Oral Fluid Drug Tests for the Workplace – Current Status

Referenced by www.navigent3.com – Advanced Oral Fluid Drug Screening Technology

Oral fluid drug tests provide a more dignified and safer method of deterring and detecting substance misuse in the workplace.

Advances in technology, not enable oral fluid to be an excellent method o determining recent abuse in almost any workplace setting.

Previously, traditional laboratory urine testing would be required which was neither cost efficient nor timely  due to the issues of travelling to remote collection sites and sending samples sending sample to labs.

Furthermore, some employees either would not, or could not donate urine specimens, for example “shy bladder syndrome”. Urine sample collection is also viewed as degrading by many.

Lastly “cheating” a urine test has become so pervasive that their are more people abusers diluting or substituting sample than there are “Positive” results.

Oral fluid detect a wide range of drugs, including THC, cocaine and heroin, alcohol, opiates (including prescription pain relievers), Ecstasy, barbiturates and amphetamines. Oral fluid is actually superior at determining parent drugs (active components) and opiate usage than the urine test.

Oral fluid and blood are the only specimens that can detect recent drug use, while urine and hair for example can only detect drugs after several hours to several days post consumption.   The value of using urine or hair testing to determine “on-the-job” substance misuse it therefore questionable at best.

The reliability and accuracy of these tests are similar to urine.  Immunoassay lateral flow technology uses for on-site testing has a 95-98% accuracy, while laboratory GC/MS/MS or LC/MS/MS is virtually error free.

With oral fluid the issue of exposure to bodily fluids is limited, if not eliminated, and there no cleaner method available for collecting a body fluid specimen.  Oral fluid is not considered a “bio-hazard” unless there are visible signs of blood per the Center for Disease Control (CDC) and OHSHA.

Employees and applicants  maintain composure and dignity during the entire testing procedure, yet specimen collection can be directly observed.

Since oral fluid tests detect recent drug use, applicants and employees are not penalized for past drug histories.  This is becoming a significant issue with respect to civil rights.

 

Drugged Driving – Testing & Results

Referenced by Navigent3 Advanced Oral Fluid Drug Screening Technology – www.navigent3.com

Drugged Driving – Oral Fluid Drug Testing

Thompson, P Traffic Support Branch, South Australia Police

Abstract

Legislation to introduce roadside driver drug testing into South Australia became operative on 1 July, 2006. A dedicated trial was established by South Australia Police (SAPOL) in partnership with the Department of Transport, Energy and Infrastructure (DTEI) to examine all facets of the regime over a 12 month period. The success of the trial saw the SA Government commit $11.1 million dollars over 4 years for the expansion of the driver drug testing regime in South Australia The expansion of driver drug testing was based on the use of 260 traffic enforcement section officers situated throughout the State performing driver drug testing duties. The model moved away from the centralised model established in SAPOL and other Jurisdictions in Australia where all operations were under the one command. This enabled driver drug testing to be conducted in a similar fashion to random breath testing in that tests can be conducted in multiple locations at any one time and coordinated independently of each other. The success of the expansion now sees SAPOL testing nearly 40,000 drivers for drugs each year.

The introduction of driver drug testing and the subsequent expansion across South Australia is helping to achieve goals set in the South Australia Police Road Safety Strategy 2006-2010 and the SA Road Safety Action Plan 2008- 2010. The strategy and plan aim to achieve a reduction by 40% in road fatalities by 2010

Conclusion

The expansion of the driver drug testing regime has been extremely

successful. All members identified to be trained under the expansion were trained and the vision to achieve 38,850 screening tests was achieved.

The expansion of driver drug testing in South Australia is helping to achieve goals set in the South Australia Police Road Safety Strategy 2006-2010 and the SA Road Safety Action Plan 2008-2010. The strategy and plan aim to achieve a reduction by 40% in road fatalities by 2010 and reduction in serious injury crashes to less than 995 people a year.

Tougher legislation and tougher policing are in line with the SA Road Safety Action Plan 2008-2010. Since 1 July 2008 the fine for a first offence drug driving has risen from $313 to $430. At the same time, all blood from drivers4 Australian Institute of Health and Welfare 2007. Statistics on drug use in Australia 2006.

Drug Statistics Series No. 18. Cat. no. PHE 80. Canberra: AIHW.9

as a result of compulsory blood testing in hospitals as a result of a crash are now be tested for the 3 prescribed drugs in addition to alcohol.

In December, 2009, further enhancements to the regime will be made when the quarantine on drug driving offences in the legislation is lifted, and all alcohol and drug driving offences will inter-relate for the purpose of penalty.

 

Excretion of Δ9-Tetrahydrocannabinol in Sweat

Excretion of Δ9-Tetrahydrocannabinol in SweatMarilyn A. Huestis,1 Karl B. Scheidweiler,1 Takeshi Saito,1,2 Neil Fortner,3 Tsadik Abraham,1 Richard A. Gustafson,4 and Michael L. Smith51 Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA2 Tokai University School of Medicine, Kanagawa, Japan3 ChoicePoint, Inc., Alpharetta, GA4 Lieutenant Commander, U S Navy, Navy Drug Screening Laboratory, Jacksonville, FL USA5 Division of Forensic Toxicology, Office of the Armed Forces Medical Examiner, Armed Forces Institute of Pathology, Rockville, MD, USAAddress correspondence to this author at: Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 5500 Nathan Shock Drive, Baltimore, MD 21224. Fax 410-550-2468; email mhuestis@intra.nida.nih.gov

via Excretion of Δ9-Tetrahydrocannabinol in Sweat.

 

Why Do Employers Drug Test ?

Alcohol and drug abuse creates significant safety and health hazards and can result in decreased productivity and poor employee morale. It also can lead to additional costs in the form of health care claims, especially short-term disability claims.

• Deter employees from abusing alcohol and drugs
• Prevent hiring individuals who use illegal drugs.
• Be able to identify early and appropriately refer employees who have drug and/or alcohol problems.
• Provide a safe workplace for employees.
• Protect the general public and instill consumer confidence that employees are working safely
• Comply with State laws or Federal regulations
• Benefit from Workers’ Compensation Premium Discount programs

Random: Random testing is performed on an unannounced, unpredictable basis on employees whose identifying information (e.g., social security number or employee number) has been placed in a testing pool from which a scientifically arbitrary selection is made. This selection is usually computer generated to ensure that it is indeed random and that each person of the workforce population has an equal chance of being selected for testing, regardless of whether that person was recently tested or not. Because this type of testing has no advance notice, it serves as an deterrent and primary detection method.

Pre-Employment: Pre-employment testing is conducted to prevent hiring individuals who illegally use drugs. It typically takes place after a conditional offer of employment has been made. Applicants agree to be tested as a condition of employment and are not hired if they fail to produce a negative test. However, it is possible for employees to prepare for a pre-employment test by stopping their drug use several days before they anticipate being tested. Therefore, some employers test probationary employees on an unannounced basis. Some states however, restrict this process. Furthermore, the Americans with Disabilities Act (ADA) of 1990 prohibits the use of pre-employment testing for alcohol use.

Reasonable Suspicion: Reasonable suspicion testing is similar to, and sometimes referred to, as “probable-cause” or “for-cause” testing and is conducted when supervisors document observable signs and symptoms that lead them to suspect drug use or a drug-free workplace policy violation. It is extremely important to have clear, consistent definitions of what behavior justifies drug and alcohol testing and any suspicion should be corroborated by another supervisor or manager. Since this type of testing is at the discretion of management, it requires careful, comprehensive supervisor training. In addition, it is advised that employees who are suspected of drug use or a policy violation not return to work while awaiting the results of reasonable suspicion testing.

Post-Accident: Since property damage or personal injury may result from accidents, testing following an accident can help determine whether drugs and/or alcohol were a factor. It is important to establish objective criteria that will trigger a post-accident test and how and by whom they will be determined and documented. Examples of criteria used by employers include: fatalities; injuries that require anyone to be removed from the scene for medical care; damage to vehicles or property above a specified monetary amount; and citations issued by the police. Although the results of a post-accident test determine drug use, a positive test result in and of itself can not prove that drug use caused an accident. When post-accident testing is conducted, it is a good idea for employers not to allow employees involved in any accident to return to work prior to or following the testing. Employers also need to have guidelines to specify how soon following an accident testing must occur so results are relevant. Substances remain in a person’s system for various amounts of time, and it is usually recommended that post-accident testing be done immediately after any required medical attention is provided. Some employers expand the test trigger to incidents even if an accident or injury was averted and hence use term “post-incident.”  Furthermore, employees in the immediate area of the incident, or who may have contributed to the incident should also be tested.

Return-to-Duty: Return-to-duty testing involves a one-time, announced test when an employee who has tested positive has completed the required treatment for substance abuse and is ready to return to the workplace. Some employers also use this type of testing for any employee who has been absent for an extended period of time.

Other: Other types of tests are also used by some employers. For example, follow-up testing or post-rehabilitation testing is conducted periodically after an employee returns to the workplace upon completing rehabilitation for a drug or alcohol problem. It is administered on an unannounced, unpredictable basis for a period of time specified in the drug-free workplace policy. Another type of testing, blanket testing, is similar to random testing in that it is unannounced and not based on individual suspicion; however, everyone at a worksite is tested rather than a randomly selected percentage. Other types of testing include voluntary, probationary, pre-promotion and return-after-illness testing.

Urine: Results of a urine test show the presence or absence of drug metabolites in a person’s urine. Metabolites are drug residues that remain in the body for some time after the effects of a drug have worn off. It is important to note that a positive urine test does not necessarily mean a person was under the influence of drugs at the time of the test. Rather, it detects and measures use of a particular drug within the previous few days and has become the defacto evidence of current use. Because alcohol passes rapidly through the system, urine tests must be conducted very quickly after alcohol consumption in order to ensure any degree of accuracy. For this reason, urine tests are generally not helpful in detecting alcohol use as opposed to illicit and prescription drug use, which is more easily traced in urine.

Blood: A blood test measures the actual amount of alcohol or other drugs in the blood at the time of the test. Blood samples provide an accurate measure of the physiologically active drug present in a person at the time the sample is drawn. Although blood samples are a better indicator of recent consumption than urine samples, there is a lack of published data correlating blood levels for drugs and impairment with the same degree of certainty that has been established for alcohol. In cases of serious injury or death as the result of an accident, the only way to determine legal intoxication is through a blood specimen. There is also a very short detection period, as most drugs are quickly cleared from the blood and deposited into the urine.

Hair: Analysis of hair provides a much longer “testing window,” giving a more complete drug-use history going back as far as 90 days. Like urine testing, hair testing does not provide evidence of current impairment, but rather only past use of a specific drug. Hair testing cannot be used to detect for alcohol use. Hair testing is the least invasive form of drug testing, therefore privacy issues are decreased.

Oral Fluids: Saliva, or oral fluids, collected from the mouth also can be used to detect traces of drugs and alcohol. Oral fluids are easy to collect (a swab of the inner cheek is the most common collection method), harder to adulterate or substitute, and may be better at detecting specific substances, including marijuana, cocaine and amphetamines/methamphetamines. Because drugs do not remain in oral fluids as long as they do in urine, this method shows promise in determining current use and impairment.

Sweat: Another type of drug test consists of a skin patch that measures drugs in sweat. The patch, which looks like a large adhesive bandage, is applied to the skin and worn for some length of time. A gas-permeable membrane on the patch protects the tested area from dirt and other contaminants. Although relatively easy to administer, this method has not been widely used in workplaces and is more often used to maintain compliance with probation and parole.

Navigent3
Natick, Massachusetts 01778
Ms. Joanne Hobrook – Partner – techsupport@navigent3.com

Products and Services
Human Resources: Drug Testing , Drug Free Workplace Programs

Safety: Drug Testing , Drug Free Workplace Programs

Navigent3 is a technology, quality, and knowledge domain leader in the field of effective drug free workplace policy development and implementation.

Our OraPoint oral fluid drug screen is on-site device that yields results available in 15 minutes or less, however, more importantly enables corporations to manage and monitor their own program vs. relying on a third party.

Navigent3 exclusively offers turnkey total product and service solutions to enable corporations to develop, implement, monitor, and report upon effective drug free workplace programs.

 

Pros and Cons of Oral Fluid Drug Testing

What are the advantages and disadvantages of oral fluid for the monitoring of drugs misuse in the workplace?

1. Oral  specimen collection is completely observed.

2. There is no loss of privacy involved with taking the oral fluid sample.

3.  Adulteration techniques that are so prevalent with urine drug testing.   Simply drinking of large amounts of fluid can reduce drugconcentrations in urine below the cut-off concentrations.

4.  In general oral fluid has a  shorter window of drug detection than urine and this is a benefit for workplace testing.  For example, with urine an individual can be positive in for a very long period of time beyond the intoxication window.  The oral fluid window of detection is closer to that of blood, it’s very similar the windows of detection to blood and potential intoxication.  For cocaine or methamphetamine, concentrations in oral fluid are increased d as compared to blood, due to process is called “ion trapping.”  Somehwhat higher concentrations in oral fluid than in blood for these drugs, and that makes it easier to detect.  Furthermore,  parent compounds are generally detected oral fluid.

www.navigent3.com

Advanced Oral Fluid Drug Screening Technology

 

Drugs of Abuse Facts

Drug abuse as always continues to threaten the health and safety of millions of people in the workplace and in our schools.

While there is a growing awareness and concerned about the consequences of drug abuse among employees, students, and parents, there a need for better education in how to combat substance misuse, as well as what substances are most prevalent.  Substance misuse ranges alcohol to prescription drugs to meth and  heroin.

Managing substance misuse requires detection and deterrence as well as education and assistance.   These drugs can be detected using urine, hair or oral fluid  samples, with random testing being the most effective method by far.   While each specimen type has its pros and cons, all specimen collections must be directly observed as substance abuses will “cheat” the tests via substitution or adulteration.

The below is the brief description of the drugs abused and their testing methods.

Marijuana:
While marijuana is generally considered to be the most commonly abused drug, this is rapidly changing due to the rapid increase in the abuse of prescription drugs.  There were 15.2 million abusers aged 12 or above in 2008. Marijuana abusers can be detected between 3 to 5 days using urine and up to a maximum of 24 hours using oral fluid.   The impairment period for marijuana is generally considered to be one hour.

Prescription drugs:
There were nearly 6.2 million people aged 12 or older who abused prescription drug non-medically in 2008.  The most commonly abused prescription drugs include opioids such as oxycodone (Oxycontin, Percoset) and hydrocodone(Lortab, Vicodin).  Most urine tests, such as DOT or SAMSHA or NIDA 5-panel tests do not yield positive results for oxycodone or hydrocodone and therefore do not provide adequate safety protection.

Methamphetamine:
Methamphetamine is highly addictive stimulant with toxic effects on the central nervous system. Studies state that there were 314,000 Methamphetamine abusers in 2008.

Ecstasy:
Ecstasy (MDMA) is a drug of abuse with stimulant and psychodelic properties. There were nearly 555,000 ecstasy abusers in 2008.

Cocaine:
Cocaine is highly addictive stimulant drug of abuse. Studies show that there were 722,000 persons aged 12 years or above in 2008, who used cocaine for the first time in the past year averaging approximately 2,000 initiates per day.
Heroin:
Heroin is an addictive opiate drug, synthesized from morphine. In 2008, there were 114,000 persons aged 12 years or above who had used heroin for the first time within the past one year.   The abuse of prescription pain relieves has been linked to heroin abuse.
Steroids:
Athletes mostly use steroids to enhance performance and physical appearance. Steroid abuse can lead to serious health problems.

Drug misuse is prevalent and with the advent of prescription drug abuse, worse than ever.

Drug abuse can be detected and deterred by using reliable on-site oral fluid drug screening and laboratory-based testing methods.   In addition to oral fluid / saliva,  urine, hair, blood, and sweat specimens can be used for detecting certain drugs, however, factors such the convenience to detect the elevated levels of the substance abused and ability to perform observed specimen collection should be considered.

www.orapoint.com

 

Florida’s Disability, Workers’ Compensation and Wage Loss Benefits | DisabilityLawyers.com

Florida’s Disability, Workers’ Compensation and Wage Loss Benefits | DisabilityLawyers.com.

 

Random drug tests for fire fighters and other public safety professional still an issue in Massachusetts

The  below letter shows the pervasive level of misinformation with respect to random drug testing.  75% of substance abusers are employed,  more than 10% of employees abuse drugs and/or alcohol, and Massachusetts has one of the worst substance abuse problems in the Nation.

I f these facts don’t demonstrate that there is a substance abuse problem to the Commonwealth’s employers and court system, nothing will.

1. Random drug testing for safety sensitive positions is legal is all states per federal statue and associated case law.

2.  Firefighters and police, as well as highway personnel are clearly involved in safety sensitive positions.

3. Drug tests can be done for less than $50.00 per test.

4. Random drug screening has proven to be an effective deterrent to substance misuse if applied properly and in concert with education and employee assistance programs.

November 06, 2009In his Nov. 2 letter, Tim Johnson of West Barnstable urges people to contact their fire chief to find out why firefighters dont take random drug tests.Had Mr. Johnson called his fire chief, heres what he would have learned:Firefighters in Massachusetts dont take random drug tests for two reasons: a lack of money and state law that generally prevents testing.Over the past two years, the West Barnstable Fire Department has requested money to conduct annual medical exams of its firefighters that would include drug testing. The cost of each exam is $296. The cost of examining and testing all 53 firefighters would be $15,688 a year. The request has been rejected.In 1991, the Massachusetts Supreme Judicial Court, in a case called Guiney v. Police Commissioner of Boston, ruled that communities cant require random drug testing of public employees absent a reasonably concrete showing that there is a drug problem within the department. Essentially, this means that unless the fire department has strong evidence of a drug problem among its staff, it cant do random drug testing without the staffs consent. I believe the staff of the West Barnstable Fire Department would consent if we had the funding.

Joe MarucaChief, West BarnstableFire Department

 

From Navigent3.com, Advance Oral Fluid Drug Screening Technology via Funding and court ruling prevent random drug tests | CapeCodOnline.com.

 

Drugs linked to up to 32% of Fatally Injured Drivers in Canada

Courtesy of www.navigent3.com- Advance Oral Fluid Drug Screening Technology via Issues of Substance 2009 Takes a Closer Look at Drug-impaired Driving in Canada.

Issues of Substance 2009 Takes a Closer Look at Drug-impaired Driving in CanadaHALIFAX, NOVA SCOTIA, Nov 15, 2009 Marketwire via COMTEX –

The Canadian Centre on Substance Abuse today announced that the issue of drug-impaired driving in Canada will take centre stage at an Issues of Substance IOS 2009 special session on November 15 at the World Trade and Convention Centre in Halifax, Nova Scotia.

The special session, entitled Drug-impaired Driving in Canada: Implications for Prevention and Treatment, will provide attendees with a summary of the research related to drugs and driving, an overview of Canada’s Drug Evaluation and Classification (DEC) Program, and an actual demonstration of a DEC evaluation.

Many Canadians may not be aware that Bill C-2, the Tackling Violent Crime Act-which passed in 2008- provides police with the authority to demand that a driver suspected of being under the influence of drugs submit to a Standardized Field Sobriety Test. In addition, the driver must participate in an evaluation of drug influence by an officer trained in the DEC program, and provide a sample of blood, urine or oral fluid to determine the type and extent of drug usage. Refusing to submit to any of these demands is a Criminal Code offence with penalties that are equivalent to those for an impaired driving conviction.  ”Impaired driving in Canada is 100 percent preventable and yet the data suggests that up to 15 percent of drivers on the road have either alcohol, illicit substances or pharmaceutical substances in their systems,” said Doug Beirness, Senior Researcher and Policy Analyst, CCSA. “The DEC program and police officers trained as Drug Recognition Experts are essential resources of a system that enables police to accurately identify, and subsequently prosecute, drivers impaired by drugs.” The DEC procedure, which enables officers to assess whether impairment is the result of drugs, follows a 12-step assessment protocol and is corroborated by toxicological evidence provided by blood, urine or oral fluid samples. This protocol, which generally takes 30-45 minutes, includes: – A breath alcohol test – Brief interview – Preliminary observations and first pulse rate reading – Eye examination – Divided attention psychophysical tests – Vital signs and second pulse rate reading – Dark room eye examinations – Assessment of muscle tone – Checking for injection sites and third pulse rate reading – Subject’s statements and other observations – Analysis and opinions of the evaluator – Blood, urine or oral fluid sample During the special session at IOS, attendees will see this 12-step protocol performed by a trained police officer and observe through video examples the different physiological changes the body undergoes to various illicit substances.

A study performed last year by CCSA of 1,349 DEC evaluations completed by Drug Recognition Experts (DRE) in Canada reported an overall accuracy rate of 95 percent. In other words, the DREs’ evaluations and conclusions were subsequently corroborated by the fluid sample analysis 95 percent of the time, reflecting a high rate of accuracy associated with DEC procedures.

The impact of drug-impaired driving in Canada is significant: – Epidemiologic studies of drug use among fatally injured drivers in Canada indicate that drugs are detected in up to 32 percent of fatally injured drivers – A recent field study of night-time drivers conducted in British Columbia by CCSA noted that 10.4 percent of drivers showed evidence of recent drug use – Data from CCSA’s 2004 Canadian Addiction Survey reported that 4.8 percent of drivers in Canada admitted driving within two hours of using cannabis at least once in the past year .

 

Drug Abuse Epidemic in Massachusetts – The Boston Globe

Drug use called epidemic in Mass.

OxyContin, heroin imperil public health.

November 6, 2009

Abuse of OxyContin and heroin in Massachusetts has reached epidemic levels and must be attacked with the same fervor now being directed toward controlling the H1N1 flu virus, a special state commission said yesterday.

“The Commonwealth is in the midst of a serious and dangerous epidemic,’’ the panel, known formally as the Massachusetts OxyContin and Heroin Commission, said in a 71-page report released yesterday at the State House.

“The Commonwealth is losing men and women on its streets at a rate of 42 to 1, compared to what the state is losing in two wars overseas,’’ the panel said in its executive summary.

“Addiction is a medical disorder, and we have a public health epidemic on our hands that is larger than the flu pandemic.’’

The report compared the number of US service men and women from Massachusetts killed in Iraq or Afghanistan and the number who died from overdosing on one or both of the drugs between 2002 and 2007. During those years, 78 service people lost their lives while 3,265 died from drug-related causes, the panel found.“We have a health crisis here,’’ said state Senator Steven Tolman, who chaired the commission.

“None of them [addicts] want to be sick. You could have a son or a daughter who was brought up properly with all the morals and values, and, when they get hooked on the stuff, it doesn’t matter; it’s all out the window.’’

Berkshire District Attorney David F. Capeless, a commission member, said prosecutors believe that fighting substance abuse will reduce crime.

“The district attorneys realize that those who suffer from substance abuse need treatment,’’ Capeless said in a telephone interview. “But those who would propagate it in hopes of profiting from it, the dealers, need treatment of a different sort. They get incarceration.’’

The panel made 20 recommendations, including:

■Strengthen the existing prescription-monitoring program so that public health officials learn more quickly about patients collecting multiple prescriptions for the same drug and about doctors who appear to be writing more prescriptions than necessary.

■ Limit criminal sanctions against substance abusers who seek medical help for using illegal drugs and create a Good Samaritan law to shield anyone helping drug users in trouble get to a hospital before they die.

■Increase support for the three “recovery high schools,’’ where teenage substance abusers recover in a supportive educational, age-appropriate environment. The schools are in Boston, Beverly, and Springfield.

■Invest in substance abuse diversion programs that steer the addicted away from costly prisons into less expensive recovery programs.

“If the H1N1 virus killed 3,000 people in a five-year period in Massachusetts, the crisis would be center stage,’’ the commission found. “Because of the stigma surrounding substance abuse, this epidemic is left in the shadows.’’

Speaking for Governor Deval Patrick’s administration, Michael Botticelli of the Department of Public Health said the agency is planning to launch a pilot jail diversion program this year.

“What we are anticipating is that this would actually be cost effective for the Commonwealth,’’ he said. It costs $45,000 a year to incarcerate someone, he said. “The cost of treatment is dramatically lower.’’

In 2007, there were 105,552 admissions to DPH-funded substance abuse programs in Massachusetts, and the total spent during fiscal 2005 on substance abuse and addiction in the justice system was $1.084 billion, equal to 5.3 percent of the state budget, the commission said.

Capeless said he and other commission members know that increasing public support for noncriminal solutions to prescription and heroin drug abuse will not be easy.

“But it can happen to anybody, to any family, whether a big city, or rural, whatever economic status, region, or socioeconomic status,’’ he said. “We’ve heard from people from all walks of life.

“And unfortunately, they tell the same sad story,’’ Capeless said. “We are hoping to reach people before it happens.’’

 

ORAPOINT ADVANCED ORAL FLUID DRUG SCREENING TECHNOLOGY WWW.NAVIGENT3.COM

 

via Drug use called epidemic in Mass. – The Boston Globe.