Drug Testing 101: Condensed

1. Drug Testing 101: Condensed Jeff Sims, C-SAPA, C-SI Past President, Substance Abuse Program Administrators Association President, a’ TEST consultants, inc.

2. Overview • 1. The Drug Testing Industry • 2. Why drug test? • 3. How and When do You Test? • 4. Specimen Types: Traditional vs Alternative • 5. Drug Testing Panels: Not one size fits all! • 6. Validity Testing and Adulterant Products • 7. Reporting Requirements • 8. Current Federally Mandated Programs • 9. Pending Drug Testing Legislation and Current Industry Issues • 10. Questions and Answer

3. 1. The Drug Testing Industry

4. Drug Testing Industry Players and Their Role • Laboratories • Third-party administrators (TPAs) and background screening retailers • Collection sites and collectors • Medical Review Officers • Manufacturers / Distributors

5. 2. Why Do Companies Drug Test?

6. How did we get to this point? • Most aggressive actions occurred since the late 1980’s:- The Anti-Drug Abuse Act of 1986 (directed U.S. Secretary of Labor to initiate efforts to address the issue)- President Reagan’s Executive Order 12564, Drug-Free Federal Workplace (made it a condition of employment to refrain from using illegal drugs)- Drug-Free Workplace Act of 1988 (required federal contractors and grantees to have drug-free workplaces)- Drug-Free Workplace Act of 1998 (establish grant programs that assist small businesses in developing drug-free workplaces)- Omnibus Employee Testing Act of 1991 (required transportation industry employers to conduct alcohol and drug testing for employees in “safety sensitive” positions) It created a model for non-regulated employers now follow.

7. The U.S. drug and alcohol problem • In 2006, estimated 20.4 million Americans were current illicit drug users, which is a rate of 8% among all Americans. No significant changes in recent years. • About 57 million people, or more than one-fifth (23.0 %) of the population age 12 and over, participated in binge drinking (having five or more drinks one the same occasion at least once in the past 30 days).

8. Drug Abusers as Employees • More likely to be involved in an accident and file a workers’ compensation claim • More likely to quit or get fired • More likely to steal from workplace • More likely to miss work • More likely to be in a confrontation • Less productive

9. The Impact on Safety Substance abusers are: • 3.6 times more likely to be involved in a workplace accident • 5 times more likely to file a workers’ compensation claim • As many as 50% of all workers’ compensation claims involve substance abuse

10. The Impact on Safety 80% of those injured in “serious” drug-related accidents at work are not the drug abusing employees… but innocent co-workers and others.

11. Bottom Line • On average it cost an employer almost $7000.00 per substance abusing employee

12. 5 Key Components A comprehensive drug-free workplace program includes: • Policy • Supervisor training • Employee education • Employee assistance • Drug testing (Alcohol testing)

13. 3. How and When do You Test?

14. How to Test? • Traditional laboratory based urine testing using: • Screen • Confirmation • Alternative specimen • Rapid result or also known as POCT using professional collectors • Medical review officer verification

15. When to Tests Pre-Employment Random Post-Accident Reasonable Cause/Suspicion Return-to-Duty Follow-Up

16. 4. Specimen Types: Traditional VS Alternative

17. Specimen Types Which specimen meets your needs? • Urine (lab and rapid result analysis) • Hair (on-site collection; lab analysis required) • Oral Fluids (rapid result and lab analysis) • Sweat Testing (rapid result and lab analysis) • Blood Testing (lab analysis)

18. Specimen Types Urine? • Legally sound • Federally endorsed • Most common • Invasive • Subject to adulteration • Split Testing

19. Alternative Specimens Hair? • Window of 90 days minus recent 7-10 days • Legally still being tested • Lacks federal endorsement • About 1-2% usage • Invasive • Scientifically questionable? • Pre-employment tool

20. Alternative Specimens Oral Fluid? • Window 4-24+ hours • Limited legal exposure • Getting federal endorsements (alcohol only) • Least invasive • Comparable to blood • Adulteration resistant • “Under the influence” indicator

21. Drug Testing Panels and Price: Not one size fits all!

22. Federally Mandated Testing Panel • Marijuana • Cocaine • Opiates • Amphetamines • Phencyclidine (PCP) The primary drugs of abuse

23. Additional Drugs Being Testing • Hydromorphone   • Oxycodone   • Oxymorphone • Hydrocodone • Propoxyphene • Ecstasy • Benzodiazepines • Barbiturates • Methadone

24. 6. Validity Testing and Adulterant Products

25. ADULTERATED, SUBSTITUTED SPECIMEN • Internet provides a list of suppliers with information on beating drug, alcohol or hair testing • Bleach, soap, Visine, other substances • Purging with water, other liquids • “Rapid” on-site drug test are the most vulnerable Innovative Resources, Inc.

26. Adulterants

27. 7. Reporting Requirements

28. Federal vs Non Federal to be Completed before Report • If it is a Federally mandated test (This would include US DOT)a. Must receive certifying scientist signed copyb. Must have MRO copy of CCF • Non Federal? Any other requirements?a. State Laws (Arkansas Law Rule 36, Act 750) b. Safe Harbor

29. Transmission of Results Typical Reporting:1. Web2. Text message with reference to web 3. Fax4. Mail (yuck!)5. Phone (yuckier!)

30. Back Office Support Apps

31. Storage of Results • Subject to audit and must be stored in a secure environment • Must maintain in accordance with state or federal requirements • Under federal rules, subject to release and must be forwarded upon termination of clients agreement to new MRO (FAA example)

32. 8. Current Federally Mandated Programs

33. Regulatory Scope of Who is Impacted Through US Dept. of Transportation

34. Who Else is Federally Mandated? Nuclear Regulatory Commission Department of Defense NASA Transportation Security Administration And other federal agencies covered under the Drug-Free Workplace Act of 1988. What’s on the horizon????? Don’t rule out new safety sensitive industry groups (electricians, construction, miners, etc..)

35. 9. Pending Drug Testing Legislation and Current Industry Issues

36. Mandatory Positive Drug Test Reporting to States • Several states have created databases • Specific to commercial drivers license • Result transmission straight from the MRO and employer, or severe penalties • Positive alcohol test, employer reports • Great idea, but why don’t they work at this point?

37. National Driver Database • Congress funded a study in 1999 • Report released to in 2004 • In early 2007, FOXNews Minnesota 5 Collection sites Inspected • Congress is involved, GAO investigation with testimony by SAPAA, ATA, IOOA, FMCA, ODAPC, Oregon State Police • Working with House Transportation and Infrastructure Committee to tighten programs

38. New Action Items • Revisit the Drug Testing Integrity Act • Implementation of the Driver Database, but include a drug testing repository • Have MRO’s, Consortia, and TPA’s do the reporting • Hire more agents to inspect employers AND collection sites • New NPRM’s issued, by SAMHSA, US DOT, and operating modes.

39. 10. Any Questions / Discussion Thanks! Contact Jeff @ 800.837.8648, Ext 117, or by email @ jpsims@atestinc.com