Does your drug testing take into account non-medical abuse of prescription painkillers?

Workplace drug abuse across our country is as bad, if not worse, than ever.

Traditional laboratory-based urine testing shows an approximate four percent positivity rate across the United States.1 Employees and employers self-report drug abuse at ten percent-plus for the 18- to 49-year-old age group, with some industry sectors, such as construction, reporting rates as high as 30 percent.2 These statistics refer to the abuse of illicit drugs (examples: heroin, methamphetamine, cocaine, marijuana) and the non-medical use of prescription drugs, and do not include alcohol.

Drug abuse directly impacts safety, productivity and profitability and is responsible for up to 30 percent of traffic accidents, 30 percent higher employee turnover, ten-times-greater absenteeism, and 30 percent or more of employee theft/inventory shrinkage, as well as workplace violence, higher workers’ compensation costs and increased medical benefit utilization rates.

Get active & vocal
Begin an effective drug-free workplace program with active, vocal, demonstrated support by executive management. Equally important is an ongoing drug awareness and education program so employees understand the goal is a safer, more productive, more profitable workplace.

The most effective drug-free workplace programs are positive versus punitive, and create an atmosphere where everyone is confident the person working next to them is not a danger due to the influence of drugs or alcohol.

Comprehensive programs incorporate these core elements:
  1. Drug-free workplace policy
  2. Drug awareness and education
  3. Drug screening
  4. Quantitative confirmatory drug testing
  5. Medical review officer (MRO) services
  6. Employee assistance programs (EAPs)
  7. Drug-free workplace audits, benchmarking and reporting
Assess your screening protocols
When developing and implementing a drug-free workplace program that includes drug testing, consider the following questions in the context of a company’s unique work environment, objectives and goals:
  1. Who will be tested for drug/substance abuse?
  2. What is the process for selecting individuals for testing?
  3. What types of testing will be done?
  4. Who pays for testing?
  5. Who will conduct testing?
  6. What are the consequences of a positive drug test(s)?
  7. Will confirmatory (GC/MS) tests be done? Process?
  8. Are steps clearly articulated for assisting individuals who confirm positive for drugs?
  9. Is there a method for challenging test results?
  10. What happens if an individual refuses to take the test? Will refusal be construed as a drug-positive test?
  11. Who will see the test results, and how will confidentiality be maintained?
Timing and test types
Most companies that test for drug use do so on a pre-employment basis. This is, at best, marginally effective. Drug abusers have learned to circumvent this technique by not taking drugs for a few days prior to their test date.

If your goal is to deter drug abuse, random drug testing is called for. In addition, companies can implement post-accident, reasonable cause and return-to-duty testing.

Most companies use a laboratory-based urine process for drug testing. In most cases, applicants or employees are sent to a collection site to donate a urine specimen.

Beware: drug abusers can purchase any one of hundreds of products available on the Internet to easily “beat” a urine test. Today, the validity of an unobserved urine test can no longer be assured. Still, urine testing is the only testing approved for use in federally-mandated drug-testing programs such as DOT or similar “safety sensitive” occupations.

Another consideration: Urine testing can detect marijuana use typically for three to five days, and in some cases up to 30 days. This presents potential privacy issues for some workers who do not abuse drugs on the job, and for employers who are more interested in employee work performance than lifestyle.

Most drug testing doesn’t fall under the “federally mandated drug testing” category, and is open to new technologies and specimen types such as oral fluid and hair testing.

Oral fluid-based drug screening and testing detects current/on-the-job drug abuse, typically detecting most drugs within minutes of consumption. On a general basis, oral fluid testing provides results similar to blood testing. There are oral fluid-based point-of-care and laboratory-based devices that have received FDA approval for various clinical uses, just as urine-based tests.

The federal government has yet to approve oral fluid-based or other alternative specimen types for federally mandated drug-testing programs, despite having considered the issue for several years. The net effect is that many corporations model their drug testing programs on 20- to 30-year-old standards. Such tests do not detect prescription painkillers such as oxycodone and hydrocodone, yet they screen for PCP, a vanishing drug that has a positivity rate of less that 0.03 percent countrywide. Still, the use of oral fluid-based testing is rapidly accelerating, growing at 65 percent or more annually.

1 2007, Quest Diagnostics’ Drug Testing Index®.
2 2006, National Survey on Drug Use and Health (NSDUH), Substance Abuse and Mental Health Agency (SAMHSA), United States Department of Health and Human Services.