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By JOSHUA CLIFTON, a Chicago-based writer who covers workers' comp and disability issues

While prescription drugs and methamphetamines have faced greater scrutiny in recent years by corporate substance abuse programs, new research indicates that employers may want to turn their attention to another growing area of concern--heroin.

Dr. Barry Sample, director of science and technology for Quest Diagnostics Employer Solutions, said that, despite the surprising findings, heroin use has a relatively low prevalence rate: 0.04 percent. However, employers shouldn't turn a blind eye to the problem, he said.

"Clearly, when you are talking about employees in safety-sensitive roles, any positive has great consequences," he said. "We wanted to call to employers' attention that this may be a bigger problem than they once thought and could bring increased risks and harm to their workplaces."

Sample said that the findings align with early data from more than 350,000 urine samples from transportation workers tested last year after the U.S. Department of Transportation's revised, federally mandated drug-testing rules went into effect. In addition to lowering the cutoff levels for amphetamines and cocaine, the rules also required urine testing specifically for the heroin marker 6-acetylmorphine. Officials found 20 percent more positives for the heroin marker under the tightened regulations.

WHICH TEST IS BEST?

In light of the findings, will oral-fluid testing surpass urine and hair analysis as the preferred testing in drug-free workplace programs? While that remains to be seen, Sample said, oral fluid testing is certainly growing in popularity, now making up 10 percent of tests among the general U.S. workforce.

One benefit of oral fluid, he said, is that the noninvasive method detects recent drug use. In addition, the specimen collection can be easily observed and administered by a hiring manager. And unlike traditional urinalysis, which shares a similar price tag, there are no known adulterants that can be used to tamper oral-fluid testing.

"Oral-fluid testing could also be administered at the workplace post-accident without the need to send someone to a third-party collection site," Sample said. "But quite frankly, all three major testing methods--urine, hair, and oral fluid--have their own distinct advantages."

If an employer is looking for an indicator of long-term, repetitive drug use, a hair test would be the preferred method. Hair testing, which is twice as expensive as urine or oral-fluid testing, can paint a 90-day picture of an individual's drug-use history and also affords little opportunity for tampering. Sample said that hair testing won't uncover recent use, however, and is therefore not suited for post-accident or reasonable suspicion testing.

Urine testing, on the other hand, generally detects only casual drug use that occurred within the past 72 hours. As the most commonly used screening method, it also allows employers to test for a broader range of substances such as prescription drugs and anabolic steroids, in addition to other widely tested illicit drugs.

"Employers need to structure their testing or specimen type based on the goals of the drug-testing program," Sample said.

GOOD VALUE NO MATTER THE METHOD

When it comes to workers' compensation, drug-free workplace programs represent a good bang for your buck, regardless of your testing method. According to federal statistics, employees who abuse drugs and alcohol are two-and-a-half times more likely than nonusers to be involved in a workplace accident and five times more likely to file a workers' comp claim.

Rebecca Shafer, president of Amaxx Risks Solutions Inc., said that despite the economic downturn and employer cost-cutting measures, drug-free workplace programs should remain a priority.

"Drug use is much more commonplace that it used to be," she said. "Couple that with the fact that about 40 states will consider the denial of a workers' comp claim if an employee is under the influence of illegal drugs or alcohol when the injury occurs. It is extremely important that you are not paying for injuries caused by substance abuse."

In addition, Sample said a drug-free workplace program can qualify employers in about a dozen states for reduced workers' comp premiums. Some states also permit participants the ability to terminate without benefits in the event that an employee tests positive for an illegal substance following an accident.

Shafer noted that, as narcotics become a bigger issue for employers, it is wise to have a variety of testing methods in your arsenal.

February 17, 2011

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