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A New Challenge for Drug-Free Workplace Programs


imagesDrug testing has evolved into a high-technology industry in the United States, one that has produced dramatic advances that allow easier and more accurate, sensitive, and specific testing. There are many settings in which the identification of drug use is important to enhance public health and safety, including the transportation industry, law enforcement, health care, the military, the nuclear power industry, and many other “safety-sensitive” industries.

Workplace drug testing also has expanded to non-safety sensitive industries, such as retail and commercial workplaces, to reduce theft, accidents, and lost productivity. Drug testing is vital for identification, treatment, and monitoring of those with addictions.

Drug testing became common in the workplace with the implementation of federal drug test requirements of the late 1980s. Although these regulations applied only to federally mandated drug and alcohol testing, they were widely used as a model for unregulated workplace programs. They focused on testing for five illegal drugs of abuse in urine: opiates/heroin, cocaine, marijuana, PCP, and amphetamines. While these federal regulations have been useful, it is past time to update workplace drug testing in the face of rapidly changing drug epidemic and rapidly evolving testing technology.

Today, many of the most commonly abused drugs are not included in federally mandated — and many other — drug testing programs. Prescription drug abuse is the fastest-growing drug problem in the United States. It will continue to spread internationally, as will abuse of synthetic drugs. Current drug testing programs, following the lead of federal programs, do not identify most nonmedical prescription and synthetic drug use, leaving many illegal drug users undetected and a safety threat to themselves, to the workplace, and to the public.

  • The Epidemic of Nonmedical Prescription Drug Use
    Nonmedical prescription drug use is the defining drug problem of the 21st Century. As Gil Kerlikowske, director of the White House Office of National Drug Control Policy (ONDCP), recently said, “Prescription drug abuse is a silent epidemic that is stealing thousands of lives and tearing apart communities and families across America.”

    The death toll from overdoses of prescription opiates has more than tripled in the past decade. Thomas Frieden, M.D., MPH, director of the Centers for Disease Control and Prevention, recently stated that “overdoses involving prescription painkillers are at epidemic levels and now kill more Americans than heroin and cocaine combined.”

    Consider the following:

  • In 2009, for the first time, drug overdose deaths in the United States (37,485) surpassed the number of highway crash fatalities (33,808).
  • In 2008, there were more than 36,000 drug overdose deaths, equal to the number of suicides (36,035) and more than the number of homicides (17,826) in that year.
  • Of all overdose deaths in 2008, 20,044 (55 percent) involved prescription drugs. Of the prescription overdose deaths, 14,800 (73.8 percent) involved opiates.
  • In 2010, hydrocodone (Vicodin™, an opiate drug used to treat pain) was the most widely prescribed prescription drug in the United States.
  • Sales of opiate prescription drugs quadrupled between 1999 and 2010.
  • Every day, there are 5,500 first-time nonmedical users of prescription pain medicines in the United States. Every year since 2005, as many or more Americans first used prescription medicines nonmedically as first used marijuana.

    These facts demonstrate a major shift in drug use in the United States and the need to update workplace drug testing programs to maintain their effectiveness.

    Emergence of Synthetic Drug Use
    New synthetic drugs are also known as “designer drugs” because they are “designed” to evade drug testing programs and drug laws. They are increasingly popular. In this category are synthetic marijuana, also known as spice or K2, and “bath salts.” Spice and K2 are labeled as herbal incense to disguise their intended uses.

    The American Association of Poison Control Centers (AAPCC) reported that in 2010, the nation’s poison control centers received 2,915 calls related to synthetic marijuana and 303 calls related to bath salts. As of November 2011, the totals for calls in 2011 had increased to 6,348 for synthetic marijuana and 5,853 for bath salts. These dramatic, short-term increases in poison control assistance requests demonstrate the increases in exposures to synthetic drugs.

    The Drug Enforcement Administration (DEA) recently took emergency action to schedule chemicals found in these types of products.

    Identifying Drug Policy Goals for the Workplace
    Drug testing programs must adapt to changing patterns of nonmedical drug use and must now focus on the prescription and synthetic drugs entering our society, including our workplaces.



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