Fentanyl – The Opioid Crisis

Posted on by Craig Bourque

Fentanyl – The Opioid Crisis

Fentanyl is a synthetic pharmaceutical prescribed for severe pain-relief. It is usually only prescribed for intense and severe pain that is physically debilitating. Fentanyl is routinely prescribed for relief from pain associated with advanced cancer diagnoses.

You may realize that morphine is a pain-reliever which can cause severe addiction. With that in mind, understand that fentanyl is 50 to 100 times more potent than morphine, so you can see how easy it would be to abuse this drug for feelings of euphoria, and pain-relief.

Fentanyl is usually prescribed as a lozenge that can be taken orally, or as a transdermal patch which is applied to the skin. Sometimes injections are prescribed. The drug is becoming in such high demand that it is being produced in overseas drug laboratories and smuggled into the US from China and other less regulated countries. The smuggled drug is often sold as a regulated dose of fentanyl. These illegal, street fentanyl products can create incredible addiction, and are responsible for overdoses and death.

 

 

 

The next level of addiction

If you hear someone speaking of China Girl, Jackpot, TNT, Dance Fever or Tango and Cash in a setting where those terms don’t seem to apply, what you may be hearing common street names for illicit fentanyl.

Like hydrocodone and OxyContin, fentanyl is considered an opioid and narcotic. The brand names for fentanyl-based pain relievers include Duragesic and Sublimaze, among others. A rush of dopamine, a “feel good” chemical, is delivered when fentanyl is taken, and this is one of the reasons this prescription or street-level opioid is so addictive.

Fentanyl has also been found to be cut or added into heroin being sold on the streets to provide users with a more intense experience.  First time or newer heroin users typically overdose almost instantly if they unknowingly use heroin cut with fentanyl.

What is Hydrocodone?

Posted on by Craig Bourque

What is hydrocodone?

Hydrocodone is an opioid used to treat severe pain of a prolonged duration, if other measures are not sufficient. It is also used as a cough suppressant in adults.  A mixture of hydrocodone and other chemicals work to suppress coughing. The narcotics in this cough treatment slow down and depress the reflex in your brain that makes you cough. Hydrocodone is usually present in a combination with different chemicals, and is often used to treat moderate to severe levels of pain. Hydrocodone is one of the class of medications considered an opioid or narcotic, and it relieves pain by blocking the ability of your brain and nervous system to sense pain.

You may be prescribed a pain-reliever or cough suppressant in a capsule, liquid or pill, or possibly a tablet. As a pain-reliever, doctors will usually tell you to take as needed to treat pain, but never more than every 4 to 6 hours. Since it is an opioid, this product can be highly addictive. Your doctor will tell you that if you take hydrocodone in combination with some other medications, you dramatically raise your risk of experiencing serious breathing problem issues, and could possibly lapse into a coma.

 

how it works

The way hydrocodone works when it “talks” to your brain and nervous system can create a powerful addiction in some people. Because it is a narcotic, it can deliver short-term euphoria which an addicted individual wants to replicate frequently. This can lead to physical dependence and addiction if hydrocodone and other opioid painkillers are taken long-term.

Also, the withdrawal symptoms after an abrupt cessation of this drug are so powerfully negative, some users will do just about anything to get their hands on some more hydrocodone, or a similar opioid or opiate such as Oxycontin, Heroin or Fentanyl.

 

Urine, Saliva or Hair…Oh My!

Posted on by Craig Bourque

urine, saliva or hair…oh my!

When it comes to drug testing choices, the most common specimen types are urine, saliva or hair follicle testing.  The differences in costs,  the ability to cheat the test as well as the window of detection of various drugs vary depending on the specimen type tested.  Depending on the reason for the drug testing, it is important to understand these differences when choosing a drug test for your particular needs.

urine specimens

The most popular, cost effective and widely available drug test is the urine drug screen. Urine specimen testing can be completed via rapid testing or laboratory testing. Urine testing allows for the largest number of drugs to be tested. When choosing a rapid test, it is imperative to have any presumptive positive results confirmed by a laboratory before taking any kind of action.  Laboratory testing is the gold standard when it comes to drug testing and provides the most accurate and scientifically valid results, period. 

 

Drug detection times for urine specimens are fairly short – most drugs only being detectable for 2-3 days. THC, the metabolite found in marijuana can be detected for a longer period (up to 30+ days) depending on the frequency of use of the substance.

 

The ability to adulterate or cheat a urine drug test is moderate in comparison to other options. Given the short window of detection, a user may be able to refrain from use for a few days prior to an anticipated drug test like a pre-employment drug test. As a result, they may be able to pass the test giving the appearance of a drug free lifestyle.  Where most urine collections are conducted in private and not observed, the opportunity to adulterate or substitute the specimen is always a possibility.

saliva specimens

Saliva drug testing is often a little more expensive than urine testing in that it is not as widely used at this time. It is, however, growing in popularity as an option for testing. Saliva testing can be completed using rapid tests or laboratory testing. Unlike urine rapid tests, saliva rapid testing is not as effective or accurate in drug detection or use. WE DO NOT RECOMMEND RAPID TESTING FOR SALIVA SPECIMENS. Laboratory testing of saliva specimens is far more accurate and scientifically valid in terms of results.

 

Drug detection times for saliva are actually shorter than urine testing for all drugs, including THC. Saliva is the only specimen type that can detect from immediate usage up to 3 days, depending on the drug.

 

The ability to cheat or adulterate a saliva specimen is very difficult as the entire collection process is observed by the collector. This eliminates the opportunity for the donor of the specimen to provide someone else’s specimen or to try and adulterate the specimen in other ways.

HAIR FOLLICLE SPECIMENS

Hair follicle testing is more expensive than urine testing or saliva testing – and for good reason. Hair follicle testing can only be completed via laboratory testing and provides many benefits above and beyond urine or saliva.  Some companies and attorneys prefer hair follicle testing by itself or in combination with urine or saliva testing.

 

The detection window for hair testing is much larger than urine or saliva, however detection of drug use can only be detected approximately two weeks after the last usage. For this reason, hair follicle testing in not a good option if looking to detect recent usage of drugs.  Detection of drug use can be detected up to 90 days or more depending on the length of hair being tested.

 

The ability to cheat or adulterate a hair follicle test is very difficult as the collection is an observed collection by a collector. This eliminates the ability to use someone else’s specimen or to adulterate the specimen in other ways.  The use of bleach or harsh chemicals may affect or mask the drug test results for some types of drugs, but not all.

CONCLUSION

When deciding on which drug test to use, consider the potential drug use time frame you are concerned with (recent or long term) as well as the ability for the donor to be able to cheat or adulterate the specimen.  Consideration for the specific drug(s) of concern may also play a factor. Not all specimen types can test for all drugs. 

Urine testing provides  the most affordable option as well as the widest availability of drugs that can be tested. To combat concerns of cheating a urine test, an observed collection may be an option. 

If privacy concerns are a factor, saliva and hair follicle specimens provide observed collections by default and offer more accurate results for the short and long term.

The most important consideration is to have a certified collector performing specimen collections and use an approved and certified laboratory to test  all specimens.

 

 

 

 

 or H

Opioid Drug Crisis – Oxycontin

Posted on by Craig Bourque

Opioid Drug Crisis – Oxycontin

Any discussion of an opioid drug crisis has to include OxyContin. From 2010 to 2017 in the United States, opioid addiction rates have exploded, up nearly 500% in that 7-year span. Right at the top of the prescription addiction list is OxyContin, a drug which has an addiction more powerful than that of morphine. The United States is far from the only country to suffer from addictions to prescribed medications, with most modern countries recognizing this is a serious public health issue.

Opioid-related deaths have risen by 300% since the turn of the century in the US, and OxyContin is one of the most addictive pain-relievers often prescribed by doctors. Because it is frequently in the news, OxyContin is routinely turned down when offered by a physician for treating pain. The potential relief it can deliver is outweighed by the possible addiction in the mind of the patient.

 

 

pathway to addiction

Ever since the late 1990s, OxyContin has been used to treat postoperative pain for a number of operations and procedures. When the pain is extremely high, this drug is sometimes prescribed because of the oxycodone it contains. One dose of OxyContin contains between 10 and 80 mg of oxycodone, which delivers a time-released relief from pain for up to 12 hours.

Whether obtained through a legal prescription or by other means, OxyContin can be crushed and then snorted or swallowed, or diluted in water and injected. This removes the time-release mechanism and gives a ‘high’ or feeling of euphoria comparable to that of heroin. This sometimes leads to criminal behavior in an effort to get more of this addictive drug than a prescription allows. Street prices for Oxycontin have risen leading people who are addicted to the drug and can no longer get the pill to seek out alternative drugs in its place including heroin which is widely available and more affordable.

 

Are You Hiring A Problem?

Posted on by Craig Bourque

Hiring Problems

Advertising a new job. Reading applications. Phone interviews. Personal interviews. Making a job offer. Onboarding. Training. Is this the right person for the job or are you hiring a problem?

 

With unemployment rates at an all time low and the pool of good quality candidates getting smaller, it is more important than ever to properly screen applicants. Effective employee screening should include a background check and drug screen at a minimum. If the job is labor intensive, a physical should also be part of your employment screening process to make sure the candidate can handle the physical requirements of the job. These employees represent your company, your service, your reputation. Are they capable of doing the job requested of them? Are you confident they will live up to your expectations and represent your company properly?

 

Reality is that background checks, drug screens and physicals do add costs to the hiring process. These costs, however, are easily offset by reduced workman’s compensation insurance premiums, lower liability insurance premium costs, reduced accidents and absences as well as creating a healthier, more productive work environment overall.  In contrast, one problem employee can cost a business far more than any background check, drug screen or physical.

 

Carolina Testing is your one stop, full service employee screening solution provider. For a free, no obligation review and proposal of recommended screening services that will benefit your company, please contact us.

 

10 Reasons To Establish A Substance Free Workplace Program

Posted on by Craig Bourque

10 Reasons to Establish a Substance Free Workplace Program

Employers and employees have a responsibility to contribute to a productive, positive, comfortable and safe work environment. Implementing a drug testing program can help to accomplish these desired outcomes. The following lists the most common reasons employers begin and continue substance free workplace programs.

  1. Improves company image. Drug testing increases consumer confidence concerning service and/or product quality, safety, reputation, and employment best practices.
  2. Provides a safe workplace for employees. A substance free workplace program can help to reduce on-the-job accidents and crime involving drugs.
  3. Complies with laws and regulations. Employers are responsible for understanding and adhering to their local, state and Federal laws. For many safety-sensitive industries, drug testing is required.
  4. Reduces healthcare and insurance costs. An enforced drug testing program can assist in avoiding increased costs related to alcohol and drug-related injuries and illness, while helping to lower worker’s compensation exposure and insurance premiums.
  5. Improves company morale. Drug testing can help promote a safer and more productive work environment, playing a role in fostering a positive corporate culture.
  6. Enhances employee productivity. A drug testing program can also help to reduce absences, tardiness, and employee turnover.
  7. Helps employees. Effective drug testing programs can help deter or prevent drug use among employees. Testing can also help to identify those who may need employee assistance or rehabilitation services for a substance use disorder.
  8. Protects employees, customers, and the public. Drug testing protects employees, customers, and the public from employees using drugs; it can also help to keep employees safe from harm and employers safe from liability.
  9. Prevents hiring candidates who use drugs. Pre-employment drug testing helps to prevent hiring individuals who use illicit drugs in the first place.
  10. Keeps employers and employees educated. A well-run drug testing program provides tools and resources employees need to participate and benefit from a substance free workplace, including education about the physical effects of drug use and the nature of abuse and addiction.

 

Employers should consider their unique business needs, and select elements of a drug testing program that will be most beneficial to their job roles and environment. An effective workplace drug testing policy, combined with proper education, can help employers and employees benefit from a number of advantages.

To learn more or to get started today, CONTACT US.

 

Saliva Based Drug Testing: What It Can Offer Your Business

Posted on by Craig Bourque

Is Saliva Based Drug Testing Right For Your Business?

Drug testing is common among employers today. Over half of United States employers require a drug test prior to employment, and many employers conduct drug testing after the initial hire as well. There are many ways to test an employee for drugs, including blood, oral fluid (saliva), urine and hair follicle testing. Many employers are moving toward saliva based drug testing as the benefits of this type of testing become more widely known. Here are some pros and cons to weigh when considering saliva-based drug testing for your company.

PROS:

Saliva based drug testing allows for fast, clean and easy administration and collection.

A saliva test collection includes inserting a swab in the donor’s mouth to collect saliva that is pooled and created in the mouth. Typical collection time take approximately 5 minutes, does not require a restroom and the specimen can be easily collected anywhere.

Oral fluid testing minimizes the opportunity to cheat the test.

While there are some mouth rinses that claim to be able to cheat a saliva base drug test, a properly administrated and collected saliva drug test cannot be cheated. The collection of the specimen is done while being directly observed by the collector and only after the collector has made sure that no food, drink, smoking or tobacco use has occurred in the prior ten minutes to the collection being conducted.

Affordability increasing as acceptance and adoption among employers grows.

The cost of saliva testing is significantly cheaper than hair follicle testing and while slightly more expensive than urine specimen testing, saliva testing continues to become more affordable as more and more companies switch to it.

Detection and accuracy of testing is higher in saliva based specimens.

A comparative study demonstrating the accuracy and dependability of oral fluid drug testing versus urine testing was conducted. Findings from this study indicate that oral fluid positive rates are higher in most categories, with significantly more positives detected and reported in THC, Cocaine, and Amphetamines when compared to similar testing conducted on the same subject using urine testing.

 

Saliva provides an earlier detection time similar to blood.

Oral fluid allows for the earliest detection of drug use starting within minutes of the drug use in most instances. Urine specimen testing requires at least four to six hours for the body to process and metabolize the drug being used before it can be detected. For this reason, oral fluid testing is a great choice for post accident, reasonable suspicion or random testing.

 

CONS:

Saliva-based drug testing has a much shorter window in which drugs can be detected than compared to hair or even urine testing.

Oral fluid drug tests have a maximum detection window of up to 3 days or less depending on the drug being tested. Urine can detect for up to 5 days (30 days for chronic marijuana users) and hair can detect for up to 90 days.

Oral fluid testing is limited in the number of drugs that can be tested.

There are a limited number of drug panels available for oral fluid drug testing, but new panels are being added on an ongoing basis. The most frequently abused drugs such as marijuana, opiates, amphetamines, cocaine, meth, PCP, barbiturates and benzodiazepines are available for testing through saliva.

 

Oral fluid is not approved for federal testing of drugs in system.

For federally regulated positions, such as the Department of Transportation, drug testing is mandatory – however oral fluid testing is not allowed to be used. While SAMHSA is working toward allowing saliva testing for federally regulated employees, current regulations limit federal testing to urine specimens only.

CONCLUSION:

In conclusion, oral fluid drug testing is fast becoming the specimen of choice when it comes to employment drug testing. It is important to note that proper collection procedures and laboratory testing of the specimen is required in order to establish the most accurate results. Instant oral fluid testing products are available and while they may be useful to provide faster negative results, non-negative results from an instant testing device must be sent to a certified laboratory to confirm a positive drug test. Employment decisions based on a non-negative result using an instant drug test without laboratory confirmation exposes you to major liability concerns.

 

Ultimately, deciding on what type of drug test a company should administer involves consideration of company goals, budgetary options, regulatory guidelines and personal preference. In any case, drug testing is a proven tool that contributes to the safety and efficiency of the workplace.

 

To learn more about oral fluid testing for your company, please contact the professionals at Carolina Testing.

 

 

Why Pre-employment Physicals are Important for Workplaces

Posted on by Craig Bourque

Why Pre-employment Physicals?

Most employers screen new applicants with background checks and drug screens. After all, this is a necessity in the modern workplace to enforce high workplace standards. But if employers knew that there was another way to ensure cost savings and quality employees, wouldn’t they do it? In short: further employee screening does exist in the form of pre-employment physicals. Employers who choose to conduct these physical examinations save time, money, and frustration while making the workplace a safer, more productive environment for everyone.

How Do Pre-employment Screenings or Physicals Help Employers?

Physicals are aimed to make the life of those who are taking them better. They are meant to point out areas in which someone is doing physically well as well as point out where they could improve. For employers, this means many holistic improvements to the workplace.

  • Liability. Many employers hire their employees because they look good on paper. While this might be fine for certain positions, most labor – including office labor – requires a certain physical ability. For example, determining whether a potential grocery worker can lift a certain weight might prevent them from receiving an unnecessary injury and save the company from unnecessary worker’s comp claims and extended absences.
  • Health Benefits. A physical could also be used to determine the health that the person is in. An employee in poor health can be a big burden for employers in terms of lost productivity due to last minute call outs or sick days. Alternately, it could be a motivator for an employee to make health and lifestyle changes in their personal life. This would ultimately make them a more efficient employee and save employers from overused sick days and insurance claims.
  • Increased Customer Service. Generally, a healthy employee is a happy one. Their health and mental well-being contribute to the way that they conduct their work, which can be extremely beneficial in a customer-facing setting. By hiring healthy employees, employers are ensuring that employee customer service skills are utilized to their utmost.

One thing that employers should keep in mind, however, is that pre-employment physicals can be a daunting experience for potential employees. If employers set expectations about the exam prior to the employee’s physical, they are telling the employee that they care about their well-being and are doing this for their own good. Additionally, when expectations are set it lessens the anxiety during the physical itself, which allows employees to perform better. With the right mindset from both employer and employee, it is possible for physicals to benefit everyone in the workforce.

CBD Users Want To Know If They Will Pass A Drug Test?

Posted on by Craig Bourque

CBD Use Raises Questions

With the nationwide rise in popularity of cannabidiol (also known as CBD) products, many consumers are concerned that they may not pass a drug test, placing them in jeopardy of losing their job or even losing their child to social service agencies.   Before we can answer the simple question of “will I pass a drug test,” we must first learn what CBD really is.

 

CBD is one of the hundreds of compounds found in the cannabis plant. This same plant also contains the more well known psychoactive compound, delta-9-tetrahydrocannabinnol, more commonly referred to as THC. CBD is a cannabinoid and it does share some similarities with THC, however, it does not produce a “high” when used or consumed. While research on CBD is still in its infancy stages, initial studies suggest CBD users experience some therapeutic and medical benefits from conditions such as seizures, post traumatic stress disorder (PTSD), pain, cancer, swelling/inflammation and some neurological disorders such as anxiety and depression.

 

It is important to note, CBD, like all cannabinoids, are still classified by the federal Drug Enforcement Agency as a Schedule I substance making CBD illegal in all 50 states on a Federal level. In spite of DEA classification, many states have permitted CBD use and sales at the state level so long as the products have zero to very low levels of THC (less than 5%). CBD products come in a variety of forms including oil, creams, soaps, vapor liquid, or infused into edibles or drinks.

 

Now to answer the question…will I pass a drug test?

Maybe. Drug tests do not test for CBD. Drug tests only test for THC which is the psychoactive ingredient found in cannabis. Because some CBD products may contain low levels of THC, it is possible that a drug test result could be reported as positive – depending on the usage of the product. It is important to know if the CBD product being used contains any percentage of THC and only products containing 0.0% THC should be considered. The only caveat here is that this is unchartered territory for this type of product and industry. It is not well controlled or regulated leaving the possibility that unscrupulous producers may allow unacceptable levels of THC in their products leaving its users at risk.

 

It is critical to know and understand that for federally regulated drug tests (such as DOT), the use of CBD products or “medical marijuana” is not a valid medical explanation for a positive test for the marijuana metabolite. As a Schedule I substance, cannabidiol remains illegal at the Federal level and testing positive on a federally regulated test comes with serious consequences. While there are some states that permit the sale and/or use of CBD, federal law still trumps state laws.

Employers need to stay informed about the constant changes concerning marijuana and its derivatives as situations like this will become more commonplace. A company’s substance abuse policy should clearly reflect the company’s position on marijuana and the use of CBD products.

For a free, no-obligation review of your company’s substance free workplace policy and program, please contact Carolina Testing.

 

Divorce and Child Custody Drug & Alcohol Testing

Posted on by Craig Bourque

Creating Drug & Alcohol Testing Agreements
In Divorce & Child Custody Situations

When drug or alcohol abuse is alleged in a divorce situation involving children, demands for testing are usually made as part of any divorce and custody agreement. Crafting a solid agreement regarding drug and alcohol testing for divorcing parents is critical to the safety and well being of the child(ren) and provides peace of mind and a level playing field for the parents.

 

In order to be effective, the agreement should cover the following seven criteria:

  1. Frequency of testing
  2. Notification for testing
  3. Specimen type to be tested
  4. Drugs to be tested
  5. Reporting results
  6. Consequences of a positive result
  7. Payment responsibilities

Frequency of testing:

Your agreement should include guidance as to how often testing will be conducted. Frequency of testing can be established in a variety of ways including:

  • Scheduled Testing (weekly, bi-weekly, monthly)
  • Random Testing (random notification by third party)
  • Pre-Custody
  • Post-Custody
  • On Demand

 

Notification for testing:

The agreement should clearly state how the party to be tested will be notified. It should also state how long they have to present for the testing requested – typically same day. To avoid parties claiming that they were not notified properly, using a third party such as Carolina Testing or an attorney to make notification is highly recommended. Carolina Testing notifies parties by phone, email and text message alerting them to the testing request and requirements.

 

Specimen type to be tested:

What specimen types can be tested? This should be included in the agreement and should include all available specimen types: urine, hair follicle, saliva, breath (alcohol), blood

Urine and saliva tests can detect recent usage. Urine testing should specify whether the collection is to be observed or unobserved. Hair follicle tests can detect use up to 90 days for drugs and alcohol. Breath alcohol testing can detect current impairment while blood PETH tests can detect 3 weeks of use.

 

Drugs to be tested:

This section of the agreement should not limit the drugs that can be tested as a user may opt for drugs that are not being tested in order to attempt to avoid testing positive. Drug testing panels today can include a wide variety of drugs and substances of abuse depending on your needs.   A simple 5 panel drug test to a comprehensive drug detection test can be ordered as long as there are no limitations listed in the agreement.

 

Reporting results:

Typically, both parties should receive the results at the same time. Attorneys of record may also be selected to receive results as well as the court if required. The agreement should require that authorization to release results to all parties must be provided by the person required to test. Failure to provide such authorization would be equivalent to a positive drug test.

 

This section should also address whether the lab test results will be reviewed by a Medical Review Officer or if the results will be required direct from the laboratory.   A medical review of laboratory results may negate a positive laboratory result if the donor has a prescription for the drug in question. It is our recommendation that this type of testing be completed without medical review and that the results be reported direct from the laboratory.

 

Consequences of a positive result:

This section should clearly articulate what happens in the event that a person tests positive. Visitation may be suspended for 30 days, may require supervision, be revoked or any other consequences that the parties may agree to. Additional consequences may require mandatory counseling, therapy, treatment, etc.

 

Payment responsibilities:

The agreement should clearly state the payment arrangements for testing. Common scenarios for payment include:

  • The person taking the test pays
  • The person requesting the test pays
  • Test costs shared equally
  • The person requesting the test pays, but will be reimbursed if the result is positive.

 

Conclusion:

Carolina Testing is frequently contacted by lawyers and divorcing parents to advise on how best to establish a drug and/or alcohol testing program for all parties involved. This article is to assist attorneys and parents in understanding the key elements that need to be built into drug and alcohol testing agreements in divorce and custody related cases to provide fair and equitable testing for all involved. If we can be of further assistance in this matter, please CONTACT US anytime.