[MCOH-EH] Use of prescription drugs - instant drug screens

[Sampson, Deborah]

We have also stopped doing instants at all. We have had several false positives on instant drug tests that required us to keep employees out of work when they were actually negative for any controlled substances. We also realized that instants are not picking up metabolites for a variety of 'street' drugs so we have potential for false negatives.

Although no drug screen program is truly foolproof, we feel it is best to follow procedure for external drug screening with independent MRO per Melanie's reply below.
Deb

Deborah A. Sampson, PhD, APRN, COHN-S, FAANP
Director
Employee Health and Wellness Services
Southern New Hampshire Health   P.O.Box 2014   8 Prospect Street   Nashua, NH 03060
p(603) 281-8583  f (603) 577-5665
deborah.sampson at snhhealth.org<mailto:deborah.sampson at snhhealth.org>

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From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Swift, Melanie
Sent: Wednesday, July 20, 2016 9:21 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] Use of prescription drugs - instant drug screens

Kevin, we don't do instant read screens, partly for this reason. One concern would be that a collector isn't qualified to determine which metabolites come from which different opiate or benzo, as that gets rather complicated. For amphetamines and methamphetamines, quantitative levels may be needed.
Aside from all that, just because someone has a legal prescription doesn't mean there isn't a safety concern, which an MRO would flag in their report.

To keep our noses clean, we mirror the DOT process in every possible way. Even though our testing is mostly non-regulated, this gives us an SOP that is fairly bulletproof if challenged.

Melanie Swift, MD
Director, Vanderbilt Occupational Health Clinic
http://occupationalhealth.vanderbilt.edu

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Kevin Matson
Sent: Tuesday, July 19, 2016 1:41 PM
To: 'mcoh-eh at mylist.net'
Subject: [MCOH-EH] Use of prescription drugs - instant drug screens

I have been asked to consider a new process for new hire drug screens. Currently when a candidate has a positive instant drug screen, we then send the specimen for confirmation testing and ultimately to the MRO. Meanwhile, the new employee is on medical hold and may not start work.

For the proposed change, I am being asked to have the candidate present their prescription bottles, and then have an occupational health nurse determine if the employee has a valid prescription. If the employee presents a valid prescription, we would then let the candidate start pending the final review from MRO. If the candidate could not present a valid prescription, they would be on a medical hold until final MRO result was obtained.

I have a strong opinion about this, but I don't want to bias the group with my opinion. Is anyone doing this and can you share your experience? Or, has anyone tried this and discontinued the practice?

Thanks,

Kevin Matson, Director
Occupational Medicine Service Line
Northeast Georgia Health System, Inc.
770-219-3957
kevin.matson at nghs.com<mailto:kevin.matson at nghs.com>




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