng/mL ng/mL
Marijuana Metabolite ng/mL ng/mL
Opiates ng/mL ng/mL
Phencyclidine ng/mL ng/mL
Barbiturates ng/mL ng/mL
Benzodiazepines ng/mL ng/mL
Methadone ng/mL ng/mL
Propoxyphene ng/mL ng/mL

27. Post Accident Drug Testing
Studies have shown drug dependent workers have % more accidents on the job!
47% of all serious workplace accidents have drug or alcohol involvement!
Drug dependent workers use twice the amount of healthcare benefits!
Drug dependent workers are 5 times more likely to file a worker’s comp. claim!
Drug dependent workers are 16 times more likely to be absent from work!

28. Post Accident Testing (Con’t)
Post-accident testing immediately following an accident can help determine whether drugs were a factor.
Employers should establish objective criteria for performing post-accident testing.
It is recommended that post-accident testing be done appropriately with urine or oral fluid testing within 12 hours of the incident, since substances remain in a person’s system for different amounts of time.

29. Testing after an Accident, proceed with caution.
If you are not required by law or contractual Agreement it is recommend to carefully reconsider testing under the following conditions:
When there is bodily injury to someone outside of your organization.
When there is property damage to a third party.

30. Alcohol on the Job
Most workplace alcohol policy violations do not involve actually drinking at work.
Usually, someone has used alcohol too close to reporting to work.

31. BAC LEVELS EXPECTED, BASED ON THE NUMBER OF DRINKS CONSUMED IN A ONE-HOUR PERIOD
body weight in pounds
1 drink
2 drinks
3 drinks
4 drinks
5 drinks
6 drinks
7 drinks
8 drinks
230 & up

32. Alcohol Testing
In workplace testing programs, testing for alcohol may be accomplished using a variety of specimen types – urine, saliva, blood and breath.
The selection of the specific specimen type for alcohol screening should be based on the goals of the drug testing program and how the results will be used.
There are four (4) methods for collecting a specimen to test for Alcohol.

33. Alcohol Testing (Urinalysis)
As stated previously, Urine is the most commonly used specimen for testing for a wide variety of drug substances, both illicit and prescribed (i.e., prescription drugs, for which their use or misuse could impact workplace safety) drugs. However, it is less commonly utilized for alcohol screening – especially in post-incident or reasonable suspicion testing.
Urine testing detects recent use of a substance, but a positive urine test does not necessarily mean that an individual was “under the influence” at the time of the collection/test, nor can it indicate how frequently a substance was used or when it was last used.  Consequently, one of the other testing methods is recommended for alcohol testing, especially in post-incident or reasonable suspicion testing situations.

34. Alcohol Testing (Saliva)
Saliva is commonly used in screening for workplace alcohol use and saliva screening is one of the methods recognized by the Department of Transportation (DOT) for alcohol testing.
Saliva alcohol screening devices (ASDs) that are approved for use in DOT mandated testing programs are listed on the National Highway Traffic Safety Administration (NHTSA) Conforming Products List (CPL). While there is a high degree of correlation between blood and saliva alcohol levels, any presumptive positive saliva test would need to be confirmed – either through blood or breath – and Federal rules require confirmation using breath alcohol.
One advantage of saliva ASDs is that they may be easily utilized by the employer at the employer’s location by a trained screening test technician (STT), eliminating the need to transport the employee/applicant to a third-party collection site, unless there is a non-negative screen result requiring confirmation.

35. Alcohol Testing (Blood)
There are a number of studies that correlate blood alcohol levels to performance and impairment.
Most States use a cutoff of 0.08 % as presumption of impairment for operation of a motor vehicle. However, collection of the blood specimen is considered to be more invasive due to the need for venipuncture. Consequently, blood alcohol testing is less commonly used for workplace screening purposes and is more likely to be used for confirmatory purposes when there a presumptive positive screening result.

36. Alcohol Testing (Breath)
Evidential breath testing (EBT) for alcohol is utilized in both DOT-mandated and company-policy alcohol testing.
EBTs are used for both screening and confirmatory purposes and the test may be performed at a third-party location or “on-site” at the employer location by a trained breath alcohol technician (BAT).
EBTs approved for DOT testing programs also appear on the NHTSA-CPL. The correlation between breath and blood alcohol results is well documented and the results of these tests are commonly used as evidence of impairment or “fitness for duty”.

37. Point of Collection Testing (POCT)

38. POCT Testing Advantages
CONVENIENT
QUICK NEGATIVE TEST RESULTS
INEXPENSIVE IF TESTING IN LARGE VOLUME
MULTIPLE TEST OPTIONS, CUPS, CARDS, SWABS.
AVAILABLE IN URINE AND SALIVA BASED TEST DEVICES

39. POCT TESTING DISADVANTAGES
NOT LEGAL IN ALL STATES
REQUIRES ADDITIONAL STEPS IF NON-NEGATIVE
PURCHASED IN CASE LOTS SO NOT PRACTICAL FOR SMALL VOLUME
LIMITED SHELF LIFE (12-14 MONTHS)
REQUIRES INTERPRETATION BY COLLECTOR.

40. Does marijuana “legalization” affect workplace drug testing?

41. Marijuana Legalization and Workplace Testing
23 states and the District of Columbia (D.C.) have legalized marijuana for medical purposes and five of these jurisdictions – Colorado, Washington, Oregon, Alaska and D.C. – have legalized marijuana for recreational use.
However, the federal government still classifies marijuana as a Schedule I drug – meaning it has a high potential for abuse and no currently accepted medical use. This disparity between federal and state regulations has caused confusion for employers who want to continue to screen their job candidates and employees for marijuana use.

42. Marijuana (State impact)
While some states may provide employee protection for medical marijuana users, many do not. And no state currently offers employee protection for recreational users.
That said, in many jurisdictions, employees can be fired for using marijuana – even if the user has a medical marijuana card or resides in a state where recreational use is “legal.” If in Arizona, research the AMMA prior to implementing policy.
Just because a drug is considered “legal,” does not mean that it doesn’t impair the user.

43. Marijuana (Schedule I Controlled Substance)
Marijuana is a schedule I drug. Under federal law, its cultivation, possession, sale and use are illegal.
In all 50 states, including the five states that have removed state criminal penalties for recreational use – employers can test their job applicants and employees for marijuana.
Since a positive drug test for marijuana is indicative of the donor’s use of an illegal drug under current federal law, these results continue to provide employers with the information they need to make proactive decisions based on state law and their company policies. Employers with employees in “medical” marijuana states should consult an attorney to find out how state laws may affect their ability to take action when there is a positive test for marijuana.

44. Defining Under the Influence
While alcohol impairment levels are well-established and recognized, the same cannot be said for drugs of abuse.
At this time, there isn’t a consensus for drug concentration levels that indicate impairment as the studies have not been widely conducted.
Lacking these studies and an agreed upon drug concentration that indicates impairment, any drug testing that seeks to determine ‘under the influence’ will be a challenge.

45. COATS V. DISH NETWORK: MARIJUANA AND ZERO-TOLERANCE DRUG USE POLICIES
The Colorado supreme court recently held that under the plain language of section , 13 C.R.S. (2014), Colorado’s “lawful activities statute,” the term “lawful” refers only to those activities that are lawful under both state and federal law. Therefore, employees who engage in an activity such as medical marijuana use that is permitted by state law but unlawful under federal law are not protected by the statute. The Court therefore affirmed the Colorado Court of Appeals’ opinion that Dish Network can terminate employees who test positive for THC, in violation of the Company’s drug policy.

46. Case Overview
In Coats v. Dish Network, an employee sued for wrongful termination after he tested positive for marijuana. The plaintiff is a quadriplegic who used medical marijuana outside of working hours. Mr. Coats was a registered medical marijuana user, accessing the product in a manner consistent with state constitutional guarantees and state statute.

47. Conclusion
In short, until the federal government removes marijuana from the list of Schedule I controlled substances, an employer in Colorado may terminate employees who test positive for THC, even if the use of marijuana is off-duty, for medical purposes, and consistent with state laws.

48. A Safer, Drug-Free Workplace
Recognize the impact of alcohol and drug abuse on the workplace
Understand and follow the Drug-Free Workplace Policy
Know your employees and look for changes in behavior. Be proactive in identifying substance abuse and alcohol misuse.
For additional information, Visit the website for the Substance Abuse and Mental Health Services Administration (SAMHSA), maintained by the US Department of Health and Human Services

49. Thank you!
QUESTIONS?