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Archive for the month “December, 2011”

Federal Job Training Program Applicants denied when they failed a drug test

 About 2 percent of applicants for an Indiana job training program were turned away after failing a drug test, according to state officials who describe the mandatory testing as a success

http://bit.ly/u1vQAp via @CBSNews

Contact USA Mobile Drug Testing 855-USA-TEST or  516-802-3546 for info how you can screen your all employees

The program was launched in part because some business owners had questioned why drug users who would not be able to pass workplace drug screening were nonetheless allowed to participate in the federally funded job training program, the state Workforce Development Commissioner Mark Everson said.

Of the 1,240 applicants tested in the five months since the program was introduced July 1, 1,217 passed the test, the Department of Workforce Development said. Thirteen people, or 1 percent, failed, three refused to take the test, and seven more samples were so diluted that they needed to be retested, the department said.

Applicants were tested for marijuana, cocaine, opiates, the hallucinogen PCP and amphetamine and methamphetamine.

Everson believes the program, which has cost the state about $45,000 and that the U.S. Department of Labor describes as a national first, has been more successful than the numbers indicate.

“When people understand you’re going to drug test them, they walk away,” Everson said. “It discourages people from going through the process.”

Everson said the testing is specifically allowed under the federal Workforce Investment Act, which funds the job training program. He said he is confident the requirement would pass constitutional muster if it was challenged in court as some drug testing programs have been elsewhere. For example, a legal challenge successfully stalled a four-month-old requirement to take a drug test to qualify for welfare benefits in Florida.

Ken Falk, legal director for the American Civil Liberties Union of Indiana, disagreed, saying he believed the drug tests violate Fourth Amendment protections against unreasonable search and seizure. The U.S. Supreme Court has ruled there are exceptions to the Fourth Amendment protections when there are special needs exceptions, for example where there are safety concerns, Falk said.

“So the question is: What is the special need justifying this search? It’s our contention there is no such need to impose a constitutional event, a search, on people in these jobs programs. So our concern is it’s a Fourth Amendment violation,” Falk said.

As for the argument about why the state should spend money on training people who won’t be able to pass drug tests when they seek employment, Falk said similar arguments could be made for almost any drug testing states might consider.

“It doesn’t justify an invasion of the privacy protected by the Fourth Amendment. That requires something a little more extraordinary than that,” he said.

The ACLU also is concerned that Indiana may try to expand drug testing. Two state Republicans say they have asked statehouse staff to draft bills that would require welfare recipients to pass drug tests before they can receive benefits.

Falk said the ACLU hasn’t yet challenged Indiana’s drug testing policy in court because it hasn’t been contacted by anyone complaining about it.

___

USA MOBILE DRUG TESTING offers expanded opiates hair analysis for codeine morphine heroin

Omega Laboratories, Inc. announced that it has become the first and only laboratory to receive 510(k) clearance from the Food and Drug Administration (FDA) for its Extended Opiates Test that detects the use of Oxycodone and Hydrocodone through human hair analysis. The clearance also included the test for Codeine, Morphine and Heroin. USA MDT can perform this hair analysis giving you a 90 day window of abuse.

The ability to test for Oxycodone (eg. OxyContin® and Percocet®)* and Hydrocodone (eg. Vicodin® and Lortab®)* has become increasingly important to organizations as prescription drug abuse continues to rise, and has been recognized as a serious and growing health problem. A recent report by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) found that use of prescription pain relievers without a doctor’s prescription, or for nonmedical use, is the second most common form of illicit drug use in the United States.

As stated at a meeting of the U.S. Department of Health and Human Service’s Drug Testing Advisory Board (DTAB) in January of this year, the DTAB views this type of clearance as a key component in the future adoption of hair testing to Federal Workplace Drug Testing Programs.  In addition, many companies regulated by Federal Guidelines, like the U.S. Department of Transportation’s 49 CFR Part 40, have come to rely on Extended Opiates testing in hair samples because they realize prescription opiate abuse is a critical workplace safety issue.  Regulated companies that have safety-sensitive positions, such as motor carriers, pipeline/energy, nuclear power and railroads, are able to conduct expanded drug testing programs under company authority and often do so because of the inherent flaws in the current urine based testing program.

“At Omega we are focused on providing the highest-quality and most reliable testing procedure available,” said Dr. John Vitullo, CEO of Omega Laboratories.  “This clearance means that we offer our clients an unsurpassed level of expertise and proficiency in our hair testing for drugs of abuse process.  This clearance is one more way Omega maintains its position as the industry leader in testing expertise and customer service.”

Omega’s 510(k) FDA submission contained over 13,000 pages and included extensive studies involving precision, agreement, stability, recovery, effects of contamination, and the effects of different hair cosmetic treatments including multiple coloring products, straighteners/relaxers, and shampoos marketed to evade a drug test. Hair color, curvature and ethnic origin of the samples were also analyzed to ensure that a diverse population was represented in the studies.  A shipping study was performed showing there were no effects to the hair samples from extreme temperature and humidity changes, unlike the problems that have plagued the transport of urine samples.

“In addition to being the only hair testing laboratory with clearance for an Oxycodone and Hydrocodone test, Omega was the first hair testing laboratory in the United States accredited to the ISO/IEC 17025 standard,” said Dr. Vitullo.  “Accrediting agencies have referred to ISO/IEC 17025 as the gold standard of laboratory accreditation, and we feel strongly that it is the most comprehensive quality process available to our industry.”

According to the January 2009 FDA Guidance Document entitled Submission of Laboratory Packages by Accredited Laboratories, “ISO/IEC 17025 is the most widely used laboratory standard for federal testing laboratories, including FDA’s own laboratories, and ISO/IEC 17025 is internationally recognized and accepted world-wide.”

*The third-party trademarks used herein are registered trademarks of their respective owners and not Omega Laboratories, Inc.

http://www.omegalabs.net/

 

SOURCE Omega Laboratories, Inc.

NY Doctors dont monitor prescription overuse USA Mobile Drug Testing can help find employees in danger!

A fraction of New York‘s doctors monitor a state database that alerts them to patients who are abusing controlled substances or visiting multiple doctors for those prescriptions per Newsday article.http://www.newsday.com/news/health/state-few-doctors-monitor-drug-database-1.3405033

The state Health Department, which manages the database, said that through November just 2,216 of about 80,000 health care providers statewide who can prescribe painkillers and other drugs used the Controlled Substance Information system. It became available to doctors and other prescribers in spring 2010. Among those 80,000, a total of 47,000 have opened accounts with the online system.

“Do I use it as much as I thought I would? Not really,” said Dr. Brian Durkin, director of the Center for Pain Management at Stony Brook University Medical Center, which has more than 4,000 patients. “It’s not easy and quick to log on, and it’s not exactly the information you want.”

Some doctors said they don’t need the system, which is voluntary, because they have controls in place to catch the patients who are drug abusers. Others said it is too cumbersome to navigate for physicians managing busy practices. Critics also say the database, which is updated monthly, is not current enough to be helpful.

In addition, the system does not allow doctors to check whether patients have gotten prescriptions for controlled substances filled in other states, and pharmacists don’t have access to it.

The importance of tracking substance abusers and so-called doctor shoppers has been heightened since the disclosure that convicted killer David Laffer and Melissa Brady, his wife and accomplice, got hundreds of painkiller pills from physicians in the months leading up to June 19, when Laffer fatally shot four people in a Medford pharmacy and stole thousands of pills.

Newsday has reported that Laffer and Brady received almost 12,000 pills in the four years before the murders, often visiting many doctors and pharmacies in the same month. One drug they sought was the painkiller oxycodone, which last year contributed to more overdose deaths on Long Island than heroin.

Suffolk County District Attorney Thomas Spota said last month he would impanel a grand jury to investigate prescription practices and to examine New York‘s effectiveness in monitoring doctors.

The state continues to inform prescribers about how to use the system and is looking at ways to improve it, said Jeffrey Gordon, spokesman for the health department. The agency must balance the need to protect patient confidentiality with making the system user-friendly, he said.

In addition to the database, the health department sends letters to doctors warning them if a patient has been getting multiple prescriptions from other physicians. Doctor shoppers are defined as people who fill prescriptions from two or more physicians at two or more pharmacies in a month.

Gordon said chain pharmacies — about two-thirds of those in the state — update data weekly, although they, like all drugstores in New York, don’t have access to it.

“The department encourages and expects practitioners to use the critical tools we are providing to them to both appropriately treat their patients and guard against those who are abusing medications,” Gordon said.

Database shortcomings

New York’s system is not a trendsetter. Most of the 37 states with similar programs are updated more frequently, usually every two weeks, said Sarah Kelsey, legislative attorney for the nonprofit National Alliance for Model State Drug Laws. Some states, such as Oklahoma, are beginning to institute systems that will make their data available in real time.

In that state, more up-to-date data have translated into more use, said Don Vogt of the Oklahoma Bureau of Narcotics. About 60 percent of Oklahoma‘s doctors use its system.

A majority of states also allow pharmacists access to their prescription monitoring programs. That is the goal of the federally funded Prescription Monitoring Program Center for Excellence at Brandeis University, said its director, John Eadie. “We are encouraging every state to provide data to pharmacists,” he said.

The lack of current data is a reason Dr. Daniel Brietstein said he hasn’t used New York’s database. Brietstein, associate director of the division of integrative pain medicine at ProHEALTH in Lake Success, whose practice sees about 5,000 patients a year, said he has instituted safeguards to ensure that he will know if someone is a drug abuser.

LI docs’ usage varies

Like many pain management specialists, Brietstein doesn’t prescribe medication on the first visit, takes a detailed medical history, insists that the patient sign a contract stipulating he won’t misuse the drugs and conducts random drug tests.

“We have so many things in place — plus I have been doing this for 15 years,” he said.

Dr. Frank Adipietro, director of anesthesiology and pain management at Eastern Long Island Hospital in Greenport, whose practice has 4,000 to 5,000 patients, said he doesn’t use the database because, like Brietstein, he believes safeguards are in place. Adipietro said he will heed letters the state Health Department sends warning him if a patient appears to be doctor shopping. He also relies on the good relationship he has with pharmacists to alert him if someone appears to be filling multiple prescriptions.

“It works in a small community,” he said.

Dr. Robert Duarte, director of the pain institute in Manhasset for the North Shore-Long Island Jewish Health System, whose practice includes more than 10,000 patient visits a year, said he uses the database to check on a new patient or if he is suspicious of a patient’s behavior, such as someone who consistently runs out of medications too soon.

“The access is a little difficult,” he said. “It is a little trying at times.”

Dr. Daniel Laieta, an internist in Holbrook, said he found the system helpful and easy to use. But he wishes it were available to pharmacists.

“It’s a less useful tool without that,” he said.

Gordon, of the health department, said when the system went online the department did mass mailings to explain how it works and has contacted prescribers through dozens of presentations and newsletters.

Possible solutions

Many of the criticisms would be addressed in legislation that Attorney General Eric Schneiderman introduced last year and hopes to reintroduce this session, said spokeswoman Lauren Passalacqua. The new system, called I-Stop and run by the health department, would operate in real time and require both prescribers and pharmacists to check prescriptions for controlled substances online.

Craig Burridge, executive director of the Pharmacists Society of the State of New York, said a mandate requiring them to use the system would place a burden on pharmacists.

“We support having access, but don’t want it mandated,” he said. “You’re talking about 74,000 controlled prescriptions a day — that’s about 10 percent of pharmacists’ business.”

State Sen. Kemp Hannon (R-Garden City), chairman of the Senate Health Committee, and Assemb. Michael Cusick (D-Staten Island) also introduced legislation last session to expand access to the system.

Dr. Thomas Jan, a pain management and addiction specialist in Massapequa, is among the minority of doctors who regularly log into the system. On a recent Monday, he was checking on seven new patients.

According to the database, between Oct. 4 and Nov. 25, one of the patients had seen three doctors who prescribed large quantities of the painkillers oxycodone and methadone and the anti-anxiety drug diazepam: 540 pills for the seven-week period.

Jan said he later confronted the patient about drug abuse and the individual “owned up to it.” He offered the person outpatient drug rehabilitation treatment and a prescription for suboxone, a medication used to treat opioid addiction.

He acknowledges the system is not initially easy to access, but he has little patience with doctors who don’t use it.

“If you don’t have time to do it right, don’t prescribe those drugs,” he said.

http://www.newsday.com/news/health/state-few-doctors-monitor-drug-database-1.3405033

Drugs—both legal and illegal—cause majority of poisoning deaths. Misuse or abuse of prescription drugs, including opioid analgesic pain relievers

  is responsible for much of the increase in drug poisoning deaths. Poisoning mortality increased during the  2010 tracking period per a report by the National Center for Health Statistics. •Poisoning is the leading cause of death from injury in 30 states In 2008: Alaska, Arizona, California, Colorado, Connecticut, Delaware, Florida, Hawaii, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Hampshire, New Jersey, New Mexico, New York, Ohio, Oregon, Pennsylvania, Rhode Island, Utah, Vermont, Washington, West Virginia, and Wisconsin  In 43 states over 80% of poisoning deaths were caused by drugs.

In addition to an increase in the number of deaths caused by drug poisoning, increases in drug use, abuse, misuse, and nonfatal health outcomes have been observed. In the past two decades, there has been an increase in the distribution and medical use of prescription drugs, including opioid analgesics. From 1999 to 2008, the use of prescription medications increased . In 2007–2008, 48% of Americans used at least one prescription drug in the past month and 11% of Americans used five or more prescriptions in the past month. Analgesics for pain relief were among the common drugs taken by adults aged 20–59 years . In 2009–2010, over 5 million Americans reported using prescription pain relievers nonmedically in the past month (that is, without a doctor’s prescription or only for the experience or feeling they caused), and the majority of people using prescription pain relievers nonmedically reported getting the drugs from friends or family . From 2004 to 2008, the estimated rate of emergency department visits involving nonmedical use of opioid analgesics doubled from 49 per 100,000 to 101 per 100,000 .
 Opioid analgesics were involved in more than 40% of drug poisoning deaths in 2008.Natural and semi-synthetic opioid analgesics such as morphine, hydrocodone, and oxycodone were involved in over 9,100 drug poisoning deaths in 2008, up from about 2,700 in 1999. Of the 14,800 drug poisoning deaths involving opioid analgesics in 2008, the majority involved natural and semi-synthetic opioid analgesics such as morphine, hydrocodone, and oxycodone.In 2008, the drug poisoning death rate was higher among those aged 45–54 years than among those in other age groups.

http://www.cdc.gov/nchs/data/databriefs/db81.pdf

What exactly constitutes prescription drug abuse?

Prescription drug abuse is the use of a medication not prescribed for you, in a way other than prescribed (for example, taking too much or for other reasons like to get high. When abused, prescription drugs can be as dangerous as “street” drugs, with similar effects on the brain, including the possibility of addiction. Prescription drug abuse is illegal, even though most abusers get them from friends and family. Almost 2.2 million people 12 and older abused prescription opioids, including pain relievers, stimulants, and sedatives, for the first time in 2009 (similar to marijuana).

 Abuse of prescription drugs can produce serious health effects, including addiction. Commonly abused classes of prescription medications include opioids (for pain), central nervous system depressants (for anxiety and sleep disorders), and stimulants (for ADHD and narcolepsy). Opioids include hydrocodone (Vicodin®), oxycodone (OxyContin®), propoxyphene (Darvon®), hydromorphone (Dilaudid®), meperidine (Demerol®), and diphenoxylate (Lomotil®). Central nervous system depressants include barbiturates such as pentobarbital sodium (Nembutal®), and benzodiazepines such as diazepam (Valium®) and alprazolam (Xanax®). Stimulants include dextroamphetamine (Dexedrine®), methylphenidate (Ritalin® and Concerta®), and amphetamines (Adderall®).

Long-term use of opioids or central nervous system depressants can lead to physical dependence and addiction. Opioids can produce drowsiness, constipation and, depending on amount taken, can depress breathing. Central nervous system depressants slow down brain function; if combined with other medications that cause drowsiness or with alcohol, heart rate and respiration can slow down dangerously. Taken repeatedly or in high doses, stimulants can cause anxiety, paranoia, dangerously high body temperatures, irregular heartbeat, or seizures.And this is illegal….results could be getting fired from your job, not getting offered a job, or getting arrested.

Drug Testing in the Workplace is Critical: Because 79% of Drug Users are Working.

Is drug testing in the workplace a necessity? Take a look at the numbers. Statistics show that 47% of workplace accidents that result in serious injury and 40% of workplace accidents that result in death involve drug and/or alcohol use. Therefore, it is universally accepted that a drug-free workplace (DFWP) is essential for safety-minded employers.

Drug testing in the workplace is necessary for a myriad of reasons, the strongest of which being the importance of safety in the workplace. A safer workplace is always a more productive workplace. Drug testing in the workplace empowers all employees with the peace of mind knowing that individuals who might pose a threat to the overall safety of the workplace are being monitored and held accountable for their actions. Individuals are then able to focus on their own responsibilities and not have to worry about monitoring or picking up the responsibilities of their fellow employees. This allows people to work to their full potential.

There are other benefits to drug testing in the workplace in addition to safety. Drug testing in the workplace will help identify and remove employees who are not contributing their full potential. Again, take a look at the numbers. In addition to posing a liability to safety, people who use drugs or alcohol in the workplace are more frequently tardy or late to work and also miss more days of work than employees who do not abuse drugs or alcohol.

Of course, drug testing in the workplace is not something that can be implemented overnight. A drug test administered in the workplace will only make an impact if the workplace also has a well-defined, written substance abuse policy. Such a policy will explain the responsibilities of the employees and employer, identify available avenues and resources for help, outline prohibited conduct and define what constitutes a violation and, consequences. The actual drug testing itself can take many different forms (including random, pre-employment, etc.)

So how can you implement a drug free workplace (DFWP) in your business or organization? A DFWP program is much more than drug-testing in the workplace. An effective DFWP program consists of five components that, together, provide a full, comprehensive management and training program designed specifically to meet the needs of your company.

Elements of a Drug-Free Program

An effective drug-free program consists of five components that, together, provide a full, comprehensive management and training program designed specifically to meet the needs of your company. Companies can and do start at different places with their drug-free programs, depending on their special needs. USA Mobile Drug Testing can help your company get started with a drug-free program that’s right for you, or help you put in place the right processes for maintaining your program, depending upon your specific situation.

  1. A Written Substance Abuse Policy
    This serves as an executive summary of the substance abuse program. It sets the tone of the program, outlines the responsibilities of employer and employee, references available help, and explains the program including prohibited conduct, types and circumstances of testing, and the consequences for violations. For a drug-free safety program to be effective, all the parameters and procedures will have been thoughtfully developed and then articulated in a user-friendly policy statement for employees, along with detailed operational guidelines and accompanying appendices (forms) for use by management.
  2. Employee Awareness & Education
    Employees are made aware of and receive education about the policy, responsibilities, consequences, alcohol and drug information, their rights and the resources available to them through the company and community if they (or one of their family members) need help.
  3. Supervisor Training
    Supervisors need to be trained in their role within the company’s substance abuse program. They should receive training about the impact of alcohol and drugs on the workplace; how to recognize, document and confront a possible substance abuse problem; the company policy and procedures; how to refer a troubled employee to available resources and/or testing; and how to support an employee returning from treatment.
  4. An Employee Assistance Plan of Action
    An employer needs to identify a plan of action and the applicable resources for employees who seek help on their own, are referred by management for a possible problem with alcohol/drugs, or have a positive alcohol/drug test. The possibilities range from a comprehensive contract with an external Employee Assistance Program (EAP) provider to knowledge of the community service network that is subsidized with tax dollars.
  5. Drug and Alcohol Testing
    An employer has a myriad of decisions to make about their drug-free testing program. These include questions such as when they will test (there are different options including pre-employment, random,post accident, return to duty, reasonable suspicion ), who will be tested, what drugs will be tested for, what are the appropriate actions for any non negative results.  USA Mobile will walk you through the process and cover all the options.

Risk Of Death And Stroke In Those With Heart Disease Increased By Herbal Amphetamine

Chewing the natural stimulant that increases the risk of death and stroke in patients with heart disease compared to those who are not users, according to new research in Circulation: Journal of the American Heart Association.

Since ancient times, people in the Arabian Peninsula and East Africa have chewed the fresh leaves of the Catha edulis plant which has effects similar to amphetamines and cocaine. It causes euphoria, hyperactivity, restlessness, loss of appetite and weight loss.

In Yemen, some people have khat picnics, chewing the leaves for as much as three hours, like tobacco chewing. Its use has spread globally throughout Western Europe and into the United States. Seven metric tons of khat travel through Heathrow Airport in England each week, and fresh and dried khat has been seized and confiscated in the United States where it is illegal, researchers said.

In the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE-2) Study, researchers – comparing 1,408 khat chewers to 5,991 people who didn’t use khat – found:

  • In the hospital, khat users had a 7.5 percent death rate from heart disease compared to 3.8 percent in those who were not khat users.
  • At one month, the death rate was 15.5 percent among khat users and 6.4 percent for non-khat users.
  • At one year, the death rate was 18.8 percent among khat users compared to 10.8 percent among non-users.

For the study, researchers enrolled men and women from 65 hospitals in Saudi Arabia, Bahrain, Yemen, Qatar, United Arab Emirates and Oman.

About 96 percent of the khat users were from Yemen, where khat is legal and socially acceptable, unlike the other countries in the study.

“Global awareness of the negative impact of khat chewing on health and social life is warranted before it becomes endemic,” said Jassim Al Suwaidi, M.B., Ch.B., study co-author and Consultant Cardiologist and Director of Cardiovascular Research in the Department of Cardiology and Cardiovascular Surgery at Hamad General Hospital in Doha, Qatar. “This report underscores the importance of improving education about the cardiovascular risks of khat chewing as well as the need for further studies in the field.”

Furthermore, researchers found:

  • Khat chewers were more likely to be men (only 14 percent were women) and had lower cardiovascular risk factors such as diabetes mellitus, hypertension and dyslipidemia.
  • Death rates were consistently higher among khat users up to age 80, but khat chewing occurs across the spectrum of young and old, male and female.
  • Users were more likely to experience adverse health effects, including heart failure, recurrent ischemia, a second heart attack, cardiogenic shock and stroke compared to non-users.
  • Women were as likely as men to experience adverse heart effects.
  • Male khat chewers were more likely to develop stroke, particularly hemorrhagic (bleeding) stroke, compared to non-users. The increased risk of stroke wasn’t significant among women using khat.

The worse in-hospital outcomes may be related to delays in people getting to the hospital after the onset of symptoms and failing to receive thrombolytic (clot-busting) therapy or treatment with beta blockers, researchers said.

Prescription Drug Deaths Triple in Decade


http://www.cdc.gov/Features/VitalSigns/PainkillerOverdoses/

The abuse of prescription pain medications kills 15,000 people in the United States annually, according to a new report released by the Centers for Disease Control and Prevention (CDC) “We’re in the midst of an epidemic,” says CDC Director Dr. Thomas Frieden.

Deaths due to prescription painkiller overdoses now exceed the number of heroin and cocaine overdose deaths combined and have tripled since 1999. The Office of National Drug Control Policy (ONDCP) describes deaths resulting from prescription drug painkillers overdoses as “our nation’s largest drug problem.”

Recent data report 1 in 20 or 12 million American adults have misused prescription painkillers like oxycodone (e.g. Oxycontin®), methadone or hydrocodone (e.g. Vicodin®). Middle-aged adults have the highest overdose rates.

Health officials say that enough prescription painkillers were prescribed last year to medicate every adult every four hours for an entire month, and this type of drug abuse is costing insurance companies up to $72.5 million each year. The CDC reported that opioid pain medication abuse accounts for the most common poisonings treated in emergency departments and nearly one million people in the United States are currently addicted to some type of opiate.

Many are working to raise awareness, promote monitoring programs, track prescriptions and advocate for drug testing. Specifically, drug screening helps to improve health and safety in the workplace, reducing cost to employers and risk to colleagues.,

Overdoses involving prescription painkillers—a class of drugs that includes hydrocodone, methadone, oxycodone, and oxymorphone—are a public health epidemic. These drugs are widely misused and abused. One in 20 people in the United States, ages 12 and older, used prescription painkillers nonmedically (without a prescription or just for the “high” they cause) in 2010. A recent CDC analysis discusses this growing epidemic and suggested measures for prevention.

A Public Health Epidemic

Photo: Prescription pill bottlesThe problem of prescription painkiller overdoses has reached epidemic proportions.

Consider that:

  • Prescription painkiller overdoses killed nearly 15,000 people in the US in 2008. This is more than 3 times the 4,000 people killed by these drugs in 1999.
  • In 2010, about 12 million Americans (age 12 or older) reported nonmedical use of prescription painkillers in the past year.
  • Nearly half a million emergency department visits in 2009 were due to people misusing or abusing prescription painkillers.
  • Nonmedical use of prescription painkillers costs health insurers up to $72.5 billion annually in direct health care costs.

Groups at Greatest Risk

Certain groups are more likely to abuse or overdose on prescription painkillers:

  • Many more men than women die of overdoses from prescription painkillers.
  • Middle-aged adults have the highest prescription painkiller overdose rates.
  • People in rural counties are about two times as likely to overdose on prescription painkillers as people in big cities.
  • Whites and American Indian or Alaska Natives are more likely to overdose on prescription painkillers.
  • About 1 in 10 American Indian or Alaska Natives age 12 or older used prescription painkillers for nonmedical reasons in the past year, compared to 1 in 20 whites and 1 in 30 blacks.

Steps for Safety

The Federal Government is:

  • Tracking prescription drug overdose trends to better understand the epidemic.
  • Working with stakeholder organizations to educate health care providers and the public about prescription drug abuse and overdose.
  • Evaluating and promoting programs and policies shown to prevent prescription drug overdose, while making sure patients have access to safe, effective pain treatment.

There are steps that everyone can take to help prevent overdoses involving prescription painkillers, while making sure patients have access to safe, effective treatment.

States can:

  • Start or improve prescription drug monitoring programs (PDMPs), which are electronic databases that track all prescriptions for painkillers in the state.
  • Use PDMP, Medicaid, and workers’ compensation data to identify improper prescribing of painkillers.
  • Set up programs for Medicaid, workers’ compensation programs, and state-run health plans that identify and address improper patient use of painkillers.
  • Pass, enforce and evaluate pill mill, doctor shopping and other laws to reduce prescription painkiller abuse.
  • Encourage professional licensing boards to take action against inappropriate prescribing.
  • Increase access to substance abuse treatment.

Individuals can:

  • Use prescription painkillers only as directed by a health care provider.
  • Make sure they are the only one to use their prescription painkillers. Not selling or sharing them with others helps prevent misuse and abuse.
  • Store prescription painkillers in a secure place and dispose of them properly.*
  • Get help for substance abuse problems if needed (1-800-662-HELP).

Health insurers can:

  • Set up prescription claims review programs to identify and address improper prescribing and use of painkillers.
  • Increase coverage for other treatments to reduce pain, such as physical therapy, and for substance abuse treatment.

Photo: A healthcare provider discussing prescription medicine with a patient.Health care providers can:

  • Follow guidelines for responsible painkiller prescribing, including
    • Screening and monitoring for substance abuse and mental health problems.
    • Prescribing painkillers only when other treatments have not been effective for pain.
    • Prescribing only the quantity of painkillers needed based on the expected length of pain.
    • Using patient-provider agreements combined with urine drug tests for people using prescription painkillers long term.
    • Talking with patients about safely using, storing and disposing of prescription painkillers.*
  • Use PDMPs to identify patients who are improperly using prescription painkillers.

* Information on the proper storage and disposal of medications can be found at www.cdc.gov/HomeandRecreationalSafety/ Poisoning/preventiontips.htm.

 



Compliance for Employer Drug & Alcohol Testing Programs offered by USA Mobile Drug Testing

http://usamdt.com/compliance-for-employer-drug-alcohol-testing-programs/

In 1986 President Reagan signed an executive order requiring drug testing for federal employees.  In 1989 the federal Department of Transportation requires private employers to test interstate drivers; the U.S. Supreme Court upheld drug testing and twelve state laws existed for private workplace testing.  Since then more private and public, non-regulated employers have recognized the benefits of testing being enjoyed by their regulated colleagues.

Any discussion of compliance for employer drug & alcohol testing programs must start with an understanding of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory Guidelines).  These guidelines were first published by the Substance Abuse and Mental Health Services Administration (SAMHSA), United States U.S. Department of Health and Human Services (HHS), on April 11, 1988.  These guidelines establish scientific and technical guidelines for Federal drug testing programs, as well as standards for certification of laboratories engaged in urine drug testing for Federal agencies.

The Mandatory Guidelines also establish the National Laboratory Certification Program (NLCP), with comprehensive standards for the testing of specimens, quality assurance and quality control, chain of custody, personnel, and confidentiality in the reporting of results. Quality assurance is addressed for the entire testing process from specimen collection through reporting of the results to the employer. Specifically, the Mandatory Guidelines requires the Department to: inspect each certified laboratory at least twice a year to document its overall performance; conduct quarterly proficiency challenges for all certified laboratories; and support an external blind control specimen program, with quality control specimens submitted by employers as though they were actual donor specimens.

Confusion often exists because the Mandatory Guidelines apply to Federal Workplace Drug Testing programs which means agencies employees of the Federal Government.  This does not include Department of Transportation (DOT) regulated employers, DOT regulated employees or private employers.  It must be noted that the Mandatory Guidelines have set the foundation and the model for a comprehensive legally defensible drug testing program for all employers who conduct drug testing.  DOT’s drug & alcohol testing program, State law programs and private employers use these Mandatory Guidelines for the structure and model of the programs to be administered.  The DOT program mirrors the Mandatory Guidelines program with a few exceptions.

For a complete review of the Mandatory Guidelines with background information and information on revisions go to: http://edocket.access.gpo.gov/2008/pdf/E8-26726.pdf

A part of SAMHSA, the Division of Workplace Programs (DWP) is mandated by Executive Order and Public Law to provide oversight for:

  • The Federal Drug-Free Workplace Program, which aims to eliminate illicit drug use in the Federal workforce, and for
  • The National Laboratory Certification Program, which certifies laboratories to conduct forensic drug testing for the Federal agencies and for some federally regulated industries.

DWP provides comprehensive information at http://workplace.samhsa.gov/ and a complete Drug-Free Workplace Kit at: http://workplace.samhsa.gov/WPWorkit/index.html.  A complete review of these web sites is necessary for one to be an expert on Drug Free Workplace programs.

The Federal Government does not require most private companies or individuals to have a drug-free workplace policy of any kind. The exceptions to this are Federal contractors and grantees, as well as “safety-sensitive industries” (DOT regulated employers).

Requirements for Federal Contractors/Grantees

The most important piece of legislation regulating Federal contractors/grantees is the Drug-Free Workplace Act of 1988. This Act requires any organization that receives a Federal contract worth $100,000 or more, to establish a drug-free workplace policy. It also requires all organizations receiving a Federal grant of any size to maintain such a policy.

At a minimum, the organization must:

  • Prepare and distribute a formal drug-free workplace policy statement. This statement should clearly prohibit the manufacture, use and distribution of controlled substances in the workplace and spell out the specific consequences of violating this policy.
  • Establish a drug-free awareness program. This program should inform employees of the dangers of workplace substance abuse; review the requirements of the organization’s drug-free workplace policy; and offer information about any counseling, rehabilitation, or employee assistance programs that may be available.
  • Ensure that all employees working on the Federal contract understand their personal reporting obligations. Under the terms of the Act, an employee must notify the employer within 5 calendar days if he or she is convicted of a criminal drug violation.
  • Notify the Federal contracting agency of any covered violation. Under the terms of the Act, the employer has 10 days to report that a covered employee has been convicted of a criminal drug violation.
  • Take direct action against an employee convicted of a workplace drug violation. This action may involve imposing a penalty of some kind or requiring the offender to participate in an appropriate rehabilitation or counseling program.
  • Maintain an ongoing good faith effort to meet all the requirements of the Act throughout the life of the contract. Covered organizations must demonstrate their intentions and actions toward maintaining a drug-free workplace. Their failure to comply with terms of the Drug-Free Workplace Act may result in a variety of penalties, including suspension or termination of their grants/contracts and being prohibited from applying for future Government funding.

Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Drug Testing

HIPAA protects the confidentiality of “medical records” of a “patient”. None of those terms apply in drug testing.  First, there is no patient.  Many state drug test laws state so. There is only a donor. Second, there is no record of a “medical” examination.  A drug test is not conducted to “diagnose” or “treat” a “patient”. It is a forensic safety exam to determine if an “employee” or “prospective employee” meets the “employer’s” work qualifications.  In fact it’s not even a “fitness for duty” exam.

Americans with Disabilities Act states as follows: (1) In general.–For purposes of this title, a test to determine the illegal use of drugs shall not be considered a medical examination.”

DOT has also published its position on this subject stating that HIPAA does not require employers and service agents in the DOT drug and alcohol testing program to obtain written employee authorization to disclose drug and alcohol testing information required by 49 CFR Part 40 and other DOT agency drug and alcohol testing rules.  Review this at: http://www.dot.gov/odapc/hipaa.html?prog 

Americans with Disabilities Act (ADA) and Drug Testing

A test for the illegal use of drugs is not considered a medical examination under the ADA; therefore, employers may conduct such testing of applicants or employees and make employment decisions based on the results. The ADA does not encourage, prohibit, or authorize drug tests.  At the same time, the ADA provides limited protection from discrimination for recovering drug addicts and for alcoholics.  An employer may discharge or deny employment to current illegal users of drugs, on the basis of such drug use, without fear of being held liable for disability discrimination. Current illegal users of drugs are not “individuals with disabilities” under the ADA. If the results of a drug test reveal the presence of a lawfully prescribed drug or other medical information, such information must be treated as a confidential medical record.

State Laws – Private Employers

Since there is no comprehensive federal drug testing law effecting non-regulated private employers,  this leaves the field open to state regulation, and many states over the past 20 years have enacted provisions imposing drug testing restrictions of various kinds. Some limit testing to “reasonable suspicion” or “probable cause” situations. Some explicitly authorize random testing under certain circumstances. Some impose restrictions on public sector employers but not on private companies. Many prescribe specific methods for handling of specimens and the use of test results.

As a general rule, testing is presumed to be lawful unless there is a specific restriction in state or federal law.  Employers are encouraged to involve unions when creating drug free workplace policies.  The National Labor Relations Act requires that the terms and conditions regarding any workplace drug testing program be included in collective bargaining agreements.  Unions are generally not against drug testing, they work hard to protect the privacy and rights of their members while understanding the importance of employee safety.

Today, more than 550 state laws that affect workplace drug testing exist.  An employer operating in multiple states can greatly benefit from utilizing a national organization such as USA Mobile Drug Testing to provide drug testing services so that all state laws are covered and addressed.  This needs to happen initially with the company’s drug free workplace program policy.

Contact via e-mail:  thecomplianceexpert@usamdt.com for a comprehensive report on the State Laws for Drug Testing in your particular state, this is a complimentary service being provided for a limited time only by USA Mobile Drug Testing, LLC

Legal Defensibility

Our experienced professionals at USA Mobile Drug Testing can help employers to insure that their drug testing programs are in compliance and have in place legal defensibility.  Mainly employers need to have a strongly written substance abuse/testing policy in place. Our experience at USA Mobile Drug Testing indicates that employers that have taken the time to construct a written policy with proper testing procedures tend to be successful with deterring potential legal issues as well as resolving them if they arise.

Some of our USA Mobile Drug Testing clients have expressed that a vague and broad Drug Free Workplace policy works best since it provides more flexibility; in reality, a policy with well defined procedures are more effective because they set clear expectations for the employees as well as for the organization.

Legal review is very important, while USA Mobile Drug Testing can assist employers with developing compliant a Drug Free Workplace, a substance abuse policy should always be reviewed and approved by the employers legal counsel.

USA Mobile Drug Testing compliance specialists see it often where management does not know or follow their own policies.  Know and follow your policy – at face value, this may seem too obvious to even mention; however, you would be surprised at how often key personnel may be unaware of their own policy in handling drug testing issues – remember, a policy is only as effective as its use in the real world!

As concerns about drug use in the workplace continue to grow, there has been an expansion in the use of drug testing in the workplace to uncover these users.  It is essential that creators of drug free workplace programs keep up with regulations, Federal and State laws and best practices that are outlined by the Mandatory Guidelines for Federal Workplace Drug Testing Programs.  Compliance specialists at USA Mobile Drug Testing are standing by to provide assistance – http://usamdt.com/.

Can Prescription Drugs Negatively Impact Employment?

In today’s world of routine drug testing in the workplace, employees are often concerned a prescription medication may affect a drug test.

A common concern may be “can I lose my job for taking it?”  Or “does my employer have a right to know what medication I am taking?”

Because some prescription medications can affect an employee’s ability to work safely, employers may have a legitimate interest in addressing them in their drug-free workplace policy.

“We are frequently approached by employers with questions about prescription drugs and how to handle them,” said Janet Matteo, Compliance Specialist with USA Mobile Drug Testing of Central Long Island, which provides on-site drug testing to companies.  “And fortunately, there are very specific guidelines on how to handle these situations, so that the employee is protected.”

Indeed, employers cannot discriminate in their hiring and firing practices based on an individual’s use of prescription medication for legitimate medical purposes, and such discrimination could be a violation of the Americans with Disabilities Act (ADA).

The ADA also prohibits an employer from asking disability-related questions unless they are job related and consistent with business necessity.

Services like USAMDT help companies to handle delicate drug testing matters correctly, as they limit a business’s exposure to liability for making non-compliant decisions.

As Matteo points out, there are a myriad of laws which protect the worker in situations like this, and “it’s best to let a qualified drug testing outfit oversee this very important aspect of a business.”

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