Source: The Associated Press
December 2, 2008

Test results show that the death of an Army gunner while on leave from Iraq in August was caused by an overdose of prescription pain medication.

Twenty-two-year-old XXXXXX was staying at his parents’ home for an 18-day break when they found him unconscious on Aug. 27, two days into his leave.

An autopsy did not show a cause of death, so more testing was ordered.

Those tests show that XXXXXX died of a lethal combination of methadone and oxycodone.

His parents say they believe their son’s wartime experiences in Iraq made it hard for him to sleep, and led him to take the drugs. He had not told his parents he was on any medication.

XXXXX had been deployed in March with the Army’s 7th Squadron, 10th Cavalry Regiment.

Brought to you by Navigent3 Drug Free Workplace Solutions featuring proven oral fluid technology.

www.navigent3.com

As teachers’ union sues over drug testing, county wants to expand its testing program

The Kanawha County Commission may join forces with the county school system in a legal fray and begin drug testing more, if not most, of its employees.

Its president, Kent Carper, wants the commission to expand its random drug-testing policy to include employees who handle money and records or deal with the public. This could include accountants, clerical workers and housing inspectors.

The commission already randomly tests “safety sensitive” county employees who operate vehicles and equipment or have firearms. Those categories include about 170 of its 417 employees.

Carper hopes the commission will join with the school board — a separate entity that is not controlled by the commission — to fight what may be a long and costly legal battle over the school system’s new policy to randomly drug test teachers.

Carper said the outcome of a lawsuit filed by one teachers union would affect the county commission’s current policy, the expanded policy he hopes to put in place, and drug testing policies around the state.

“To believe that the final result of this lawsuit will not affect and set the road map, the rules of the road, for drug testing public employees, you’d have to be naïve,” he said.

County commissioner Dave Hardy said that while he supports the Kanawha County school board’s endeavor to implement what he calls a well-thought out testing policy, he doesn’t want the commission to “jump on the bandwagon and make a rash decision” that could cost the county hundreds of thousands of dollars in legal fees.

Hardy said he is willing to consider filing a friend of the court brief in support of the school board. But he noted that it took the commission more than six months to arrive at its current drug testing policy and that it did so only after receiving legal advice.

The West Virginia chapter of the American Federation of Teachers filed a lawsuit Wednesday in Kanawha Circuit Court against the county school board and Superintendent Ron Duerring.

The suit alleges that the school system policy to randomly drug test teachers is an unconstitutional invasion of privacy.

AFT-WV also asked for a preliminary injunction to halt the policy while the courts consider the case. Both the school system and the union expect the injunction to be granted by the court, meaning the board could not begin testing teachers in January, as it had planned. The delay would likely last for years until a series of appeals from either side is exhausted.

Since education alone can’t stop substance abuse, and treatment requires detection… How can the ACLU support it’s position? … it’s your call.

(Source: Albany Times Union – October 2008 )

White House argues for school drug testing

Effort predicts less drug use, but opponents contend federal program marginalizes at-risk students
Waldman, S. Staff writer
First published in print: Thursday, October 30, 2008
ALBANY — To drug test or not to test is a tough question for a school district.

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Proponents of a Bush administration initiative aimed at convincing more schools to give random drug tests to students came to Albany to argue their case before a roomful of educators. Protesters from the New York Civil Liberties Union tried to poke holes in their arguments during question-and-answer sessions with the speakers.

Officials from the Albany school district and the Albany Roman Catholic Diocese schools were among the 50 educators from three states who attended the seminar. Speakers included an attorney who has written a book supporting testing, a school principal that aggressively tests student athletes and Dr. Dave Murray, chief scientist for the White House Office of National Drug Control Policy.

Testing, Murray said, is “a useful tool. It’s an opportunity not to punish (drug users), but to give them help and counseling.”

Nationwide, more than 4,000 schools have instituted drug testing programs for students participating in extracurricular activities, according to White House figures. Since 2003, the office has awarded 136 grants worth $40 million to assist with implementation and development of existing student drug testing programs.

Albany area school officials said they were at the presentation just to gather information and that such programs were not imminent. Cathy Golas, director of Prevention Services for the Albany Diocese schools, said more needs to be done to curb substance abuse at the high school level.

“People are realizing it’s not just telling kids not to do drugs and alcohol — you have to have strategies,” Golas said.

William Judge, co-author of the book “Doing It Right: Drug Free School Testing,” said such programs only cost about $4,000 annually and give students an additional incentive not to cave into peer pressure. “You save one child, it’s been worth it,” Judge said.

But Rahul Saksena, a NYCLU spokesman, said testing pushes many students out of activities that otherwise could keep them away from drugs. Districts that implement such policies face potential costly legal battles, he said. “”It has to be a more comprehensive solution,” Saksana said. “These policies ruin the trust students have with their teachers.”

Navigent3 delivers drug free workplace solutions based upon oral fluid technology.  Oral fluid / saliva drug testing is more accurate than urine for the recent use of drugs or alcohol, and specimen collection is directly observed, eliminating the prevalent practice of ” beating a urine test” .  Oral fluid testing is also not invasive or degrading.

In response to “ To Catch a Cheat “ …     the only way to assure an accurate drug test is via observed specimen collection.

Recently updated SAMHSA / DOT Guidelines will do little to prevent the prevalent practices of urine substitution and adulteration. Urine drug testing laboratories can not detect basic forms of adulteration, such as dilution, to any significant degree, and are completely powerless to address substitution or more complex forms of adulteration.

It’s quite simple actually, urine is too procedurally complex and invasive to use as a drug testing specimen. The DOT in particular has had over 10 years deploy an effective urine-based program, and it has FAILED to do so. This fact has been substantiated by Federal GAO studies and multiple independent case studies.

The following recent quotations concisely summarize the failure urine bases drug testing… specifically DOT-based programs:

"Here in the United States of America, we have no meaningful program of drug testing for commercial truck drivers, none."
- Peter A. DeFazio, Rep., Chairman of the House Subcommittee on Highways and Transit

“It’s frankly astonishing and shocking and dismaying. You can manipulate urine tests, you can mask substance abuse and go undetected on the roadways.” - Jim Oberstar, D-Minnesota, Chairman of the House Transportation and Infrastructure Committee

Oral fluid / saliva technology, both on-site and laboratory-based is accurate, and allows for observed specimen collection. Employees can be tested at their worksite, and don’t have the ability to stop of and “prepare” for test on the way to a collection site. A urine collection site, by the way, that typically has the least skilled and lowest paid individuals of a TPA (Third Party Administrator) organization or urine testing laboratory.

Safety professionals need to step forward.

They are uniquely qualified to develop, implement, and monitor drug free workplace programs and associate drug testing, drug education, and employee assistance. They are the ones that have the credentials to administer drug testing and monitor ancillary activities. Thankfully, there are hundreds of innovative individuals and private corporations that are beginning to act.

Unfortunately, there is little hope for Federal Mandated Drug Testing Occupations in the short term, as the DOT and SAMHSA continue to knock heads relative to approving alternative specimen times such as oral fluid and hair.

The, general workplace, however, exclusive of these mandated occupations, is not stuck in their quagmire, is able to deploy effective drug free workplace programs.

It is important to be aware the DOT / SAMHSA guideline do NOT test for prescription pain relievers such as Oxycodone (Oxycontin, Percoset), Oxymorphone, ,Hydrocodone (Vicodin, Lortab), Hydromorphone… the most widely abused of all prescription medications and likely the most significant workplace safety threat today? Also, DOT/SAMHSA guidelines specify a cut-off level for Opiates of 2000 ng/ml, which virtually makes the detection of a significant percentage of codeine, heroin, and morphine abusers impossible.

Lastly, the below chart does not represent a cleaner workplace.

Not a Cleaner Workplace !

Not a Cleaner Workplace !

It represents the continuing ability of drug abusers to defeat urine tests, as well as the shifting dynamics of drug abuse.

The graphic is primarily a representation of pre-employment tests that are urine-based. Of course they will decline. Ask any expert and they will tell you that “Drug abuse in America is as bad, if not worse than ever”, and the real safety and health threat over the past 10-15 years is the abuse

Chemical & Engineers News Article

(Source: September 9 2008 – Chemical Engineering News)

To Catch A Cheat

Clinical chemists battle products designed to fool workplace drug tests

Melody Voith

EAGER JOB CANDIDATES who receive an offer of employment might feel as though they have won an Olympic gold medal—especially when they are asked to provide a sample for a drug test. And just like at the Olympics, some test subjects will try to beat the system.

But unlike at the Olympics, where officials test athletes for performance-enhancing substances (C&EN, Aug. 11, page 25), workplace drug tests are performed to identify those whose use of illicit substances may impair their job performance and create liabilities for their employers.

iStock

Urine trouble Clinical chemists check for adulterants in drug test samples.

According to Amitava Dasgupta, professor of pathology and laboratory medicine at the University of Texas Medical School, Houston, many products are on the market that prospective employees can use to dilute, substitute, or adulterate their test samples. In a talk at the annual meeting of the American Association of Clinical Chemists in Washington, D.C., in late July, he advised laboratory chemists to be vigilant in their pursuit of valid test results. “Toxicologists are smarter than drug users,” he said, but they need to know the tricks of the trade.

President Ronald Reagan started the drug-testing arms race in 1986 when he issued an executive order directing federal agencies to achieve a drug-free workplace. Since then, all federal agencies have followed the mandatory guidelines of the Federal Drug-Free Workplace programs administered by the Department of Health & Human Services (DHHS). The guidelines cover testing for marijuana, cocaine, opiates, amphetamines, and phenylcyclohexylpiperidine (PCP).

Many private employers use similar procedures to create a drug-free workplace. In a survey by the Society for Human Resource Management (SHRM), 84% of employers said they conduct preemployment drug testing.

According to R. H. Barry Sample, director of science and technology in the employer solutions division of Quest Diagnostics, a leading test firm, federally mandated test programs currently require the use of urine samples. DHHS has drafted revised regulations that would permit hair and saliva collection, but they are not yet in effect. Almost 90% of drug tests performed by Quest are on urine samples, and saliva tests are the second most common.

Many products that enable cheating target urine tests. Easily found on the Internet, they are marketed under names such as Urine Luck, Ultra Klean Detox Drink, Power Flush, Tinkle, and the Wizzinator.

In his talk Dasgupta described how most methods for cheating on drug tests focus on the first of two testing hurdles—the initial quick-result screening test. The screen is an immunoassay, similar to the at-home drug screens available at many pharmacies. Usually, test administrators at sample collection sites send only nonnegative results to a lab for confirmation testing by gas chromatography/mass spectrometry.

The hundreds of products marketed to help drug users circumvent urine drug tests fall into three main categories: products that are consumed prior to the test, products that are added to the test sample, and devices for smuggling synthetic or borrowed “clean” urine into the testing facility. Toxicologists focus on the first two because, as Sample pointed out, “if it’s someone else’s urine, there is not a lab test in the world that would tell you that.”

CLEANER Workplace Positive drug test results have declined in U.S. workforce

SOURCE: Quest Diagnostics

Spectrum Labs’ Aqua Clean effervescent tablet, available from detoks.com, is a consumable product that claims to clean the body of drugs and drug metabolites. Like all similar products, it requires the user to drink a vast quantity of water—between 40 and 60 oz—in a short amount of time. Dasgupta’s examination of these products has shown they are nothing more than expensive caffeine pills—diuretics that create a lot of urine and dilute drug content to below the screening cutoff values.

IN ADDITION to lowering the concentration of drugs in the urine, however, the excess water also decreases creatinine levels to below 20 mg/dL and specific gravity to less than 1.003, both key indicators of a diluted specimen. Creatinine is a breakdown product of creatine from muscle tissue, and in healthy people it is excreted by the kidneys at a constant rate. Dasgupta recommended creatinine and specific gravity tests on all samples and suggested that lowering drug cutoff values on the screening test would catch most dilutions.

Test takers also try to beat the immunoassays by adding adulterants—including common household chemicals—to their urine sample. Drano drain opener, for example, inactivates the antibodies used in the screen. Table salt, vinegar, and liquid soap can all interfere with the enzyme-multiplied immunoassay technique and the fluorescence polarization immunoassay.

The collection site and laboratory can detect samples contaminated with “do it yourself” adulterants, Dasgupta said, by ensuring that the temperature is between 90.5 and 98.9 ºF, specific gravity is between 1.005 and 1.030, and pH is between 4.0 and 10.0. A common adulterant is plain tap water, so labs should ensure that creatinine concentration is 20–400 mg/dL. If the test sample does not meet the criteria, then it would be considered invalid, likely resulting in the employee not being hired.

On the Internet other adulterants are available that Dasgupta acknowledged are “very tricky.” He commonly sees two types. One product, Urine Luck, comes in small tubes and contains the active ingredient pyridinium chlorochromate (PCC) to reduce the response rate of tests for opiates and THC (marijuana). The other, marketed as Klear, consists of white crystalline potassium nitrite. These oxidizers are most effective on tests for THC. “They are very strong oxidizing agents. They destroy the drug molecule so you can cheat the drug test in both the screening and the confirmation,” Dasgupta said.

Dasgupta reassured the clinical chemists in the audience that simple spot tests can identify the oxidizers. The addition of a few drops of hydrogen peroxide to PCC-adulterated urine creates a dark brown precipitate. To detect nitrite he suggested adding a small amount of the suspect sample to potassium permanganate solution and then adding a few drops of hydrochloric acid. The pink permanganate solution will immediately become colorless and effervescent if nitrite is present.

Because most negative samples are not sent to the laboratory for confirmation testing, companies such as Sciteck Diagnostics have found a market niche for instant test strips that detect urine adulteration. The company makes several versions of AdultaCheck test strips in various combinations to check creatinine and pH levels, as well as nitrites and other commercial additives.

Data from Quest Diagnostics show that positive drug test results have decreased by 72% since 1988, when workplace testing became common. Experts attribute this reduction to the deterrent effect of the tests rather than successful cheating; habitual drug users shy away from applying for jobs that require testing.

According to Quest’s Sample, the data also show that over the past six years, the number of invalid and adulterated samples has remained constant at about 0.15%. That figure does not include altered samples that show a positive result despite the best efforts of the donor. “With adulterants, not everything is effective,” Sample said. “Even in the case of oxidants, they are only effective against the detection of marijuana and have no impact on amphetamines, cocaine, or PCP.”

Melody Voith/C&EN

In the clear Immunoassay drug screens can be performed at home with the help of kits from the pharmacy.

Because of the possibility of cheating, employers who want to ensure a drug-free workplace should work closely with their diagnostics labs and take advantage of new testing methods, Sample advised.

IF EMPLOYERS are concerned about substituted or synthetic urine, they should consider hair or saliva testing because sample collection can be observed, whereas sample collection for urine tests is usually not monitored. One notable benefit of hair tests is that drug residue stays in the hair shaft for 90 days, a far longer residence time than in urine.

Robert G. Miller, director of human resources for the Greater Los Angeles County Vector Control District, a pest control agency, agreed that hiring companies depend heavily on the expertise of their diagnostics lab partners. “Employers are not experts in drug testing and should not be,” he said. Miller’s agency works with hazardous pesticides and thus requires a safe working environment. “We are extremely dependent on the industrial lab,” he said. Miller suggested visiting the diagnostic lab’s facility to see how the testing is done and to review security procedures.

In his role as a member of SHRM’s Employee Health, Safety & Security Panel, Miller advises human resource managers about the necessity of providing a drug-free workplace. “The point of preemployment testing is to ensure that you are not buying a liability and to weed out those individuals that might have a propensity to drug use, which could lead to accidents on the job.”

Although today’s employers focus on controlling liability insurance and absentee worker costs, Miller sees a future for tests that monitor the lifestyles of prospective employees. “Anything external to the organization—tobacco, alcohol, and drug use that affects the employee’s wellness—may be something that employers restrict in hiring,” he said. Employers who offer health benefits have a vested interest in showing they have healthy employees, Miller said. “The line is going to get a little blurred on the responsibility of employees for their own private habits,” he predicted.

As trends in employee drug testing change, so will the market for products aimed at helping drug users avoid detection. Quest’s Sample continually monitors the Internet to stay abreast of the latest technologies. “That means Googling to find out what’s new, obtaining those products, and testing them to see what impact they have. We need to know what else is going on out there,” he said.

High schooler charged with giving fake urine for drug test

One more of millions of examples of why urine based drug testing is ineffective.  Most drug abusers do not get caught.

A Seneca Valley High School senior was charged in connection with providing a false urine specimen during a drug testing program in the school district.

The charge is a misdemeanor of the third degree.

The Jackson Township Police Department, in conjunction with the school district, yesterday said the false sample was provided by a male who was unaware of the reason for giving the sample.

Source: September 6, 2008 – Charleston Gazzette

MSHA: Test coal miners for drugs and alcohol

“A preliminary review of fatal and non-fatal mine accident records revealed a number of instances in which alcohol and drugs or drug paraphernalia were found or reported, or where the post-accident toxicology screen revealed the presence of alcohol or drugs.” – MSHA

Drug Testing in Coal Mines

Drug Testing in Coal Mines

MSHA cited a study that showed more than 13 percent of full-time miners were heavy alcohol users and 7 percent admitted that they had used illicit drugs within the past month.

U.S. Mine Safety and Health Administration ( MSHA ) officials are pushing for speedy approval of a new drug testing rule, offering the mining community and the public a tight 30-day comment period – less than half the time provided for two other rules proposed by MSHA this year.

“An alcohol- and drug-free mine program as proposed in this rule will contribute to the prevention of such incidents and provide all miners, regardless of what state they work in and the size of the mine they work for, equal safety protection from working alongside miners under the influence of alcohol and/or drugs on the job,” MSHA said in a proposal scheduled to be published in Monday’s Federal Register.

The proposed rule would replace existing standards for drugs and alcohol at metal and non-metal mines with an industry-wide rule that also covers coal operations.

It would designate certain substances – alcohol and a list of controlled substances – that could not be possessed on mine property or used while performing safety-sensitive job duties, unless they were being used according to a valid prescription.

Mine operators would be required to establish an alcohol- and drug-free program, including a written policy, employee education, supervisory training and drug testing for miners in safety-sensitive jobs and their supervisors. Safety-sensitive job duties are defined as “any type of work activity where a momentary lapse of critical concentration could result in an accident, injury or death.”

Company policies also must include treatment referrals for miners who violate the policy. The proposed rule also would require those who violate the prohibitions to be removed from the performance of job-sensitive duties until they complete recommended treatment and their alcohol- and drug-free status is confirmed by testing.

“Mining under the best of circumstances can be dangerous,” said MSHA chief Richard Stickler, “and the use of alcohol and illegal substances creates additional, unnecessary hazards in the workplace.”

MSHA’s Federal Register notice did not include any mention of a public hearing on the proposal.

Department of Labor spokesman David James said the agency anticipates receiving a request for a hearing and that MSHA “is preparing to do” such a hearing.

“There will likely be a notice for public hearing published sometime during the public comment period,” James said.

Coal industry officials have long sought an MSHA rule to require drug testing of miners, but the United Mine Workers union has questioned the need for such testing and worried about the specifics of how companies would carry out such testing.

Kentucky adopted its own drug-testing program for miners in 2006, and Virginia passed similar rules in 2007. West Virginia has declined to adopt drug-testing requirements for coal miners.

In October 2005, MSHA announced that it was working on such a rule, but after a string of mine disasters in 2006 and 2007, the drug-testing proposal appeared to have been put on the back burner as the agency scrambled to enact numerous safety reforms mandated by Congress.

Source: US World and News Reports August 2008

5 Ways Teens Might Cheat on Drug Tests—and How to Catch Them

These tricks are out there on the Web, so parents need to be informed

Note: There are no known methods to cheat an oral fluid / saliva drug test.

Google “beat drug test,” and the search engine spits out page upon page of ploys and products that can make incriminating urine seem drug free. All it takes is a computer-savvy teen to access them. The ease of cheating, in fact, is one of at least seven reasons parents shouldn’t try to test their kids for drug use. Instead, experts say, they should seek out a professional assessment.

“Cheating remains the Achilles’ heal of drug urine testing in all settings,” says Robert DuPont, president of the Institute for Behavior and Health Inc. and former director of the National Institute on Drug Abuse. With increasing opportunities for testing—by prospective employers, schools, and parents—experts worry that teens may have more impetus than ever to try.

Last week, at the American Association for Clinical Chemistry’s annual meeting in Washington, D.C., toxicologist Amitava Dasgupta of University of Texas-Houston medical school demonstrated various ways that employees try to beat workplace drug tests—and how experts foil these schemes in the laboratory. There’s nothing to stop kids from using the same tricks, and there’s no guarantee that parents will be able to catch them at home.

Here are five ways—some of them downright dangerous—that teens may try to cheat drug tests. They’re all described elsewhere on the Internet, so parents should be aware of them.

1. Tampering. A sprinkle of salt or a splash of bleach, vinegar, detergent, or drain cleaner is all that’s needed to muck up a urine specimen. These and other household substances are all too often smuggled into the bathroom and used to alter the composition of urine, making the presence of some illegal substances undetectable, says Dasgupta. Same goes for chemical concoctions sold all over the Internet. Sometimes these additives or “adulterants” will cloud or discolor urine, easily casting suspicion on the specimen, but others leave the sample looking normal. Laboratory toxicologists employ simple tests to catch these cheats. For example, a few drops of hydrogen peroxide will turn urine brown if it’s been mixed with pyridinium chlorochromate, an otherwise-imperceptible chemical designed to foil drug tests.

2. Water-loading. Gulping fluids before providing urine, a long-standing tactic, is still the most common way that teens try to beat tests, says Sharon Levy, a pediatrician and director of the Adolescent Substance Abuse Program at Children’s Hospital Boston. Whether cheats use salty solutions to induce thirst, flushing agents that increase urine output, or just plain old H20, their aim is to water down drugs so they can’t be detected. Some testing facilities may check urine for dilution and deem overly watery samples “unfit for testing.” But consuming too much fluid too quickly can occasionally have dire consequences. “Water intoxication” reportedly killed a woman following participation in a radio show’s water drinking contest, says Alan Wu, a professor of laboratory medicine at the University of California-San Francisco.

3. Switching drugs. Perhaps most alarming, says Levy, is that teens bent on defeating drug tests will sometimes switch their drug of choice to an undetectable (or harder to detect) substance that’s considerably more hazardous. Inhalants, for example, include numerous types of chemical vapors that typically produce brief, intoxicating effects. “You don’t excrete [inhalants] in your urine,” says Levy, but “inhaling is acutely more dangerous than marijuana.” Indeed, inhalants can trigger the lethal heart problem known as “sudden sniffing death” in otherwise healthy adolescents, according to the National Institute on Drug Abuse. The tragic case of young David Manlove is an example.

4. Popping vitamins. Perhaps it’s because niacin (aka vitamin B3) is known to aid metabolism, or perhaps it’s because Scientologists are said to take it in excess to flush their bodies of toxins. Whatever the reasons, some teens got the idea that extreme doses of this vitamin would erase any trace of their illicit drug use. Instead, it almost cost them their lives. In two separate incidents, emergency physician Manoj Mittal of Children’s Hospital of Philadelphia has found adolescents who downed at least 150 times the daily recommended dose of niacin (15 mg) to cheat drug tests. (He described the cases last year in the Annals of Emergency Medicine.) Both kids were vomiting, had low blood sugar, and had “significant” liver toxicity when they arrived at the ER. And the niacin didn’t even do what they’d intended; both tested positive for illicit drugs. “People might think that since [niacin] is a vitamin it’s harmless,” says Mittal. “But these cases suggest that our bodies have limits.”

5. Swapping urine samples. Whether they use a friend’s clean urine, synthetic pee, or even freeze-dried urine purchased online, some teens try to pass off foreign samples as their own, says Levy. The biggest tip-off is temperature. “Anything significantly lower than body temperature is suspicious,” says Dasgupta, which is why some have tried to shuttle samples in armpits or taped to thighs to keep them warm. Possibly the oddest trick of all is a device marketed to those trying to beat witnessed drug collections, says Wu: a sort of prosthetic penis called the “Whizzinator” that claims to come equipped with clean urine “guaranteed” to remain at body temperature for hours, with the help of special heat pads. “Believe it or not, [the prosthesis] comes in different colors,” says Wu.

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