Drug

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Drug Alcohol Testing In The Workplace.
Presented By John Hawes SureHire
Inc. www.surehire.ca
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Presentation Outline

• Drug Testing
• Reasons to Drug Test
• Specimens to test
• Drugs to test for
• Methods of Drug Testing
• Adulteration

• Recommendations
• Pre-Employment
• Post-Incident
• Return To Work
• Random Testing
• Policy

• Alcohol Testing
• Units of Measurement
• Types of Testing
• Specimens to test
• Cut-off limits

• SureHire
• Our Services
• How we are different

6. Question and Answer Period

• Third Party Administrators
• What are they?
• What do they do?

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Drug Testing 1.

• Reasons To Drug Test. . .
• Pre-Employment and Pre-Access
• Post Incident (Have in Drug and Alcohol Policy)
• What Types Of Incidents?
• Clear Times Of When Testing Needs To Occur
• Who Is To Be Tested?
• Just The Injured Person
• The Whole Crew
• At The Supervisors Discretion
• Reasonable Suspicion
• Have Supervisors Trained And Be Clear In Company
  Policy Of The Process

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Drug Testing 2.

• Reasons To Drug Test. . .
• Return To Work
• After Suspension Period And Clearance From
  Substance Abuse Professional (SAP)
• Follow-Up
• Based on recommendation of SAP
• Random
• Legal Issues Regarding

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Drug Testing 3.

• Types Of Specimens For Drug Testing. . .
• Urine
• Most Common type of testing done
• Pros readily available across North America,
  easy to administer
• Cons hard to prove impairment, easily
  adulterated, collection issues
• Oral Fluid (Saliva)
• Up and Coming
• Uses useful for post incident or reasonable
  suspicion, can be used pre-employment as well
• Pros closer timelines to impairment, unable to
  adulterate
• Cons POCT testing is evolving (THC)

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Drug Testing 4.

• Types Of Specimens For Drug Testing. . .
• Hair
• Uncommon In Workplace
• Uses useful for follow-up testing
• Pros If desired gives long historical view
• Cons gives long historical views
• Sweat
• Uncommon In Workplace
• Uses useful for follow up and court ordered
  substance abuse programs
• Pros unable to adulterate/cheat
• Cons longer to administer, donor must return in
  7-10 days

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Drug Testing 5.

• Types Of Specimens For Drug Testing. . .
• Blood
• The Gold Standard
• Uses usually hospital based
• Pros direct correlation to impairment
• Cons very invasive

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Drug Testing 6.

• What Drugs To Test For. . .
• THC (Marijuana)
• Detects THC Metabolite
• Cocaine
• Detects Benzoylecgonine (Cocaine Metabolite)
• Amphetamines/Methamphetamines
• Detects Amphetamine, Methamphetamine, (Crystal
  Meth, Ice)
• Detects MDA/MDMA (Ecstasy and Metabolites)
• Opiates
• Detects Codeine, Morphine, 6-Monoacetylmorphine
  (Heroin Metabolite), Hydrocodone, Hydromorphone,
  Oxycodone
• PCP
• Detects Phencyclidine

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Drug Testing 7.

• What Drugs To Test For. . .
• Benzodiazepines
• Detects Alprazolam, Bromazepam, Clonazepam,
  Flurazepam, Lorazepam, Nordiazepam, Oxazepam,
  Temazepam, Triazolam
• Barbiturates
• Detects Secobarbital, Butalbital, Phenobarbital,
  Pentobarbital
• Methadone (MTD)
• Methaqualone
• Propoxyphene

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Drug Testing 8.

• Methods Of Drug Testing. . .
• Lab Based
• Department Of Transportation (D.O.T)
• Non D.O.T.
• Number Of Panels Of Drugs To Be Tested
• Instant
• Referred To As A Point Of Collection Test
  (P.O.C.T.)
• If an instant test is non-negative it usually
  gets sent to the lab for confirmation

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Drug Testing 9.

• Urine vs. Oral Fluid. . .
• Detection Of Timeframes
• Historical vs. Recent Use (does not mean
  impairment)
• Collection Issues
• Gender
• Privacy
• Shy Bladder
• Collection Area/Process
• Portability For On-Site Testing
• Adulteration

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Drug Testing 10.

• Adulteration. . .
• Urine
• Masking Agents
• Flush Kits
• Smuggled Samples
• Synthetic
• Other Human/Animal Samples
• Dilution
• In Collection Cup
• Drinking Water
• Normal Kidney Output 2ml/min
• Drink 1L water in 10min 12ml/min

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Drug Testing 11.

• Adulteration. . .
• How Do You Catch Them?
• Might Catch apx. 30 Of Them
• Chem Strip
• ph between 5.0 and 9.0
• Specific Gravity
• Water is 1.000
• Normal Urine Should Be More Then That
• Nitrates or Oxidants
• Not Normally In Urine, Found In Some Masking
  Agents (Not Many)
• Temperature
• 90? 100? Fahrenheit
• Body Temperature 98.5? Fahrenheit

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Drug Testing 12.

• Adulteration. . .
• Collection Process
• Remove Items And Loose Clothing
• Show Tops Of Socks
• Client Pat Down Pockets/Thighs
• Coloured Toilet Water
• Cant Flush Toilet

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Drug Testing 13.

• Adulteration. . .
• Oral Fluid
• No Known Adulterant Kits That Work
• There Are A Few On The Market
• Bleach Invalidates Test Completely
• Mouthwash, etc. Out Of Oral Fluid By The Time You
  Collect
• Oral Fluid Reproduces In Mouth Every 5 Minutes
• Collection Process Is To Check Donors Mouth, Give
  Them A Glass Of Water, Wait 10 Minutes, Then
  Collect Saliva

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Alcohol Testing
1

• Units of Measurement
• Percent Blood Alcohol Concentration (BAC)
• dL/g
• Types of Testing
• Saliva Alcohol Test
• Used as a screening tool
• Easy to use in the Field
• Cheap
• Urine Alcohol Test
• Not Valid for DOT testing
• Unable to correlate to Impairment
• Ethanol does not show up until elimination phase
  in urine

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Alcohol Testing 2.

• Breath Alcohol Test
• Used Most Common
• Most Reliable
• D.O.T. Approved For Confirmation
• Quick
• Ability To Confirm Machine Is Working Correctly
• Alcohol Concentration Levels. Blood Alcohol Test
• Gold Standard
• All Other Methods Of Testing Use Known Tables To
  Give Blood

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Alcohol Testing 3.

• Blood Alcohol Cut-off Limits
• D.O.T. 0.02
• Most Common Industrial 0.04
• Legal Limit 0.08
• Unconscious 0.35 - 0.40
• Death 0.45 - 0.50

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Third Party Administrators 1.

• A Company That Organizes And Administers Drug
  And Alcohol Testing For Other Companies.
• Schedule Collection (Usually Across Canada or
  North America)
• Administer Tests
• Process And Distribute Results
• Maintain A Companys Results For A Period Of Time
  (Usually 10 Years)
• Ensure Collection Facilities And Personnel Are
  Trained And Certified To Do Collections
• Decrease The Liability Of A Company Performing
  Tests In House

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Third Party Administrators 2.

• In Choosing A TPA, Here Is What To Ask
• Are They Able To Perform Collection In The Areas
  You Need?
• What Are The Turn-Around Timelines For Results?
• Negatives
• Lab-Based 24 Hours
• POCT Should Be Within The Day Of The Collection
  (We Offer 2 Hours)
• Positives
• Varies Depending On The Drug (Anywhere From 72
  Hours To 5 Days)
• Are The People Doing The Collections Certified?
• Drug Testing D.O.T. Certified, DATIA Certified
• Alcohol Testing
• B.A.T. Breath Alcohol Technician (Able To
  Perform D.O.T. Tests)
• S.T.T. Screen Test Technician (Able to Perform
  All Non-D.O.T. Tests)

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Third Party Administrators 3.

• Do They Belong To Any Associations?
• DATIA (Drug And Alcohol Testing Industry
  Association) etc.
• Do They Have Insurance?
• General Liability
• Errors And Omissions Insurance
• How Much Do They Charge?
• Watch Out For Hidden Charges (Sign Up Fee,
  Monthly/Yearly Fee For Stats Or Admin, Drug Test
  Confirmation Of Positives Included Or Extra)
• Ask For References

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Johns Recommendations 1.

• Pre-Employment Drug And Alcohol Testing
• Drug Either Urine Or Oral Fluid POCT Test
  (Depending If Company Wants Historical Or Recent
  Use)
• Alcohol Breath (Saliva Is OK If Not Available At
  Some Collection Sites)
• Cut-off Concentration of 0.04
• Post Incident, Reasonable Suspicion
• Oral Fluid Drug POCT Test
• Oral Fluid Alcohol Test (If In The Field), Breath
  Alcohol (If In Town Or At A Collection Site)
• Return To Work, Follow-Up
• Urine Lab Based, or Hair

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Johns Recommendations 2.

• No Random Testing
• Unless very clear in policy
• All Non-Negative Drug Tests Go To The Lab
• Drug And Alcohol Policy
• Ensure Your Policy Reflects The Types Of Tests
  And Reasons For Testing You Choose
• Have Your Policy Written By An OHS Professional
  that has experience in drug testing policy
• FOLLOW YOUR POLICY!!
• Most Lawsuits That Are Lost Are Because Companies
  Do Not Follow Their Policy

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SureHire 1.

• Occupational Health Testing Company
• Third Party Administration Services (Across North
  America)
• Drug Testing
• Alcohol Testing
• Physiotherapist Full Body Medicals
• Critical Strength Mobility Testing
• Computerized Carpal Tunnel Testing
• Audiometric Testing
• Spirometry Testing
• Mask Fitting
• Background Checks
• Corporate Wellness

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SureHire 2.

• Why Are We Different
• Our Technology
• SureBook Our Proprietary Web Based Booking
  Solution
• Book Your Appointments Online, Real-Time 24/7/365
• Check Your Companys Appointments Online Anytime
• Receive Instant Booking/No Show Email
  Notifications
• SureWire Our Instant Web Based Results
  Distribution Solution
• Receive Client Tests Results Instantly Via Email
• View Your Companys Results Online For 10 Years