 "Accurate & Affordable Drug Testing"
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Sunday, March 4, 2012
BEST PRACTICES EVALUATING YOUR URINE DRUG-TESTING PROGRAM By Eric, Ryan and James Fitzsimons There are several matrices available to test for drugs of abuse. The use of urine as the primary means to conduct these tests will not be supplanted in the near future. Drugs and their metabolites are highly concentrated in urine and more in known about this matrix than any other. It is the most legally defensible method. It is also a quick and inexpensive means to test and enables agencies to test more frequently thereby enhancing deterrence, the positive role of drug testing. Drug testing processes vary widely state-to-state, county-to-county, and office-to-office. There are many features that, in our opinion, separate effective drug-testing programs from those less effective. The following are the rank ordered features that are characteristic of the best programs, those that maximize detection and deterrence: Is your drug testing process fully randomized (no scheduled submissions)? In order to be truly effective, a drug testing process must be fully randomized. With the defeating of drug tests a multi-million dollar business in this country, any predictability will inevitably lead to test tampering. Scheduled drug tests invite donors to try to beat your system either by substitution, hydration or adulteration. Conducting fewer drug tests on a random basis is probably superior to conducting more tests on a scheduled basis. Do you at least occasionally test on weekends? The essence of deterrence is no safe drugs to use and no safe periods to use drugs. Testing on weekends is absolutely essential in deterring the casual user. For example, when testing does not occur on weekends, donors can safely use on Friday night and generally be “clean” by Monday. Absent at least occasional weekend tests, you give tacit approval to drug use. Are you using rapid-result testing devices? Any type of delayed-result testing is not a good fit with the criminal justice system. There are a myriad of advantages associated with rapid results including, but not limited to, a high degree of admissions. When admissions obviate the need for confirmatory testing, dramatic savings may be realized since confirmatory testing will always be the most expensive part of any testing process. Rapid results allow you to confront the user immediately and implement a curative course of action. It also allows you to know definitively when a donor is clean so that this behavior may be supported and/or rewarded. Is the rapid-result product that you use available over-the-counter or over the Internet? A product readily available to the donor enables them to: 1. Pre-test themselves before meeting with their correctional officer. If they test positive, they may delay the meeting until the drug has passed through their system. 2. Purchase the identical product so that they may analyze its performance characteristics, e.g. how much water must be ingested in order to fall below the cutoff level, how sensitive a product may be for a specific drug, etc., etc. With any sophistication, a donor will soon learn how to minimize the chances of submitting a positive specimen. 3. If the product is a cup device, it provides the donor a far better and easier means to substitute the urine of another. Do you use a SAMHSA or CAP Certified Laboratory for Confirmations? An essential component of any drug-testing process is the inclusion of a high-standard laboratory for confirmations. With either of these certifications, we know about the accuracy of a lab since there is a built-in check and balance system. When using a lab that holds neither of these certifications, we virtually know nothing about what or how well they are performing GC/MS confirmations. Some labs do not even perform GC/MS confirmatory tests. A true confirmation test must be able to provide semi-quantitative results, should include a routine validity check and have the capacity to report results at less than SAMHSA cutoff levels. Are confirmatory results reported out in LOD or LOQ levels? SAMHSA cutoffs were set for the workplace and are far too conservative for the criminal justice system. Limit of Detection (LOD) or Limit of Quantitation (LOQ) levels will establish that the donor absolutely used the drug in question but this is a lower level than SAMHSA. SAMHSA is, in fact, currently considering reducing the screen and confirmation levels for amphetamine, methamphetamine and cocaine in the belief that too many users are circumventing detection. A lower level of detection is a good fit with criminal justice in that it provides a much higher level of protection for your community. Some other areas, though not as critical: Do you always test for the same panel of drugs? Donors soon learn for which drugs they are likely to be tested. Drug substitution, such as switching stimulants, is commonplace when a donor’s freedom is on the line. In order to have an effective drug-testing program, donors should never be able to predict for what they will be tested on a given day. Is the supervising officer quickly notified of a positive screen? In order to be effective, a decision maker must be notified of a positive submission in a timely manner. With rapid-result testing, a probation officer may decide on a course of action before the drug-usage reaches addiction. The earlier in the addiction cycle that usage is detected, the less intensive and therefore less expensive the treatment response. Once again the community is best protected by early intervention. With laboratory, or delayed-result testing, once the result is finally received, the donor must be tracked-down and confronted. Most delayed-result testing results in denial of usage and the penetrating of this denial can be a difficult and time-consuming process. Ideally the PO should be notified on the same day the test is administered. Are you using a formalized admission form for positive submissions? In most instances an admission form obviates the need for a confirmatory test. Admissions are generally considered preferable to a confirmation in that the donor admits usage and a course of action may be formulated. With admissions there is no denial to penetrate and treatment may commence immediately. Many donors will also admit and sign an admission form prior to the test, which may save precious funds as well. Finally, many sites report that they get admissions, even when the screening and/or confirmation tests are negative. This is dealt with in different ways in different locations. Are collectors aware of subterfuge and how donors beat the test? Collectors must be aware of when to, and when not to, accept a specimen as creditable. Specimens which appear dilute, are a “neon” yellow, appear “strange” in any other manner or where the donor is exhibiting other substance abusing cues, should be held to a higher standard. The usage of a simple dipstick device on a judicious basis adds measurably to the credibility of any program. Strategically placed mirrors, etc., demonstrate that we care enough to make beating the test difficult. When donors can easily defeat a drug test, word spreads and impacts on the credibility of your program. Is every specimen tested for temperature? This is the number one guard against specimen substitution and provides additional integrity for your program. Are the testing devices you are using considered “aggressive”? An “aggressive” device is one that does not yield false-negative results. With false-negative results the donor knows they’ve used, as do their friends, but they are told they’re “clean” and sent on their way. This affords the community little in the way of protection. An aggressive device will detect usage at or around the cutoff level. It may occasionally yield a low level positive result, but this will be rectified during a confirmatory procedure. Devices need to be tested with “at-cutoff” controls to evaluate this criterion. Are the consequences for trying to beat a drug test greater than for a positive test? Absent greater consequences, this becomes a cat and mouse or catch-me-if-you-can process. What has a donor to lose if there is not a great sanction imposed? Is some “action” taken as a result of the first positive test? If a certain number of “positives” are condoned before action, this is tantamount to giving permission to limited “usage.” In order for a program to truly deter usage, there must be some “consequence” for any positive submission. Do you have access to 24/7/365 technical support? When questions such a cross-reactivity, interpretation, accuracy, sensitivity, etc., arise, they need to be addressed promptly. Do you have an evaluative process for measuring the actual effectiveness of your testing program? Many testing programs are perfunctory in nature with no means to measure effectiveness. What drugs do you commonly see? Are there drugs for which you routinely test that are rarely seen? Could you test for fewer drugs more often and have a better program? Are you keeping donors guessing or can they easily predict for what drugs they will be tested? Do you at least occasionally test for drugs not commonly seen (e.g. Oxycodone (OxyContin), Ecstasy, Darvon, etc.)? It is my belief that the most effective drug testing program at this time is the use of an aggressive rapid-result urine test on a random basis, a focus on admissions and the judicious use of a SAMHSA or CAP Certified laboratory with results reported out at LOQ or LOD levels. Labels: ecstasy, laboratory, oxy, testing, urine by: BioTechScreening 
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1 Comments:
Evaluating your drug testing program is essential to ensure its effectiveness, compliance with regulations, and alignment with your organization's goals. Here are some best practices for evaluating your drug testing program:
Define Clear Objectives: Start by defining the objectives of your drug testing program. Determine what you aim to achieve, whether it's improving workplace safety, enhancing employee health, complying with legal requirements, or deterring substance abuse.
Review Legal Requirements: Familiarize yourself with federal, state, and local laws and regulations related to drug testing. Ensure that your program complies with all applicable laws, including privacy and discrimination laws.
Assess Program Effectiveness: Evaluate the effectiveness of your drug testing program by analyzing key metrics such as the reduction in accidents or incidents related to substance abuse, the percentage of employees who test positive, and the program's cost-effectiveness.
Data Analysis: Collect and analyze data from drug test results, including the type of drugs detected, testing frequency, and testing outcomes. Identify trends and patterns that may indicate areas for improvement.
Employee Feedback: Seek feedback from employees about their perceptions of the drug testing program. Anonymous surveys or focus groups can provide valuable insights into employee attitudes and concerns.
Review Testing Methods: Evaluate the testing methods and technologies used in your program. Ensure that the methods are reliable, accurate, and up to date with industry standards.
Random Testing: Assess the effectiveness of random testing in deterring substance abuse. Consider whether the frequency and randomness of testing are appropriate for your organization.
Training and Education: Review the training and education provided to employees about the drug testing program. Ensure that employees understand the program's purpose, procedures, and their rights and responsibilities.
Quality Control: Implement quality control measures to ensure the accuracy and reliability of drug testing. This includes regular calibration of testing equipment and the use of certified laboratories.
Policy Review: Review your drug testing policy to ensure it is clear, up to date, and reflective of your organization's values and goals. Communicate any policy changes to employees.
Confidentiality: Assess the confidentiality of drug test results and the handling of sensitive employee information. Ensure that privacy is maintained throughout the testing process.
Substance Abuse Assistance: Evaluate the effectiveness of your employee assistance program (EAP) or resources available to employees struggling with substance abuse. Ensure that employees are aware of these resources.
Cost Analysis: Conduct a cost-benefit analysis of your drug testing program. Compare the program's costs to the benefits it provides, such as reduced accidents, improved productivity, and enhanced workplace safety.
Continuous Improvement: Use the evaluation results to identify areas for improvement and develop an action plan for making necessary changes to the program.
Documentation: Maintain thorough documentation of all aspects of your drug testing program, including test results, policy changes, employee communications, and program evaluations.
Regards: Crackscut
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