Cannabis and the Workplace, Oral Fluid Flashcards
List some causes of impairment.
Legal and illegal substances, alcohol, medical conditions, fatigue, life stresses.
List some impacts of impairment.
Inability to concentrate, think clearly and make decisions; dizziness, drowsiness, disorientation and confusion; slowed reaction times and lack of coordination; confrontational and aggressive behaviours, disinterest.
What are responsibilities of the worker?
As per policy, declare anything that might impair your ability to do your work safely; work in a safe manner; follow education and training; report concerns to your supervisor.
List some signs that someone at work might be impaired.
Personality changes or erratic behaviour; odour of alcohol or drugs on their breath or clothes; glassy or red eyes, unsteady gait, slurring, poor coordination; consistent lateness, absenteeism or reduced productivity or quality of work.
What are the laws regarding smoking or vaping cannabis in an enclosed workspace in ON?
ON prohibits smoking or vaping cannabis for recreational or medical purposes in an enclosed workplace.
What are the laws regarding edible cannabis in an enclosed workplace in ON?
An employee can consume edibles for medical purposes related to a disability in an enclosed workplace, as long as it does not interfere with workplace health and safety or performing essential job duties.
Describe the significance of Aitchison v L & L Painting and Decorating Ltd.
Human Rights Tribunal of ON found that the termination of a painter who smoked cannabis for a medical purpose at work during his breaks was not discriminatory.
What three sector regulations in the Occupational Health and Safety Act expressly prohibit impairment or the presence of alcohol or drugs in the workplace?
Regulation 854 (Mines and mining plants), Regulation 855 (Oil and gas – offshore), Regulation 629 (Diving operations).
What is the substance use policy of the RCMP?
All employees must be fit for duty when reporting for work, which includes not being impacted by alcohol or drugs.
What questions are considered when workplaces are determining if there is a duty to accommodate cannabis use in the workplace?
Is the cannabis use for a medical purpose or because of an addiction, is the cannabis use for a medical purpose smoked or vaped, what is cannabis use causes impairment at work.
What are the two main mechanisms for testing workers for cannabis?
Urine and oral.
What type of urine testing is used for drug screening?
Point of collection (POC) testing.
What are the benefits of POC testing?
A convenient tool with results obtained in a short time period.
What type of technology is used for rapid testing?
Immunoassay based technology.
What two important things should be considered when using POC testing?
1) A testing procedure designed to reduce issues of sample adulteration and dilution; 2) analytical confirmation of positive screening results.
How is the integrity of a sample collected via POC testing ensured?
Use of secure washroom; temperature check of the collected sample; visual inspection for obvious signs of adulteration; use of adulteration strips designed to detect possible tampering.
What are the benefits of testing oral fluid over urine?
Quicker and less invasive to collect, meaning the amount of drug measured is a better reflection of cannabis exposure at time of suspected impairment.
What advances have led to oral fluid testing gaining acceptance as an alternative biological matrix for detecting drugs in clinical and forensic settings?
Advances in analytical technology and new research.
What is oral fluid?
Saliva plus other materials in the oral cavity.
From what three glands is oral fluid primarily secreted from?
Parotid, submandibular, sublingual.
Describe the composition of oral fluid.
97% water plus electrolytes, immunoglobulins, enzymes and other proteins.
Describe the flow rate of oral fluid.
Varies from 0 to several mL per minute.
What factors impact oral fluid flow?
Emotional state, hunger.
What can cause dry mouth syndrome?
Anxiety of collection procedure, lack of proper hydration.
How does THC impact oral fluid?
THC decreases oral fluid and leads to dry mouth.
Why does THC cause dry mouth?
Effects is due to stimulation of CB receptors.
Describe how THC leads to dry mouth.
Cannabinoid receptors are found on the submandibular glands. THC binds to CB receptors and acts via the parasympathetic nervous system.
About how much saliva production are the submandibular glands responsible for?
~70%.
In what two ways are cannabinoids believed to block messages from the parasympathetic nervous system?
Binding to receptors in salivary glands and receptors in the brain.
Describe THC concentrations in blood and oral fluid.
THC does not distribute well into either and concentrations can thus vary greatly.
What factors cause THC blood and oral fluid concentrations to vary?
Dose, route of administration, patterns of use.
What happens to the oral mucosa when cannabis is smoked or consumed orally?
Extensively contaminated for a short period of time.
Why is oral fluid preferred for THC testing over blood?
Taking blood is an intrusive procedure; requires specialized personnel; poses biohazard issues.
Why is oral fluid preferred for THC testing over urine?
Urine samples typically test for the metabolite THC-COOH, making interpretation of such tests difficult; privacy issues for taking the sample; sample adulteration may occur.
What three methods can be used for oral fluid collection?
Passive drool, expectoration, oral fluid collection devices.
List a benefit and drawback of passive drool collection.
Closest to the concentrations excreted from salivary glands but unpleasant for donors and collectors.
What is a benefit of expectoration?
More cost effective than collection devices.
List two drawbacks of expectoration.
Expectorated oral fluid is viscous and contains mucus, food particles and other debris; dry mouth after cannabis use may make it difficult to obtain an adequate sample.
What is expectoration?
Coughing up and spitting out phlegm or mucus from the respiratory tract.
Describe the process of oral fluid collection via collection devices.
Use a pad or sponge to absorb oral fluid and a buffer to stabilize the drug and extract them from the collection pad. Pad filters oral fluid. Buffer reduces viscosity and absorption of lipophilic cannabinoids onto container surfaces.
When can an officer demand a driver provide a sample of oral fluid to be tested by the approved drug screening equipment?
Under reasonable suspicion that the driver has a drug in their body.
What is considered sufficient evidence for an officer to proceed with their investigation into impaired driving?
Positive test result.
What is the Drugs and Driving Committee (DDC)?
A committee within The Canadian Society of Forensic Science.
What is the role of the DDC?
To act as an advisory body to the DoJ with respect to issues of drug impaired driving.
What professionals comprise the DDC?
Forensic toxicologists and other experts from across Canada.
What are the two forms of drug screening equipment approved for use in ON?
1) Drager DrugTest 5000 and a Drager Drug Test 5000 STK-CA when used together and 2) SoToxa, Abbott SoToxa Test Cartridge and Abbott SoToxa Oral Fluid Collection device when used together.
What is the oral fluid cut-off for THC?
25 ng/mL.
What is the oral fluid cut-off for cocaine?
50 ng/mL.
What is the oral fluid cut-off for meth?
50 ng/mL.
What are the DDC recommendations designed to do?
Maximize likelihood of an individual testing positive on drug screening equipment also having the drug in their blood at or above any per se limit and to minimize the likelihood of individual testing negative on drug screening equipment but having the drug in their blood at or above any per se limit.
True or false: Passive inhalers of cannabis will be confused with actual consumers in an oral screen.
False: the 25 ng/mL cut-off is well above levels observed from passive inhalation.
Within how many hours of smoking do smokers generally test negative for THC?
Within 4 hours.
Within how many hours of ingestion do oral THC users generally test negative on drug screening equipment?
Within 4 hours.
What practical considerations should be made regarding drug screening equipment to be used in Canada?
Electrical requirements, battery, printer; Metric system, language requirements; roadside testing – portability, ruggedness, time to complete; storage and operating temperatures; storage questions (i.e., storage temp).
At what minimum ambient temperature range should an oral fluid collection system be capable of being stored at?
5 to 30 deg C.
What type of legal challenges have been seen for oral fluid screening?
Some defense lawyers have obtained their own devices and performed testing to refute use for impaired driving; constitutionality cases have also been filed.
How to increase confidence in oral fluid screening devices?
Increased education and research.
What types of future research should be done on oral fluid drug testing equipment?
Incidence of false positives, use in cold climates, correlation between positive oral fluid results and per se drug levels.
