Truck Drivers Driving Drugged?

Can Big Rig Drivers Beat Drug Tests?

By Robert ArnoldPOSTED: 10:03 am CST December 20, 2007UPDATED: 12:46 pm CSTDecember 22, 2007HOUSTON --
Local 2 investigates potentially dangerous loopholes in federal drug testing laws. Our hidden cameras expose a flawed system that can allow drug addicts to get behind the wheel of an 18-wheeler or even a school bus.
Local 2 investigative reporter Robert Arnold shows us how what we uncovered now has Congress and the industry demanding change.
We sent our hidden cameras to a Houston drug testing facility where we signed up to take an official Department of Transportation drug test.

Federal law requires every driver to get a drug test before they're allowed to drive an 18-wheeler, a school bus or any kind of commercial vehicle.But before Local 2 went for the test, we were able to order drug-free urine off the Internet.The kit Local 2 purchased came with a tube of dehydrated urine, a vial and a small heater. We mixed the powdered urine with water then used the heater to bring the sample up to the temperature of the human body.At the collection facility, Arnold was ordered to take off his sport coat and place the contents of his pockets in a secure locker.
That was the extent of the search, which meant no one at the facility knew Arnold had the vial of mail-order urine hidden as he entered the bathroom.Once inside the bathroom, Arnold was allowed to close and lock the door, which allowed him to use the vial of mail-order urine as his sample for the drug test.Arnold was then sent to a bathroom to provide a urine specimen for drug test.A few days later the results of Arnold's drug test came back negative. The mail-order urine passed with no problems at all.

The facility Local 2 tested did absolutely nothing wrong. Employees followed every procedure they are required to follow when collecting a specimen for a Department of Transportation drug test. Yet, Local 2 still found it easy to beat the test.

"Your investigation shows how easy it is to circumvent the law," said U.S. Rep. Ted Poe, who sits on Congress' Transportation Committee."Those regulations were written based on the premise that the person giving the sample was going to be honest about it," said Poe. "That's not the world we live in."

Poe said what concerns him is if Arnold had been a drug user, then that negative test would still allow him to drive an 18-wheeler, a school bus or any kind of commercial vehicle."When it's so easy to circumvent the law, the law becomes meaningless," said Poe."Whatever needs to be done to tighten the regulations to ensure that we don't have anyone slip through the cracks like you did, then I think that needs to be addressed," said Van O'Neal, the head of Houston Community College's truck driving school.O'Neal's program is one of the largest in the country and requires 50 percent of students and faculty to undergo random drug tests. He says that's why Congress has to tighten the regulations."Those policies must be followed, not need to be followed, but I believe must be followed to ensure that our roadways are safe," O'Neal said.Congress is promising to come up with tougher regulations because what Local 2 did was not an isolated case. A report from the Government Accountability Office shows federal investigators also circumvented drug testing laws at several facilities. The report even warns Congress it impossible to determine how many drivers have been able to beat the federally required drug test.Federal law also requires trucking companies to randomly test employees to hopefully catch those who may have beat the test the first time. But after Local 2 Investigates combed through tens of thousands of federal violations, we found not everyone is following the law.

Oxycodone / Hydrocodone Drug Related Deaths Exceed Those for Heroin

Tampa, Florida -

Drug related deaths for oxycodone and hydrocondone exceed those for heroin in the State of Florida.

U.S. Drug Czar John Walters again voiced concern about the abuse of prescription drugs.

Walters, National Director of Drugs Control Policy, noted that many teens and young people believe prescription pills are not as dangerous as street drugs.

12% of people between the ages of 18 and 25 report abusing prescription drugs in the past year.


CBS NEWS - WTSP - Tampa Bay's 10 News - Tampa / St. Petersburg

DOT Urine Drug Testing Not Working - New Government GAO Report

Now even the US Government knows the obvious ....

Drug testing without observed specimen collection, is a waste of time and money.





Private interest groups, consisting largely of urine drug testing laboratories, urine-centric TPA's, occupational health clinics, some unions, as well as a select group of archaic government bureaucracies (DOT, FAA, etc.) continue to exclusively support urine-based testing vs. superior, user-friendly technologies - most notably oral fluid / saliva and hair-based drug screening.

Oral fluid / saliva and hair-based drug screening technologies allow for observed specimen collection and are relatively non-invasive vs. traditional urine drug testing. Oral fluid delivers information on "current" / "on-the-job" drug and/or alcohol use, while hair detects "historical drug abuse".

• Oral fluid / saliva is suitable for random, post-accident, and reasonable suspicion testing, and also can be used for pre-employment testing.
• Hair is most appropriate for pre-employment testing, especially for employers that wish to track drug use history for a period of up to 90 days.

The DOT and other government agencies, including "regulatory agencies" such as SAMHSA are largely to blame for the continued emphasis upon traditional urine-based testing, and ultimately serving to help perpetuate America's problem with substance abuse.

Why? Government agencies resist moving to newer technologies either due to the fear of having to "do more work", and/or are impacted by private interest groups with heavy lobbying budgets and well established "old boy networks".
In their defense, the DOT claims "success" by noting a "2% positive rate". This is a blatant misuse of statistics. Of course the is only a 2% positive rate... as most drug abusers are cheating the test!
As noted below, if drug testing involved observed specimen collection, and/or more stringent techniques the positive rate soars to 10%.

Urine-based drug testing is simply:
1. too difficult, costly, and noxious to apply consistently and on a corporate-wide / industry-wide basis,
2. prone to drug abusers "beating the test".

Several documented cases support the above facts:
For example, a recent construction site that had a low "positive rate" using tradition urine drug testing, but had several site issues and eventually discovered hypodermic needles on-site.
When they implemented Avitar's oral fluid-based testing, conducing a full site-based random screen, the positive rate registered 20%!

Urine testing laboratories, in most cases, are not able to determine if urine samples are adulterated or substituted, other than in the most basic and severe cases.
Despite this fact, they continue to spread misinformation, claiming the opposite.
The Director of Workplace Drug Testing for SAMHSA is on record, testifying before Congress, that detect adulterants, that labs can only detect a very small fraction of the many products available on the Internet available to beat urine-based drug tests, and that substituted drug free urine and synthetic urine also are undetectable.

GAO: Easy to cheat on trucker drug tests
Three-quarters of testing sites don’t provide secure conditions, report finds
The Transportation Department estimates that fewer than 2 percent of truck drivers test positive each year for controlled substances.
But when Oregon conducted its own tests, 9 percent of truck drivers tested positive.
Dozens of products on the Web are marketed to truckers as fail-safe ways to defeat the mandatory drug tests.
WASHINGTON - Undercover federal investigators discovered that it was surprisingly easy to cheat on random drug tests designed to catch truck drivers who use drugs, NBC News has learned.
Undercover investigators with the Government Accountability Office (GAO), the investigative arm of Congress, used bogus truck driver’s licenses to gain access to 24 drug-testing sites.
They found that 75 percent “failed to restrict access to items that could be used to adulterate or dilute the [urine] specimen, meaning that running water, soap, or air freshener was available in the bathroom during the test.”
The GAO team also bought drug-masking products over the Web and was able to mix them with real specimens at the drug-testing sites “without being caught by site collectors,” the agency said in a report scheduled to be made public ThursdayDrug - screening labs never realized that there was a problem.
“Every drug masking product went undetected by the drug screening labs,” said the report, a copy of which was obtained by NBC News.Rep.
Jim Oberstar, D-Minn., chairman of the House Transportation and Infrastructure Committee, said the report was “frankly astonishing and shocking and dismaying.
You can manipulate the tests, you can mask substance abuse and go undetected on the roadways.”Oberstar, who planned to hold a hearing Thursday, said the drug-testing system was broken and was placing other drivers in danger.“It fails, it is not sufficient, it is not protecting the public interest,” he said.
How many are cheating?
The Transportation Department estimates that fewer than 2 percent of truck drivers test positive each year for controlled substances in random federal tests.
But when Oregon law enforcement officials conducted their own random tests this year, 9 percent of truck drivers tested positive.
Dozens of products widely available on the Web are marketed to truckers as fail-safe ways to defeat the mandatory drug tests.
“My first reaction was total disbelief. I just felt sick,” said Kathleen Ellsbury, whose husband, Tony Qamar, was killed two years ago when a truck driver in Washington state lost his load of logs on a curve, crushing Qamar’s car.
Also killed was Daniel Johnson, a fellow seismologist at the University of Washington.Ellsbury learned later that the truck driver, who was sentenced to 4½ years in prison for vehicular homicide, had previously been convicted of possessing methamphetamines and that he had meth in his blood at the time of the crash.
“The system has big holes, let’s say that,” said Ellsbury, who said she had a message for truck drivers who might be tempted to cheat:
“I’d like to be standing right outside the bathroom and hold up a picture of my husband — remind them there's consequences.”
Truckers promise to do betterSpokesmen for the trucking industry said truck drivers were among the safest drivers on the road, with much lower rates of drug use than the general population. Still, they said, having roughly 30,000 drivers test positive each year was unacceptable.
Lisa Myers is chief investigative correspondent and Richard Gardella is an investigative producer for NBC.

BCTD Building Construction Trades Department " New " Drug Testing Program - A Costly Mistake

For Safety Professionals attempting to innovate and improve efforts can be frustrating, largel due to the fact that politics can easily supersede logic.



That said, while potentially well-intentioned, the "new" Building and Construction Trades Department - BCTD drug testing program ( which oddly requires outdated and relatively ineffective urine-based testing as well as the use of a specific laboratory, third party administrator, and their specific product and services ) represents a step backwards...not forward ,



more importantly, however, this archaic structure does NOT serve the best interests of unions, union members, contractors, insurers, or owners.



The Need for Change:

Abuse in the Construction SectorWe all know that a drug free workplace is a safe workplace and the union skilled trades and contractors were ahead of their time years 16 years ago, when urine-based drug testing was introduce by innovators as evidence by the MUST program, LEAD, and others.However, times change, the drugs of choice change and the numbers of ways to “beat” the tests have changed.

It’s time again for the union skilled trades and contractors to leap ahead of the national status quo.



Recently the States of Hawaii and Georgia passed legislation to improve safety and reduce workers compensation costs through the implementation of on-site oral fluid / saliva drug screening.The construction industry played a key role in driving these changes, especially in Hawaii.

Organized labor in particular, as well as contractors, owners, and insurers recognized the following:



Drug abuse in the construction sector is as bad, if not worse than ever,



Effective drug testing, especially random drug testing is required to truly manage workplace substance abuse,



Observed specimen collection, convenience, and low cost are mandatory to ensure compliance.



It's time again for union's to put politics aside and address the issue from from a safety point of view:



Why should every construction site drug test?

Simple. While 10% of employees aged 18 – 49 years abuse drugs (not including alcohol), the construction industry runs 2x-3x this rate.With over 50% of reportable job-site accidents linked to substance abuse, it’s clear that employee safety and the corporate bottom line are sufficient reasons to implement a drug free workplace program.



A need for change

Pre-employment drug testing has become an intelligence test. Access to the internet has made defeating drug tests an easy task. Workers are able to get information on how to “flush” their system; adulterate samples; and there are even products like the Whizinator, which uses synthetic urine undetectable by current drug testing methods, designed to defeat observed urine collection.

Random drug testing, post-incident and reasonable suspicion modes are required components of any comprehensive, effective safety program.

The goal of any drug / alcohol policy is deterrence vs. “catching” employees. Random testing has consistently demonstrated to be singularly effective in reducing on-the-job substance abuse.

Any effective testing mode must involve direct observation of specimen collection. But observed urine collection is embarrassing and degrading to both the observed and the observer.Arguably, there are more instances of drug abusers defeating unobserved techniques, such as traditional urine-based testing, than there are “positives”. Just look at nationwide statistics for validation. Seventy-seven percent (77%) of drug abusers are employed. Furthermore most drug testing (approx. 90%) involves traditional urine laboratory-based pre-employment testing.



Oral fluid works

Oral fluid tests are cheaper, faster and easier to use than urinalysis… and unlike urine, can not be easily defeated.Random testing via on-site oral fluid is fast, provides results within 5-15 minutes, and averages $20 per test. It has the additional advantage of detecting current, vs. historical drug use. Oral fluid tests typically detect from within minutes of consumption up to 2-3 days for most drugs (for THC, the psychoactive ingredient in marijuana, the maximum is 24 hours.). Urine testing can not detect drugs for up to the first several hours and is only an indicator of historical drug use. Furthermore, for THC, detection can go back as far as 30 days. Do you as an employer really care what an otherwise dependable employee does at his/her home on the weekend? Do you even have a right to know?“This measure (on-site oral fluid drug testing) provides a cost effective on-the-job alternative to laboratory tests that can be costly and difficult to schedule."- Aiona, Lt. Governor, HawaiiAlso look at the true costs of urine-based random testing. In many cases our current program requires we send our employees off site for random testing. The cost involved includes not only the hourly labor rate, probably $50/hour with benefits, but the productivity loss also. The end result is that a typical off-site urine test is truly costing a job about $300 per test, and the effectiveness is questionable at best.On-site oral fluid based testing works.



Here are actual results from a contractor who switched from urine-based to oral fluid-based drug screening:













Where do we go from here?
Occupational health, safety, and risk management professionals must assist in driving change. This groups and only this group knows what truly happens every day on our job sites. At the end of day, they “get it”.It’s time for safety professionals to join with all constituencies to update current drug and alcohol free workplace programs to assure compliance and effectiveness.

It’s also time for the union skilled trades and contractors to again lead the charge in effecting change.It’s time to implement oral fluid-based testing techniques at a few “pilot sites” and demonstrate the advantage of effective drug testing programs vs. the status quo.

References:

2006 United States Department of Health – Substance Abuse and Mental Health Agency (SAMSHA) National Survey on Drug Use & Health (NHSDA)- Office of Applied Studies. (2007) Results from the 2006 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 07-4293, NSDUH Series H-32). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Peter N. Cholakis and Roger Bruce (July 2007) Drug Testing in the Workplace – A look at oral fluid-based testing. Professional Safety Journal of the American Society of Safety Engineers, July 2007, 31-36

Schools Infested with Drugs

New Study: Schools Infested with Drugs - August 17, 2007
A New Study from the National Center on Addiction & Substance Abuse (CASA) suggests that US Schools are infested with drugs. The survey revealed that at least once a week on their school grounds, 31 percent of high school students (more than four million) and nine percent of middle school students (more than one million) see illegal drugs used, sold, students high and/or drunk. At least weekly, 17 percent of all high and middle school students (4.4 million) personally see classmates high on drugs at school.

Construction Safety / Drug Testing: Michigan AGC / MUST Drug Testing

The Need for Change: Drug Testing in Construction

Lynn A. Corlett, C.S.P.

We all know that a drug free workplace is a safe workplace and the Michigan union skilled trades and contractors were ahead of their time when the MUST drug screening program was implemented 16 years ago in 1991.
However, times change, the drugs of choice change and the numbers of ways to “beat” the tests have changed.
It’s time again for the union skilled trades and contractors to leap ahead of the national status quo.

Recently the States of Hawaii and Georgia passed legislation to improve safety and reduce workers compensation costs through the implementation of on-site oral fluid / saliva drug screening.
The construction industry played a key role in driving these changes, especially in Hawaii. Organized labor in particular, as well as contractors, owners, and insurers recognized the following:

Drug abuse in the construction sector is as bad, if not worse than ever,

Effective drug testing, especially random drug testing is required to truly manage workplace substance abuse,

Observed specimen collection, convenience, and low cost are mandatory to ensure compliance.

This article attempts to address ... from the construction industry’s point of view:
Why should every construction site drug test?
Where do we go from here?


Why drug test? Simple.
10% of employees aged 18 – 49 years abuse drugs (not including alcohol), the construction industry runs 2x-3x this rate. Over 50% of reportable job-site accidents linked to substance abuse.
It’s clear that employee safety and the corporate bottom line are sufficient reasons to implement a drug free workplace program.

A need for change.
Pre-employment drug testing has become an intelligence test. Access to the internet has made defeating drug tests an easy task. Workers are able to get information on how to “flush” their system; adulterate samples; and there are even products like the Whizinator, which uses synthetic urine undetectable by current drug testing methods, designed to defeat observed urine collection.
Random drug testing, post-incident and reasonable suspicion modes are required components of any comprehensive, effective safety program.
The goal of any drug / alcohol policy is deterrence vs. “catching” employees. Random testing has consistently demonstrated to be singularly effective in reducing on-the-job substance abuse.Any effective testing mode must involve direct observation of specimen collection. But observed urine collection is embarrassing and degrading to both the observed and the observer.Arguably, there are more instances of drug abusers defeating unobserved techniques, such as traditional urine-based testing, than there are “positives”. Just look at nationwide statistics for validation. Seventy-seven percent (77%) of drug abusers are employed.
Furthermore most drug testing (approx. 90%) involves traditional urine laboratory-based pre-employment testing. Oral fluid worksOral fluid tests are cheaper, faster and easier to use than urinalysis… and unlike urine, can not be easily defeated.

Random testing via on-site oral fluid is fast, provides results within 5-15 minutes, and averages $20 per test. It has the additional advantage of detecting current, vs. historical drug use. Oral fluid tests typically detect from within minutes of consumption up to 2-3 days for most drugs (for THC, the psychoactive ingredient in marijuana, the maximum is 24 hours.). Urine testing can not detect drugs for up to the first several hours and is only an indicator of historical drug use. Furthermore, for THC, detection can go back as far as 30 days.
Do you as an employer really care what an otherwise dependable employee does at his/her home on the weekend?
Do you even have a right to know?

Also look at the true costs of urine-based random testing. In many cases our current program requires we send our employees off site for random testing. The cost involved includes not only the hourly labor rate, probably $50/hour with benefits, but the productivity loss also. The end result is that a typical off-site urine test is truly costing a job about $300 per test, and the effectiveness is questionable at best.

On-site oral fluid based testing works. Multiple case studies have documented significant improvements in accident reduction due to switching from urine-based to oral fluid-based drug screening.

Where do we go from here?
Occupational health, safety, and risk management professionals must lead the charge to effect change. We know what truly happens every day on our job sites. At the end of day, we “get it”. It’s time for us to update our current drug and alcohol free workplace program.
It’s time for the Michigan union skilled trades and contractors to again lead the charge in effecting change.
It’s time to implement oral fluid-based testing techniques at a few “pilot sites” and demonstrate the advantage of effective drug testing programs vs. the status quo.

References:
2006 United States Department of Health – Substance Abuse and Mental Health Agency (SAMSHA) National Survey on Drug Use & Health (NHSDA)- Office of Applied Studies. (2007) Results from the 2006 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 07-4293, NSDUH Series H-32). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Peter N. Cholakis and Roger Bruce (July 2007) Drug Testing in the Workplace – A look at oral fluid-based testing. Professional Safety Journal of the American Society of Safety Engineers, July 2007, 31-36.

Return on Investment - Drug Testing

Employee Theft and Fraud
- Average cost Per employee involved: $650
- U.S. Chamber of Commerce estimates 30% of all business failures are due to employee theft and fraud.
- 70% of these crimes are committed by repeat offenders.
- Up to 70% of employee theft is drug related


Cost of Negligent Hiring
- Average cost per incident: $150,000
- Courts are holding companies liable in negligent hiring cases not only for what they knew about a new employee, but also what they should have known.


Employee Turnover]
- Average cost per incident: $32,000
- Turnover costs average 1.5 times a person’s yearly salary

Workplace Violence Estimated
- Average cost per incident: $1,000,000
- Violence at work is a serious problem, with homicide now the #2 cause of death in the workplace.
- Up to 70% of criminal arrests are drug related

Accidents / Worker's Comp.
- Average cost $10,000 + per incident
- 50%+ related to substance abuse

Significant Changes to Employee Drug Testing Laws

Significant Changes to Substance Abuse Testing Laws

Recently the States of Hawaii and Georgia passed legislation in support of workplace drug testing, specifically relative to oral fluid-based/saliva drug on-site screening, and workers compensation premium credits. These actions highlight the need for effective drug-free workplace programs as well convenient drug screening technologies that can be applied consistently, across all modes of testing, especially, however, for random, post-incident, and reasonable suspicion.

It is critical that drug-free workplace safety initiatives are enhanced for the betterment of the American workplace as a whole: employers, employees and families, insurors, etc.
Drug abuse is as bad as it has ever been in our places of employment as well as school systems, and hopefully, these new statutes are a sign of a commitment to change.

Our society cannot continue to sweep America's drug abuse problem under the rug. Abuse of prescription drugs, especially pain-relievers, has superseded marijuana and is is a dangerous trend world-wide.

Arguably, “recreational” marijuana use outside of the workplace may have little, if any, impact to employers or employees, excluding the obvious legal issues. The non-medical use of prescription pain relievers, however, in addition to being potentially lethal, commonly leads to addiction and even escalates to heroin use. The safety and wellness aspect of prescription drug abuse is a very serious issue that must be addressed.
Hawaii
A law that became effective on July 1, 2007, now allows employers to perform on-the-job drug testing using instant, on-site oral fluid/saliva drug screening devices. Oral fluid tests are cheaper, faster and easier to use than urinalysis, hopefully leading to more widespread and consistent drug testing programs.

While it may surprise many, the construction industry and locals unions in particular strongly advocate the new legislation as a means to replace the typical, more expensive laboratory-based urine drug testing. With oral fluid, initial results are available in minutes, and observing the sample collection mitigates the prevalent practice of drug abusers “beating the test” via sample adulteration or substitution. Urine laboratory testing typically required the expensive practice of sending employees off-site to a clinic or laboratory, a process that takes at least 3-4 hours with results available for 24-48 hours. As noted by Lt. Governor Aiona of Hawaii, "Drug and alcohol abuse remain a problem in Hawaii's workforce. The law will go a long way towards helping to promote a drug-free workplace. This measure provides a cost effective on-the-job alternative to laboratory tests that can be costly and difficult to schedule."According to the U.S. Department of Labor, drug or alcohol abuse is involved in the majority of fatal accidents in the workplace. These laws represent an effort by the State Government to make the workplace safer for everyone.Although the new law permitting oral drug testing was effective on July 1, 2007, in many cases collective bargaining agreements will have to be updated before companies can start using the non-FDA approved tests. This procedure isn't expected to take long, however, since the unions - as well as management and the State Government - are in favor of the new law. According to union sources, they welcome the improved safety and working conditions that the tests will introduce.
One representative of the Pacific Resource Partnership, an alliance between contractors and the Carpenters Union Local 745, said construction workers and the industry pushed for the new tests as a way to decrease costs and save time while keeping job sites safe."This is something that I think is going to be a great asset for employers, especially in the construction industry where public safety is a huge factor," said Lt. Governor Aiona.

Georgia
In a similar bill, Governor Perdue of Georgia recently signed Senate Bill 96 into law which provides the option for companies throughout Georgia to drug test employees using an on-site rapid result oral fluid/saliva devices.

As in Hawaii, initial qualitative results are available in minutes, and if “negative” an employee goes back to work. Any “non-negative” (preliminary positive) results are sent to a lab for a GC/MS or LC/MS/MS quantitative analytical testing prior to substantive employers’ actions such as mandatory enrollment in employee assistance programs/counseling, removal from safety-sensitive duties, and/or suspension.
Per Governor Perdue, the bill which overwhelmingly passed the State Senate and House of Representatives, "had the strong support of the Georgia Chamber of Commerce and many other advocates of safe and drug-free workplaces that protect not only business owners, but employees and consumers as well.Companies using on-site oral fluid/saliva screens will now receive a 7.5 percent reduction in their worker's compensation insurance premiums. Summary

Drug testing in the workplace is not only legal, it may very well be part of an employer’s responsibility to provide a safe workplace for employees. The United Supreme Court has ruled that drug testing, including random drug testing, is legal. Furthermore, per the Department of Labor, OSHA, it is an employer’s responsibility to provide a safe workplace for all employees.

Assuming a comprehensive safety program is in place, a safe workplace is simply not possible without also maintaining a comprehensive drug-free workplace program inclusive of employee education, drug testing, and employee assistance/counseling.
Regardless of the specimen type used such as oral fluid/saliva, urine, or hair, it is critical that specimen collection be directly observed, and that drug testing is done on a regular basis. This includes; random, post-incident, reasonable suspicion, and return-to-duty mode. Pre-employment testing, while currently the most widely practiced of modes, is referred to by many experts as an “intelligence test”, and should not be relied upon exclusively.

When combined with education, and employee assistance programs, comprehensive drug-free workplace programs consistently result in a reduction in reportable site accidents of up to 50% or more, as well as multiple other safety and “bottom-line” benefits.

False Negatives & False Positives

Qualitative Results
A qualitative drug test is one that provides a dichotomous result, that is, it indicates whether a sample is positive or negative for a specified drug. However, there are four possible results of a qualitative drug test.

A true-positive result occurs when the test correctly identifies the presence of a drug in the sample taken.
A false-positive result is one where the test incorrectly detects the presence of a drug where in fact no drug is present.
A true-negative result occurs when the test correctly confirms the absence of a drug.
A false-negative result is one where the test fails to detect the presence of a drug when it is in fact present.

Interpreting a Positive Test Result
A positive result indicates that the specific drug (or class of drug) is present at or above the designated cut-off level. Typically, the cut-off concentration is set to the lowest concentration the drug can be reliably detected following consumption. It considers environmental and analytical variability caused by such factors as passive contamination/ingestion, technological limits, etc.

False-positives resulting from qualitative screening
A false-positive result can occur when a benign substance in the biological sample mimics the chemical effect of the targeted substance on the test. The test indicates a positive result even though the targeted drug was absent. Such results have reportedly occurred after ingestion of antihistamines, certain anti- inflammatory drugs, cold and flu medications, and poppy seeds (Selavka, 1991). The false-positive rate for particular testing methods is discussed in the relevant chapters below. Although levels are generally low, it does highlight the necessity of appropriate confirmatory testing with parent / metabolite quantification to identify and safeguard against this.

Interpreting a Negative Test Result
In the majority of cases a negative result indicates that the parent drug (typcially the active ingredient) and / or its metabolites are absent in the biological sample. It does not mean that the person has not used the substance in the days or weeks prior to testing. The amount of drug present in the sample at the time of sample collection, and thus whether a positive result is obtained, is determined by a number of factors which include: the cut-off level used; the testing schedule employed; the biological sample analyzed; when the drug was ingested; the amount of drug ingested; the form in which it was ingested; and physical and pharmacological characteristics of the user.

False-negatives
When an initial screen result in negative and (1.) the individual ingests a drug and the concentration of the drug in the sample is at our above the cut-off, or (2.) the individual ingests a drug and the concentration of of the sample is below the the cut-off due to sample adulteration or substitution, the result referred to as a “false-negative”.
Relative to urinalysis, there are a number of actions an individual can take, to increase the likelihood of a false-negative result. An individual can adulterate the specimen via dilution by drinking excessive amounts of water (in vivo adulteration), or by adding water or chemicals that will affect the test (in vitro adulteration) (Coleman & Baselt, 1997). Hair testing may be susceptible to excessive washing (Rohrich, Zorntlein, Potsch, et al., 2000), bleaching (Yegles, Marson & Wennig, 2000) and other cosmetic hair treatment (Skopp, Potsch & Moeller, 1997). There are no currently proven methods to adulterate or substitute oral fluid.

Quantitative Results
Quantitative drug testing involves the determination of the specific concentrations of a parent drug and/or its metabolite(s) in a sample, typically via GC/MS and LC/MS/MS. In addition to confirmatory testing of qualitative screening results, quantitative results quantitative results using blood or oral fluid / saliva specimens can provide additional information regarding the quantity and frequency of drug use (Cone, 1997). Blood and/or oral fluid / saliva may also be useful when establishing impairment levels for certain drug classes. Urine and hair specimens are generally considered effective for historical use only. With knowledge of the drug’s pharmacokinetic parameters, including its half-life, an estimate of the frequency of new drug use can be obtained using quantitative analysis (Cone, 1997, Huestis and Cone 1998).

The Physiology of Urine Production
Urine is produced continuously by the kidneys and may be considered an ultrafiltrate of blood. During urine production the kidneys reabsorb essential substances. Excess water and waste products, such as urea, organic substances and inorganic substances, are eliminated from the body. Parent drugs (typically the active ingredient) are often present in urine in very low concentrations or not detected at all. Therefore distinguishing between codeine, heroin and morphine use, for example, can be difficult. Furthermore, inter-subject variations in urine drug concentrations, even after similar dosing, is high.
Absorption into urine is usually slow when a drug is orally administered and excretion may be delayed for several hours (approximately 6-9 hours) .Generally, a urine specimen will contain the highest concentration of parent drug and metabolite at this time period. As drug elimination usually occurs at an exponential rate, for most illicit drugs a dose will be eliminated almost completely within 48 hours. A number of factors influence detection times including the quantity of drug administered, parent drug and metabolite half- life, cut-off level used, and a number of physiological factors. It is also noted that for many of drugs, frequent, multiple dosing over extended periods of time can cause the drug to accumulate in the body resulting in significantly extended detection times.

The Physiology of Oral Fluid
Salivary gland is a term used to include any tissue that normally discharges a secretary product into the oral cavity. Thus, oral fluid refers to the mixture of fluid in the oral cavity. Saliva is a complex aqueous fluid (99% water) containing electrolytes (principally sodium,potassium, chloride and bicarbonate), proteins (mostly enzymes, including amylase) and muncin (Kidwell, Holland & Athanaselis, 1998). The mucin gives oral fluid its sticky character. Saliva also contains cell and food debris and oral microorganisms. The composition and production of oral fluid is determined by the relative contribution of the different glands, which in turn is dependant on a variety of factors including nutritional and emotional state, sex, age, season of the year, time of day, and a variety of diseases and pharmacological agents (Höld, 1996; United Nations, 1998)
The three major salivary glands are: (1) the parotid, at the top of the mouth, (2) the submandibular, at the base of the tongue, and (3) the sublingual, at the sides of the oral cavity. The parotid gland, responsible for about 25% of the saliva produced, excretes saliva derived primarily from blood plasma (serous fluid); the submandibular and sublingual glands excrete both serous fluid and mucin and contribute approximately 71% and 4% respectively (Kidwell, Holland & Athanaselis, 1998). The volume of saliva produced by an adult ranges from 500 to 1500 ml per day. Unstimulated saliva has a pH range between 5.6 and 7. Stimulation increases the pH to a maximum of 8 (Kidwell, Holland & Athanaselis, 1998).

A thin layer of epithelial cells separates the salivary ducts from the systemic blood circulation (capillaries). The lipid membrane of these cells determines which molecules may be transferred from blood plasma into oral fluid. Three routes have been identified that may transport a drug across the lipid membrane; these include active transport (secretion), passive diffusion through the membrane across a concentration gradient, and diffusion through pores in the membrane (ultrafiltration) (Höld, de Boer, Zuidema & Maes, 1996,United Nations, 1998). Some molecules with a low molecular mass (i.e. ethanol) may diffuse through the water-filled pores in the membrane. Other small molecules are primarily transported through secretion. For larger molecules (most drugs of abuse), passive diffusion across a concentration gradient is thought to be the major factor in transport (Höld, de Boer, Zuidema & Maes, 1996; Huestis & Cone, 1998). Equilibrium occurs between plasma and saliva. In plasma a large proportion of a drug is bound to proteins. Drug concentrations in oral vary with the free fraction of drug in plasma, and therefore mimic concentrations found in blood (Cone, 1993).
Interpretation of Drug Concentrations in Saliva
Saliva has been shown to be a suitable matrix for the detection of drugs of abuse, specifically cocaine and benzoylecgonine (e.g. Cone, 1993; Schramm, Craig, Smith, et al., 1993), heroin, 6-MAM and morphine (e.g. Goldberger, Darwin, Grant, et al., 1993), codeine (in Huestis & Cone, 1998b), methadone (e.g. Wolff, 1991) and amphetamines (Cone, 1993). Cannabis use is somewhat more difficult to detect in saliva though it has been shown to be possible (e.g. Menkes, Howard, Spears, et al., 1991). Saliva drug concentrations generally correlate well with the free fraction of drug in blood (Cone, 1993; Kidwell, Holland & Athanaselis, 1998).
Saliva can be used to provide both qualitative and quantitative information on the drug status of an individual undergoing testing for all drugs of abuse reviewed (Cone, 1993).

Much research into saliva testing has examined its utility as an alternative test matrix to blood and urine.

THC Detection in Oral Fluid / Saliva

THC Detection
First and forement, devices / techniques must screen for THC-delta-9 in oral fluid NOT THC-COOH and/or delta-11, etc. The latter is a metabolite found only in urine at any level that can be commonly detected, the former is the active ingreadient of marijuna and found in oral fluid.Detection of THC-delta-9 in oral fluid has repeatedly been demonstrated to be possible from connsumption... up to 24 hours post consumption.The following is one of several references available on this topic:Relationship of (9)-tetrahydrocannabinol concentrations in oral fluid and plasma after controlled administration of smoked cannabis byHuestis MA, Cone EJ.Intramural Research Program,National Institute on Drug Abuse, National Institutes of Health,Baltimore, Maryland 21224. J Anal Toxicol. 2004 Sep;28(6):394-9ABSTRACTUnderstanding the relationship of (9)-tetrahydrocannabinol (THC) concentrations in oral fluid and plasma is important in interpretation of oral fluid test results. Current evidence suggests that THC is deposited in the oral cavity during cannabis smoking. This "depot" represents the primary or sole source of THC found when oral fluid is collected and analyzed. In this research, oral fluid and plasma specimens were collected from six subjects following smoking of cannabis cigarettes containing 1.75% and 3.55% THC. There was at least one week between each cannabis administration. Plasma specimens were analyzed by gas chromatography-mass spectrometry (GC-MS) and paired oral fluid specimens were analyzed by radioimmunoassay (RIA). In addition, one individual's oral fluid specimens were also analyzed by GC-MS. These data are unique in that they represent simultaneous or near simultaneous collection of oral fluid and plasma specimens in subjects following controlled cannabis dosing. The first oral fluid specimen, collected from one subject at 0.2 h following initiation of smoking, contained a THC concentration of 5800 ng/mL (GC-MS). The similarity in oral fluid and plasma THC concentrations following the dissipation of the initial "contamination" indicates the likelihood of a physiological link between these specimens. Recent studies have shown that sublingual or transmucosal administration of pure THC results in direct absorption of intact THC into the bloodstream, thereby bypassing the gastrointestinal tract. The current study demonstrates that THC is deposited in the oral cavity and remains for up to 24 h following cannabis smoking. The decline in THC oral fluid concentration over this time suggests that there may be absorption of THC into blood as previously shown with pure THC. Passive cannabis exposure studies appear to indicate that positive oral fluid tests for THC can occur shortly after cannabis smoke exposure, but results were negative within 1 h. Consequently, when very recent passive exposure to cannabis smoke can be ruled out, it is concluded that a positive oral fluid test provides credible evidence of active cannabis use.

Detection Windows vs. Specimen Type

The primary goal of any drug-free workplace policy is to deter substance abuse.

In order to accomplish this end, a combination of education, drug testing, and employee assistance / counseling is required.

Relative to the drug test the following elements must be present:

1. Ability to detect current / on-the-job drug abuse.

2. Convenience for both donor and test administrator.

3. Observed specimen collection.

Only oral fluid / saliva meets all three objectives.

Urine can only detect historical drug abuse and there is no relationship between drug metabolite concentration and impairment and/or time drug was ingested. Observed collection is not possible in most workplace settings.

Hair is the best method for detecting historical drug abuse, and allows for observed collection. However, is only suitable for pre-employment testing as it can not detect drug consumption within the past seven days.

Oral fluid can detect drug consumption within minutes of consumption, up to 2-3 days for many drugs. THC detection is limited to approximately 24 hours, however, the impairment period for marijuana is generally reported to be one hour (two hour maximum).

Georgia Also Extolls Benefits of On-site Oral Fluid / Saliva Drug Screening

Saliva drug testing bill signed by Gov. Perdue

Gov. Sonny Perdue recently signed Senate Bill 96 into law, which provides the option for companies throughout Georgia to drug test employees using an on-site rapid result saliva test.
Within 5-10 minutes, at the job site, an employer screen for drugs.

If the result is negative....employee goes back to work. Any non-negative (preliminary positive ) results are sent to a lab for a GC/MS or LC/MS/MS quantitative analytical testing prior to any adverse action against an applicant or employee.

The bill overwhelmingly passed the state Senate and House of Representatives. “This legislation had the strong support of the Georgia Chamber of Commerce and many other advocates of safe and drug-free workplaces that protect not only business owners, but employees and consumers as well,” Senator Golden.

Companies using on-site oral fluid / saliva screens will now receive a 7.5 percent reduction in their worker’s compensation insurance premiums.

Oral fluid drug screening offers unique advantages to employers and employees.
Specimen collection is easily observed reducing the likelihood of adulteration or dilution of specimens. The use of saliva eliminates the problem of “shy bladder syndrome” that occurs when a donor can’t provide or intentionally avoids providing a urine specimen.

Collections can be performed at remote work sites, particularly those in the construction or utility industries, as bathrooms and other specialized facilities are not required.

International Drug Testing - Finland

Finnish companies ratchet up drug testing

Finnish daily Aamulehti on Wednesday quoted a National Public Health Institute (KTL) doctor as saying that Finnish companies had anywhere between 50,000 and 100,000 drug tests done a year, up from an estimated range of 20,000 to 40,000 carried out three years ago.
A number of companies have introduced drug screening after a new law entered into force in 2004.
For example, TietoEnator and Nordea have all their new employees screened for drugs.
The 2004 Act on the Protection of Privacy in Working Life says that an employer "may receive or otherwise process information entered in a drug test certificate, subject to the consent of the applicant selected for the job, only if the applicant is to do the type of work that requires precision, reliability, independent judgement or quick reactions and if performing the work while under the influence of drugs or while addicted to drugs could" endanger lives, national defence or security, traffic safety, the environment, privacy or business secrets.

Source: Produced by: Ministry for Foreign Affairs of FinlandDepartment for Communication and Culture/Unit for Promotion and Publications

Employee Drug Testing

Why Most Drug Testing Programs DON'T WORK !

Effective Substance Abuse Management or The Importance of Deterrence ....

Pre-employment drug screening, using traditional lab-based urine tests, is the most widespread method of drug testing. Yet, data shows that this mode of testing is not effective at deterring workplace drug abuse. Why ....

Scheduled drug screening allows abusers to either temporarily stop using drugs or take advantage of the abundance of products available on the Internet to adulterate urine-based tests.

RANDOM DRUG TESTING via OBSERVED SPECIMEN COLLECION is Required!

Urine is clearly out of the question in a workplace environment... are YOU going to WATCH SOMEONE PEE INTO A CUP?

Oral fluid-based testing for drugs of abuse, however, enables corporations to perform random drug testing – conveniently, easily, and accurately.

The unpredictability of a random drug test virtually eliminates the possibility of an employee temporarily abstaining from drug use.
With observed collections, oral fluid testing removes any possibility of sample adulteration or substitution.

Oral fluid-based technology is changing the way companies drug test, allowing them to establish more effective drug free workplace programs to benefit employees and employers alike.

STATS support that Urine Drug Testing isn't the Solution
77% percent of drug abusers are employed
Nearly 10% of U.S. workers are abuse drugs
The average annual cost of drug abuse for U.S. businesses averages $10,000 per abuser and well over $140B nationwide.

Employees Reporting Drug Abuse Within Past Year by Industry
vs. 10% Average

Construction MORE
Manufacturing MORE
Hospitality / Lodging MORE
Retail MORE
Finance / Real Estate MORE

Why Drug Test?
The devastating impacts of drug abuse upon corporate safety, productivity, and the financial bottom-line are well documented. Up to 65% of on-the-job construction accidents can be related to substance abuse, while insurers note that drug and alcohol use is linked to 40% of construction fatalities. Drug abuse also negatively impacts employee turnover, absenteeism, workplace violence, inventory shrinkage/employee theft, and medical insurance utilization rates.

How can owners, employees, unions, and insurers, significantly improve job-site safety?
- Deterring and/or detecting on the job substance abuse. It is a first step to ensuring a safer, happier workplace environment, and one that just might just save a drug abuser’s life, or your own.



How should you drug test?
Manycorporations/contractors believe following “DOT Standards” is the most effective way to create a safer, drug free workplace. Unfortunately, this is a false, yet common belief.
DOT and other federally mandated drug testing regulations, are required in certain limited circumstances (truck drivers for specified classes of vehicles, vehicles carrying a certain number of passengers, etc.).
However, this traditional type of drug testing is over 20 years old and doesn’t test for many of today’s newer designer drugs. Furthermore, it is cumbersome to say the least, as it relies exclusively upon laboratory-based urine drug testing “Beating a test” by adding any of the hundreds of products readily available on Internet or substituting one’s specimen with drug-free urineor synthetic urine is commonplace. The practice has become so ineffective that thereare arguably more drug abuser’s “beating urine tests” than there are drug positives from this outdated method.

Drug Free Workplace Policy

A good place to start with any drug-free workplace program is to establish goals and objectives appropriate for your organization. These will help you create a foundation to write your workplace drug policy: a prerequisite to the implementation of any drug testing program.

When it comes to implementing a drug free workplace program, the documentation and impartial application of policy are critical. Not only do ad hoc approaches not work, they can cause serious employee moral and legal issues. Drug testing is a strategic corporate issue affecting everyone in the organization as well as corporate image. Therefore, company-wide involvement and “buy-in” are needed across all levels, including CEOs, CFOs, COOs, HR, Loss Prevention, Risk Management, Occupational Health and Safety, and employees. When implementing any drug testing program, it is recommended that the following areas be considered:·

Legal ramifications, a.k.a. “What rules apply”·

Type of testing: pre-employment, random, post accident, return-to-duty, reasonable suspicion/cause ·

Ease of use/administration of testing methods·

Immediacy of results

The following components are typically included in a comprehensive drug-free workplace program:

A written, signed drug testing policy

Drug tests: on-site as well as laboratory-based, using appropriate specimen types: oral fluid, urine, and hair

GC/LS/MS laboratory confirmatory testing

MRO (medical review officer) services

Employee assistance programs

Ongoing drug education and awareness programs

The problem with Pre-employment Testing ONLY:
While many companies have been practicing pre-employment testing for more than twenty years, it has been only marginally effective at reducing drugs in the workplace for two reasons: 1) Pre-employment testing, by definition, only addresses a small part of the workplace and 2) pre-employment testing ignores the fact that more than 77% of drug abusers are currently in the workforce.
Pre-employment testing can also be easily circumvented by drug abusers. Any type of testing with a previously scheduled date, allows applicants or employees that abuse drugs to employ a wide variety of methods to avoid detection as previously noted.

Random Testing
Random testing of the full workforce, while currently practiced by a small subset of corporate innovators, has proven to be the most effective deterrent to illicit drugs in the workplace.

Post-accident testing
Post-accident testing has become the norm for larger businesses, and most states allow employers to deny workers compensation benefits to employees who test positive for drugs of abuse.


Reasonable cause/suspicion testing
Reasonable cause/suspicion testing is helpful if employees and supervisors are trained to recognize the signs/ symptoms of drug abuse. Return-to-duty testing Return-to-duty testing is a means of enabling employees to come back to work, after testing positive to drugs of abuse. These employees usually complete an employee assistance program and/or similar substance abuse recovery program and undergo random testing.

Newer technologies are also important to consider
– A mini Case Study When one construction firm decided to institute a random drug testing program for all the company’s employees, they began researching drug testing tools. They discovered that many companies relied on lab-based urine testing. But, by nature, urine testing wouldn’t lend itself well to a construction environment. Collecting the sample would be troublesome, as laborers would have to be observed during the entire process to ensure no adulteration would take place. Furthermore, workers would have to leave the job site, possibly for hours at a time, for specimen collection. Plus, each test would cost more than $150-$200 including lost labor. Urine testing was determined to be cost-prohibitive. After further research, they discovered that oral-based drug testing eliminated many of the drawbacks of urine testing and offered more effective results. In fact oral-based testing was the only technology that would allow the company to implement a truly random drug testing program. By collecting just a swab of a person’s saliva oral fluid-based tests can detect drugs almost immediately after ingestion. Urine tests can only detect drugs six to nine hours after a drug has been ingested; enough time for the drug to metabolize show up in urine. Current oral-based testing tools were easy to administer and would allow the Director of Safety to do all the testing himself, with results ready in less than 15 minutes. The impacts on this construction firm were astounding. Its accident rate dropped to near zero, workers compensation premiums dropped 13%, and overall savings were calculated in the millions.

A Workplace Benefit
A carefully designed comprehensive drug-free workplace program is a clear benefit to everyone: employers, employees, unions, insurers, and owners/shareholders.
While zero tolerance relative to substance abuse is critical, however, programs can be non-punitive in nature.
The existence of a random drug testing program acts as a strong deterrent, however there will still be instances where employees are detected abusing drugs. When this occurs, it is recommended that the employee be offered an opportunity to participant in, and successfully complete, an employee assistance program. While not being allowed to work in a position that could negatively affect workplace safety during an interim period is a benefit, “firing” an employee, vs. temporary suspension, might not best serve anyone’s best interests. The company may be losing an otherwise excellent employee based upon the specific circumstances involved. Furthermore, fellow non-abusing employees are more likely to come forward and report incidents of drug abuse, if they know that fellow workers will be provided an opportunity to address the issue vs. being terminated.
Training employees, supervisors, and even families of the signs/symptoms of drug abuse may also be of significant benefit. How effective will an employee be if a family member has reached advanced stages of drug abuse?


The Future
Many, if not most, senior “C-level” professionals aren’t even aware of the significant threats posed by workplace drug abuse.

The following responses are typical to “Why don’t you drug test at XYQ corporation?” and demonstrate a cultural tendency to sweep the problem under the rug, and/or a lack of education/awareness:

“ We don’t have a drug abuse problem at OUR company”

“ Implementing a comprehensive drug-free workplace problem, inclusive of drug testing would be TOO HARD for our corporation.”

Unfortunately a catastrophic event is required to drive some corporation’s to effect change. Yet, more and more companies are beginning to take the advice of their safety and risk management teams, and pro-actively address workplace drug abuse.

Drug free-workplace programs and innovative technologies such as oral fluid-based random testing offer employers and employees a means to protect themselves, from this pervasive problem.

With multiple avenues available to help solve the problem of workplace drug abuse, the final question remains, “Why don’t you test?”

Prescription Drug Abuse #1 Problem in Schools and Workplace ?

Prescription Drug Abuse is a MAJOR PROBLEM

According to the 2006 annual report of the International Narcotics Control Board, (as well as recent SAMHSA survey results) the domestic and worldwide abuse of licit drugswill surpass that of illicit drug abuse (potentially excluding cannabis) in upcoming years. In fact, in middle schools and high schools the first drug a child abuses these days is likely a prescription drug such as a pain reliever such as OXYCONTIN or VICODIN (52%) vs. marijuana (48%) (SAMHSA Report). Worst yet …. is that the United States leads the way in its contribution to this international problem!