Alcohol & Drugs - Why should we test?

Alcohol & Drugs – Why should we test? - Richard Evers

Richard Evers

Laboratory Manager

Synergy Health Laboratory Services

Alcohol & Drugs –Why should we test?


Contents

+ Understand why drug testing is justified

+ Know what regulations apply

+ Understand the process of testing

+ Know the rights of the employee

+ Have confidence in the results


Understand Why Drug

Testing is Justified


Drink Driving+ Level of impairment linked to dose

+ Drink drive limit 80mg/100mL blood

+ Blood / Breath alcohol linked to dose+ 3 Units alcohol ~ Drink drive limit

+ Accidents statistically linked to Drink Driving


Accident rate+ Little firm evidence that drugs lead to accidents and

absenteeism+ 5 Studies associate drug use with accidents+ 7 studies find little or no evidence (HSE 2002)

+ Prevalence of Drug use lower than alcohol+ British Crime Survey

+ Not all accidents lead to drug tests+ Hangovers also lead to accidents


How Common is Drug Use?+ British Crime Survey 2009-2010

+ Working Age Adults in England and Wales+ 8.6% used drugs in the last 12 months

+ 3.1% used a Class A drug+ 6.6% used Cannabis

+ Young Adults (16-24)+ 20% used drugs in the last 12 months

+ 10.7% used a Class A drug

+ 16.1% used Cannabis


Incidences of Positive Tests Synergy Health Laboratory Services Figures

+ Includes prescribed and over the counter medications+ UK Energy Industry 2010

+ 6.5% positive

+ UK Leisure Industry 2010+ 7.9% positive

+ UK Light Industry+ 4.1% positive


Right to respect for private and family life: -

1.Everyone has the right to respect for his private and

family life, his home and his correspondence

Article 8 European Convention on Human Rights


Acute Effects of Cannabis Use

+ 1976 study of 7 professional

and 3 private pilots

+ Flight simulator performance

30 minutes after smoking 6mg

+ Deviation from desired height

of 2600ft

+ Placebo gave deviation of

680ft


How long do the effects of Cannabis last?

+ 1985 study of 10 private

pilots

+ 19mg THC (3 x 1976 dose)

+ How close to the runway

midline can they land in a

simulator?


Cannabis effects last all week


Impairment due to drugs+ Detection times unrelated to impairment

+ Cannabis in urine detected for up to 1 month+ Cannabis in saliva detected for <24 hours

+ Urine results do NOT link to impairment+ Tests show use, not impairment

+ Not everybody reacts the same+ May Cause drowsiness+ Addiction+ Withdrawal


Right to respect for private and family life: -

1.Everyone has the right to respect for his private and family life, his home and his

correspondence

2.There shall be no interference by a public authority with the exercise of this right

except such as is in accordance with the law and is necessary in a democratic

society, in the interest of national security, public safety or the economic well-

being of a country, for the prevention of disorder or crime, for the protection of

health or morals or for the protection of the rights and freedom of others.

Article 8 European Convention on Human Rights


So when is testing justified?

+ Safety Critical Industries+ Airline pilots+ Train drivers+ Trackside workers+ Steel workers+ HGV drivers+ Fork Lift operators+ Healthcare


Integrity critical

+ Police+ Prison staff+ Drug testing staff+ Customs & Excise


Know What

Regulations Apply


+ Misuse of Drugs Act 1971+ Offence to allow drug use, or fail to act if drug use is known to employers

+ Health and Safety at Work Act 1974+ Health, Safety and Wellbeing of Employees

+ Reasonable care to protect Health and Safety of people affected by work

+ Management of Health and Safety at Work Regulations 1992+ Assess the Health and Safety to employees and the public

Criminal Liability


Civil Liability+ Plaintiff often works for the company

+ Damages

+ No Win, No Fee – Blame Culture

Competent Staff+ “Your employer must ensure, to the best of their ability, that the people the that

he employs around you are competent in their jobs and do not put others at risk by their actions. So if an employee injures another through a failure to use equipment properly, a drink or drugs problem or simply by messing around then the employer is potentially liable for those actions”

www.lawontheweb.co.uk/personal_injury/work_injury 08/03/2011


+ Original Regulations on which others are based+US Federal employees+Strictly defined criteria+Only covers 5 drugs

+ UK Laboratory Guidelines for Legally Defensible Workplace Drug Testing

+Cover urine drugs only+Technology change+Cover range of drugs

+ European Laboratory Guidelines for Legally Defensible Workplace Drug Testing

+More up to date+Saliva and Hair testing guidelines

SAMHSA Guidelines


Informed consent

+ Is the employer justified in testing?+ Safety critical or integrity driven?

+ Staff participation essential+ Consultation prior to implementation + Staff information sessions+ Junior Manager / foreman buy-in

+ Discrimination MUST be avoided+ External randomisation+ For Cause guidelines defined+ All staff on all shifts


Understand the

Process of Testing


+ For-Cause+ Testing may be carried out if an accident/incident occurs and there

are reasonable grounds to suspect the accident was a result of substance misuse

+ Pre-Employment+ Employers may request prospective employees to undertake

substance misuse test before employment commences

+ Random+ Employers may wish to randomly test a selection of their workforce to

discourage substance misuse

Reasons for Testing


+ Urine Testing+ The mainstay of drugs of abuse testing as the sample is easy to collect

and analyse+ The process is well controlled and is legally defensible+ Retention time of drugs in urine is mostly between 2 and 4 days

+ Saliva Testing+ Newer technology+ Smaller sample size+ Less invasive

+ Hair Testing+ Very small sample size+ Difficult to test+ 3 month drug history+ Shows Abuse levels only, not use

Methods of Testing


+ Privacy required+ Toilet facility

+ Interview room

+ Translator present if required

+ Company representative+ Identify Donor

+ Decide on actions

Testing process


+ Donor must :

+ Understand the process

+ Understand why they have been picked

+ Know that confidentiality is maintained

+ Have sufficient opportunity to ask questions

+ Know how to appeal against a test

Informed consent


Sample+ Freshly voided urine

+ Toilet not flushed+ Temperature measured

+ Split between ‘A’ and ‘B’ bottles+ Tamper evident seals applied+ Initialled by donor and collector+ Sealed in Tamper evident bag with CoC form+ Posted by Royal Mail or courier


Laboratory Analysis+ Primary Screen

+ Chain of Custody Checks+ Adulteration checks+ Negative or Non-negative+ Quickly eliminate negative results+ Negative samples discarded

+ On site testing+ Primary Screen may be done on site+ Provides instant negative+ Allows donor to return to work


LCMS Analysis+ Sensitive

+ Can identify very low levels of drug+ Specific

+ Does not cause false positive results

+ Can identify illicit and legal drugs+ Compares against defined threshold+ Report as Positive or Negative

+ Medication+ Consistent with medication declared+ Further information required+ Not consistent with medication declared


Understand the Rights

of the Employee


Privacy+ Anonymous collections

+ Synergy Health Staff not conspicuous+ Staff ID number not names if required

+ Collection process+ Private room+ Informed Consent+ Observed collections NOT routine+ Collection completed and sealed before next collection starts


Confidentiality+ Drug History on CoC form

+ Only recent medicine use requested+ Reasons for medication not asked+ Medications withheld from company

+ Medical Review Officer+ Company doctor or external reviewer+ Doctors confidentiality of results+ Can change positive results to negative


Informed Consent+ Cannot give informed consent for mandatory procedures

+ Staff consultation+ Union consent+ Consequences of positive results

+ Drug & Alcohol policy+ Communicated to all staff+ Universal in operation+ Amnesty period


Have Confidence in

the Results


Chain of Custody+ Ensures protection of donor & company

+ Prevents allegations of interference+ Provides legally defensible results+ Follows sample through laboratory processes

+ Ensures the reported results come from the donor named on the form


Laboratory Quality+ Quality Control sample with every batch

+ Known sample must produce results within a specified range

+ Validated methods+ Tested for interferences, reproducibility and accuracy

+ Authorised, Trained and Qualified Staff

+ External Proficiency tests+ Test whole laboratory performance

+ Results of unknown samples compared with other laboratories


ISO 17025:2005

+ UK Accreditation Service (UKAS)

+ Independent of Laboratories

+ Annual assessment of quality systems

+ Audit of methods to ensure “fit for purpose”


Challenges+ ‘B’ sample challenge

+ ‘B’ sample stored as ‘A’ sample+ Analysed by independent laboratory+ Chain of Custody checked

+ Cost of challenge met by donor+ Test costs around £150-£200+ Reduces timewasting+ Often leads to admission of drug use


Summary+ Drug testing may be justified where safety or integrity are

paramount

+ Drug testing is covered by a number of regulations, and the justification will depend on the risk

+ The process is designed to ensure accurate results that are traceable to the donor and to international standard materials

+ The employee has the right to privacy as far as it does not compromise safety or integrity

+ Quality is an integral part of the drug testing process, and laboratories spend a significant amount on maintaining quality


Thank you for listening

Does anybody have any questions?

Alcohol & Drugs - Why should we test?

Recruiting & HR

Transcript of Alcohol & Drugs - Why should we test?