Lec 15 - Drug Testing in the Workplace

what is regulated drug testing in the workplace

mandatory drug testing (for certain workers) with strict rules and a specific list drugs; testing is done at accredited labs and reviewed by medical review officer

what is non-regulated drug testing in the workplace

non-mandatory drug testing with no rules, any drug can be tested, and testing is not done at accredited labs + MRO is not required

sample types for drug testing in the workplace

urine, oral fluid or breath, and hair (if non-regulated)

what is forensic testing

there is a legal process involved

what is clinical testing

testing done so medical staff can use results to manage patients

arguments in support of drug screening

• job safety
• absenteeism
• quality/quantity of production
• increased health costs
• increased liability costs
• unlawful activity
• government regulation

arguments against drug screening

• opposition to US enforcement and US rules
• union opposition
• legal concerns and complications
• does not measure performance
• opponents question extent of problem
• opponents prefer education
• opponents question accuracy
• what employees do outside of work is not the employer's concern
• marijuana and cocaine are "safe" drugs
• marijuana is legal in many countries

examples of industries that use drug screening

• transportation
• petroleum
• mining
• pulp and paper
• other industrial operations with transportation
• financial, commercical, security sports, service, etc.

reasons drug testing is implicated

• pre-employment
• random
• reasonable suspicion/cause
• post-accident
• return to duty
• follow-up

list of drugs in SAMHSA/DOT mandatory drug tests

• amphetamines
• cannabinoids
• cocaine metabolite
• opioids
• phencyclidine
• ethanol

will mandatory or non-mandatory drug testing in the workplace detect all possible drugs

no

are IA screening tests more limited when compared to MS

IA screening is more limited than MS

limitations of using MS screening tests

broader scope but still limited by menu

elimination time for amphetamines in urine

1-2 days

elimination time for cannabinoids in urine

1-30 days

elimination time for cocaine metabolites in urine

12-48 hours

elimination time for opioids in urine

1-3 days

elimination time for phencyclidine in urine

1-30 days

elimination time for EtOH in urine

up to 14 hours but it is eliminated faster through the blood than breath or urine

elimination time for barbiturates in urine

1 day - 3 wks

elimination time for benzodiazepines in urine

1 day - 6 wks

elimination time for methadone in urine

1-3 days

elimination time for methaqualone in urine

1-7 days

elimination time for propoxyphene in urine

1-3 days

PCP appearance

crystal, powder, liquid or tablet

what class of drug does PCP belong to

hallucinogen

how is PCP dosed

ingested, smoked, injected, snorted

PCP effect

• unpredictable and variable
• rapid thought and action
• euphoria to depression
• hallucinations, irrational and violent behaviour
• increased sensory perception

amphetamine appearance

varied pills, powders, or solutions

what class of drugs does amphetamines belong to

CNS stimulant

how is amphetamines dosed

ingested, injected, snorted, or smoked

caution with using amphetamines

• strength and contamination unpredictable
• designer drugs are difficult to test for and can be very toxic

opioids appearance

white/brown powder, tablets, tonics

what class of drugs do opioids belong to

narcotic analgesic, CNS depressants

caution with using opioids

• strength and contamination unpredictable and can be lethal
• many OTC meds contain codeine
• fentanyls and new NPPs difficult to detect and deadly
• can be problematic even when prescribed
• IV users risk AIDs and Hepatitis

what class of drug does cocaine belong to

• CNS stimulant
• local anaesthetic
• vasoconstritor

how is cocaine dosed

injected, smoked, absorbed via mucus membrane

caution with using cocaine

strong psychological dependence, can be mixed with other drugs, sudden death possible

what is the most abused drug

alcohol

risk of using alcohol with other drugs

increases toxic effects of other drugs

what class of drugs does alcohol belong to

CNS depressant

what class of drugs do benzodiazepine belong to

CNS depressant

caution when using benzodiazepines

increased toxic effects with other drugs, often abused with opioids

source of natural opioids (opiates)

opium poppy -> morphine, codeine, opium

examples of semi-synthetic opioids

oxycodone, oxymorphone, hydrocodone

what are synthetic opioids

natural opioids that are chemically modified

example of synthetic opioids

fentanyl