Prescription Drug Abuse - Oxycontin Vicodin Lortab

Granted, society is 5-8 years late recognizing this serious problem, but at least it is now out in full view.


Prescribed problem Illegal use of medications a growing concern

OHIO - 2009 - The Daily Record - The stereotypical view of drug addicts buying their daily fix in small bags in back alleys is giving way to a new reality of prescription drug abuse where pharmaceuticals come in plastic bottles with a prescription pasted on the side.

Police and drug enforcement are dealing with a growing threat in the form of abuse of pharmaceutical opiates such as Oxycontin, Vicodin and Percocet. Typically prescribed for pain through legitimate prescriptions, obtained by deceptive means, or raiding medicine cabinets, the drugs are creating a new culture of addicts and dealers.

Only the OraPoint on-site drug screen effectively screens for these prescription pain relievers.

The problem with pharmaceutical opiates, according to Medway Drug Enforcement Agency Director David Smith, has grown in recent years so much it had to double its pharmaceutical diversion unit.

"If they learn there's an easy mark out there, they'll travel. Within that type of community, that word travels real fast. I'm sure they go to rural areas because they assume no one's watching, (rather) than to go to a bigger city," Smith said. "We have seen people from all over, not just adjacent counties, (but) two, three counties away."

The pharmaceutical diversion unit began May 2008, with aid of grant funding, consisting of former Wayne County Sheriff's deputy Jim Garrett. Bill Hofer, a former Wooster Police officer, came on in May to help with the caseload.

Cases investigated come from complaints filed, whether it's a doctor's office, a pharmacy, law enforcement or anonymous tips.

Medway made seven buys of Xanax in 2008, compared to two buys in 2007, and six buys of Oxycontin in 2008, compared to one buy in 2007. Other opiates purchased in 2008, not seen in 2007, include morphine, Darvocet, Lorazepam, Percocet, Klonopin and Hydrocodone.

Garrett said he has done a lot of outreach to local pharmacies, hospitals and they have been receptive and cooperative.

"They're on the front lines, they have a keen sense of observation," he said of local doctors. "Red flags will go up. They'll either question it or call us."

In 2008, Wooster Police reported 29 thefts of medication. So far this year, 11 thefts of medication were reported, Chief Steve Glick said.

"It's a tough one for us to do anything in a preventative measure because it's going to be happening inside people's homes," Glick said. "... It's kind of a wide ranging problem. Drugs like cocaine have to be imported and have to get here. Oxycontin, Vicodin, Percocet, those drugs are readily available, and it's not the health profession's fault necessarily, it's just the fact that the drugs are available because they are prescribed."

Millersburg Police detective Sgt. Roger Estill said investigations have turned up instances of trafficking as well as addiction involving opiate-based prescription drugs. The drugs are often obtained through fraudulent means from pharmacies and emergency rooms, prompting physicians and pharmacists to watch for signs that illegal activity is occurring.

"I don't think there is an increase in activity. What's happening is an increase in reporting," Estill said. "The medical community is looking for it more, were getting a lot of cooperation from pharmacies."

Two individuals facing felony charges in Holmes County Common Pleas Court are charged with using deceptive means to obtain the drugs. The cases involve a 48-year-old Millersburg man who tried to get a prescription filled twice after claiming to have lost the first prescription, and a 28-year-old Warsaw woman charged with changing the number of pills on a prescription form.

In both cases, the drugs were legally prescribed by a physician, only not in the amounts requested.

"I find that when you go talk to them, they acknowledge it's a problem, but they don't know how to address the problem," Garrett said of people addicted to opiates. "They're just embarrassed to come to their family and say 'I have a problem.' Unfortunately, it takes us to contact them to admit it."

Drug Abuse Rising, While Alcohol Use Declines

SAMHSA and the White House improperly use statistics to show a decline in substance abuse, electing to point to lower "positive" rates as determined from urine-based drug testing. This defies logic, as most people are aware that prescription drug abuse is at an all time high, and a component of a worldwide problem.



In reality, drug abusers easily "cheat" urine based testing, and most urine drug tests do not target prescription drug abuse such as oxycodone, hydrocodone, and benzodiazepines.

On the other hand, treatments episode data show a different story. The number of people seeking treatment for drug abuse continues to rise, while those seeking treatment for alcohol misuse is declining.

Prescription Pain Reliever Abuse in Schools

SAMHSA Report - United Stated Department of Health and Human Services

12.4 percent of young adults age 18 to 25 used prescription pain relievers nonmedically in the past year.

How did these young adults get these medications?
According to a recent report from SAMHSA's Office of Applied Studies, among young adults age 18 to 25 who used prescription pain relievers nonmedically in the past year, over half (53.0 percent) obtained their most recent pain reliever used nonmedically from a friend or relative for free.

Among young adults age 18 to 25 who used prescription pain relievers nonmedically in the past year and met the criteria for prescription pain reliever dependence or abuse, 37.5 percent obtained their most recent prescription pain relievers for nonmedical purposes for free from a friend or relative, 19.9 percent bought them from a friend or relative, and 13.6 percent obtained them from one doctor.

www.navigent3.com
Oral Fluid-based Drug Free Workplace Solutions

Workplace Drug Testing Primer

Drug tests in the USA can be divided into two general groups, federally and non-federally regulated testing.



Federally regulated drug testing started when Ronald Reagan enacted executive order 12564, requiring all federal employees refrain from using illegal substances in specified DOT regulated occupations. Drug testing guidelines and processes, in these areas exclusively, are established and regulated (by the Substance Abuse and Mental Health Services Administration or SAMHSA, formerly under the direction of the National Institute on Drug Abuse or NIDA) require that companies who use professional drivers, specified safety sensitive transportation and/or oil and gas related occupations, and certain federal employers, test them for the presence of certain drugs. These test classes were established decades ago, and include five specific drug groups. They do not account for current drug usage patterns. For example, SAMHSA / DOT tests exclude semi-synthetic opioids, such as oxycodone, oxymorphone, hydrocodone, hydromorphone, etc., and other prescription medications that are widely abused in the United States

Non-federally regulated or General workplace drug testing allows for far more effective drug testing procedures. While SAMHSA / NIDA guidelines only allow laboratories to report quantitative results for the " NIDA-5 " / " SAMHSA-5 " for their official SAMHSA-approve tests, many drug testing laboratories and on-site tests offer a wider, " more appropriate " set of drug screens to better detect current drug use patterns. As noted above, these tests include synthetic pain killers such as Oxycodone (Oxycontin, Percocet), Oxymorphone, Hydrocodone (Vicodin), Hydromorphone. Some also include benzodiazepines (Valium, Xanax, Klonopin, Restoril) and barbiturates in other drug panels (a "panel" is a predetermined subset of tests run). The confirmation test (usually GC/MS, or LC/MS/MS) can tell the difference between chemically similar drugs such as methamphetamine and methylenedioxymethamphetamine (MDMA or ecstasy). In the absence of detectable amounts of methamphetamine in the sample, the lab wold report the sample as negative, or report it as positive if present.

More Trouble with DOT Drug Testing

Problems with urine-base DOT drug testing continue.... 2008

GAO: Truck drivers taking illegal drugs get hired


WASHINGTON (AP) — Tractor-trailer and bus drivers who tested positive for illegal drugs have flouted federal regulations by returning to work without the required treatment, in some cases transporting hazardous materials for many months, congressional investigators say.

The study by the Government Accountability Office, obtained Tuesday by The Associated Press, is the latest to detail problems involving unfit commercial drivers who can operate vehicles weighing 40 tons or more.

The GAO found that 19 out of 37 commercial drivers who had a positive drug test in the last two years were hired elsewhere less than a month later — keeping quiet about their previous test result.

These tractor-trailer or bus drivers, who had tested positive for cocaine, amphetamines or marijuana, passed a new pre-employment drug test either by quickly going clean or using products such as synthetic urine to mask drug use. They subsequently operated commercial vehicles for periods ranging from one month to over a year, GAO said.

Transportation Department regulations require that prospective employers request drug-testing records — with the commercial driver's consent — from previous employers. But because some drivers testing positive do not go through treatment and do not disclose test results, the new company might not be aware of drug use if it does not vigorously investigate.

The House Transportation and Infrastructure Committee, led by Rep. James Oberstar, D-Minn., is currently looking at ways to help get unfit commercial drivers off the nation's highways. One proposal would create a clearinghouse for drug test results for commercial truck drivers to make it easier for employers to conduct checks.

Some cases cited by GAO:

_A Tennessee truck driver tested positive for cocaine in May 2007. He moved to a different employer and was rehired after passing a new test eight days later. Prior to his tests, the driver was charged with possession of a controlled substance. He worked for several months afterward, driving trucks containing cargo and hazardous material.

_An Oklahoma truck driver tested positive for marijuana in October 2007 and passed a subsequent test with another company nine days later. The driver told investigators he "took appropriate measures to clean his system before applying at the second employer." The new employer said it was unaware of the prior drug test during the hiring and let him drive for a couple of months, but that he was now no longer working for the company.

The latest review comes after a GAO safety study disclosed by the AP earlier this month found hundreds of thousands of drivers carry commercial licenses even though they also qualify for full federal disability payments

. According to that report, 563,000 commercial drivers were determined by the Veterans Affairs Department, Labor Department or Social Security Administration to be eligible for benefits over health issues, with alarming examples that raised doubts about the safety of the nation's highways.

Last week, lawmakers in the House scolded federal regulators for failing to implement recommendations made in 2001 that are aimed at keeping medically unfit commercial truck and bus drivers off the roads.

In the latest GAO study, investigators looked at data from a third-party administrator for commercial drivers who had tested positive for illegal drugs with one employer and then negative for another employer. The GAO then identified cases from the past two years where drivers had tested negative less than a month after a positive result.

On the Net:
Government Accountability Office: http://www.gao.gov
House Transportation and Infrastructure Committee: http://transportation.house.gov/

Drugged Driving - July 2008 - New Laws

Police expect challenges to roadside drug test law
DOUG MACKENZIE
The Cape Breton Post



SYDNEY — Drivers who operate a motor vehicle while high will no longer be able to refuse road side drug tests under new laws which came into affect last week.

Police can now require drivers to submit to roadside tests and also have the power to take suspected drug-impaired drivers to a police station or hospital to get a blood, urine or saliva sample.

Under the old law, police were obliged to tell drivers suspected of being high that roadside tests weren’t mandatory.
While the new law is being heralded by law enforcement officials, they also realize there will be challenges involved with enforcement.
“To us, this is a great thing, it’s another tool in our toolbox in terms of our officers out on the streets dealing with people they believe are drug induced and driving and now we actually have the law in place which gives us the authority to deal with these issues,” said deputy chief Myles Burke, of the Cape Breton Regional Police. “I think this is a great thing for law enforcement and a great thing for the community – it’s a positive step. There will no doubt ... be challenges to the law, challenges to the constitutionality of the demand and even the expertise of the experts themselves …
“This stuff can be challenged, but that’s fine. That comes with every law we’re dealing with, but at the end of the day we will have people here who are certified experts, who will be doing the field testing that is required and will be going to court in cases where they feel someone is driving under the influence of narcotics.”
Burke said training of officers within the traffic safety unit will be the key to successful enforcement of the law and he would like to see experts on call 24/7 to help deal with situations when they arise.
“The training is very specialized and although there are funds available to train officers, it does require a significant commitment and officers have to leave the local area (for training),” said Burke. “One component of the course, the officers are actually trained at a U.S. prison doing testing of people going in and out of the prison. Their field subject testing is actually live at a prison.
“We have requested for the next training course available to have a couple of seats made available. We are very interested in having a couple of our officers trained as experts.”

New Specimen Validity Ruling Ineffective

The recent "final rule" for urine-based "Specimen Validity Testing" (outlined below) is clearly of limited value, as it does little to address the prevalent practice of drug abusers cheatig urine tests.

Observed collection is the only method to assure specimen validity.

The ODAPC / DOT / & SAMHSA must stop their "political crumbling" to private interest groups such as large urine laboratories and accept alternative specimen types - oral fluid, hair - where observed specimen collection is the norm.

While the General Workplace can develop effective drug free workplace programs, those subject to Federal Mandated Drug Testing clearly can not.


Summary of Final Rule for Specimen Validity Testing

Published in today’s Federal Register is a Department of Transportation Final Rule:



Procedures for Transportation Workplace Drug and Alcohol Testing Programs





In summary:



1. This Final Rule makes it mandatory for laboratories to test all DOT specimens for specimen validity (i.e., adulterants and urine substitutes) and for laboratories to follow all Department of Health and Human Resources (HHS) protocols for doing so.



2. Observed collections will afford less privacy in order to guard against employee use of items designed specifically to beat the testing process.



a. Directly observed collections will continue to occur only when there is a specific reason to believe that an employee may be attempting, or have sufficient reason, to evade the testing process.



b. Items such as prosthetic devices designed to carry clean urine will be checked for by observers with both male and female donors. The observer will have the employee raise and lower clothing, and then put it back into place for the observed collection.



c. Observed collections will now be required, rather than optional, for all return-to-duty and follow-up drug testing.



3. In an effort to thwart those who would manufacturer products designed to adulterate specimens, the Final Rule will no longer have easy-to-follow tables and charts outlining the adulterants for which laboratories are testing and the scientific cutoff levels at which laboratories are testing them.



4. Definitions in the Final Rule have been changed to harmonize with the HHS.



5. During an invalid result Medical Review Officer (MRO) review, an employee admission of adulterating or substituting a specimen is now a refusal to test.



6. Pursuant to MRO requests, the Final Rule will close the potentially endless loop on invalid specimen results; and employees requiring negative results [for example, pre-employment tests], when they have medical reasons for providing invalid results, will be able to obtain them through medical evaluations to rule out signs and symptoms of drug use.



7. The Final Rule will also streamline and simplify the potential myriad of complicated laboratory-confirmed and MRO-verified drug test results.



8. The Final Rule requires drug testing laboratories to report to DOT semi-annual statistical summaries on all of their DOT testing.



9. The Final Rule effective date is August 25, 2008.

Boston Massachusetts Fire Fighters Union - Not the Norm

Random drug-testing programs are problematic for some unions.

Union leadership claims random drug testing is a violation of workers' right to privacy. Yet, this is appears to be an indefensible position.

Concerns of employee safety and public safety should be the #1 priority with union leaders. Sadly, it may not case for some.

Many non-union employees are required to have a pre-employment drug test and a random drug test. If workers refuse testing, they are terminated. If employees fail a drug test ... they are terminated - (which I don't view as best practice)-, or suspended and subsequently referred to an employee assistance program (EAP), which may or may not be funded by company insurance.

Simple... straight forward... and effective.

Random drug testing, conducted properly, is an effective deterent to on-the-job substance abuse, as well as a detection mechanism. What an employee does at home is not the business of any employer. When employee's behaviors effect the safety of their collegues or the public... it's not only their employers' business... it's their employers' legal obligation.

While many unions have adopted, or at least allowed random drug and alcohol testing, the Boston / Massachusetts Fire Fighters Union has failed to protect its members and the public at large.

No employee, or the public wants a drug or alcohol impaired individual in a safety sensitive position.

The Boston Fire Department had a recent tragedy in which two fatalities tested "positive" for drugs and/or alcohol. Whether this information should have been released to the public the way it was... is certainly questionable. No one should question the bravery of the individual involve, and most would not consider it.

The subsequent stonewalling of the fire fighters unions relative to drug testing is unconscionable, however, and a disgrace to everyone.

Drug Abuse in Construction & The Role of Union Leadership

"A construction work site is no place for an alcohol- or drug-impaired worker," says LI UNA General President Terence M. O'Sullivan. "To limit this risk and, also, to ensure that workers who need help get it, the Laborers support efforts to establish comprehensive drug-free workplace programs in the construction industry."



Abstract

Union stewards, general members, & senior management benefit from training on the many manifestations of substance misuse in the workplace, and their impact on working people and their children, contractors, insurers, and owners. Avitar's novel approach to workplace substance abuse management can assist in providing a framework of knowledge as well as implementation monitoring tools.

Joint development of the training curriculum, drug policy, and testing programs, would, however, require the direct involvement of union management. While Avitar can supply the technical components, to gain organization-wide commitment requires high level of participation and support of union leadership. Arguably, this leadership has been lacking in specific cases.

Unions would benefit by working with contractors, owners, insurers, and innovative drug-free workplace service providers to establish comprehensive drug-free workplace policies that include an education component to demonstrate their commitment to a drug-free workplace, support random testing via observed specimen collection, and provide employee assistance programs.

Random testing via oral is convenient, effective, non-invasive, and targets "on-the-job" drug misuse. Unlike traditional urine-based testing, oral fluid testing;

1. deters substance misuse
2. reduces accidents, workers comp claims and,
2. improves workforce image and quality.


While Construction Union may be aware of the unresolved, and epidemic problem of substance abuse in the construction sector, they may not be aware that a solution exists and the importance of their playing a leading role in mitigating the issue.

Substance abuse diminishes the ability of unions to build membership and mobilize current members.
- It erodes self-esteem and autonomy and undermines union participation, power, and leadership.
- It damages the solidarity of the union community and weakens its ability to withstand employer "attacks".

1. Unfortunately many contractors, owners, and insurers view unions as an impediment to resolution of the substance abuse in the construction sector. The lack of a comprehensive and effective occupational drug-free workplace approach by Unions contributes ineffective, ad-hoc industry practices. Similarly, the AFL-CIO program requiring urine testing and specific vendors, even further delays positive, pro-active change.

2. Unions must be proactive in efforts to deter the abuse of controlled substances and alcohol on construction sites. Laborers, management, and all related constituencies would benefit by developing and negotiating a drug and alcohol testing template programs for all contractors / owners / insurers.

3. A comprehensive drug-free workplace program MUST include:
random drug testing (via observed collection - traditional urine-based testing is relatively ineffective),
education, and
assistance.


Measurement is crucial to the recognition, treatment, and prevention of substance abuse related occupational injuries, and other negative impacts. Deterrence and identification of substance abuse benefits the individuals, their immediate coworkers, workers throughout the industry, and others exposed to the negative impacts of substance misuse. (insurers, owners, contractors, public).



4. What union members do away from work is a private affair as long as they aren't impaired when reporting to work, however, traditional urine drug testing is contrary to this notion. Neither unions nor employers should not be allowed to dictate behaviors while away from work.


5. Deterrence is the goal, however, detection and assitance are true benefits.
Union MAP's (member assistance programs) are underutilized (not used 60% of the time). MAPs serve members as well as health & MMwelfare funds, contractors, owners, alike.
- MAPs help laborers & families access to assistance most needed for personal problems/issues
- MAPs control costs (lack of care created costs far exceeding MAP cost).
Labor organizations can only offer assistance to their members on a variety of health, welfare, and safety issues, including substance use disorders, only if aware of the problem.





Sources and Additional Information:

1. 50% of abuse detected now involves prescription drugs, esp. pain relievers. The abuse / misuse of many popular prescription pain releivers is not tested via traditional DOT-based urine testing.

2. While approximately 15%- 20% of construction workers abuse drugs, the US Bureau of Labor Statistics survey significantly underestimate the incidence of work related injuries and illnesses. The United States does not have a comprehensive national surveillance system for occupational injuries and illnesses. Lacking this system, major sources of US occupational health data include the Bureau of Labor Statistics (BLS) annual survey of occupational injuries and illnesses, workers' compensation records, and physician reporting systems. Data produced by these systems have been described as fragmentary, unreliable, and inconsistent. Moreover, they have been shown to underestimate the incidence of workrelated injuries, illnesses, and even fatalities by as much as several hundred percent. (Occupational injury and illness surveillance: Conceptual filters explain underreporting; Azaroff, Lenore S; Levenstein, Charles; Wegman, David H American Journal of Public Health 09-01-2002 )

3. 77% of adults with substance abuse disorders are employed - Results From the 2004 National Survey on Drug Use and Health: National Findings. DHHS Publication No. (SMA) 05-4062. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies, September 2005, p. 72.

4. LIUNA MAPs save money - Detroit, first-quarter 2003 data indicate that the LAP saves the fund about $175,000 annually over the likely cost of service to members if no MAP existed. In Southern Illinois, drug expenditures for the first two quarters since MAP usage was mandated are running more than 50 percent below the previous year's average. In Massachusetts, since the MAP was established in 1991, the Fund has saved about $8.8 million in average length of service and per diem costs for in-patient care.

5. Substance use disorders affect people from all walks of life, workers & families. According to a 2005 Hazelden Foundation survey, more than 69 percent of employed people indicated that if a family member were struggling with abuse or addiction, it would negatively affect their ability to concentrate and be productive at work. In fact, 36 percent of people who are employed admitted that at least one of their coworkers had been distracted, less productive, or missed work because of alcohol/drug abuse or addiction within their family.

6. A key message for labor organizations to communicate to employers is that treatment for substance use disorders has substantial benefits for businesses. Reported job problems, including incomplete work, absenteeism, tardiness, work-related injuries, mistakes, and disagreements with supervisors, are cut by an average of 75 percent among employees who have received treatment for substance use disorders. Furthermore, treatment has a benefit-to-cost ratio of 7:1, with substance use disorder treatment costing $1,583 on average and having a monetary benefit to society of nearly $11,487.

7. Domestic violence is directly related to substance abuse. Despite the obvious importance of involving unions in domestic violence prevention with men, little works has been done is this area. This may reflect fears that unions would not be receptive to addressing domestic violence. Senior office holders within some unions have been hesitant to apply their leadership to this issue, for various reasons. Sometimes union leadership has not understood how widespread domestic violence is. Sometimes they have argued that it is a private matter best left to the couple affected. At other times they have expressed concern but felt pessimistic about their ability to do anything about it. And on other occasions they have felt torn between their desire to protect a worker from disciplinary action or job loss and their conviction that domestic violence is wrong.

- It is every employer's legal responsibility to ensure safety in the workplace. Domestic violence compromises the well-being, job performance, and productivity of valuable employees. Many of the attitudes and gender roles that increase men's risk of using domestic violence also predispose men to other high risk behaviors, such as drug and alcohol abuse, workplace violence, or taking unnecessary safety risks to demonstrate "toughness" to peers.
- Domestic violence is a leading cause of workplace violence; it also creates safety and health risks to everyone in the workplace:
- Since almost one in four women is affected by domestic violence, we can make a conservative estimate that 10% of employees may be affected by domestic violence.
- 24% of abused women said they were either late or missed days of work due to abuse
- 54% of abused women missed up to three full days of work per month.
- 94% of corporate security directors surveyed rank domestic violence as a high security problem at their company.
- Violence against women weakens unions and diminishes their ability to build membership or mobilize current members.
- Domestic violence is a safety and health issue for all members since perpetrators often stalk and harass women at their workplace, possibly jeopardizing co-workers as well. Additionally, domestic violence is a work/family issue, since it has devastating economic and personal consequences for the family.

8. Most union members are in support of drug testing (Discriminating characteristics of union members' attitudes toward drug testing in the workplace, Journal of Labor Research, 2007.)

Drugged Driving and Alcohol DUI Leading Cause of Deaths

2008 SAMHSA REPORT - United Stated Department of Heatlh and Human Services

5% of people drove under the influence of illicit drugs in the past year (10 million drivers)
(15% under influence of alcohol).

States with the highest drugged driving rates:
District of Columbia (7.0 percent),
Rhode Island (6.8 percent),
Massachusetts (6.4 percent),
Montana (6.3 percent), and
Wyoming (6.2 percent).

Impaired driving is the LEADING CAUSE OF DEATHS among persons aged 3 to 33.

Illicit drugs, as defined above, includes marijuana/hashish, cocaine (including crack), inhalants, hallucinogens, heroin, or prescription-type drugs used nonmedically.

SAMHSA TO APPROVE ORAL FLUID / SALIVA DRUG TESTING

(source: Forensic Sci Int. 2007 Apr 12)

Despite the lack of speed, likely due program mismangement and lobbying on the part of urine labs and large TPAs that have a vested interest in urine testing, SAMHSA will (per the below) have to approve alternative forms of drug testing in order to manage workplace drug abuse.


The U.S. Mandatory Guidelines for Federal Workplace Drug Testing Programs: Current status and future considerations.
Donna M Bush - Division of Workplace Programs, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, One Choke Cherry Road, Room 2-1033, Rockville, MD 20857, USA.

The U.S. Department of Health and Human Services (HHS) drug testing standards were published in 1988 and revised in 1994, 1998, and 2004.

In a separate notice, HHS proposed to establish scientific and technical guidelines for the Federal Workplace Drug Testing Program to:

(1) permit laboratory testing of hair, oral fluid, and sweat patch specimens in addition to urine specimens for marijuana, cocaine, phencyclidine, opiates (with focus on heroin), and amphetamines [including methylenedioxymethamphetamine (MDMA), methylenedioxyethamphetamine (MDEA), methylenedioxyamphetamine (MDA)];

(2) permit use of on-site point of collection test (POCT) devices to test urine and oral fluid at collection sites;

(3) permit use of instrumented initial test (screening only) facilities [IITF] to quickly identify negative specimens; and (

4) add training requirement for collectors, on-site testers, and MROs.

This proposal was published in the Federal Register on 13 April 2004, with a 90-day public comment period.

The Substance Abuse and Mental Health Services Administration, HHS, reviewed those comments and is preparing the Final Notice that will define the requirements for such testing, including: specimen collection procedures, custody and control procedures that ensure donor specimen identity and integrity, testing facility, initial and confirmatory test cutoff concentrations, analytical testing methods, result review and reporting, evaluation of alternative medical explanations for presence of drug or metabolite in the donor's specimen, and laboratory certification issues.

Voluntary pilot performance testing (PT) programs for each specimen type are on-going since April 2000 to determine how to prepare PT materials for specimens other than urine to evaluate laboratories' ability to routinely achieve accuracy and precision required.


Certification programs will be developed using the current urine drug testing National Laboratory Certification Program model.

The addition of accurate and reliable workplace drug testing using hair, oral fluid, and sweat patch specimens will complement urine drug testing, and aid in combating industries devoted to suborning drug testing through adulteration, substitution, and dilution.

Saliva / Oral Fluid Proteins Mapped

Protein map of human spit created
By Julie Steenhuysen 27 minutes ago

CHICAGO (Reuters) - U.S. researchers have identified all 1,116 unique proteins found in human saliva glands, a discovery they said on Tuesday could usher in a wave of convenient, spit-based diagnostic tests that could be done without the need for a single drop of blood.

As many as 20 percent of the proteins that are found in saliva are also found in blood, said Fred Hagan, a researcher at the University of Rochester Medical Center in New York who worked on the study.

"This is potentially a large field that has many clinical implications in the area of disease diagnostics," said Hagan, whose work was published in the Journal of Proteome Research.

The researchers hope saliva-based tests could be used to diagnose cancer, heart disease, diabetes and a number of other conditions.

"To be able to diagnose disease using saliva, you really have to have a comprehensive understanding of the saliva proteome," Hagan said in a telephone interview.

Like a genome, which lists all of the genes in an organism, a proteome is a complete map of proteins. While genes provide the instruction manual, proteins carry out the instructions by regulating cellular processes.

Researchers from five universities -- the University of Rochester, The Scripps Research Institute, the University of Southern California, The University of California San Francisco and the University of California Los Angeles -- sought to determine the complete set of proteins secreted by the major salivary glands.

BLOOD, SPIT AND TEARS

They collected saliva from 23 healthy men and women of several races. They tested saliva samples using some form of mass spectrometry, which determines the identity of proteins based on measurements of their mass and charge.

They compared their findings with recent protein maps of human blood and tears.

Early analysis has already turned up a number of proteins with known roles in Alzheimer's, Huntington's and Parkinson's diseases; breast, colorectal and pancreatic cancer and diabetes.

Most of the proteins were part of signaling pathways, which are key to the body's response to system wide diseases.

Hagan said the work should accelerate the development of new tools for tracking disease throughout the body.

Already there are saliva-based antibody tests to detect human immunodeficiency virus, or HIV, and hepatitis infections, Hagan said. He said this protein map will provide new targets.

"Monitoring disease as well as drug use could be more easily done with saliva as opposed to blood or urine," he said.

Other groups are working on a saliva-based test for breast cancer that would detect a protein fragment from the HER2 protein. Hagan said such tests could eventually replace uncomfortable and costly mammograms.

"We envision in the future spitting in a tube and looking for a marker like this breast cancer marker. It would be much easier to do, potentially at home," he said.

"Given that we've made this information publicly available, we fully expect a number of research groups will be picking their favorite targets and developing their own tests. That is the intent -- to create a wealth of data to stimulate more research and increase the chances of producing better diagnostic tests," Hagan said.

(Editing by Maggie Fox and Mohammad Zargham)

Workplace Drug Abuse Statistics Misleading?

The following statistics are misleading at best.

A review of the data shows that drug abuse rates among workers have been stagnant for past decade.

Any statement that workplace drug abuse is lower, would be unsupportable by the findings.

The data does potentially indicate that that drug abusers have learned to cheat urine-based drug tests. This being supported by research recently concluded by the U.S. Government General Accounting Office (GAO) noting that cheating urine-based testing is easily accomplished and virtually undetectable.


The report also neglects to point out the opiate detection rates continue to climb. .. particularly oxycodones have gone up nearly 40% in one year!

" Use of Methamphetamine Among U.S. Workers and Job Applicants Drops 22 Percent in 2007 and Cocaine Use Slows Dramatically, Reports Quest Diagnostics"

Findings from Quest Diagnostics Drug Testing Index® also show that overall drug positivity remains at record lows

MADISON, NJ, March 12, 2008 — The percentage of positive tests for methamphetamine among U.S. job applicants and workers in the general U.S. workforce dropped more than 22 percent between 2006 and 2007.

These findings, from the Quest Diagnostics Drug Testing Index®, reflect the reversal of an upward trend in use of the drug by more than 73 percent from 2002 to 2004. These data were released today by Quest Diagnostics Incorporated (NYSE: DGX), the nation's leading provider of employment-related drug testing services.


The report also shows that positive tests for cocaine in the general U.S. workforce were down 19 percent between 2006 and 2007 and that overall drug use, among workers subject to drug testing, remains at an all-time low.

Methamphetamine, the most commonly abused type of amphetamine, increased in production and trafficking during the 1990’s to become the most prevalent illegally manufactured synthetic drug in the United States. Analysis of the Quest Diagnostics Drug Testing Index, released semi-annually, suggests that efforts to reduce illicit, clandestine production of methamphetamine may be having an impact on workplace positive tests for the drug.

"The fact that America's workers are using cocaine and methamphetamine at some of the lowest levels in years is further evidence of the tremendous success that law enforcement is having at impacting the nation's illicit drug supply," said DEA Acting Administrator Michele M. Leonhart. "DEA will continue its relentless assault on the drug supply to help keep these dangerous drugs out of our neighborhoods."

While the 2007 Quest Diagnostics Drug Testing Index shows that positive methamphetamine tests have decreased, it also indicates that the use of amphetamine in the general workforce has increased slightly, by about five percent. Testing for methamphetamine and amphetamine was conducted among employees and applicants in the U.S. workforce tested for the class of drugs called amphetamines.

"Although some may conclude that there is a reduced availability for methamphetamine, the fact that our data show an increase in amphetamines suggests that some workers might be replacing one stimulant drug for another in the larger drug class of amphetamines," said Barry Sample, Ph.D., Director of Science and Technology for Quest Diagnostics' Employer Solutions division.

Methamphetamine and amphetamine are both types of stimulants, which typically are used by individuals to increase alertness and relieve fatigue. Stimulants are also used for euphoric effects or to counteract the "down" feeling of tranquilizers or alcohol. Possible side effects of stimulants include increased heart and respiratory rates, elevated blood pressure, dilated pupils and decreased appetite. High doses may cause rapid or irregular heartbeat, loss of coordination or collapse. Indications of possible misuse may include excessive activity, talkativeness, irritability, argumentativeness or nervousness.

Cocaine Use Continues to Decline

The Quest Diagnostics Drug Testing Index shows that the percentage of positive tests for cocaine was down 19 percent among the U.S. general workforce since the first half of 2007 - the largest single-year drop since 1997. Positive tests for cocaine among the general workforce declined to 0.58 percent in 2007 from 0.72 percent in 2006.

Overall Drug Use Remains at All-Time Low

Additionally, drug use by employees remains at its lowest level since Quest Diagnostics began publishing the Drug Testing Index in 1988. Among the combined U.S. workforce, only 3.8 percent of the tests had positive results — the same level reported in 2006 — compared to a high of 13.6 percent in 1988. Further, among safety-sensitive federal workers only, the Drug Testing Index showed that drug use was at an all-time low of 1.8 percent of the tested work force.

The 2007 Drug Testing Index is a summary of results from 8.4 million workplace drug tests performed by Quest Diagnostics between January and December 2007. Results are based on tests that Quest Diagnostics performs for employers that conduct pre-employment, random or for-cause drug testing. For more information, see additional results below.

About the Drug Testing Index

The Drug Testing Index is published as a public service for government, media and industry and has been considered a benchmark for national trends since its inception in 1988. It examines positivity rates — the proportion of positive results for each drug to all such drug tests performed — among three major testing populations: federally mandated, safety-sensitive workers; the general workforce; and the combined U.S. workforce. Federally mandated, safety-sensitive workers include pilots, bus and truck drivers, and workers in nuclear power plants, for whom routine drug testing is mandated by the U.S. Department of Transportation and the Nuclear Regulatory Commission.

About Quest Diagnostics

Quest Diagnostics is the leading provider of diagnostic testing, information and services that patients and doctors need to make better healthcare decisions. The company offers the broadest access to diagnostic testing services through its national network of laboratories and patient service centers, and provides interpretive consultation through its extensive medical and scientific staff. Quest Diagnostics is a pioneer in developing innovative new diagnostic tests and advanced healthcare information technology solutions that help improve patient care. Additional company information is available at: www.questdiagnostics.com.

The statements in this press release which are not historical facts or information may be forward-looking statements. These forward-looking statements involve risks and uncertainties that could cause actual results and outcomes to be materially different. Certain of these risks and uncertainties may include, but are not limited to, competitive environment, changes in government regulations, changing relationships with customers, payers, suppliers and strategic partners and other factors described in the Quest Diagnostics Incorporated 2005 Form 10‑K and subsequent SEC filings.

The Drug Testing Index © 2008 Quest Diagnostics Incorporated. All rights reserved.

Tables Follow
Positive Prevalence Rates for Amphetamine and Methamphetamine —
Percentage of All Tests for “Amphetamines“
2007 2006 2005 2004 2003 Amphetamine 0.40% 0.38% 0.44% 0.45% 0.41% Methamphetamine 0.14% 0.18% 0.28% 0.33% 0.32% Percent Difference - Amphetamine 5.3% -13.6% -2.2% 9.8% Percent Difference - Methamphetamine -22.2% -35.7% -15.2% 3.1%

Positivity Rates for Cocaine
2007 2006 2005 2004 2003 Cocaine 0.58% 0.72% 0.70% 0.72% 0.74% Percent Difference - Cocaine -19.4% 2.9% -2.8% -2.7%

Annual Positivity Rates
For Combined U.S. Workforce
(More than 8.4 million tests from January to December 2007)
Year Drug Positive Rate 1988 13.6% 1989 12.7% 1990 11.0% 1991 8.8% 1992 8.8% 1993 8.4% 1994 7.5% 1995 6.7% 1996 5.8% 1997 5.0% 1998 4.8% 1999 4.6% 2000 4.7% 2001 4.6% 2002 4.4% 2003 4.5% 2004 4.5% 2005 4.1% 2006 3.8% 2007 3.8%

Positivity Rates By Testing Category
Testing Category 2007 2006 2005 2004 2003 Federally Mandated, Safety-Sensitive Workforce 1.8% 2.0% 2.3% 2.3% 2.5% General U.S. Workforce 4.4% 4.4% 4.5% 4.9% 5.0% Combined U.S. Workforce 3.8% 3.8% 4.1% 4.5% 4.5%

Positivity Rates By Testing Reason
For Federally Mandated, Safety-Sensitive Workforce
(More than 1.8 million tests from January to December 2007)
Testing Reason 2007 2006 2005 2004 2003 Follow-Up 2.8% 3.0% 3.1% 3.3% 3.4% For Cause 11.1% 12.5% 13.4% 14.1% 13.8% Periodic 0.75% 0.59% 0.76% 0.51% 0.75% Post-Accident 2.6% 2.7% 3.0% 2.9% 3.1% Pre-Employment 2.0% 2.3% 2.6% 2.7% 2.9% Random 1.5% 1.5% 1.8% 1.8% 1.9% Returned to Duty 3.3% 3.2% 3.0% 2.9% 2.8%

Positivity Rates By Testing Reason
For General U.S. Workforce
(More than 6.6 million tests from January to December 2007)
Testing Reason 2007 2006 2005 2004 2003 Follow-Up 7.7% 7.4% 9.6% 9.9% 9.6% For Cause 19.2% 18.1% 28.3% 27.8% 28.2% Periodic 1.4% 1.9% 2.4% 1.9% 2.2% Post-Accident 5.8% 5.7% 5.8% 5.7% 5.7% Pre-Employment 3.9% 3.9% 3.9% 4.1% 4.1% Random 5.7% 5.5% 6.6% 7.1% 6.6% Returned to Duty 5.6% 5.8% 6.0% 5.5% 5.6%

Positivity Rates By Drug Category
For Federally Mandated, Safety-Sensitive Workforce, as a percentage of all such tests
(More than 1.8 million tests from January to December 2007)
Drug Category 2007 2006 2005 2004 2003 Amphetamines 0.25% 0.28% 0.35% 0.31% 0.29% Cocaine 0.44% 0.58% 0.60% 0.57% 0.59% Marijuana 0.88% 0.94% 1.10% 1.25% 1.34% Opiates 0.18% 0.17% 0.18% 0.17% 0.19% PCP 0.04% 0.03% 0.04% 0.04% 0.04%

Positivity Rates By Drug Category
For General U.S. Workforce, as a percentage of all such tests
(More than 6.6 million tests from January to December 2007)
Drug Category 2007 2006 2005 2004 2003 Amphetamines 0.44% 0.42% 0.48% 0.52% 0.49% Barbiturates 0.24% 0.23% 0.25% 0.27% 0.29% Benzodiazepines 0.67% 0.62% 0.58% 0.58% 0.60% Cocaine 0.58% 0.72% 0.70% 0.72% 0.74% Marijuana 2.34% 2.38% 2.54% 2.88% 2.96% Methadone 0.23% 0.22% 0.23% 0.21% 0.20% Opiates 0.35% 0.32% 0.32% 0.32% 0.34% Oxycodones 0.88%1 0.64%2 0.56%3 -- -- PCP 0.02% 0.01% 0.02% 0.01% 0.03% Propoxyphene 0.58% 0.55% 0.57% 0.63% 0.67%

Positivity Rates By Drug Category
For Combined U.S. Workforce, as a percentage of all such tests
(More than 8.4 million tests from January to December 2007)
Drug Category 2007 2006 2005 2004 2003 Amphetamines 0.40% 0.39% 0.46% 0.49% 0.45% Barbiturates 0.24% 0.23% 0.25% 0.27% 0.29% Benzodiazepines 0.67% 0.62% 0.58% 0.58% 0.60% Cocaine 0.55% 0.69% 0.69% 0.70% 0.71% Marijuana 2.01% 2.04% 2.28% 2.59% 2.67% Methadone 0.23% 0.22% 0.23% 0.21% 0.20% Opiates 0.32% 0.28% 0.29% 0.29% 0.31% Oxycodones 0.88%1 0.64%2 0.56%3 -- -- PCP 0.02% 0.02% 0.02% 0.02% 0.03% Propoxyphene 0.58% 0.55% 0.57% 0.63% 0.67%

Non-Negative Rates By Specimen Validity Test (SVT)4 Category
For Federally Mandated, Safety-Sensitive Workforce, as a percentage of all such tests
(More than 1.8 million tests from January to December 2007)
SVT Category 2007 2006 2005 2004 2003 Acid-Base 0.01% 0.00% 0.01% 0.01% 0.01% Invalid 0.11% 0.12% 0.12% 0.08% 0.08% Oxidizing Adulterants 0.00% 0.00% 0.00% 0.02% 0.03% Substitution 0.05% 0.05% 0.05% 0.06% 0.06%

Non-Negative Rates By Specimen Validity Test (SVT)4 Category
For General U.S. Workforce, as a percentage of all such tests
(More than 6.6 million tests from January to December 2007)
SVT Category 2007 2006 2005 2004 2003 Acid-Base 0.00% 0.00% 0.00% 0.01% 0.01% Invalid 0.13% 0.15% 0.16% 0.10% 0.10% Oxidizing Adulterants 0.00% 0.00% 0.00% 0.01% 0.02% Substitution 0.01% 0.01% 0.01% 0.03% 0.03%

Non-Negative Rates By Drug/SVT Category
For Federally Mandated, Safety-Sensitive Workers, as a Percentage of All Non-Negatives
(More than 35 thousand non-negative test results from January to December 2007)
Drug/SVT Category 2007 2006 2005 2004 2003 Acid/Base 0.47% 0.15% 0.27% 0.32% 0.37% Amphetamines 12.7% 12.6% 14.8% 12.7% 11.4% Cocaine 22.2% 26.3% 25.4% 23.2% 22.7% Invalid 5.5% 5.7% -- -- -- Marijuana 45.2% 43.8% 47.8% 52.4% 53.6% Opiates 9.2% 7.8% 7.7% 7.1% 7.4% Oxidizing Adulterants 0.00% 0.00% 0.06% 0.42% 0.52% PCP 2.1% 1.6% 1.8% 1.4% 1.7% Substituted 2.7% 2.2% 2.3% 2.4% 2.3%

Non-Negative Rates By Drug/SVT Category
For General U.S. Workforce, as a Percentage of All Non-Negatives
(More than 315 thousand non-negative test results from January to December 2007)
Drug/SVT Category 2007 2006 2005 2004 2003 Acid/Base 0.04% 0.04% 0.06% 0.11% 0.16% Amphetamines 9.2% 8.8% 10.1% 10.0% 9.0% Barbiturates 2.8% 2.6% 2.7% 2.7% 2.8% Benzodiazepines 6.9% 6.1% 5.4% 5.0% 5.1% Cocaine 12.2% 15.0% 14.7% 13.8% 13.8% Invalid 2.8% 3.2% -- -- -- Marijuana 48.8% 49.5% 53.0% 55.0% 55.0% Methadone 2.2% 2.0% 2.0% 1.7% 1.6% Methaqualone 0.00% 0.00% 0.00% 0.00% 0.00% Opiates 7.4% 6.6% 6.6% 6.1% 6.3% Oxycodones 1.5% 0.74% -- -- -- Oxidizing Adulterants 0.00% 0.00% 0.05% 0.16% 0.48% PCP 0.35% 0.31% 0.31% 0.28% 0.51% Propoxyphene 5.6% 4.9% 4.9% 4.9% 5.0% Substituted 0.26% 0.27% 0.26% 0.49% 0.58%

Non-Negative Rates By Drug/SVT Category
For Combined U.S. Workforce, as a Percentage of All Non-Negatives
(More than 350 thousand non-negative test results from January to December 2007)
Drug/SVT Category 2007 2006 2005 2004 2003 Acid/Base 0.09% 0.05% 0.08% 0.13% 0.18% Amphetamines 9.6% 9.3% 10.6% 10.2% 9.3% Barbiturates 2.5% 2.3% 2.5% 2.5% 2.5% Benzodiazepines 6.1% 5.4% 4.9% 4.5% 4.7% Cocaine 13.2% 16.4% 15.7% 14.7% 14.6% Invalid 3.0% 3.5% -- -- -- Marijuana 48.4% 48.8% 52.5% 54.8% 54.9% Methadone 2.0% 1.8% 1.8% 1.5% 1.4% Methaqualone 0.00% 0.00% 0.00% 0.00% 0.00% Opiates 7.6% 6.7% 6.7% 6.2% 6.4% Oxidizing Adulterants 0.00% 0.00% 0.09% 0.19% 0.52% Oxycodones 1.4% 0.65% -- -- -- PCP 0.53% 0.46% 0.45% 0.38% 0.61% Propoxyphene 5.0% 4.3% 4.4% 4.4% 4.5% Substituted 0.51% 0.49% 0.45% 0.66% 0.73%

1 More than 500,000 tests

2 Approximately 400,000 tests

3 More than 200,000 tests

4 Specimen validity testing is the evaluation of a specimen to determine if it is consistent with a normal human specimen. Tests for specimen validity include tests to determine whether a specimen is adulterated or substituted.

Open a printable copy (requires Adobe Acrobat Reader)

Accuracy of On-site Oral Fluid / Saliva Drug Testing

Journal of Psychoactive Drugs

A comparison between instant and laboratory oral fluid analysis among arrestees.
Yacoubian GS; Wish ED.

Research studies that collect biological measures of drug use have traditionally utilized laboratory urinalysis.

Several recent studies have also documented the utility of laboratory oral fluid (OF) analysis.
A new method of drug testing -- instant OF technology -- may offer a quicker, equally accurate alternative to laboratory OF assays.

To date, however, no field studies have compared the two methods.

In the current study, an instant OF test (Avitar ORALscreen (TM)) was administered to adult arrestees surveyed through Maryland's Substance Abuse Need for Treatment among Arrestees (SANTA) study.

Following a research interview, a second OF sample was collected (Avitar ORALconfirm (TM)) and shipped to the manufacturer's laboratory for analysis.

The Avtiar ORALscreen instant OF test was -

96% sensitive and 83% specific for cocaine,

100% sensitive and 75% specific for opiates, and
100% sensitive and 94% specific for marijuana.

Copyright 2006, Haight-Ashbury Publishing

Reference Source: Yacoubian GS; Wish ED. A comparison between instant and laboratory oral fluid analysis among arrestees. Journal of Psychoactive Drugs 38(2): 207-210, 2006. (10 refs.)

Drugged Driving

Drivers is Australia who tested positive to drugs in roadside checks have had their results confirmed in a laboratory and will be charged.

Police had to wait until Queensland Health Scientific Services analysed the drivers' saliva samples in its laboratory and confirmed the presence of drugs before they could be charged.
All 10 drivers tested positive to driving while under the influence of methamphetamine.

A 42-year-old man has been summonsed to appear in Brisbane Magistrates Court on January 31 and a 25-year-old man will appear in the same court on February 11.

Since random drug-testing of drivers was introduced on December 1, 19 drivers have tested positive to drugs, up until midnight on Thursday.

Police are still awaiting laboratory confirmation of the remaining nine test results.

Of the 19 drivers, 17 tested positive to methamphetamine, one tested positive to both methamphetamine and cannabis and one tested positive for ecstasy.

Drug-drivers can be fined up to $1050, lose their licence or face up to three months' jail.
Police hope to saliva-test about 20,000 drivers in the first year of the random roadside drug-testing operations and expect about 300 to test positive to illicit drugs.

The introduction of drug testing comes as Queensland cut its road toll by more than two-thirds for the official holiday period, with four deaths against last year's 13.
Across Australia, 45 people died on the roads this season compared with 62 last year.

Courts Uphold Workplace Drug Testing - Once Again

Alberta Court of Appeal ruling upholds construction workplace drug testing
(Source: Canadian Press)

EDMONTON - Construction and energy companies are happy with an Alberta court ruling that upholds the right of employers to test workers for drugs.

The Alberta Court of Appeal's decision overturned a lower court judgment that said Kellogg, Brown & Root Co. discriminated against a man in 2002 when it fired him from an oilsands project near Fort McMurray after he tested positive for marijuana.

John Chiasson, who admitted to being a recreational pot smoker, filed a complaint with the Alberta Human Rights Commission, which ruled against him. The commission said there needs to be a balance between an individual's human rights and the needs of an employer in protecting others.

But Court of Queen's Bench Justice Sheilah Martin then ruled in his favour. She said he should have been treated the same as someone with a drug addiction, which is considered a disability in human rights case law.
The panel of three Appeal Court justices disagreed. The judges said it is legitimate for Kellogg, Brown & Root to presume that people who use drugs at all are a safety risk in an already dangerous workplace.

"We see this case as no different than that of a trucking or taxi company which has a policy requiring its employees to refrain from the use of alcohol for some time before the employee drives one of the employer's vehicles," the justices wrote.

"Extending human rights protections to situations resulting in placing the lives of others at risk flies in the face of logic."

Kellogg, Brown & Root, one of the largest construction firms in the world, was helping to build an expansion to Syncrude Canada's plant at the time of Chiasson's case and is still active in the oilsands.

Andrew Robertson, a lawyer for the company, said the Appeal Court's decision is important to energy and construction industries.

"It is refreshing to see the Alberta Court of Appeal factor in risk management in safety-sensitive workplaces in a circumstance when there had been a recent focus on human rights issues," he said.

Heather Browne, a spokeswoman for Texas-based Kellogg, Brown & Root, hailed the ruling.
"KBR is a leader in workplace safety, and maintaining that commitment is the company's top priority," Browne said Wednesday.
"The court ruling upholds that commitment and we look forward to continuing our work in that regard."

"This affects a lot of people and it is important. The commission does have a duty to ensure that the rights of all Albertans - both employers and employees - are balanced in this respect."

During the original court case, officials with oilsands giant Syncrude testified that the company's lost-time rate from accidents has dropped in part because of drug and alcohol testing.

Syncrude, Suncor, Albian Sands and other major oilsands heavyweights test their employees for drugs before they are allowed on jobsites.

Kara Flynn, a spokeswoman for Syncrude, said that in a broad sense, the Appeal Court ruling supports the company's drug-testing policy and goals.

"Any judicial decisions that support that are greatly appreciated," she said.

The impact of the ruling is already starting to ripple beyond Alberta's boundaries.
Phil Hochstein, president of the Independent Contractors and Business Association in British Columbia, said while workplace drug testing is common on major projects in Alberta, it is the exception in B.C.

He expects that is going to change.
"I think that workplace testing of construction workers is probably an issue whose time has come," he said from Vancouver.
"I think this case is going to spur more of this jobsite testing, not only on big industrial jobs, but on commercial and institutional jobs throughout the country."

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.

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