Drug Testing in the Workplace Flashcards
regulated drug testing
mandatory drug testing for certain types of workers
- strict rules/guidelines
- list of drugs that can be tested for; all of them need to be included
- only accredited labs can perform testing
- SAMSHA = substance abuse and mental health substance abuse of USA
- HHS = health and human services
- DOT = department of transportation
MRO = medical review officer
non-regulated drugu tetsing
not mandatory (employer may say mandatory but not mandatory under any laws or government regulations)
- no rules
- any drugs
- not accredited
- MRO not required
specimens for workplace drug testing
urine oral fluid or breath
non -regulated sometimes hair
arguments for drug testing in the workplace
job safety
absenteeism
quality/quantity of production
increased health costs
increased liability costs
unlawful activity - don’t want ppl selling drugs at workplace
govt regulations
arguments against screening
- opposition to US enforcement and rules
- union opposition
- legal concerns + complications
- does not measure performance
- opponents question extent of problem
- opponents prefer education
- opponents question accuracy
- what employees do off worksite not employer’s concern
- marijuana and cocaine = safe
- marijuana = legal
industries using screening
transportation
petroleum
mining
pulp and paper
other industrial operations with transportation
financial, commercial, security, sports, service, etc….
pharmacokinetic considerations
ADME
urine variables
limitations : dose, time, effect
DOT mandatory tests
amphetamines
cannabinoids
cocaine metabolite
opioids
phencyclidine (PCP)
ethanol
drugs included in non-regulates testing
benzos
barbiturates
methadone
methaqualone
propoxyphene
LSD
other drugs
amphetamines elimination time
1-2 d
cannabinoids elimination time
1-30
cocaine metabolite elimination time
12-48 hrs
opioids elimination time
1-3 d
PCP elimination time
1-30 d
biphasic like cannabinoids
ethanol elimination time
up to 14 hrs
barbiturates eliminiation time
1d- 3 wks
benzos elimination time
1dd to 6 wks
methadone elimination time
1-3 d
methaqualone elim time
1-7d
propoxyphene elim time
1-3 d
types of testing
pre-employment
random
reasonable suspicion/cause
post accident
return to duty
follow-up
PCP
phencyclidine
- angel dust, peace pills, hogs, elephant tranq, etc.
appearance: crystal, powder, liquid, tablet
class: hallucinogen
dose: ingested, smoked, injected, snorted
effect of PCP and its prevalence in Canada
unpredictable and variable effect
rapid thought and action
euphoria to depression
hallucinations, irrational, violent behaviou
increased sensory perception
rarely seen in Western Canada; DANGEROUS!
Amphetamines
speed, bennies, black beauties, copilot, doxies, crystal meth, etc.
appearance: varied pills, powders, solutions
class: CNS stimulant
dose: ingested, injected, snorted or smoked
effects of amphetamines
euphoria, mood elevation, increased alertness and energy
increased HR, BP, tremor, anxiety, sweating
hyper irritability
restlessness, bizarre behaviour, weight loss, paranoia
chest pain, psychosis, brain damage, cardiac arrest, etc.
“Rush & Crash”
meth
opioids
codeine, morphine, oxycodone, oxymorphone, hydrocodone, heroin, dust, horse, junk, etc.
appearance: white/brown powder, tablets, tonics
class: narcotic analgesic, CNS depressant
dose: ingested, injected, sniffed or smoked
effects of opioids
skin flushing “rush”, euphoria “nod”, diminished sensory perception, lethargy, confusion
resp depression => death
physical dependence quick! withdrawal = nausea, diarrhea, insomnia, chills, tremors, weakness
IV users = AIDS, hepatitis
cananbinoids
dope, grass, weed, smoke, po, hash, Reefer, Mary Jane, etc.
appearance: green/brown dried leaf, light to dark, resin/past or oil
class: psychoactive; possible appetite stimulant, anti-nausea, epilepsy, neuromuscular
dose: smoked or ingested
effects of cannabinoids
euphoria, passivity, relaxation, drowsiness, increased auditory/visual perceptions, disinhibition, sensory distortion
impaired short-term memory, diminished learning, attention lapses, disorientation, delirium, depersonalization, hyperemesis syndrome
bloodshot eyes, increased HR; alc amplifies effects
this has possible links to psychiatric disorders, dependence, and carcinogen
cannabinoids
T or F. There is no cross rxn with synthetics in conventional cannabinoid assays
T
T or F. Synthetic cannabinoids are toxic
T
cocain
coke, nose candy, snow, toot, blow, crack
appearance: white crystalline powder or transparent crystals
class: CNS stimulant, local anesthetic, vasoconstrictor
dose: injected, smoked, absorbed via mucus membranes
cocaine effects
sweating, rapid shallow breathing, increased HR and BP, elevated temp, euphoria
tremors, twitching, chest pain, nausea, seizures. resp depression, cardiac arrhythmias, death
weight loss, constipation, septal necrosis, etc.
This drug has a strong psychological dependence, can be mixed with other drugs and produce sudden death
cocaine
ethanol, ethyl alcohol
CNS depressant
effect: drowsiness, dizziness, flushing, slurred speech, staggering, dbl vision, stupor,; OD = resp failure
withdrawal = headache, stiff muscles, weakness, tremors, hallucinations, rarely death
most abused drug and increases effects of other drugs
alcohol
T or F. Drug testing is a measure of impairment
F! Drug testing not a measure of impairment but ac=lcohol testing is
collection protocol for drug testing
- ID donor
- explain procedure
- ID specimen
- split sample specimen collection
- complete chain of custody form
- seal specimen
- transport to lab
elements of chain of custody
- ID specimen
- acknowledgement of testing
- ID of collector
- security of specimen
- individual(s) performing test
certifies that the result for that specimen from individual and has not been tampered with
drug testing procedure
specimen log-in
chain of custody verification
pH, creatinine/SG check
prelim testing by IITF (immunoassay)
verify ALL pos with GC/MS, LC/MS or GC (ethanol) (alt confirmation methods)
GC/MS for drug testing
confirmation test
extraction of drug
clean up/ concentration / derivatization
chromatography
detection
alternate confirmation methods besides GC/MS
LC/MS
LC/MS/MS
LC/TOF
GC/MS/MS
GC/TOF
other
this is the traditional, accepted confirmation method
GC/MS
- large spectral database
- SAMHSA slow to change
other confirmation methods characteristics
GC/MS/MS, LC/MS, LC/MS/MS, ToF, etc.
- increased sensitivity
- increased spectrum of drugs
- increased efficiencies (sample prep, multi-drug analysis)
- improvements in data analysis
analytical consideations of specimen prior to reporting
specimen adulteration
specimen types
non-lab testing
MRO
breath alc testing
types of adulteration methods
internal dil
external dilution
substitution
contamination
tampering
specimen adulteration testing
collection site protocol
sample tmep
creatinine/SG
pH
oxidizing adulterants
odor/colour/particulates
screening/confirm interference
acceptable SAMHSA sample type
urne
what is an MRO
medical review officer
- licensed doctor of medicine/osteopathy
- knowledge of drug abuse disorders
- certified training program with re-training
- receives all results
- contacts all positive donors
- determines reportable positives
- rpeorts results to company
