Drug Testing & Alcohol Testing

Drug Testing & Alcohol Testing

Riverview Medical Center, Arrowood Medical Center, and Occumed Occupational Services offer a wide range of drug testing and alcohol testing services.

Statistics

Here are a few statistics that illustrate why drug testing is so important for your company.

Two thirds of the people who reveal the use of illegal drugs are employed. (Substance Abuse and Mental Health Services Administration)

Employee drug abusers cost their employers about twice as much in medical and workers’ compensation claims as their drug-free co-workers. (Substance Abuse and Mental Health Services Administration)

Employment and productivity losses related to drug and alcohol abuse totaled $81.6 billion in 1990. (Substance Abuse and Mental Health Services Administration)

More than 60 percent of adults have gone to work under the influence of drugs or alcohol. (Hazelden Foundation)

Drug-using employees are:

  • 2.2 times more likely to request early dismissal or time off
  • 2.5 times more likely to have absences of eight days or more
  • 3 times more likely to be late for work
  • 3.6 times more likely to be involved in a workplace accident
  • 5 times more likely to file a workers’ comp claim
    (National Institute on Drug Abuse)

The economic and human costs of drug abuse are astounding. In fact, the National Institute of Health reported that alcohol and drug abuse cost the economy $246 billion in 1992, the most recent year for which economic data is available. (National Institute on Drug Abuse)

Between 1988 and 1995, Americans spent $57.3 billion on drugs, broken down as follows: $38 billion on cocaine, $9.6 billion on heroin, $7 billion on marijuana, and $2.7 billion on other illegal drugs and on the misuse of legal drugs. (The White House Office of National Drug Control Policy)

Standard Test Panels

5-Panel Drug Screen (DOT and non-DOT standard test panel) includes:

  • Amphetamines (“Uppers”, Methamphetamines )
  • Cocaine
  • Marijuana
  • Opiates (Morphine, Heroin, Vicodin, Codeine, Hydrocodone, etc.)
  • Phencyclidine (PCP, Angel Dust, etc.)

9-Panel Drug Screen (available for urine) adds:

  • Methadone (Anti-Heroin drug)
  • Propoxyphene (Darvocet, Darvon)
  • Barbiturates (Sleeping Pills, Phenobarbital, Yellow Jackets, etc.)
  • Benzodiazepine (Valium, Xanax, etc.)

Testing Methods

Urine

Helps deliver a historical perspective of drug use over the past few hours up to several weeks, dependent on the donor and level and type of drug use. It is appropriate for random, pre-placement and post-accident testing.

Hair

Hair drug screening offers a historical perspective over the past 90 days. It is appropriate for random and pre-placement, but can be cost-prohibitive. It is not a good tool for post-accident testing as it takes approximately five to 10 days from the time of drug use for the affected hair to grow above the scalp.

Collection Conditions

Urine specimen collection is done at our facilities in accordance with all federal and state regulations to ensure accurate results. All of our collectors are certified to the Department of Transportation (DOT) standard. To prevent tampering, restrooms where collections are received have no running water and commodes have bluing agents (so specimens cannot be diluted). Ceilings are of a height and/or composition that doesn’t allow for “hiding” of additional specimens. Patients are instructed to not flush after the collection (or specimens are collected with a remote-flushing commode).

Hair Sample Collection is done by cutting a hair sample from the crown as close to the scalp as possible. A standard screen with GC/MS confirmation requires 20 milligrams of hair or approximately 60 strands. Hair can be collected from several locations on the head and combined to obtain the required amount of hair. In addition, body hair can be used as an alternative to head hair.

Adulterants

Some people can try to alter their drug tests by adding adulterants to their urine specimens. Both the collection site and the laboratory have a number of mechanisms to detect potentially invalid urine specimens.

Routine Specimen Integrity

  • Temperature of specimen (90 to 100 degrees)
  • Urine Specific Gravity
  • pH
  • Creatinine

Adulterants impose a new challenge in the testing for abused drugs. Fortunately, spot tests have been introduced by laboratories to detect these adulterants and several strip tests are available for further validation of specimen integrity.

Adulterants for hair drug screens are also available, but can be detected by the lab and only stay in the system a limited amount of time.

Dilute Specimens

Some urine specimens may be reported as dilute. They can be dilute-positive, which would still be considered a positive drug screen. If they are dilute-negative, employers have the option to have the patient return for an additional drug screen. There may have been adulteration or intentional dilution or it could just be as simple as too much water intake prior to the test.

Results

All drug testing is conducted through SAMHSA-approved processes and laboratories.

Negative results from urine drug screens are typically available for reporting within 24 hours. Results for a positive test may take 48-72+ hours, since the specimen is confirmed by the lab using Gas Chromatography/Mass Spectrometry (GC/MS).

Hair drug screening results are available within 48-72+ hours.

We also offer a rapid or instant urine drug screen done with special kits at our clinics. Negative results are available within an hour. Non-negative results are sent out to the lab and are reported within 48+ hours.

Results can be received via e-mail, phone, mail or fax.

Medical Review Officer (MRO)

A Medical Review Officer (MRO) is a trained medical professional who reviews all federally-regulated drug test samples. All drug screen results are reviewed by our MRO physicians. Test results are reported as:

  • Negative
  • Negative-Dilute
  • Rejected for Testing
  • Positive – (Name of Drug(s))
  • Positive – (Name of Drug(s)) – Dilute
  • Adulterated
  • Substituted
  • Invalid Result

Results are checked to be sure the sample was in the right temperature range, that the social security number matches the patient, that the pH, specific gravity and creatinine are at proper levels and the Chain of Custody (COC or CCF) is complete. Patients with non-negative results are called by the physician to be sure that there is no alternative and legitimate reason that the drug is present in their system. In the event of a prescription medication, the MRO may request a one-on-one interview with the patient for further assessment.

There are cases where a test would be reported from the lab as a positive, but when the MRO would determine after speaking with the patient that there was a legitimate reason why they tested positive. That test would then be reported to the employer as a negative. Second-hand smoke and other passive situations will not cause a positive drug screen. Cut-off levels for opiates have recently been increased in order to avoid false positives caused by ingestion of food containing poppy seeds.

Drug screens should always be reviewed by a neutral third party MRO. Positive results should not be directly reported to an employer from the lab as it puts the employer in a very sensitive and potentially confrontational situation with the employee or potential employee.

Window of Detection – Urine

  • Amphetamine – 2-3 Days
  • Methamphetamine – 2-3 Days
  • Cocaine – 2-3 Days
  • Marijuana Metabolites – 2 Days – 3 Weeks
  • Opiate Metabolites – 2-3 Days
  • Phencyclidine – 8 Days – 3 Weeks
  • Benzodiazepines – 3 or more Days
  • Methadone – 3 Days
  • Methaqualone – 2 Weeks

Re-testing

Except in the case of a dilute specimen, immediate re-testing of a drug screen candidate is ill-advised. Because drugs are metabolized at different rates, employers may end up with a negative drug screen obtained shortly after a positive. (See chart above.) This can create legal issues if a decision is made to not hire or to terminate the employee.

DOT Guidelines

An employer must receive a negative pre-placement drug screen in conjunction with a DOT physical as a requirement of the Department of Transportation for CDL drivers before they are placed in safety-sensitive duties; however, on a recertification DOT physical, a DOT drug screen should not be done. If a company’s policy is to have a drug screen with re-certification physicals, it should be a non-DOT test.

On post-accident testing, the DOT only requires a DOT drug screen and Breath Alcohol Test when there has been an accident involving a citation, injury treatment away from the scene, towing of a vehicle or a fatality. If your company requires a post-accident drug screen, be sure it is a non-DOT test unless it meets the criteria above.

CDL Drivers are mandated to be in a random program for DOT drug and alcohol testing on a random basis.

For further information, visit http://www.dot.gov/odapc.

Breath Alcohol Testing

Breath Alcohol Tests (BATs) are done at each of our centers with state-of-the-art equipment and immediate results. Our staff is fully-trained in breath alcohol testing procedures and certified in accordance with the DOT.

An initial screening is done and reported as negative if the result is 0.00. If it is a result of greater than 0.00, the patient is observed for 15 minutes and a confirmation test is performed. This is done to ensure that the result is not affected by mouthwash, gum, mints, etc. If the result is still above 0.00, then it is reported as positive.

Additional Alcohol Testing Methods

Saliva, urine and blood testing are additional methods available. We recommend Breath Alcohol Testing because of ease of testing, non-invasiveness, test accuracy and cost-effectiveness.

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