What’s the best policy for employee drug testing?
Read a Bethesda Care physician’s philosophy…
Your company’s drug tests may not be detecting what you want. Current laboratory test panels don’t include screening and confirmation for many abused prescription medications.
“What we see on the drug screen is limited to what we’re looking for,” said Dr. Jeff Davin, Regional Medical Director for Bethesda Care Arrow Springs and Queensgate Occupational Medicine Centers.
Dr. Davin adds that in our current 5 and 10 panels, most positive tests show marijuana or cocaine use. But with increasing abuse of prescription medicines like oxycodone and hydrocodone, Dr. Davin suspects there would be a significant number of positives for these narcotics if they were included in the testing. Current 5 and 10 panels only test for codeine and morphine on the opiate test.
The increased abuse of synthetic opiates translates into a growing concern for employers trying to maintain safe and healthy workplaces. National data shows abuse of prescription drugs- especially narcotics- continuing to rise, with an estimated 7 million Americans abusing them. And the Office of National Drug Abuse Policy has identified prescription painkillers as the number one emerging threat in America’s war on drugs
Dr. Davin cites a recent article in the Cincinnati Enquirer in which the sheriff of West Union in Adams County reported sixteen drug overdoses in 2009, all but a few of them from prescription drugs.
“These drugs are being sold more on the street,” Dr. Davin said. “They’re taking a vicodin (hydrocodone) single dose tablet and scraping it into a powder that can be dosed five times for use as a nasal inhalant.”
Most labs currently offer standard panels for two types of drug testing:
- Five panel (Federally-mandated by the Department of Transportation) includes:
- Amphetamines/methamphetamines
- Opiates (codeine, morphine, heroin)
- Cocaine
- Marijuana
- PCP
- Ten panel (contains five additional substances that are likely to be abused or impair):
- Benzodiazepines (valium, librium, xanax)
- Barbiturates (sedatives)
- Methadone (used for chronic pain relief and addiction medicine)
- Methaqualone (Quaaludes)
- Proproxyphene (darvocet)
Dr. Davin notes one other potential drawback to the current 10 panel screening: that it includes a drug rarely seen anymore---methaqualone (Quaaludes). “I personally haven’t really seen this drug since the 70’s and I have never seen a test come back positive for it,” he said. “It’s useless to test for something not currently used, so why labs haven’t excluded it, I don’t know.”
Dr. Davin believes it’s now time to update testing to include the synthetic opiates, namely oxycodone (percocet) and hydrocodone (vicodin), which can be done through an expanded test. “We believe it is becoming important to test for these on a routine basis with the expanded opiate panel. In the current drug culture, there’s much more abuse of prescriptions we’re not testing for, and many companies aren’t aware.”
Bethesda Care and Good Samaritan Occupational Medicine Centers offer the expanded opiate panel, which includes prescription pain relievers--including those above and dilaudid. Though the labs charge extra for that panel, Dr. Davin said Bethesda Care recommends all employers investigate testing for these additional drugs.
“Our physicians believe the cost is worth it,” he said.
Dr. Davin is Board Certified in Occupational Medicine. He served as the Facility Medical Director at Bethesda Care Blue Ash from 1987 to 2009. Currently, Dr. Davin is a Regional Medical Director for TriHealth Occupational Medicine. He is a certified Medical Review Officer(MRO). Dr. Davin is also a Volunteer Associate Professor for the University of Cincinnati for residents in the Occupational Medicine program, and he teaches residents for the Bethesda Family Practice Residency.
SOURCE: Cincinnati Enquirer, October 4, 2009.