EDPM Blog

SAMHSA Approves Significant Drug Testing Changes

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The Substance Abuse and Mental Health Services Administration (SAMHSA) announced last week that it has accepted the recommendations of its technical advisory committee, the Drug Testing Advisory Board (DTAB), and will proceed with revisions to the Department of Health and Human Services (DHHS) Mandatory Guidelines for Federal Workplace Drug Testing Programs.  The changes will include: (1) expanding the drug testing panel to include additional Schedule II prescription medications (e.g. hydrocodone, hydromorphone, oxycodone, and oxymorphone), prescription painkiller opioid drugs, and (2) including oral fluid as an alternative specimen for Federal workplace drug testing programs.  The additions of testing for prescription medications and having oral fluid as a specimen for drugs of abuse testing are seen as measures to strengthen the existing federal drug abuse prevention and control programs.  (For a copy of the announcement click here)

The revisions to the DHHS Guidelines will establish the laboratory methods, cut-off levels and reporting standards for testing for additional Schedule II controlled substances, including many of the prescription opioid painkiller medications that are more widely prescribed, misused, and abused than ever before.  The ability to test for these drugs in the Federal drug testing programs which apply to safety-sensitive and security critical employees in the public and private employment sectors is expected to improve workplace safety and serve to deter and detect misuse and abuse of these substances. (For more information of prescription drug abuse and accidents see EDPM Blog Jan 25, 2012)

The addition of oral fluid as a specimen for drug testing is important on two counts.  First, it helps address the continuing concerns about adulteration, substitution, and tampering with urine specimens in workplace testing.  Oral fluid specimens are more difficult to compromise.  Second, oral fluid collections are essentially an “observed collection” without additional invasion of privacy concerns, and provide an alternative for individuals who cannot produce adequate, acceptable urine specimens for drug testing purposes. 

The US Department of Transportation (DOT) has voiced its support for SAMHSA’s actions, and will follow with rulemaking to amend its drug testing regulations that govern drug testing of over 9 million workers in transportation occupations.  The DOT is required by law to follow HHS procedures for the drugs for which it tests and the specimens it tests. 

This is GOOD NEWS for workplace drug testing!  It will give employers more tools in achieving drug-free workplaces and improve the efficacy of drug testing programs.  The frustration for everyone is that it will not happen overnight!  The federal rulemaking process is a deliberate one and there will be many months ahead of proposed rules, comment periods, further evaluation and data collection, final regulations, and implementation schedules.  BUT….it’s progress!   The strength of the Federal drug testing regulations over the past two plus decades has been the thoroughness with which the procedures, processes, legal implications, and other factors have been vetted and examined by all the stakeholders—and these latest changes will be no exception. 

Report: Prescription Drug Abuse Now Leading Cause of Accidental Deaths

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The United States has long been the world's most heavily-medicated country.  Americans purchase and consume more prescription drugs per capita than any other, and the number of retail prescriptions filled per capita in this country is increasing year after year.  According to the health policy and research group Kaiser Family Foundation, annual spending in the U.S. on prescription drugs has risen over 600% since 1990. Source: http://www.kff.org/rxdrugs/upload/3057-08.pdf

Unfortunately, a new study reveals the harsh reality associated with this trend.  According to a report released last month by the National Center for Health Statistics, drug poisonings related to prescription drug abuse is the leading cause of accidental deaths in the United States, topping automobile accidents for the first time in more than 30 years.

Three classes of prescription drugs most frequently abused include opiates (painkillers), sedatives (sleep aids) and stimulants.  Of the three, opiates pose the most significant health threat. While many natural and synthetic opiates are effective painkillers, they also carry a high risk of dependency and abuse.  According to the report's findings, opiates were involved in more than 40% of drug poisoning deaths in 2008.

Consider the following data in the report (linked here in PDF format - http://www.cdc.gov/nchs/data/databriefs/db81.pdf):

 • Poisoning is now the leading cause of death from injuries in the United States and nearly 9 out of 10 poisoning deaths are caused by drugs.
 • Poisoning is the leading cause of death from injury in 30 states.
 • Natural and semi-synthetic opioids such as morphine, hydrocodone, and oxycodone were involved in over 9,100 drug poisoning deaths in 2008, up from about 2,700 in 1999.

Many of these drugs are easily accessible, frequently prescribed, and difficult to monitor.  Although nearly all 50 states now have a prescription drug monitoring program, not all programs are fully operational.  

As an employer, it's important to note that while standard drug screening panels like the DOT 5-panel typically include schedule I or II drugs (those that carry the highest risk for potential abuse), not all schedule I or II drugs are tested.  Drugs like oxycodone (OxyContin) and hydrocodone (Lortab) are schedule II drugs that are not detectable on a DOT drug test or even a standard non-DOT 10-panel test.  Most other painkillers as well as anti-anxiety drugs and sleep aids fall under Schedule III-V drugs, also making them undetectable on these tests. 
For a full list of Schedules I-V drugs, please click here (PDF): Schedule I-V Drugs 

Employers do have options, however, to fight back utilizing all three components of an effective drug testing program (policy, training, and testing).  

Medical Card Requirements for CDL Holders Take Effect 1/30/12

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In an effort to streamline commercial driver's license (CDL) procedures throughout all states, medical cards will now be required as part of the CDL application process.  The measure goes into effect January 30th, 2012.

The following update, specific to CDL holders in Alabama comes courtesy of our friends at the Alabama Truckers Association.

Beginning Jan. 30, 2012, the Alabama Department of Public Safety's Driver License Div., in accordance with new federal guidelines, will require new applicants for commercial truck and bus driver licenses to submit a photocopy of their medical certificate. This change also affects current CDL holders wanting to renew, transfer or change class or endorsement.

Current CDL holders must submit a photocopy of their medical card to DPS either in person, by fax or by mail to continue holding a commercial driver license. The final deadline to provide medical certificates is Jan. 30, 2014.

Full ATA regulatory update can be found here: http://www.alabamatrucking.org/articles/templates/?a=813&z=1

Please note this does not affect DOT physical requirements nor does it impact any DOT drug screening guidelines.  For questions or more information, contact the Alabama Department of Public Health via email at cdlmedicalmerger@dps.alabama.gov. 

DOT Announces 2012 Random Drug & Alcohol Testing Rates

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Last week, the Department of Transportation (DOT) announced that the 2012 annual random drug & alcohol testing rates will remain the same as they were in 2011.  The chart below illustrates the drug and alcohol minimum annual rates for each DOT division.

Source: Chart courtesy of the United States Department of Transportation - http://www.dot.gov/odapc/rates.html

For more information about best practices for your organization's random drug testing and/or a list of FAQ's pertaining to random testing management, please visit our previous blog entries linked below:

Random Testing FAQ's: http://blog.edpm.com/blog-0/bid/61161/DOT-Random-Drug-Testing-Regulations-Q-A
Random Testing Best Practices: http://blog.edpm.com/blog-0/bid/53820/So-You-Think-You-Can-Drug-Test-Factor-4-Random-Testing

Urine Drug Testing Detection Windows

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Have you ever wondered how long various drugs stay in a person’s system and are detectable through an employer drug test? This is a common question that the EDPM staff receives from our clients. In an effort to better educate our clients on the window of detection for drug metabolites that are commonly tested EDPM created the following chart for urine laboratory based drug tests. In addition to windows of detection for each drug listed common street names, signs of abuse and other relevant drug testing information is provided.

 *Windows of detection are estimates and may vary from person to person. EDPM makes no warranties regarding the application and/or accuracy of window of detection.

Common Errors Made By DOT Collectors

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Since employment drug testing first began, the collection process has long been viewed as the weak link in the drug testing process. Several Department of Transportation (DOT) officials in the Office of Drug and Alcohol Policy and Compliance (ODAPC) recently held a conference call with the Drug and Alcohol Testing Industry Association (DATIA), Substance Abuse Program Administrators Association (SAPAA) and other drug and alcohol industry groups and asked them to disseminate information about current problems with DOT urine specimen collections to collectors, collection sites, employers and other stakeholders in the DOT drug testing process. In an effort to further educate companies and collectors on the errors, DATIA has outlined below the errors and correction process to prevent the errors from occurring in the future. 

Issue:  Custody and Control Forms (CCFs) received are illegible.

Corrective Measure:  Collectors should review all copies of the CCF prior to distributing them to ensure that they are legible. In regards to copies that are to be faxed, if the writing is light then collectors should make a darker copy to be sent via fax.

Issue:  MROs and Employers are reporting that they are not receiving their respective copies of the CCFs despite multiple requests. Per DOT regulations, collectors must send the CCFs within 24 hours or the next business day and must keep their copies of CCFs for at least 30 days.

Corrective Measure:  A best practice in ensuring that this requirement is met is to maintain a copy of the fax transmittal form with the CCF. Just because you hit ³send² on the fax machine does not mean it went through. Only with a fax transmission receipt (can configure any fax to do this) can delivery be confirmed.

Issue:  Collectors are not marking step 1D in the CCF to indicate the transportation mode that the collection is for (FAA, FRA, FTA, FMCSA, etc.).

Corrective Measure:  This is a new step for the CCF and collection sites should be sure to post notices within the collection area reminding collectors to mark this information on the CCF. As with other steps, this automatic inclusion will become second nature with time.

Issue:  The donor initialing of the specimen bottle labels is being done while the labels are on the CCF contrary to DOT regulations that require the labels be signed on the specimen bottle.

Corrective Measure:  Again, collection sites are encouraged to post reminders to complete this step as required within the collection area.

Issue:  Collectors are not adequately informing donors that leaving the collection site prior to the completion of the collection process (with the exception of pre-employment tests) is considered a refusal to test.

Corrective Measure:  A best practice to ensure that this is not an issue within your collection facility is to instruct collectors to make a note in the remarks line that states, Donor notified that leaving prior to completion of the collection is considered a refusal to test. This way the notification is documented.

Saturday is National Prescription Drug Take Back Day

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Tomorrow marks the U.S. Drug Enforcement Agency's (DEA) third National Prescription Drug Take Back Day.  Between the hours of 10AM and 2PM on Saturday, October 29th, Americans are encouraged to safely and effectively dispose of unused or unwanted prescription drugs at thousands of designated drop off sites across the country. 

Prescription drug abuse has skyrocketed in the United States in recent years, with over 7 million Americans abusing prescription pain killers, depressants, or stimulants.  In an effort to fight back, the DEA launched the first Prescription Drug Take Back day in September of 2010 and staged another one in April of this year.  All totaled, over 300 tons of prescription pills were collected in those two days.

Take Back Days will continue semiannually, the DEA says, until a more efficient method for safe disposal of the drugs can be finalized.

To find your local drop off site, click here: Drop-Off Sites

The Need for Drug Testing in Hospitality Industry

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Customer satisfaction and retention are critical to any successful company. This is especial true for any hotel in the hospitality industry where dissatisfied customers can simply take their business next door to a rival hotel. Having a healthy and drug-free workplace can minimize a hotel’s legal risk while strengthening the overall profitability of the company. According to a report published by the Arkansas Small Business Development Center, Jeff Hayes, MHRS Division Director of Assets Protection at Marriott's Corporate Headquarters in Washington, D.C., believes in large part pre-employment testing has helped to decrease turnover and reduce accidents.

The Substance Abuse Mental Health Services Administration issued the result of a survey that revealed the hospitality industry, which includes hotel/motel companies, experienced some of the highest rates of alcohol and drug abuse.

Among employees in the hotel/motel sector:

•        9.3 percent admit to using illicit drugs during the past month
•        17 percent admit to using illicit drugs during the past year.
•        Nearly 10 percent admit to heavy alcohol use.¹

Broken down by a few specific occupations within the hotel industry, workers report substance abuse at the following levels:

The federal government has long documented the need for regulated drug and alcohol testing over certain employee classifications. As time has progressed from the original mandate of Department of Transportation (DOT) regulated testing, more and more non-regulated employers have jumped on the same bandwagon. From large national chains to smaller locally owned hotels, hospitality industry employers across the country are seeing the value of implementing drug testing in the workplace.

Dr. Donna Smith Joins EDPM as Regulatory Compliance Officer

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EDPM is proud to welcome aboard Dr. Donna Smith to EDPM as Program Development and Regulatory Compliance Officer.  Dr. Smith served in similar positions with Substance Abuse Management, Inc. (SAMI), First Advantage, and FirstLab.   She has over 35 years experience in the policy, program, and compliance aspects of workplace drug and alcohol testing programs. 

Dr. Smith is a principal author and architect of the regulations for U.S. military, federal employees, and U.S. Department of Transportation (DOT) drug and alcohol testing programs. She is a nationally recognized expert and has advised hundreds of employers in the areas of:

• Federal drug testing regulations

• Drug and alcohol testing procedures

• Drug and alcohol abuse awareness training for employees and managers

• Medical Review Officer(MRO) procedures

• Drug free workplace policy and procedures

• Substance abuse prevention and rehabilitation  

“Dr. Smith is known throughout the United States and the world as a regulatory and procedural expert for appropriate drug testing within the workplace and in schools,” said Charles Ash, Chief Executive Officer of EDPM.  “Her addition to EDPM reunites her to her long-time colleague, Dennis Bennett, who was also one of the original architects of the DOT’s drug and alcohol testing regulations now affecting over eight million employees throughout the United States.”   

Dr. Smith serves on the faculties of the American Society of Addiction Medicine (ASAM) and the American College of Occupational and Environmental Medicine (ACOEM) for continuing medical education courses in drug and alcohol testing.  She also sits on the MRO exam development committee of the Medical Review Officer Certification Council (MROCC).  She has twice been awarded the ACOEM President’s award for outstanding contributions in the field of substance abuse education and training for physicians. 

Her current professional activities include serving on the Substance Abuse and Mental Health Services Administration’s (SAMHSA) federal Drug Testing Advisory Board (DTAB), President of the Substance Abuse Program Administrators’ Association (SAPAA), and appointment to the Board of Trustees of Capital University.  Dr. Smith is an invited presenter at more than ten national conferences and symposia each year and is a qualified expert witness in drug and alcohol testing for labor arbitration and civil litigation cases. She is the co-author of the definitive published text for Medical Review Officers, The Medical Review Officer Manual,and has authored or contributed to numerous journal articles, text book chapters, and other publications in the field of drug and alcohol testing. 

Dr. Smith is also renowned for her training and education courses for urine specimen collectors, breath alcohol technicians, labor attorneys, managers and supervisors, employees, Substance Abuse Professionals (SAP), and MROs.  Additional areas of expertise include recovery monitoring programs for healthcare and other professionals, and  student and professional athlete drug and alcohol testing programs.

Dr. Smith’s academic credentials include a bachelor of arts degree in sociology from Capital University, a masters of social work from Hunter College, and a doctorate in counseling psychology from Ball State University. She has held teaching positions in sociology and psychology on the faculties of Hampton University, Virginia State University, and Richard Bland College.  

“We are entering a new chapter in EDPM’s 21 year history,” Ash said. “Our ability to provide value added services to our many current and future clients is unsurpassed in the industry.  We are excited about the tremendous abilities that Donna and Dennis bring in the development of compliance and training programs."

EDPM is a nationwide leader in providing employment screening services to enable clients to create end-to-end solutions that safeguard and protect their human capital. Based in Birmingham, Alabama and with over 3000 clients globally, EDPM tailors scalable solutions that seamlessly and cost-effectively integrate employment screening and educational programs into employer talent management processes. 

DOT Drug Testing 101: Are you Covered?

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If you're an employer with employees subject to Department of Transportation (DOT) mandated drug and alcohol testing, you know that compliance with the numerous and often very specific regulatory requirements can be a challenge (to say the least). Yet in this effort to navigate through the regulations, sometimes we can miss the proverbial forest for the trees. So it may be worthwhile to take a step back and ask a couple of basic questions: do I know which of my employees are covered under DOT regulations? If they are, then under which agency or agencies?

Keep in mind that there are multiple DOT agencies and, while there are certain common drug testing standards for all of them (found in 49 CFR Part 40), each agency does have its own unique requirements.  So a random testing program that works for a Pipeline employee (PHMSA-covered) will not work for a CDL-holder driving an 18-wheeler (FMCSA-covered). So in the spirit of a DOT Drug Testing 101 refresher, take a look at a quick summary (recently published by DOT) of the key agencies and types of positions covered under each.  

Federal Motor Carrier Safety Administration (FMCSA)

Covered employee: A person who operates (i.e., drives) a Commercial Motor Vehicle (CMV) with a gross vehicle weight rating (gvwr) of 26,001 or more pounds; or is designed to transport 16 or more occupants (to include the driver); or is of any size and is used in the transport of hazardous materials that require the vehicle to be placarded

Federal Railroad Administration (FRA)

Covered employee: A person who performs hours of service functions at a rate sufficient to be placed into the railroad’s random testing program. Categories of personnel who normally perform these functions are locomotive engineers, trainmen, conductors, switchmen, locomotive hostlers/helpers, utility employees, signalmen, operators, and train dispatchers

Federal Aviation Administration (FAA)

Covered employee: A person who performs flight crewmember duties, flight attendant duties, flight instruction duties, aircraft dispatch duties, aircraft maintenance or preventive maintenance duties; ground security coordinator duties; aviation screening duties; and air traffic control duties.

Note: Anyone who performs the above duties directly or by contract for a part 119 certificate holder authorized to operate under parts 121 and/or 135, air tour operators defined in 14 CFR part 91.147, and air traffic control facilities not operated by the Government are considered covered employees.

Federal Transit Administration (FTA)

Covered employee: A person who performs a revenue vehicle operation; revenue vehicle and equipment maintenance; revenue vehicle control or dispatch (optional); Commercial Drivers License non-revenue vehicle operation; or armed security duties

Pipeline and Hazardous Materials Safety Administration (PHMSA)

Covered employee: A person who performs on a pipeline or liquefied natural gas (LNG) facility an operation, maintenance, or emergency-response function

United States Coast Guard (USCG)

Covered employee: A person who is on board a vessel acting under the authority of a license, certificate of registry, or merchant mariner's document. Also, a person engaged or employed on board a U.S. owned vessel and such vessel is required to engage, employ or be operated by a person holding a license, certificate of registry, or merchant mariner's document

Remember that as an employer you may need to comply with multiple agency requirements. It's also possible to have one employee that is covered under multiple agencies. We always want to make sure that "DOT compliance" begins with the proper identification and classification of employees. If you have questions about your "covered employee" profiles and testing programs and would like to consult with one of our DOT experts, feel free to contact us by clicking here.