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Mercy Occupational Health
Center
Lorain Clinic
1800 Livingston Ave
Lorain, OH 44052
440-233-1068
Elyria Clinic
491 N. Abbe Road
Elyria, OH
440-366-5577
Drug and Alcohol Testing
Update
DHHS-Department of Health
and Human Services

SAMHSA-Substance Abuse & Mental
Health Services Administration:

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Center for Substance Abuse Prevention
Center for Substance Abuse Treatment
Center for Mental Health Services
Center for Substance Abuse
Prevention

Manages the National Laboratory
Certification Program:

Scientific methodology used in testing

Technical expertise to certify & decertify labs
(SAMHSA-certified lab)
DOT Follows DHHS Guidelines


Omnibus Transportation Act of 1991
Changes in DHHS rules leads to…
Changes in DOT regulations
leads to…
Changes in BWC guidelines.
DHHS Changes:

Lowered cut-off level for Cocaine

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Screening- 150ng/ml
Confirmation- 100ng/ml
Lowered cut-off level for Amphetamine

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Screening -500ng/ml
Confirmation- 250ng/ml
Review your company policy!
DHHS Changes- con’t.


Mandatory Initial Testing of Heroin
(6-AM)
Testing for Ecstasy
(MDMA, MDA, MDEA)
Review your company policy!
New Forms

DOT (Dept. of Transportation)

New federal form effective 10/1/10

Can use up old forms until 9/30/11

Still request a 5-panel test
DOT Form-con’t.
Specify Testing Authority:
 HHS-Health & Human Services
 NRC-Nuclear Regulatory Commission
 DOT-Dept. of Transportation

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FMCSA- Federal Motor Carrier Safety Admin.
FAA- Federal Aviation Admin.
FRA- Federal Railroad Admin.
FTA- Federal Transit Admin.
PHMSA- Pipeline & Hazardous Mat. Safety Admin.
USCG- United States Coast Guard
Forms-con’t.

NON-DOT

Still called 5, 9 or 10-panel

Lab codes may have changed
Change in DOT Regulations

DOT can regulate its own non-scientific
guidelines:

Direct Observed Specimen Collection


Purpose and Procedure
DOT vs. BWC requirements for RTD and Followup testing
Review your Company Policy!
Hair Testing & Instant Testing

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DOT authorized to use only testing
methods approved by DHHS.
DHHS has not approved any specimen
testing method except urine.
DOT tests must be confirmed by DHHS
certified lab using scientific testing
methods and verified by an MRO.
BWC follows DOT rules.
Medical Marijuana

49 CFR Part 40
40.151 does not authorize “medical
marijuana” under a state law to be a
valid medical explanation for a
transportation employee’s positive drug
test result.
Medical Marijuana-con’t.

40.151 As an MRO, you are prohibited
from doing the following as part of the
verification process:
(e) You must not verify a test negative
based on information that a physician
recommended that the employee use a
drug listed in Schedule I of the
Controlled Substances Act.
Medical Marijuana-con’t.

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MROs follow federal guidelines.
All positive tests - reported positive
In states where legal, MROs not
allowed to say if employee got Rx from
physician due to confidentiality.
Company would have to pursue the
same as fitness-for-duty.
Synthetic Marijuana



Developed in 1993 as a research project
to determine how different chemical
formulas interact with the brain.
Never intended for human use.
These compounds are sprayed on
various herbs and spices to give them a
“marijuana look.”
Synthetic Marijuana-con’t

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Common names- Spice, K2, Black
Mamba, Blaze and Red X Dawn
Sold in head shops, tobacco stores, gas
stations, boutiques, and over the
Internet as herbal incense or bath salts.
$10-$20 per gram
Smoked like real marijuana
Touted as “legal” alternative to pot.
Synthetic Marijuana-con’t.

Contains chemicals x5 more powerful than
marijuana.

Overdoses, suicides, hallucinations, seizures

Increased ER visits, calls to Poison Control

Effective March 2011, Drug Enforcement
Administration has banned in U.S.
(Schedule I Drug)
Testing for K2, Spice

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Now Available through Clinical
Reference Lab (CRL)
NON-DOT only
Stand-alone test
Additional charge
Must be requested
Electronic Cigarettes

E-Cigs
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“Vaping” vs. smoking
Battery powered plastic or metal device
Heat a liquid nicotine solution in disposable
cartridge and inhale vapors.
Vapors are mostly water.
Vapor has been found to contain other
toxins and carcinogens.
E-Cigs-con’t.

Controversial:

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Research being conducted on secondhand “vapor”
inhalation.
Promoted as a way to break the addiction to real
cigarettes.
Difficult to enforce “No smoking” policy.
New Jersey and other local governments
addressing under smoke-free laws.
May want to address in your company policy.
Mercy Occupational Health
Center
Kathy Brown RN
440-233-1081