Drug abuse has become a problem for small and large companies around the country. You don’t have to look far to see news reports talking about the opioid epidemic.
And it raises a number of issues that companies need to be aware of including drug testing for truck drivers, signs of impaired workers in a plant and ways to properly dispose of needles or drug paraphernalia found at a job site. These tips can help you stay legal and improve your drug screening program.
Changes in Drug Screening Laws
The Department of Transportation (DOT) has made a revision to its mandated drug testing regulation, which impacts approximately 6.3 million regulated tests per year. These changes will be made by your registered drug testing provider, that you and the consortium that manages your company’s DOT random testing programs uses. These changes primarily affect the drug types to be included in the DOT approved drug screen panels. As a business, these revisions don’t require changes to your policies and procedures, other than those drugs that must be included in your random, for cause and post-accident drug screening.
These new guidelines harmonize various standards and update section 49 CFR part 40. The new regulations went into effect on January 8, 2018. The final rule clarifies certain existing drug testing program provisions and definitions, makes technical amendments, and removes the requirement for employers and consortium/third party administrators to submit blind specimens.
Unlike in 1988 when previous DOT standards were developed, opioids are the most commonly abused drug today. These substances work on the nervous system in the body or specific receptors in the brain to reduce the intensity of pain.
The United States is in the midst of an opioid overdose epidemic, and according to the Center for Disease Control (CDC) opioids (including prescription opioids, heroin, and fentanyl) killed more than 42,000 people in 2016, more than any year on record, and 40% of all opioid overdose deaths involve a prescription opioid.
Drug overdose deaths and opioid involved deaths continue to increase in the United States, with more than three out of five drug overdose deaths involving an opioid.
DOT currently requires urine testing for safety sensitive transportation industry employees subject to drug testing under Part 40. There are two changes to the HHS Mandatory Guidelines which were proposed to harmonize Part 40.
The revised HHS Mandatory Guidelines allow federal agencies with drug testing responsibilities to test for four additional controlled substances. These controlled substances are Schedule II prescription medications, which include: Hydrocodone, hydromorphone, oxycodone, and oxymorphone. The HHS Mandatory Guidelines also remove methylenedioxyethylamphetamine (MDEA) as a confirmatory test analyte from the existing drug testing panel and add methylenedioxyamphetamine.
Common types of opioids prescribed today are oxycodone (OxyContin), hydrocodone (Vicodin), morphine, and methadone. Fentanyl is a synthetic opioid pain reliever. Fentanyl is many times more powerful than other opioids and is approved for treating severe pain, typically advanced cancer pain. Illegally made and distributed fentanyl has been on the rise in several states, further increasing the risks of overdose.
Prescription opioids can be prescribed by doctors to treat moderate to severe pain, but can also have serious risks and side effects. As per the DOT regulations, it’s a requirement that employers have their transportation/fleet supervisors trained to recognize these signs and symptoms of the side effects.
Signs and Symptoms / Side Effects of Opioids
In addition to the serious risks of addiction, abuse, and overdose, the use of prescription opioids can have a number of side effects, even when taken as directed:
• Increased tolerance for the drug
• Increased physical dependence
• Increased sensitivity to pain
• Constipation
• Nausea, vomiting, and dry mouth
• Sleepiness and dizziness
• Confusion
• Depression
• Low levels of testosterone that can result in lower sex drive, energy, and strength
• Itching and sweating
Whenever an employee is suspected of being under the influence of alcohol, legal or illegal drugs, it’s extremely important that all incidents, behaviors, and communications are well documented, and that state and federal regulations are followed. Training guidelines are available:
Employers can obtain training videos and materials through the following links:
• Reasonable Suspicion Training for Supervisors Video: https://goo.gl/SG6gxE
• Federal Transportation Administration’s Reasonable Suspicion Referral for Drug and Alcohol Testing Training Program for Transit Supervisors: https://goo.gl/etPN3U
Bloodborne Pathogen Exposure Controls and Universal Precautions
With illegal drug use on the rise, it’s important that your staff have training in exposure controls and universal precautions. Finding discarded needles and syringes (SHARPS) around the workplace, that were used for illegal drug injections, is getting to be all too common these days. Discarded SHARPS are dangerous, and how these items are handled is extremely important in preventing disease transmission, especially HIV and hepatitis.
It is very important that employees are trained in the hazards related to Bloodborne Pathogen Diseases, and the BBP exposure controls and universal precautions. See Sidebar 1 to read the proper exposure controls and universal precautions that should be taught to employees about BBP.
With substance abuse on the rise, the workplace is changing. And employers need to be on the lookout for employees who could endanger themselves or others.
Editor’s Note: Jary Winstead is a safety consultant, author and trainer who serves a variety of industries including the forest products sector. He owns Work Safety Services LLC and can be reached at SAFEJARY@gmail.com.
Exposure Controls and Universal Precautions
• Treat all human body fluids and other potentially infectious materials as though they are infectious
• Wear personal protective equipment whenever an exposure to human body fluids or other potentially infectious material exists
• Latex or Nitrile gloves
• Safety glasses
• Face mask
• CPR barrier
• Pliers or tongs for handling SHARPS
• Properly dispose of all potentially infectious materials
• Place in color coded or biohazard container / bag
• Handle carefully, always carrying the container / bag away from the body
• Handle all garbage bags and containers as though they contain potentially infectious materials.
• Carry the container away from your body to prevent the container from touching your body
• Never reach inside a garbage container or bag
• Never attempt to compress garbage
• Soiled clothing
• Remove all soiled clothing and place in a color coded or biohazard container / bag
• Do not take soiled clothing home; all clothing must be properly cleaned prior to re-using
• Clean up all human body fluids and other potentially infectious materials with an approved disinfectant solution
• Safety with SHARPS
• Never place your hands in areas obstructed from your vision. Look first!
Examples of areas prone to discarded needles:
• Around and behind buildings and corridors
• Near fences and walls
• Areas common to transients
• Bags or discarded trash
• Under hedges, in plant beds, bushes, and trees
• Gathered or compiled grass clippings, leaves, and conifer tree needles
• Handle all SHARPS as though your life depends on it
• Never attempt to bend or break a SHARPS
• A used sharp is a dangerous SHARP
• If you must handle a SHARPS, use a tong or pliers. Place one hand behind your back to prevent accidental contact (Do not use your hands).
• Properly dispose of all sharps in an approved biohazard container
• Follow the proper hand washing procedures after coming in contact with human body fluids and other potentially infectious materials
• Thoroughly rinse hands and arms in warm running water
• Use an antiseptic soap
• Thoroughly distribute soap over hands and arms
• Vigorously scrub hands and arms for at least two minutes
• After scrubbing, thoroughly rinse under running water while scrubbing
• Exposure reporting requirements
• Report exposures to human body fluids and other potentially infectious materials to your supervisor immediately
• Complete a Close Call, Hazard, and Accident Report Form in the event of an exposure
