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Drug Testing in the Workplace – Fit for Purpose
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  • http://www.medterms.com/script/main/art.asp?articlekey=89631 viewed 20/10/2011

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  • 1. Drug Testing in the Workplace – Fit for PurposeJames Wruck, Business Unit Manager Toxicology January 25, 201028 October 2011 A1153 1
  • 2. Alere Overview• Global leader in near-patient diagnostics for Cardiology, Infectious Disease, Women’s Health and Drugs of Abuse, with expanding capabilities in Oncology.• 2010 revenues > $USD2.1 Billion• Employs over 13,000 staff worldwide• Has a substantial presence in Asia Pacific region, with manufacturing, R&D, Sales and marketing staff in all major countries• World’s largest manufacturer of Point of care Drugs of Abuse tests A1153 2
  • 3. Alere Toxicology Solutions Smart products & services for DOA testing, roadside testing, workplace testing & advanced laboratory services: • Leader in POC DOA devices • Blood, urine, oral fluid & hair testing • >US $350 million revenue annually • >190 million tests manufactured in 4 countries • 7 toxicology labs with global reach in 3 countries • Routine drug screening • Hair testing • Pain ManagementEmpowering decision makers to make timely decisions toimprove workplace safety, personal safety and clinical outcomes A1153
  • 4. A Definition – Fit for Purpose • Something that is fit for purpose is good enough to do the job it was designed to do • That is capable of meeting its Objectives or Service LevelsA1153 Drug Testing in the Workplace – Fit for Purpose
  • 5. What is a Drug Test?An examination of biologic material (such as urine,hair, saliva, or sweat) to detect the presence ofspecific drugs and determine prior drug use.Drug tests may be performed to detect illegal druguse as well as the use of drugs and substancesnot permitted in specific occupations or athleticcompetitions. A1153
  • 6. Note:• Drug abuse isnt just about illicit drugs like marijuana or cocaine.• Legal medicines with legitimate uses can be abused• Commonly abused prescription drugs • depressants, pain relievers, and stimulants and • some non-prescription (over-the-counter) drugs.A1153
  • 7. Where is drug screening performed?• Laboratory • Schools• Workplace • Hospital Emergency Room• Sporting arena• Roadside• Prisons• Clinical treatment A1153
  • 8. Types of Drug tests Carried out inWorkplace• Pre-employment• Random workplace• Post incidence• Just Cause A1153
  • 9. What is the purpose of Drug Test inthe workplace?• Corporate Governance • Retaining good employees• Safety of employees, customers or public • Cleaning out drug users• Genuine concern for • Scare / to Deter from wellbeing use• Meeting Legislative requirements• Ticking the boxes A1153
  • 10. Drug Testing Specimens• Blood • Used for Therapeutic Drug Monitoring (TDM) • Detection period: 0-2 days for most drugs• Oral Fluid (Saliva) • Lower levels of drugs • Detection from hours to 1-2 days • Used in roadside testing in AUS, EU• Hair • No detection for about 7-10 days • Detects as long as the sample obtained (1/2”/month)• Sweat • Leave patch on for 2 days to 2 weeks • Analyze sweat that is collected • Lower levels, similar to blood and saliva• Urine • Drug concentrations are higher in urine than in blood – easier to detect • Urine is aqueous = simpler testing matrix • Large amount of data • Detection periods typically 1-3 days A1153
  • 11. Generalised Window of detection Oral Fluid/ Blood Urine Hair Time (Hours – Days) (Days – Weeks) (Days – Months)  Dose & Route Please  Frequency of dose Remember  Individual MetabolismA1153
  • 12. Which Product?A1153
  • 13. Urine Drug Screen Tests A1153 Not all products are available in all markets.
  • 14. Oral Fluid Drug Screen Tests A1153
  • 15. Comparison of Urine and Oral FluidParameter Saliva UrineCollection Non -Invasive Intrusion of privacy Need special facilities and checksPrinciple Analyte Parent Drug MetabolitesAnalyte Low Moderate to HighConcentrationPotential Problem Oral Contamination Possibility of adulterationPotential Advantage Almost impossible Long window of to adulterate detection A1153
  • 16. Example of testing requirementsOral Fluid UrineA1153
  • 17. What drug testing product to use?• Testing method should reflect desired objective• Understand the features of each method• Understand the value gained of one method over the other, not just the cost of the testing product• Accredited to standards• Part of independent verificationA1153
  • 18. Visual vs. Instrument• How many lines do you see?12345678910A1153
  • 19. Test Reading MethodsVisual InstrumentNo instrument cost Extra Cost for instrumentDecision on the person reading Assured results are correctthe testNo record or results Results can be stored and checked at later dateCan test multiple people at one Need multiple devices to testtime multiple peoplePerson reading may be legally Takes away subjectivityliable for incorrect resultsResults may be bias towards an Removes bias as instrumentindividual makes decisionA1153
  • 20. Internal or External TestersInternal External• May seem less expensive • More expensive per test but• Need to be employed longer only test when needed• Onsite - quick to respond • May take time to get to site for• Experience only on past and in post incidence current business • Wider experience – working• May not be up to date on latest with other businesses products and technology • Well trained and continue to be• May be biased trained• Working side by side with fellow • Experts in field of knowledge employees • Have accreditations and quality systems • Independent A1153
  • 21. Other factors• Cost vs Value• Technical ability of product• False positive / False negative• Portability• Support from manufacturer• Interpretation of results• Time to carry out test• Fit for purpose A1153 21
  • 22. Selection for purpose is complex• Outcomes of program • Quality of the product being used• Methods Available • Cost of incorrect result• Cost benefits of to business program • Instrument vs visual• Internal vs external testers • Oral vs Urine or Hair• Time to carry out • Risk of not testing testingA1153
  • 23. Smart. Connected. Empowering. A1153
  • 24. For Further Information Technical Assistance Alere James Wruck, Business Unit Manager Toxicology ANZPI www.alere.com.au www.alere.co.nz Email: james.wruck@alere.comA1153