Revealing results about drug and alcohol testing

The AusHealth Hospital Research Fund Ltd

Tuesday, 02 February, 2016

Revealing results about drug and alcohol testing

In this article, Safety Solutions asks MedVet’s in-house toxicologist Steve Korkoneas about what drug and alcohol testing results are revealing about Australian workplaces and how drug and alcohol testing policies and procedures can be implemented effectively.

Does your analysis of actual drug and alcohol test results reflect the community perceptions on drug use in Australian workplaces, ie, is there really an ‘ice epidemic’?

Lab results don’t reflect an ice epidemic as might be expected, with no recent significant spike in laboratory-confirmed samples containing methamphetamine. This might be due to factors such as the types of industries that conduct testing — hospitality, as an example, has very high rates of drug use as well as workplace injuries, but very low rates of testing. While Medvet works with clients of all sectors, testing is more prevalent in the visibly safety-conscious industries, such as aviation, rail transportation, and mining and resources.

From your trend analysis of drug and alcohol results, what are the biggest problems facing the workplace?

Cannabis is still the leading illicit drug affecting the workforce, with as much as one in 10 people having used it in the last year, and many of those on a frequent basis. After that, the misuse of prescription medications is a growing concern. It’s also important to note that alcohol is still by far the leading drug of abuse in Australia, with extensive impacts on workplace safety and productivity.

How can drug and alcohol testing policies and procedures ensure workers are ‘fit for work’?

The policy and procedure specifies the requirements for working for that business or on that site. These might change between job roles or the subjective levels of how safety-critical jobs might be, but the policy sets out what the company deems appropriate conduct for its workers and contractors. It’s a vital first step in keeping the workplace safe for all.

What are the main challenges that need to be addressed when implementing a drug and alcohol program in the workplace, eg, privacy concerns, type of drugs included in the testing, implementing zero tolerance policies, ensuring accuracy of the results, etc?

The first step (perhaps challenge) is to draft a comprehensive drug and alcohol policy. It needs to be clear and specific in setting out the expectations the business has for its workers. For example, is the breath alcohol limit to be zero, 0.02 or 0.05? The policy needs to reflect the standards and realities of a specific workplace, so it’s rarely a one-size-fits-all situation. In drafting the policy and procedure, many companies consult a number of stakeholders so they can get the best outcome and overcome any conflicting viewpoints that might create challenges for beginning testing. The next step is to educate employees, not just on the potential harms of drugs and alcohol on their workplace, but on the specifics of the company policy — the staff need to know the expectations in order to follow them.

Privacy, drug classes, the types of testing (oral fluid or urine, for example) are all aspects of the policy and procedure to be addressed, and as long as they are handled in a constructive manner, may not present major challenges to running an effective program. Accuracy of results is usually confirmed by the accreditations and quality standards of an external agency conducting testing — if they are NATA-accredited and meet Australian Standards, the results can be accepted as reliable.

Does a drug and alcohol program need to meet any accreditation standard in Australia; and what training and educational information needs to be provided to employees?

There are a number of relevant Australian Standards to which providers can (or perhaps should) be accredited by NATA (National Association of Testing Authorities): AS/NZS 4308 and AS 4760 for drug testing (urine and oral fluid, respectively) and AS 3547 for breath alcohol certified devices (screening). These Standards can confer quality and consistency of results, as they cover specimen collection through chain of custody to a laboratory. If the specific business providing on-site testing is NATA-accredited, and sends the sample to a NATA-accredited laboratory, then you should be able to trust the reliability of their results.

With regard to training, it’s recommended that an external training provider be an accredited RTO, as this confirms they have the systems, processes and qualified trainers to provide the best learning outcomes for employees. When rolling out a new program, or refreshing the knowledge of your team, we recommend educating employees initially on the impacts of drugs and alcohol on the workplace, training supervisors in assessing if their team are affected by drugs or alcohol (‘reasonable cause’), and if you’re conducting your own testing, that the collectors are trained and certified in the appropriate collection and chain-of-custody processes.

What are the pros and cons of testing in-house versus outsourcing the testing?

When outsourcing, the business reduces the perception of bias in the selection of specimen donors. For example, Medvet can fully randomise a program, from when the site is visited to who is selected on-site, either electronically or as simply and transparently as having employees select from a bag of coloured marbles. Importantly, outsourcing also means that an accredited drug testing company conducts the tests in line with the latest best practice — if an employee conducts tests only rarely, they may inadvertently breach chain of custody and call into question the results of a potentially positive drug test. We also note that in a privacy-conscious setting, it’s often difficult for an employee to fully disclose medications, making the situation uncomfortable for them, and it’s often difficult to conduct a drug test on one’s own peers. An external provider reduces all of these concerns with professional impartiality. You are also hiring expertise, experience and knowledge that may not exist in the company.

What are the main features and standards that are required for equipment used in a workplace drug and alcohol testing program?

Each drug or alcohol testing device should be validated to the standards above, confirmed by a NATA-accredited laboratory that they detect the appropriate drug classes at the correct cut-off or target concentrations (which differ between drugs). Manufacturers or suppliers, including Medvet, can advise if each device has its own certificate of compliance with the Australian Standards.

What procedures should be followed if a non-negative result is detected on the equipment?

From the employer’s point of view, this depends on the policy and procedure it puts in place. Many businesses might stand down the employee (with or without pay) until the confirmation sample result is provided by the laboratory. Other businesses might put the employee on light duties for that time. Once the results are returned from the lab, they can continue to follow their policy, with outcomes such as a first and final warning, forwarding the employee on to the company’s Employee Assistance Program, or perhaps termination.

From the agency’s perspective, a sample is securely dispatched to the laboratory for further screening or testing as necessary, and a report is provided to the employer’s nominated contact for the appropriate action.

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