Workplace Drug Testing

Areas of Drug Testing in Society

1. Military
2. CJ System (parole and probabtion)
3. Public section (transportation and FWT)
4. Private sector (insurance, athletics and clinical)

T/F: The military was the first to initiate employee drug testing

TRUE

NTSB

National Transportation Safety Board

NIDA

National Institute on Drug Abuse

DOT

Department of Transportation

What is the preferred specimen for federal workplace drug testing?

Urine

Causes for drug testing in the private sector

1. Pre-employment
2. Random
3. For cause
4. Post-accident

What is involved in the protocol for FWT?

1. Witnessing of urine collection
2. Chain of custody
3. Proper labeling (donor initials, collection personnel initials and integrity seals)
4. Transportation with documentation
5. Access to evidence and inspection for tampering
6. Initial drug tests and if positive, confirmatory test required

SAMHSA

Substance Abuse and Mental Health Services Administration

What makes up the "NIDA 5"?

1. Cannabis
2. Cocaine
3. Opiates
4. PCP
5. Amphetamines

Forms of Donor Manipulation

1. Substitution
2. Dilution
3. Adulteration

Examples of in vitro (external) adulterants

Bleach, detergent, ammonia, ascorbic acid, salt, vinegar, water, hydrogen peroxide.

Examples of in in-vivo (internal) adulterants

Pamprin, midol, diuretics, caffeine, golden seal root

T/F: If methamphetamine positive (500 ng/mL or more) then amphetamine must also be present at a concentration of at least 200 ng/mL

TRUE

Advantages of Immunoassay Tests

1. Minimal sample prep
2 Highly sensitive
3. Moderately specific (depending on cross reactivity)

Disadvantages of Immunoassay Tests

Adulteration issues

What are samples called after getting a positive result from an immunassay-based test?

"Presumptive Positive"

Examples of Immunoassay-based tests

1. RIA (Radioimmunoassay)
2. EMIT (Enzyme mediated immuno technique)
3. ELISA (Enzyme-linked immunosorbent assay)

Advantages of GC/MS

1. Sensitive
2. Not subject to cross-reactivity (specific)
3. Allows for definitive identification of a substance
4. Provides quantitative information

Disadvantages of GC/MS

1. Labor-intensive
2. Involves sample prep

Examples of alternative specimens

Blood
Urine
Breath
Saliva
Sweat
Hair
Breast milk
Nails
Semen
Feces
Meconium

What are some considerations for alternative specimens?

1. Metabolism
2. Ease of collection
3. Invasiveness
4. Training required for collection
5. Sample preparation
6. Concentration
7. Potential for adulteration or contamination
8. Time of drug use
9. Stability of matrix
10. Ease of storage, shipping, risk of pathogens

T/F: Generally detection times for most drugs are 2- 40 days following single use.

TRUE

What are the advantages of urine as a specimen?

1. Ease of collection
2. Ease of testing
3. Minimal sample preparation
4. Amenable to automated testing
5. High concentrations of drug and/or metabolite
6. Relatively inexpensive

What are some disadvantages of urine as a specimen?

1. Not related to impairment
2. Indicates only past use not recent use
3. Privacy issues (collection)
4. Potential for manipulation

What are the advantages of hair as a specimen?

1. History of drug use (long-term use) - months
2. Ease of collection, storing, shipping
3. No privacy issues
4. Low disease risk

What are the disadvantages of hair as a specimen?

1. Bias of color/texture of hair
2. Environmental contamination
3. Possible Inability to detect recent drug use
4. Commercial hair testing labs relatively limited as yet

What are the advantages of sweat as a specimen?

1. High subject acceptability
2. Low rate of allergic reactions
3. Can monitor drug use over one week with one patch
4. Cumulative measure of drug use
5. Relatively tamper proof

What are the disadvantages of sweat as a specimen?

1. Risk of accidental removal during testing period
2. Potential for environmental contamination

What are the advantages of saliva as a specimen?

1. Easy collection & accessibility
2. No privacy issues
3. Parent drug is present (similar to blood)
4. Known S/P ratios for some drugs
5. Indicates recent drug use

What are the disadvantages of saliva as a specimen?

1. Risk of contamination or increased concentration
(oral, smoked, intranasal)
2. Short detection time for drugs
3. Recent not historical drug use
4. S/P ratios vary with pH, flow rate, collection
method