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ENFORM INFORMATION SESSION

ENFORM INFORMATION SESSION. The Playing Field: Alcohol and Drug Considerations Wayne St. John BSc. Psy. DISCUSSION TOPICS. What is Drug Testing All About? Testing Workflow - Overview How Does Impairment Fit Into The Workplace? Testing Methods: Are They All The Same?

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ENFORM INFORMATION SESSION

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  1. ENFORMINFORMATION SESSION The Playing Field: Alcohol and Drug Considerations Wayne St. John BSc. Psy.

  2. DISCUSSIONTOPICS What is Drug Testing All About? Testing Workflow - Overview How Does Impairment Fit Into The Workplace? Testing Methods: Are They All The Same? How to Recognize Drug Use In The Workplace Why Does It Matter? Leveling Out The Playing Field: The Rights Of The Company Defensible Results: Best Practices

  3. Drug Testing How Does It Work?

  4. TESTING WORKFLOW • Medical Review Officer Substance Abuse Professional • Laboratory Testing • TPA Client • Collection

  5. Drug Testing What is it all About?

  6. SAFETY • Drug testing programs are one more tool in a larger safety program. • We know through many studies that alcohol and drug use and associated hangovers negatively impact coordination and the ability to perceive and respond to hazards, resulting in injury to the user and other innocent victims. • Statistics show that as testing becomes engrained in the culture of a safety program, positive rates decrease over time. • As positive rates decrease, so do the heightened safety risks associated with having employees in safety sensitive positions performing duties while under the influence of drugs and alcohol. • Increased ability of employees to perform their jobs in a safe manner result in decreased incidents, injuries and fatalities.

  7. YEAR BY YEAR COMPARISON OF POSITIVE DRUG TESTS (EXCLUDES ALCOHOL)

  8. WHAT DO THE STATISTICS TELL US? • With several days notice, 92.2% of employees were able to get on site. • Once on location, 6.8% of reported accidents resulted in a positive drug test. • 43.3% of individuals on location who showed signs of not being able to perform work safely resulted in a positive drug test before they were involved in an accident.

  9. Drug Testing and Impairment

  10. DRUG TESTING AND IMPAIRMENT • Testing for drugs does NOT show impairment. What the results do show is a heightened safety risk if the levels of a particular substance are higher than the set safety threshold. • Cutoff levels have been established through post-incident testing and autopsy results. These cutoff levels are reviewed and adjusted to eliminate the potential for passive ingestion leading to a laboratory confirmed positive result (second hand smoke, poppy seed muffins)

  11. Testing Choices

  12. EXPRESS (POCT) URINE TESTING • It’s important to note that these devices designed for POCT urine testing only have to maintain an accuracy level to within 75% (worst case scenario; which means that the devices have a potential of 12.5% false negatives and 12.5% false positives) of the approved cutoff levels in order to remain FDA certified as testing devices. • CannAmm runs QA/QC protocols on the batches of devices before they are shipped out to our collection sites to maximize this accuracy, but there is still a discrepancy between the accuracy of these devices and lab based testing. For this reason, all express tests that do not produce a conclusive negative result are sent on to the laboratory for further testing.

  13. ORAL FLUID EXPRESS (POCT) TESTING • For POCT oral fluid testing, there are currently no devices that are able to maintain even to the minimal FDA standards while testing to the approved cutoff levels, so accuracy (and therefor defensibility) of test results using a POCT oral fluid device are highly unreliable. As such, CannAmm does not support the use of these devices. • Currently, one device has received FDA certification, however it tests marijuana levels at 10 times the recommended cutoff level, which leads to a dramatic increase in false negative results.

  14. LAB BASED URINE TESTING • Considered the “Gold Standard” for drug testing • Science behind this testing has been upheld in courts over and over again • The lab performs a screening test utilizing a more sophisticated immunoassay method than the POCT device, and if required (the sample is above the initial test cutoff levels) performs a second confirmation test utilizing Gas Chromatography-Mass Spectrometry (GC/MS). • A screening test is designed to identify the family of drugs (i.e. Amphetamines) and GC/MS testing bombards the sample with ions to take a “picture” of the exact drugs present under that family of drugs (i.e. Dextroamphetamine). • GC/MS testing is performed to the confirmatory cutoff levels on the above chart. • The two levels differ in some cases because the screening level tests for all drugs in the family and if the total amount of all the drugs within the family is greater than the initial test cutoff level a confirmation test is done where at least one individual drug within the family needs to be over the confirmatory cutoff level for the test to be reported as a positive.

  15. LAB BASED ORAL FLUID TESTING • While this is a relatively newer method for testing, the sample goes through the exact same screening and confirmation testing at the lab as has been established for urine. • Chain of Custody protocols for oral fluid testing closely mirror those of urine testing. While this testing methodology has not yet been challenged in courts, it is assumed that these similarities would also provide a defensible test result.

  16. COLLECTIONS: MEETING YOUR BUSINESS NEEDS • Be flexible enough to allow for unique testing procedures in unique situations. • While lab based urinalysis is the “Gold Standard”, there may be situations such as a post-incident where your business need may be more suited to express (POCT) testing in order to return the employee to the worksite sooner. • Oral fluid collections may be appealing however all oral fluid collections must be sent to the lab for analysis. • The goal of any testing program is to have trusted, defensible results. Depending on the methodology of testing and the medium being tested (urine/oral fluid), there are varying levels of risk mitigation. Choose a testing method that meets your company’s business needs while providing an acceptable level of risk mitigation for your organization.

  17. Risk Mitigation

  18. Leveling OUT the Playing Field

  19. LEVELING OUT THE PLAYING FIELD • In drug and alcohol testing, all the fail safes and checks/balances are in place for the protection of the employee • A well written policy is the backbone of a testing program and where the company can assert their rights within the program • The company has a legal responsibility to provide safe working conditions for all employees and visitors to site • A well designed program balances the rights and protection of the employee with the rights of the company – all while maintaining the requirements under Human Rights.

  20. Best Practices

  21. BEST PRACTICES: DRUG & ALCOHOL TESTING PROGRAMS • Don’t re-invent the wheel • Ensure legal defensibility through chain of custody, lab confirmation, EBT confirmation, MRO review • Comply with Human Rights (accommodation) • Be consistent

  22. Is it true that? What if? Do we need to? How long? QUESTIONS

  23. Contact Us: Wayne St. John 1.800.440.0023 ext. 4256 Wayne.StJohn@cannamm.com THANK YOU

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