Oral fluid drug test

federal-form.jpgEarlier this year, the Department of Health and Human Services (HHS) revised the Mandatory Guidelines for Federal Workplace Drug Testing Programs. The HHS guideline revisions will lead to the following changes:

  • Expanded Federal urine workplace drug testing to include four Schedule II drugs: hydrocodone, hydromorphone, oxycodone, and oxymorphone
  • Removed MDEA for confirmatory testing
  • Raised the lower pH cutoff from 3 to 4 to identify an adulterated specimen
  • Allowed a Medical Review Officer (MRO) to recommend the collection of an oral fluid specimen in certain situations, as permitted by agency policy

This week, the Office of Management and Budget (OMB) approved the revised Federal Custody and Control Form (CCF). This approval essentially links the forthcoming testing changes to the required paperwork that will accompany the testing specimens. HHS published a Q&A document to help clarify a number of the changes.

While the impact of these revised regulations is somewhat complex, here are a few key insights that you should be aware of at this time:

1. These changes only apply to Federal employee testing. If your company performs oral fluid, hair, instant, or non-DOT urine drug testing, these changes do not apply to your program.

**Update** On Friday, November 10, 2017, the U.S. Department of Transportation (DOT) amended its regulations to add hydrocodone, hydromorphone, oxymorphone, and oxycodone, four commonly-abused opioids; add methylenedioxyamphetamine as an initial test analyte; and remove methylenedioxyethylamphetamine as a confirmatory test analyte. This change harmonizes DOT regulations with the HHS guidelines published earlier this year. The Final Rule published in the Federal Register on Monday, November 13, and the new testing standards will go into effect on January 1, 2018. Read the full text of the Final Rule.

The most current guidance, DOT Drug Testing: Part 40 – Employee Notice, was published on December 12, 2017.

2. At this time, you should not order new paper CCF forms. The new Federal form was approved earlier this week—on August 8, 2017. As such, the printing of new forms has not yet begun. The Federal forms you have on hand today are still valid and can be used without issue for another 10 months—until June 30, 2018.

**Update** On Tuesday, August 15, 2017, the Department of Transportation (DOT) published a notice in response to the HHS release from August 8, 2017. In this notice, they state that because the DOT’s final rule on synthetic opiates has yet to be issued, “…employers and their service agents are to continue using the ‘old’ CCF until further notice from DOT’s Office of Drug and Alcohol Policy and Compliance.”

3. The anticipated go-live date for the testing changes detailed in the bullet points above is October 1, 2017. This week’s announcement only pertains to Federal CCF forms, and was essentially published to give laboratories and other service providers the ability to cease production of the legacy form and to transition production to the new form.

4. There has never been a better time to switch to eCCF. You have better things to do than keeping tabs on changing form and panel regulations, ensuring you’re using the correct form at the proper time, and dealing with the expense and hassles of shipping and storing all of this paperwork. Our electronic CCF (eCCF) process helps bear the regulatory and administrative burden for you— the new, online form is scheduled to go live in our system on October 1. There’s no cost to use it, it’s available today for all specimen types and testing reasons, and it’s simple to use. In the time it’s taken you to read this article, you could have signed up and gotten started.

As your partner in drug testing and workplace safety, we are aware of the changes and are working diligently on your behalf to ready our laboratories, systems, and personnel. We are committed helping create a smooth and seamless transition as we collectively adapt to the regulatory obligations to which we’re bound.

As we do all of this, you should do four simple things:

  • Continue testing as usual. The effort at this point falls on the laboratory, not on you or your drug testing program. You do not need new forms at this time.
  • Get news and updates from the DOT via email by subscribing to the DOT notification system (list serve).
  • Subscribe to our newsletter to ensure you stay current with news and updates on this and other topics.
  • Join the thousands of customers of all sizes and in all industries who have moved away from paper-based drug testing documentation and who are now processing millions of eCCFs each year

For more information about drug testing, visit our website or contact us online.

 

new trends in workforce drug useIn the early afternoon of Jan. 4, 1987, an Amtrak train crashed into a locomotive 18 miles northeast of Baltimore, causing 16 deaths and dozens of injuries. In post-accident drug and alcohol testing, the engineer driving the train tested positive for marijuana, although no one noticed anything unusual about his behavior before the crash that day.

The threat of workplace drug use was well-known even before the tragedy. Six years prior to the Amtrak incident, the crash of an aircraft aboard the USS Nimitz spurred an investigation by the U.S. military that found widespread use of drugs among U.S. Navy personnel.

These events helped prompt Congress to pass the Drug-Free Workplace Act in 1988 to address the issue of workforce drug use. The act requires certain federal contractors and all federal grantees to agree that they will provide drug-free workplaces as a condition of receiving a contract or grant from a federal agency. In 1991, the government also authorized mandatory random drug testing for employees in “safety-sensitive” jobs in industries regulated by the U.S. Department of Transportation.

Similarly, the explosive growth of crack cocaine in the United States in the mid-1980s focused attention on the workplace impact of drug use in the private sector. This led to the implementation of workplace drug education, monitoring and employee assistance programs for both public and private employees.

Thanks to the coordinated efforts of the medical and business communities, the rate of positive drug tests in the workforce has declined significantly among employers who have instituted a drug-free workplace policy since the implementation of the Drug-Free Workplace Act.

But this overall trend does not mean that employers, medical professionals, and policymakers can declare victory in the battle against drug use in the workplace. The Quest Diagnostics Drug Testing Index™ 2016 report offers new evidence of the challenges ahead.

Based on analysis of more than 10 million workforce drug test results, Quest found that, while overall workplace positivity rates have dropped dramatically over the past two decades, drug positivity rates are climbing once again in the American workforce. In 1988, the first year of the Drug Testing Index, the overall positivity rate for all drugs was 13.6%. By 2016, that rate had fallen to 4.2%. While this is a major improvement, the workplace positivity rate has actually increased annually for the past five years and is now at its highest level since 2004.

The positivity rate in urine tests for cocaine increased for the fourth consecutive year in the general U.S. workforce and for the second consecutive year in the federally-mandated, safety-sensitive workforce. Methamphetamine positivity has also been on the rise, climbing 64% in the general U.S. workforce and 14% among federally-mandated, safety-sensitive workers between 2012 and 2016.

The report also found that marijuana positivity continued to increase. In oral fluid testing, which detects recent drug use, the marijuana positivity rate increased nearly 75% in the general workforce, from 5.1% in 2013 to 8.9% in 2016. Marijuana positivity also increased in tests of urine (2.5% in 2016 versus 2.4% in 2015) and hair (7.3% in 2016 versus 7.0% in 2015).

Quest examined state-level data for marijuana, including states with recreational use statutes. In Colorado and Washington, the first states in which recreational marijuana was legalized, the 2016 positivity rate for marijuana outpaced the national average for the first time since the statutes took effect in 2014. The national positivity rate increased 4% between 2015 and 2016, but jumped to 11% in Colorado and 9% in Washington in the same period.

Given this data, it seems reasonable to conclude that the legalization of marijuana for medical and recreational purposes will lead to increases in the rates of marijuana use in the workforce, which could affect more and more companies as the legalization movement spreads throughout the country. While current policy discussions are largely focused on marijuana, employers must not lose sight of the other trends in workforce drug positivity. Drug use of any kind can have a major impact on workplace safety and productivity. Employers need to be aware of the problem and take any necessary steps to protect their employees and their workplaces from the threat of drug use.

Robert L. DuPont, MD, is president of the Institute for Behavior and Health, Inc., a nonprofit organization that works to reduce illegal drug use. He was the first director of the National Institute on Drug Abuse (1973-1978) and second White House Drug Chief (1973-1977).

Risk Management magazine features analysis, insights and new from the Risk and Insurance Management Society, Inc. (RIMS) The “New Trends in Workforce Drug Use” article was published on August 1, 2017.

For more information about drug testing, visit our website or contact us online.

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On January 23, 2017, the U.S. Department of Health and Human Services (HHS) revised the Mandatory Guidelines for Federal Workplace Drug Testing Programs. More specifically, the notice expanded federal urine workplace drug testing to include four Schedule II drugs: hydrocodone, hydromorphone, oxycodone, and oxymorphone. The effective date for the revised Guidelines is October 1, 2017. […]

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Our By the Numbers series takes a closer look at the numbers, facts, data, and outputs that impact workplace drug testing programs. In this post, we examine the surge in oral fluid drug testing positivity over the past three years. Laboratory-based oral fluid is reliable for detecting recent drug use, and because the collection is […]

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