Tackling Drugs in the Workplace

1. New Challenges Tackling Drugs in the Workplace

2. New decade … new challenges • Medical Marijuana • Prescription Drug Issues • Specimen Validity

3. Medical Marijuana - the wonder drug?

4. A few Marijuana facts • Marijuana (grass, pot, weed) is the common name for a drug made from the plant Cannabis saliva. • The main mind-altering (psychoactive) ingredient in marijuana is THC (tetrahydrocannabinol), but more than 400 other chemicals also are in the plant. • When smoked, the effects start within minutes and peak in 10-30 minutes. Usually the high is over in about 3 hours. • When ingested, such as eating a brownie laced with marijuana, the effects are slower to peak and last for a longer period of time. • Numerous studies have shown that marijuana has no medical value that can’t be met more effectively by legal drugs

5. Marijuana and Driving • Driving experiments show that marijuana affects a wide range of skills needed for safe driving -- thinking and reflexes are slowed, making it hard for drivers to respond to sudden, unexpected events. • A driver's ability to "track" (stay in lane) through curves, to brake quickly, and to maintain speed and the proper distance between cars is affected. Research shows that these skills may be impaired for at least 4-6 hours after smoking a single marijuana cigarette, long after the "high" is gone. • If a person drinks alcohol, along with using marijuana, the risk of an accident greatly increases.

6. Replacing the noontime martini…

7. Arizona’s Medical Marijuana Law • Arizona became the 15th state to approve marijuana to be used by individuals who have a debilitating medical condition such as cancer, glaucoma, HIV, hepatitus C, Crohn’s disease, severe and chronic pain. • Arizona is the 1st state with specific employer language regarding discrimination against medical marijuana users.

8. Arizona’s Medical Marijuana Law • An employer may not discriminate against an employee who is a medical marijuana cardholder unless: • The employee used, possessed or was impaired by marijuana on the premises of the place of employment or during the hours of employment. • Employers may take action against medical marijuana users if the failure to do so “would cause an employer to lose a monetary or licensing benefit under Federal Law or Regulation” • Department of Transportation (DOT) Regulation does not authorize “medical marijuana” under a state law to be a valid medical explanation.

9. Medical Marijuana & Drug Free Workplace Programs • Carefully review and revise if needed your drug and alcohol policies. Determine with legal counsel whether the federal exemption will apply. • Note – most contracts that are funded with federal funds usually have an agreement to comply with the Federal Drug-Free Workplace Act. • Train supervisors to recognize impairment and document appropriately. Use the drug test as confirmation • Coordinate testing policies with your MRO and testing laboratory

10. Medical Marijuana Impairment • Train Supervisors to know the signs • Performance indicators • Excessive absenteeism or tardiness • Impaired ability to concentrate and retain information • Increased minor accidents, mistakes, reports of theft • Physical indicators • Bloodshot eyes • Dry mouth • Smell like marijuana

11. Synthetic Marijuana

12. Synthetic Marijuana • Spice/K2 is a substance which has been marketed as incense since 2006. The incense is sprayed with JWH-018 or similar synthetic THC. • Produces a high similar to marijuana – often more quickly / more intense - with longer effect • DEA enacted temporary ban of 5 of the chemicals used to create Spice. • In Arizona, Governor Brewer signed law which classifies 10 chemicals that can be sprayed on the herb as dangerous drugs under state law and therefore banned.

13. Bath Salts • Products may contain synthetic stimulants called MDPV, CFT, and mephedrone. • Effects are similar to cocaine or MDMA • Side effects from ingesting bath salts include seizures and paranoia

14. Changing Patterns of Drug Misuse • From 1997 to 2006, retail sales of opioid pain medications increased dramatically • Americans are 4% of the world’s population, but consume 80% of the world’s opioids • Between 1998 and 2009, hydrocodone moved from 13th to 1st most commonly prescribed medication in the US

15. Prescription Drug Issues • "What many people forget is that prescription drugs have the potential to be just as harmful as street drugs, and that most of today's illegal drugs were once marketed and sold as pharmaceuticals." -- Gary W. Smith, Executive Director of Narconon Arrowhead.

16. Prescription Drug Issues • The rate of employees testing positive for prescription opiates rose by more than 40% from 2005-2010 • In Arizona: • Marijuana positives are No. 1 of drug positives • Opioids are No. 2 • Benzodiazepines are No. 3

17. Prescription Drug Issues • Testing for prescription drugs identifies a lot of use that is unapproved, but not necessarily illicit: • Your employee had a root canal and her roomate gave her a Vicodin. • Your employee test positive for oxycodone. He has a 3-year old prescription. • Your employee just returned from a trip to Cancun. He said the clinic gave him codeine when he burst his ear drum while scuba diving. • Your employee uses on-line pharmacies without a prescription because it is less expensive.

18. Prescription Drug Issues • Workplace testing for prescription drugs as well as illicit drugs should be done for reasons of safety, security, and job performance. • Check your testing panel to be sure that it includes hydrocodone and oxycodone (not just the standard “5 Panel”). • Work closely with your MRO

19. Specimen Validity • A recent Google search on “Beat the Drug Test” gave 820,000 results in 0.14 seconds

20. Specimen Validity • “Suspicious result”There are four basic terms we use to report unusual specimens: • Dilute • Substituted • Adulterated • Invalid

21. Specimen Validity • Dilution involve ingestion of large volumes of water immediately prior to providing a urine specimen.  A number of products, all which accomplish essentially the same thing, are available in most health food stores and on the Internet.  Dilution is easily determined by initial screening for creatinine and followed up with a specific gravity test. • Specimens are reported as “Substituted” have creatinine and specific gravity values that are so diminished that they are not consistent with normal human urine.  

22. Specimen Validity • An Adulteratedspecimen is one that contains a substance that is not expected to be present in human urine, or contains a substance expected to be present but is at a concentration so high that it is not consistent with human urine.   Adulterated is the term used for a specimen that has been altered by the donor in an attempt to defeat the drug test.   Many substances can be used to adulterate a urine specimen in vitro, including common household products, commercial chemicals and products developed specifically for that purpose. • An Invalid result is when a specimen appears to be adulterated with an unknown oxidant or when it is overly dilute but does not meet the federal definition of substituted.

23. Signs and Symptoms • Alcohol : • Odor on breath • Difficulty focusing / eyes glazed over • Gradual decline in appearance / hygiene • Increased absenteeism • Benzodiazepines • Behaviors like alcohol with no odor

24. Signs and Symptoms • Cocaine • Extremely dilated pupils • Excessive activity, difficult to sit still • Irritable / Nervous • Talkative, but conversation lacks continuity • Cannabinoids • Forgetfulness in conversation • Bloodshot eyes • Dry mouth • Brown residue on fingers

25. Signs and Symptoms • Opioids • Lethargy, drowsiness • Constricted pupils • Frequent doctors visits for pain

26. Benefits of Drug-Free Workplace • Employees depend upon the benefits of drug-free workplace policies. They know that these policies create safer working conditions and establish clear standards for performance. • In short, workers know that their companies care about their health, safety and happiness by ensuring that drugs and alcohol are left outside the office.

27. Contact information Sonja Hoppe Vice President Southwest Laboratories 4625 E Cotton Center Blvd Phoenix, AZ 85040 800-279-0027, ext 111 sonjahoppe@southwestlaboratories.com