Recent News & Updates

Drug & Alcohol Clearinghouse: An Update

Beginning January 6, 2020

To ensure you are prepared on January 6, 2020, when the Federal Motor Carrier Safety Administration (FMCSA) Drug and Alcohol Clearinghouse (Clearinghouse) becomes operational, we want to remind you about an upcoming change related to recording information on the Federal Drug Testing Custody and Control Form (CCF) and Alcohol Testing Form (ATF).

What Changed?

The current versions of the CCF and ATF specifically permit the use of either the driver’s social security number (SSN) or employee identification number (EIN) when completing the CCF or ATF.  However, effective January 6, 2020, FMCSA is requiring that the commercial driver’s license number (CDL) must be used instead of the SSN or EIN when FMCSA-covered drivers’ positive drug or alcohol test results are reported to the Clearinghouse.

Therefore, Employers, Consortia/Third Party Administrators (C/TPAs), Collection Sites, Laboratories, and Medical Review Officers (MROs) may want to ensure that their respective data systems can accommodate a donor identification number of up to 25 alphanumeric characters.

What does this mean for Employers, C/TPAs, Collectors and Alcohol Technicians?

  • In accordance with 49 CFR 382.123(b), the person completing the CCF or the ATF must annotate the driver’s CDL number and State of Issuance in Step 1, Section C of the CCF or Step 1B of the ATF for each FMCSA-regulated test.
  • If the employer or C/TPA does not provide the CDL and the State of Issuance, then the collector or alcohol technician should ask the driver for this information at the collection site.
  • Even if the CDL number and State of Issuance is not listed on the CCF, the collector must send the controlled substance test specimen to the laboratory for testing.

What does this mean for Laboratories?

Laboratories who receive a CCF that indicates this is a FMCSA-regulated urine specimen but does not have the driver’s CDL number listed in Step 1 C should process the urine specimen without delay, and send the results to the MRO.

What does this mean for the MRO?

When the MRO receives a laboratory-confirmed positive drug test result for a FMCSA-regulated employee, and the CCF is without the driver’s CDL number and State of Issuance listed, the MRO should contact the driver, driver’s employer or designated employer representative to obtain it.  The MRO will report the verified positive test result in the Clearinghouse.

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Drug-Impaired driving

Drugged, or drug-impaired, driving is defined by the National Highway Traffic Safety Administration (NHTSA) as driving under the influence of substances such as cocaine, marijuana, opioids, and includes drugs prescribed by a physician. Often people mix substances, which can change the effects of a drug making them unpredictable. Drug use can slow reaction times, cause drowsiness or dizziness, impact judgment, and increase aggression. This may be demonstrated by a driver weaving in and out of the lane, driving slower or faster speeds than permitted, and/or paying little attention to the road or traffic signals.

How many people drive under the influence of drugs? According to a Drug Use and Health Survey, approximately 12.8 million Americans aged 16 or older self-reported that they drove under the influence of illicit drugs in 2017.

The National Highway Traffic Safety Administration publishes research about the impact of drug-impaired driving and compares its data to previous years. According to their most recent findings, approximately 20% of surveyed drivers tested positive for potentially impairing drugs. The number of drivers who tested positive for marijuana increased by 48% from 2007 to 2014. Weekend evenings from 10 pm until midnight and from 1 to 3 am show a higher prevalence of drug-impaired driving.

Changes to states’ marijuana legislation coupled with a gap in education have led to misconceptions about the effects of marijuana, including how driving under the influence of marijuana may pose a risk to our roadways. Data shows that driving after smoking cannabis interferes with psychomotor functions and a driver’s ability to multitask. A report from the Governors Highway Safety Association reports that 41.1% of the drug-positive, fatally injured drivers were positive for marijuana. Since recreational marijuana was legalized, marijuana-related traffic deaths have increased by 151 %.

Do you have company vehicles? Do you have concerns about your staff driving while drug-impaired? Call us today to talk about your options! Dial 1.800.452.0030 ext. 203

Drug Testing in the Era of Marijuana Decriminalization

The rapidly evolving legal landscape presents new challenges for employers, particularly those with offices and employees in several states. Employers must balance complying with often different federal and state laws, maintaining a safe work environment, and protecting employees’ rights.

Most employers have a zero-tolerance policy banning the use of alcohol and illegal substances for apparent safety reasons. However, new state laws can create additional problems partly because some company policies exclude prescription drugs when a worker informs the employer about using them.

On the one hand, some states require employers to accommodate an employee’s use of medical marijuana. States like Oklahoma prohibit an employer from taking adverse actions based on a medical marijuana card unless the employer is required to or would lose a benefit under federal law or regulations.

On the other hand, states like California and Ohio, where medical marijuana is decriminalized do not require accommodation of employee use. Developing a well-defined company policy on marijuana use can minimize the risk of harm to persons and property and decrease the likelihood that drug testing and disciplinary action arising from marijuana intoxication will expose the company to any liability.

If an employee tests positive for marijuana, the recourse available to an employer can vary under federal and state law. Rest assured that in all of the states, even those that have decriminalized medical marijuana use, federal prohibitions continue to prohibit operating under the influence of marijuana for certain occupations such as truck drivers and airline pilots.

If you haven’t reviewed your substance abuse policy recently, it might be time. Give our office a call and let’s talk about your policy and goals. Our compliance director has been in the industry for 26 years and is here to help you ensure compliance with both state and federal law.

Call us today at 1(800) 452-0030 ext. 0

What Happens to a Specimen after Collection?

What happens to a specimen immediately after it is collected?

1. From the point of collection, the specimen is packaged & sent to the laboratory via carrier or FedEx.

2. Specimens are processed in a strategic fashion by the certified laboratory. Once the specimen arrives at the lab, the specimen and the accompanying COC are unpackaged. The COC and the specimen vials are scanned at multiple points in each process for record keeping & also to guarantee accuracy.

3.The specimen is divided into equal parts for the testing process & the first immunoassay test is conducted. If the preliminary finding suggests that the specimen is positive, it is sent to another part of the lab for GC/MS confirmation testing. Another primary reason for dividing the specimen is to also reserve a portion in the event that a split specimen test is requested by the donor.

4. The specimen is then tested via the GCMS or Gas Chromatography/Mass Spectrometry. Gas chromatography-mass spectrometry (GC-MS) combines the features or gas-liquid chromatography (GC) and mass spectrometry (MS) & makes it possible to identify different substances within the sample. Initial (immunoassay) and confirmatory (gas chromatography-mass spectrometry [GS-MS]) tests are the methods most frequently utilized for drug tests. Implementing these tests allows a high level of sensitivity and specificity. The approach also reduces the chance for false positives or false negatives greatly.

5. The exact findings of the screening test are confirmed and the laboratory generates an official report to record their findings. The report will include the specific test performed, the panels or drugs that the specimen was tested for, and the final verdict for each panel (positive, negative, or a cancelled specimen as a whole). Positive results will also feature the appropriate quantitative level for the verified substances and corresponding panels listed.

6. Normal negative results are reported immediately by the applicable reporting arrangements determined by the lab account profile.

7. If a result is positive, it is sent to the MRO or Medical Review Office for a final review. Multiple attempts are made to contact the donor in an effort to obtain a valid medical explanation. Quality and accuracy are of utmost importance to NTA, Inc. as the valid medical explanation is determined. Since drug tests are based on the detection of drug metabolites, it is of primary importance that the correct medication causing the positive is identified. In short, the goal of the Medical Review process and steps is to verify that the prescription serving as the contributing factor was legally prescribed to the donor prior to the drug test collection date. The Medical Review Officer or Medical Review Assistants attempt to contact the donor adhering to a high-level of procedural standards and practices based on the type of test being processed, for example;

7a. DOT Results are processed in accordance of DOT Regulations and federal guidelines and with respect to the Medical Review Officer’s responsibility.
7b. NON-DOT Results are processed according to NON-DOT procedures and are generally processed by our highly-qualified Medical Review Office Assistant Staff.

8. If the laboratory determines that a result is cancelled, the MRO Office will review the result and attempt to make contact with the donor as outlined above. A cancelled result can be attributed to a multitude of scenarios and findings. Examples of Cancelled Result causes or contributing factors include fatal flaw detection or rejection, abnormal PH, immunoassay interference, or abnormal creatinine level.

9. Once the full medical review process has concluded, the result is reported to the client as a verified result, negative result, or cancelled result.

  •          Normal Negative tests are usually reported within 24-48 hours from the time they enter the laboratory for analysis.
  •          Positive or Cancelled tests are usually reported from the laboratory within 5-7 business days from the time they are received for processing.

NTA, Inc. has one of the best Medical Review Offices in the country and we guarantee that diligent care is taken for each result that we review and process!

FDA Says Beware Of CBD For These Reasons

The U.S. Food and Drug Administration (FDA) wants the American public to know that cannabidiol (CBD), the non-intoxicating component of the cannabis Sativa plant, might not be as safe and effective in the grand scheme of their overall health and wellness as they are being told.

Other than one prescription drug product to treat rare, severe forms of epilepsy, the FDA has not approved any other CBD products, and there is very limited available information about CBD, including about its effects on the body. Therefore, the FDA wants to clarify a couple of critical points surrounding CBD before more of the public jumps on the bandwagon.

Research shows CBD can cause liver damage. The FDA admits that it does not yet have a real understanding of the potential health risks associated with CBD. But liver damage is one of the side effects that it has uncovered in its limited study. The agency wrote, “ The FDA identified certain safety risks, including the potential for liver injury.”

The University of Arkansas for Medical Sciences did a study that found high doses of CBD brought about liver damage in mice within 24 hours. Many of the animals died or were close to death within three or four days. Critics have argued that the dosage used in this study was extreme, but the highest dosage used (615 mg/kg for 10 days) was “The allometrically scaled mouse equivalent of the maximum recommended human maintenance dose.” So while the dosage leading to liver damage in mice was, in fact, high, there are epileptic children in the U.S. right now being administered a comparable amount. This is the reason that doctors must monitor the liver enzymes of these patients. In clinical trials, 5 to 20% experienced liver issues. As a result, some patients were permanently removed from the study to prevent the damage from escalating.

Even doctors in Colorado, where marijuana is legal for any purpose, monitor the liver enzymes of patients who decide to treat themselves with CBD or Marijuana, according to a report from STAT News.

The most common side effects associated with CBD based products include: “Sleepiness, Sedation, and lethargy; Elevated Liver Enzymes; Decreased Appetite; Diarrhea; Rash; Fatigue; Malaise and Weakness; Insomnia; Sleep Disorder; Infections.”

According to a news release from the FDA, “More severe side effects include “thoughts about suicide, attempts to commit suicide, feelings of agitation, new or worsening depression, aggression, and panic attacks.”

The cannabis industry has been trying to convince the public that CBD can remedy their pain, help with anxiety, pull them out of depression, give them a healthy heart, and even protect them from cancer. The FDA worries that all of the unsubstantiated allegations floating around about how CBD can help relieve or even cure medical conditions will give consumers a false sense of hope. The FDA writes, “ Misleading and false claims associated with CBD products may lead consumers to put off getting important medical care, such as proper diagnosis, treatment, and supportive care.”

It is essential to make sure you stay educated. Don’t just buy into the CBD hype blindly. If you need help educating your staff on CBD use in the workplace, give our office a call at 1.800.452.0030 ext. 203.

Post Accident Drug Testing Positivity

After a workplace accident, an employer may be required or may choose to drug test individuals involved in the accident to determine if drugs played a role. Post-accident drug testing is the third most common reason for drug testing. New findings from the Quest Diagnostics Drug Testing Index show the following facts about post-accident urine drug testing.

  • Post-accident drug positivity for urine testing has been increasing annually since 2011 across the combined US workforce.
  • For the general US workforce tested, post-accident positivity in 2018 was 8.4%, up 9% from 2017.
  • One in twelve US workforce employees tested was positive for drugs following an accident.
  • For the federally mandated safety-sensitive workforce tested, post-accident positivity in 2018 was 4.7% up 51% from 2017.
  • General US workforce positivity has increased by 29% over five years.
  • Safety-sensitive workforce positivity has increased by 81% over five years.

According to the Centers for Disease Control and Prevention, opioid prescribing rates are still very high in certain areas across the country. Having a valid prescription does not mean the medication is risk-free or is being used properly.

In 2018, marijuana was more than twice as likely to be detected by a post-accident drug test than in 2009. Marijuana can impair body movement, cause difficulty with thinking, and may even cause hallucinations and delusions when taken in high doses. All of these impacts can pose a risk and lower a user’s productivity regardless of the workplace setting.

Are you doing post-accident testing? Should you be? Contact our office today to learn about the risks! (800) 452-0030