Many employers focus their efforts solely on drug and alcohol testing and overlook the importance of educating their employees about substance abuse in the workplace. SureHire’s Reasonable Suspicion Training programs offer a simple, cost-effective solution.
Reasonable suspicion training is also known as RST, reasonable cause training, or drug and alcohol awareness training. These programs are designed to educate supervisors and employees about the adverse effects of drugs and alcohol on workplace safety.
SureHire is pleased to announce the acquisition of Spectrum Safety Services, a trusted provider of first aid, fall protection, confined space, H2S, and workplace safety...
Canadians are facing increased stresses, pressures, and health challenges, leading some individuals to turn to alcohol and drugs as a coping mechanism. Recent data from...
We are thrilled to announce that today, May 6, 2024, SureHire Occupational Testing has officially acquired COHR Health, a well-known leader in occupational health services....
Many employers focus their efforts solely on drug and alcohol testing and overlook the importance of educating their employees about substance abuse in the workplace. SureHire’s Reasonable Suspicion Training programs offer a simple, cost-effective solution.
Reasonable suspicion training is also known as RST, reasonable cause training, or drug and alcohol awareness training. These programs are designed to educate supervisors and employees about the adverse effects of drugs and alcohol on workplace safety.
SureHire is pleased to announce the acquisition of Spectrum Safety Services, a trusted provider of first aid, fall protection, confined space, H2S, and workplace safety...
Canadians are facing increased stresses, pressures, and health challenges, leading some individuals to turn to alcohol and drugs as a coping mechanism. Recent data from...
We are thrilled to announce that today, May 6, 2024, SureHire Occupational Testing has officially acquired COHR Health, a well-known leader in occupational health services....
Many employers focus their efforts solely on drug and alcohol testing and overlook the importance of educating their employees about substance abuse in the workplace. SureHire’s Reasonable Suspicion Training programs offer a simple, cost-effective solution.
Reasonable suspicion training is also known as RST, reasonable cause training, or drug and alcohol awareness training. These programs are designed to educate supervisors and employees about the adverse effects of drugs and alcohol on workplace safety.
SureHire is pleased to announce the acquisition of Spectrum Safety Services, a trusted provider of first aid, fall protection, confined space, H2S, and workplace safety...
Canadians are facing increased stresses, pressures, and health challenges, leading some individuals to turn to alcohol and drugs as a coping mechanism. Recent data from...
We are thrilled to announce that today, May 6, 2024, SureHire Occupational Testing has officially acquired COHR Health, a well-known leader in occupational health services....
Canadians are facing increased stresses, pressures, and health challenges, leading some individuals to turn to alcohol and drugs as a coping mechanism. Recent data from the Canadian Centre on Substance Use and Addiction highlights growing concerns around mental health and substance use. As a result, the risk of workplace substance abuse has escalated, prompting employers to take proactive measures. One key step is ensuring supervisors are equipped with reasonable suspicion training to help identify and address potential issues, ultimately supporting a safe and healthy work environment.
Alcohol and drugs are known to have harmful effects on the health, safety, and overall well-being of individuals, colleagues, and the public. In workplaces, it can result in:
Increases in employee injuries,
Increases in property or equipment damage,
Increases in absenteeism and/or sick leave,
Increases in conflict and violence,
Increases in turnover,
Reduced productivity,
Increases in theft, and
Decreased employee morale.
Employers cannot initiate reasonable suspicion testing without first going through the 5-step process. Reasonable suspicion training provides critical information about how to initiate reasonable suspicion training, including the 5-step process and other tools employers can use to help manage the misuse of alcohol and drugs in the workplace.
What is reasonable suspicion?
Reasonable suspicion is a term used to describe circumstances that usually indicate a reason to complete an investigation or assessment of an employee’s fitness for duty or to explore possible explanations for an employee’s unusual conduct, actions, or appearance. The findings of this assessment may conclude that an individual is either under the influence of a prohibited substance or facing other physical/mental strains. If the assessment points toward possible substance impairment, reasonable suspicion testing may be required.
What is included in the 5 Step Reasonable Suspicion Process?
To properly complete an investigation or assessment of an employee’s fitness for duty, it’s important for supervisors to fully understand each step of the process to ensure:
The observed behaviours correlate with possible alcohol and/or drug use
The necessary documentation is collected and reported
The appropriate conversation is had with the employee
The alcohol and drug screens are completed only when necessary
The 5-Step Reasonable Suspicion Process includes:
Observation. There are 4 main indicators that will help you determine if someone may be under the influence.
Confirmation. Get a second opinion.
Documentation. All companies should have a reasonable suspicion checklist in their drug and alcohol policies that is readily available for all supervisors and managers.
Confrontation. You must effectively communicate your findings with the employee.
Testing. Check your policy – understand what testing is required.
Important Considerations
Consistency. there must be a consistent process followed to ensure that there is no bias involved. Ensuring that a consistent checklist is used, and the same process is followed for each case will assist the employer. If there are inconsistencies in the process, it can have a negative effect on the employer in the case that a complaint is filed.
Confidentiality. The reasonable suspicion process is extremely confidential and is not to be taken lightly. The entire process is not to be shared with any individual who is not privy to this information.
SureHire’s Reasonable Suspicion Training Programs
Reasonable suspicion training is an important tool that employers can use to help manage the misuse of alcohol and drugs in the workplace. Properly trained and educated supervisors will be able to contribute to a healthy and safe workforce by having the ability to recognize the signs and symptoms of potential substance impairment and take the appropriate actions to manage reasonable suspicion circumstances, thereby preventing safety incidents from occurring.
SureHire offers a variety of interactive and self-study Reasonable Suspicion Training programs for employees and supervisors. Our courses have been completed by hundreds of individuals across North America and have been rated 5 stars.
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TAKEAWAY: Workplace addiction is a real issue that can impact employees in several ways. It adversely affects workplace safety and productivity, proving costly for business owners. Fortunately, employers can use several tools, programs, and resources to help curb addiction in the workplace.
Many employers may not realize technology can help improve addiction among workers. Therefore, this article highlights the benefits of using technology for addiction and explores the options available to employers. Read on to discover the best tips for using technology to help with addiction treatment.
According to Dr. Kelly, a professor in addiction medicine at Harvard Medical School, more than 70 percent of individuals with drug and alcohol problems continue to maintain employment because they remain “functioning.”
However, “functioning” employees affected by drugs or alcohol are costly to businesses. Decreased productivity, increased turnover, high absenteeism, increased workplace injuries, decreased morale, and reduced work quality are all potential consequences of addiction in the workplace that ultimately affect the company’s bottom line.
Addiction impacts individuals on a cognitive, emotional, and behavioural level and has far-reaching effects across organizations. The American Addiction Centers explains that alcohol and substance use disorders are prevalent in construction, mining, manufacturing, agriculture, and transportation, often among workers in safety-sensitive roles.
They also highlight concerning statistics around addiction in the workplace. For example, a national survey of the U.S. workforce found that 15 percent of employers admitted working while under the influence of alcohol, and three percent reported being under the influence of illicit drugs.
Luckily, employers can take several action steps to help curb addiction problems in the workplace.
What can employers do to improve addiction in the workplace?
Employers can ensure they have robust drug and alcohol policies to help address the problem of workplace addiction. Drug and alcohol testing and reasonable suspicion training are strategies that can form part of the plan to reduce and eliminate workplace addictions.
Book Impairment Awareness Training Today!
SureHire offers impairment awareness training to help supervisors and employees understand how to identify signs of drug abuse and when to carry out reasonable suspicion testing. We offer private sessions both virtually and in-person as well as self-study sessions through our online learning centre iNTELLECT.
Substance Abuse Professionals (SAPs) are also crucial to the equation. SAPs help employers by assessing workers with a disclosed substance abuse problem or those who tested positive on a drug or alcohol test. The assessment results enable the SAP to explain legal obligations to employers, help everyone chart a path forward, and highlight ways to accommodate a substance problem safely.
Employers can also tackle the root causes of addiction by addressing mental health and wellness in the workplace. Emotional Intelligence, also known as Emotional Quotient or EQ, is a vital piece of the puzzle when recovering from addictions. It consists of five essential areas in addiction recovery: self-awareness, self-regulation, motivation, empathy, and social skills.
Benefits of using technology to improve addiction
Digital technology has expanded the scope of addiction interventions and offers several benefits:
It enables evidence-based treatments to reach a broad audience
Tailored support is crucial in addiction intervention, and digital technology can achieve this via interactive responses and face-to-face support.
It ensures timely treatment options so individuals can receive the help they need when needed, rather than waiting weeks or months for an in-person appointment.
Digital technology is more cost-effective, making treatments available to more people.
For these reasons, digital technology is an essential consideration for employers seeking practical solutions for combating addiction. Several options are available so employers can choose the technology that will best meet their organization’s and its individuals’ needs.
What type of technology is available for improving addiction?
Digital technology for addiction is available in various formats. For example:
Web-based self-help interventions
Web-based self-help interventions vary in features and offerings. Some are designed to inform and educate but do not provide therapy. Others go a step further and offer personalized feedback following an assessment.
Web-based self-help interventions can also include a human element, with support from peers or mental health professionals. Others consist of a step-by-step program the user can work through at their own pace.
Online counselling and therapy
Online counselling involves communication with a therapist via an online channel, such as video calls. It enables one-to-one interaction that surpasses the distance barrier and eliminates travelling time. It may not be suitable for all types of addiction treatment or clients, but it will benefit many.
Artificial intelligence (AI) and virtual reality (VR) software
AI is an emerging technology used in addiction treatment. Once limited to text only, the technology has evolved to voice communication and applications which can detect the user’s emotional needs.
Some technology uses gamification or virtual reality to help with addiction recovery. Certain games can help retrain the brain in those with addiction, whereas VR uses virtual avatars to navigate pathways to addiction recovery and participate in online forums.
What specific technology is available for improving addiction?
Employers and employees have a wide range of digital options for tackling workplace addictions. A few are as follows:
The Therapeutic Education System (TES) is an interactive web-based intervention for substance use disorders. It focuses on the Community Reinforcement Approach, Contingency Management Behavior Therapy, and HIV Prevention. Research shows that TES has the potential to improve addiction treatment outcomes.
In conclusion, when chosen well, digital technology can help improve addiction among workers and form part of an overall plan for a safer and healthier workforce.
Employers cannot initiate reasonable suspicion testing without first going through the 5-step process. Reasonable suspicion training provides critical information about how to initiate reasonable suspicion testing, including the 5-step process and other tools that employers can use to help manage the misuse of alcohol and drugs in the workplace.
We are thrilled to announce that today, May 6, 2024, SureHire Occupational Testing has officially acquired COHR Health, a well-known leader in occupational health services.
Read on…
In this case study, we will explore how mining companies can use various types of occupational tests to reduce Total Recordable Incident Rates (TRIR) long term.
Canadians are facing increased stresses, pressures, and health challenges, leading some individuals to turn to alcohol and drugs as a coping mechanism. Recent data from...
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In a recent National Safety Council survey, 86% of employers reported concerns that prescription drug use negatively impacted their workplace. They may have a good reason. According to Statistics Canada, 23% of Canadians aged 15 years and older use psychoactive pharmaceuticals, and in the United States, over 16 million Americans admit to abusing prescription drugs.
Prescription medications can be an even more significant problem for workers in safety-sensitive positions. Here is what employers need to know.
What is a safety-sensitive workplace?
A safety-sensitive workplace is one in which an employee is responsible for their safety or the safety of others. The term also refers to jobs in which a worker impaired by drugs or alcohol could put themselves or others at risk of injury.
In a safety-sensitive job, drug or alcohol impairment could result in significant injury to the employee and others in the area. Lack of attention in a safety-sensitive position can result in an incident that adversely affects the health or safety of employees, contractors, customers, the public, or the environment. These types of incidents can negatively impact a company’s financial position or reputation. Examples of safety-sensitive jobs include operating heavy machinery, driving on public roads or handling dangerous chemicals.
What are the dangers of taking prescription medication while working in a safety-sensitive position?
The legality of prescription drugs makes them more challenging to deal with in the workplace than illegal drugs. However, they can be equally dangerous. Even if used legitimately, prescription drugs can have serious side effects that may induce dizziness, nausea, hallucinations, or an inability to remain alert. These effects can decrease productivity and increase errors. However, these same side effects in safety-sensitive positions also dramatically increase the risk of injury or death.
What is the duty to accommodate employees with disabilities under human rights legislation?
The duty to accommodate exists under Canadian and provincial human rights legislation and U.S. legislation, including the Americans with Disabilities Act (ADA). However, these laws vary widely with respect to what and how employers must accommodate disabilities in the workplace. Essentially, this legislation is a guideline that ensures employers provide job prospects and employees with any additional support they may need to allow them to participate fully in the workplace to the extent that it does not impose an undue hardship on the employer.
Under Canadian human rights laws, employers may be required to accommodate an employee taking prescription medications or developing an addiction. Prescription drugs can adversely affect a worker in a safety-sensitive job and put the worker and others at risk. In these situations, the employer, employee, and potentially union all have an obligation to address the issue. Possible accommodations could include a transfer to a non-safety sensitive position, reduced work hours or even short and long-term medical leaves.
However, it is essential to note that these accommodations must work for everyone. The employer’s duty to accommodate under all existing legislation is limited if it causes undue hardship to the employer. Changes to a policy, practice, by-law or physical space that would cost too much or create health or safety risks, for example, could negate the employer’s duty to accommodate.
Fitness-to-Work Testing & Accommodation: How it Works
SureHire’s fitness-to-work testing program helps employers make important determinations around employee accommodation on the job. Results are reviewed by a team of SureHire’s trained healthcare professionals, including physiotherapists, chiropractors, athletic therapists, and physicians.
All results are issued using a level 1-5 assessment scale. Depending on the result issued, SureHire may recommend work accommodations and/or restrictions related to the findings noted during testing.
Want to learn more? Contact us today and speak with a member of our team!
How can employers create a policy that accommodates employees with disabilities while maintaining a safe work environment?
Employers should have a medical disclosure policy in place for safety-sensitive positions if they believe using certain prescription drugs could threaten safety. This policy should not be too broad and should be limited to employees in specific safety-sensitive positions. It should also include only those prescription medications that pose a safety risk.
In addition to the medical disclosure policy, employers should create an accommodation policy and educate employees with respect to both the policy and the procedures for requesting accommodation. This open approach ensures employees understand how a request for accommodation is made but also encourages employees to disclose suspected safety risks.
The workplace accommodation policy should include procedures that identify the following:
Who informs employees and job applicants about their accommodation rights
Who can employees approach to request accommodations
How requests are processed, including who has the authority to implement accommodations and who is responsible for financial decisions related to accommodation
Who has responsibility for decisions concerning questions of undue hardship?
How an appeal process works when an employee or job candidate is refused accommodation
Training requirements for staff that are responsible for workplace accommodation policy and procedures
Review procedures for accommodation policies and procedures, including responsibilities for review and a timeline
What to do if you are an employee who needs accommodation in the workplace?
Employees are responsible for working safely and understanding that using prescription medications can pose health and safety risks to themselves or others. Additionally, employees are responsible for reporting any circumstance that could pose a safety risk to themselves or others.
Although employers can and should offer accommodation to workers who need it, the employee also must request accommodations if needed. The employee is also obliged to participate in the accommodation process, which means providing the employer with enough information to make an accommodation possible. This request is best made in writing and should include (as necessary) the following:
The provision of the Code on which the employee is requesting accommodation
Reason for requesting accommodation
Information to confirm the existence of a need for accommodation.
Suggestions of possible accommodation measures
Employees can also provide additional documentation to support their request to expedite the accommodation. This documentation might include, for example, medical notes from a physician.
Are there resources for employers and employees on prescription medication and the workplace?
Employers cannot initiate reasonable suspicion testing without first going through the 5-step process. Reasonable suspicion training provides critical information about how to initiate reasonable suspicion testing, including the 5-step process and other tools that employers can use to help manage the misuse of alcohol and drugs in the workplace.
We are thrilled to announce that today, May 6, 2024, SureHire Occupational Testing has officially acquired COHR Health, a well-known leader in occupational health services.
Read on…
In this case study, we will explore how mining companies can use various types of occupational tests to reduce Total Recordable Incident Rates (TRIR) long term.
We are thrilled to announce that today, May 6, 2024, SureHire Occupational Testing has officially acquired COHR Health, a well-known leader in occupational health services....
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TAKEAWAY: What is fentanyl, why is it used, and why are employers adding it to their drug detection program? Get answers to these frequently asked questions and more!
The opioid crisis continues to grow across North America, much of it driven by fentanyl and fentanyl derivatives. In many workplaces, testing for fentanyl abuse has become crucial to ensuring worker health and safety. Here are the answers to your questions about fentanyl testing.
What type of drug is fentanyl?
Fentanyl is a prescription drug often prescribed as a treatment for severe or chronic pain following surgery or as a substitute for other opioids if patients have become tolerant of them. Prescription forms of this synthetic opioid analgesic include Actiq®, Duragesic®, and Sublimaze®. Fentanyl is often compared to morphine but is 50 to 100 times more potent. This makes also makes it more dangerous.
In addition to its prescription form, fentanyl is produced in illicit labs and sold illegally. This is the fentanyl that is most often associated with overdoses.
How is fentanyl used?
Prescription fentanyl can be administered as a shot, skin patch, or lozenge. Fentanyl that is illegally produced generally comes in the form of a powder or liquid or is made into pills that look like prescription opioids. Illegal synthetic fentanyl can be delivered as a powder or liquid or made into pills that look like other prescription opioids. It is sold illegally on blotter paper, in nasal sprays, eye drops, or even candies. Street names for illegal fentanyl include apache, dance fever, friend, goodfellas, jackpot, murder8, tango, & cash.
Because it is cheap to produce and requires relatively small amounts to create a high, drug dealers will frequently mix fentanyl with other drugs, including heroin, cocaine, MDMA and methamphetamine.
What are the effects of fentanyl use?
Like other opioids, fentanyl binds to the body’s opioid receptors in parts of the brain that control pain and emotions. This is what allows it to be used to manage chronic or severe pain. Illegal fentanyl produces an intense, short-term high and feelings of euphoria. However, over time, the brain can become less sensitive to fentanyl while failing to react to normal stimuli, leading to addiction and overdose. Additional effects of fentanyl can include:
Sedation
Confusion
Drowsiness
Dizziness
Nausea and vomiting
Urinary retention
Pupillary constriction
Respiratory depression
Reduced blood pressure
Fainting
Seizures
Death
How long after use can fentanyl be detected?
The timeline for detection of fentanyl differs for every person based on their metabolism, body mass, the amount ingested, the potency of dose(s), physical activity, health conditions and other factors, making it difficult to determine an exact timeline for detection. The estimated detection window for fentanyl in urine is 8–72 hours; in oral fluid, the detection window is generally 12 hours.
Will fentanyl be detected as an opioid on a standard drug test?
Unfortunately, standard instant drug tests will not detect fentanyl, nor most other standard drug tests. This is because these tests are typically set up to detect opiates which metabolize into morphine. Fentanyl, unlike many opiates, does not metabolize into morphine. However, a targeted drug test can easily detect it in urine, hair and oral fluid tests. Fentanyl testing can be added to many standard drug tests.
What type of fentanyl testing does SureHire offer?
Fentanyl can be tested for as an add-on to any of the following SureHire tests:
Urine Express Panel 5, 8 or 13
Urine Lab Based 5, 8 or 13
Oral Fluid Lab Based 8 or 13
Want to add Fentanyl to your drug testing program?
How is fentanyl detected through lab-based urine testing?
Laboratory urine testing for fentanyl involves immunoassay testing with a cut-off threshold of 2ng/mL. The test seeks to detect Fentanyl metabolites, including norfentanyl, hydroxyfentanyl and hydroxynorfentanyl.
What is the cut-off level for fentanyl drug testing?
Cut-off levels for fentanyl drug testing vary depending on the type of test that is ordered:
Urine Express – 10ng/ml
Urine Lab – 2ng/ml screening and 1ng/ml confirmation
Oral Fluid – 1ng/ml
What is SureHire’s process for determining if a positive result for fentanyl is due to recreational or prescription use?
As with any result confirmed as positive through GC/MS testing, the results will be forwarded to our MRO (Medical Review Officer), who will attempt to contact the individual within 48 hours. Once contact is successful, the MRO will ask the individual if there is any reason for fentanyl to be detected in their sample.
If the individual discloses the use of fentanyl as being directed by their physician, the MRO will request proof of the prescription or evidence that the drug was administered at the direction of a physician, such as a letter from the physician. If the MRO receives these documents, they may overturn the test result and release it as negative.
However, if the individual cannot provide proof of legitimate use of fentanyl or the MRO is unable to contact the donor within 48 hours, the result may be released as positive. Because of its potency and the long list of side effects, the use of prescribed fentanyl may still be deemed as “Negative – Safety Sensitive” by the MRO.
What is the turn-around time for receiving lab-based fentanyl test results?
The turn-around time to receive lab-based fentanyl test results is between 2 to 5 business days.
What is the cost of adding fentanyl to a drug test?
Employers cannot initiate reasonable suspicion testing without first going through the 5-step process. Reasonable suspicion training provides critical information about how to initiate reasonable suspicion testing, including the 5-step process and other tools that employers can use to help manage the misuse of alcohol and drugs in the workplace.
We are thrilled to announce that today, May 6, 2024, SureHire Occupational Testing has officially acquired COHR Health, a well-known leader in occupational health services.
Read on…
In this case study, we will explore how mining companies can use various types of occupational tests to reduce Total Recordable Incident Rates (TRIR) long term.
Canadians are facing increased stresses, pressures, and health challenges, leading some individuals to turn to alcohol and drugs as a coping mechanism. Recent data from...
TAKEAWAY: Workplace addiction is a real issue that can impact employees in several ways. It adversely affects workplace safety and productivity, proving costly for business...
TAKEAWAY: Drug testing specimen procedures are critical to ensuring fair and reliable results. Here are the answers to your questions regarding our urine specimen collection...
TAKEAWAY: Drug testing specimen procedures are critical to ensuring fair and reliable results. Here are the answers to your questions regarding our urine specimen collection and dilution protocols.
Dilution occurs when a urine sample is diluted by the addition of large amounts of fluid, most often by someone attempting to affect the outcome of the test. However, it can also be caused accidentally by drinking large quantities of water or certain medications or illnesses. Laboratories leverage a substance called creatinine to measure dilution. If a sample lacks sufficient creatinine, it is considered diluted.
What are creatinine and specific gravity?
Creatinine is a by-product created by the normal breakdown of muscle tissue and is excreted in the urine in constant quantities with average liquid intake. Excessive liquid intake or dilution reduces a drug’s concentration in the urine. However, it will also reduce the amount of creatinine, so urine samples used in drug-abuse testing are also tested for creatinine. If the concentration is below 20 mg creatinine/dl urine, the urine sample is usually rejected for drug testing.
When technicians find low creatinine levels in a sample, the lab will conduct another test known as specific gravity to confirm the results. This test compares the density of a urine sample to water, which has a specific gravity of 1.000. The lab will deem samples with a specific gravity of 1.005 to1.030 and low creatinine either negative dilute or positive dilute.
Why is dilution a problem?
Positive dilute results mean that the worker tested positive for an illegal substance regardless of the dilution. A negative dilute, however, could mean that either there are no illicit substances present or the specimen was too diluted to permit detection. These outcomes pose a problem for employers who must either confirm or accept the results. This is where Medical Review Officers (MRO) can offer guidance. Dilution is a severe issue for employers because diluted samples make it more challenging to confirm that a person is using illegal drugs.
Although a negative dilute test result alone cannot be used as grounds to reject applicants or action against existing employees, it does mean another test is warranted. Most of the time, employers require a second test following a negative dilute test. This suspends the delivery of results and can further stall hiring decisions or delay the delivery of critical help to employees who need it.
What protocols does SureHire have in place to capture dilution?
SureHire utilizes rapid specimen validity tests, which are semi-quantitative, colour comparison screens for the detection of creatinine and specific gravity within urine specimens. This assessment is a preliminary screen only. A more specific alternate chemical method must be used to obtain a confirmed analytical result at a Health and Human Services-certified laboratory.
The participant is placed on a Dilution Log if a urine specimen is flagged as dilute at the collection site. Collection technicians will then ask the participant to produce additional specimens every 15–20 minutes to flush the excess water out of their system. The participant is given one (1) hour to provide an acceptable specimen before the test is deemed incomplete, and a re-test is required.
Book an Appointment Today!
If you’re looking for a trusted provider to help you navigate the drug and alcohol testing process, contact a member of our team today!
SureHire recommends that testing participants restrict their fluid intake two hours before their appointment and limit their fluid intake 24 hours prior to their appointment. This will ensure their specimen concentration is within normal limits and prevent them from having to participate in the one-hour dilution log process.
What should employers do if they receive a negative-dilute result?
While SureHire’s dilution protocols prevent the occurrence of negative-dilute test results the vast majority of the time, there are limitations to the collection site specimen validity tests, and negative-dilute test results may still occur. If an employer receives a laboratory-confirmed negative-dilute test result, SureHire strongly recommends that a re-test be conducted to ensure test result validity.
Employers cannot initiate reasonable suspicion testing without first going through the 5-step process. Reasonable suspicion training provides critical information about how to initiate reasonable suspicion testing, including the 5-step process and other tools that employers can use to help manage the misuse of alcohol and drugs in the workplace.
We are thrilled to announce that today, May 6, 2024, SureHire Occupational Testing has officially acquired COHR Health, a well-known leader in occupational health services.
Read on…
In this case study, we will explore how mining companies can use various types of occupational tests to reduce Total Recordable Incident Rates (TRIR) long term.
Canadians are facing increased stresses, pressures, and health challenges, leading some individuals to turn to alcohol and drugs as a coping mechanism. Recent data from...
TAKEAWAY: Workplace addiction is a real issue that can impact employees in several ways. It adversely affects workplace safety and productivity, proving costly for business...
TAKEAWAY: What is fentanyl, why is it used, and why are employers adding it to their drug detection program? Get answers to these frequently asked questions...
TAKEAWAY: What is an enantiomer? What are amphetamine enantiomers? Why is it essential to conduct an enantiomer analysis? Get answers to these frequently asked questions and more!
In chemistry terms, enantiomers are pairs of molecules that are chemically identical and exist as mirror images of one another. However, they cannot be superimposed on one another. The two isomers are designated as d- (Dextro) and l- (Levo), indicating the direction in which they rotate a beam of polarized light.
Despite their similarities, enantiomers often have very different effects on the human body. One enantiomer can be inactive, while another can have therapeutic effects. The enantiomers will also react with the body at different speeds and markedly different strengths. For example, methamphetamine is a controlled substance, but its L-isomer is used in several over-the-counter medications.
Because amphetamines are the primary metabolite of methamphetamine, assessing this drug is even more complex. For methamphetamines and amphetamines, the D-isomer is considered much more active biologically, and most illegal drugs are D-isomers.
Enantiomers are problematic in drug testing because standard drug tests, such as immunoassay, cannot distinguish between enantiomers. Because of this, they can deliver inconclusive results. Test results reported by a laboratory will not indicate the specific enantiomer because the laboratory procedure is set up to identify only the presence of amphetamine or methamphetamine. Labs must perform additional analysis to determine which enantiomer is present.
What are amphetamine enantiomers?
Amphetamine is a central nervous system stimulant with 2 enantiomers: levoamphetamine and dextroamphetamine. The effects of dextroamphetamine on the central nervous system are more pronounced than levoamphetamine. Physicians prescribe it to treat attention deficit hyperactivity disorder and narcolepsy. However, athletes also use it to enhance performance. It is also sold illegally as an aphrodisiac and to induce euphoria.
Amphetamine and methamphetamine exist in 2 isomeric structural forms known as enantiomers. Enantiomers are non-superimposable mirror images. The 2 isomers of each substance are designated as d- (Dextro) and l- (Levo), indicating the direction in which they rotate a beam of polarized light. As with many pharmacological enantiomers, the d- and l-isomers have distinct pharmacological properties. In this case, the d- isomer of each substance has a strong central nervous system stimulant effect, while the l-isomer of each substance has a primarily peripheral action. Illegally manufactured amphetamine and methamphetamine are principally found as the d-isomer. However, significant amounts of the l-isomer of each substance may be present depending on the starting materials used by the clandestine laboratories.
When does D- and L-enantiomer analysis need to be completed?
Enantiomer analysis can help determine if positive drug tests are due to a lawful use of prescription or over-the-counter medications rather than illegal consumption. These tests may be warranted if the test participant indicates the use of a legal substance that contains the l-enantiomer. Medical Review Officers (MROs) can also order enantiomer testing for all specimens with positive amphetamines initial test results and all specimens with a positive methamphetamine confirmatory test result or request additional testing on a case-by-case basis. The analysis will differentiate between the d- and l-enantiomers. Urine containing 20% or more d-enantiomer suggests exposure to the schedule 2 substance. However, a sample with less than 20% d-enantiomer may indicate another reason for the positive test.
Why is it essential to conduct an enantiomer analysis?
Although both are controlled drugs, the d- and l-enantiomers have very different effects on the body. From a safety perspective, l-enantiomers can be far much dangerous. Since standard drug tests do not distinguish between d- and l- enantiomers, enantiomer analysis is crucial in identifying the origin of a drug detected in a routine test. The test results will provide a percentage of the d- and l-enantiomers present in the sample. These percentages allow the MRO to more accurately determine whether the positive result was the illicit use of a banned substance or happened through a more innocent use of over-the-counter or prescribed medications.
This additional testing ensures that employers do not mistakenly rule out potential new hires or unfairly penalize employees inadvertently exposed to a drug.
What is SureHire’s process when enantiomer analysis is requested?
SureHire does not require enantiomer analysis for every specimen. However, it is necessary if the participant has disclosed specific medical information (e.g., use of nasal inhaler within days of drug test) to the MRO. SureHire will notify the employer or recruiter who booked the appointment of the additional testing requirements and arrange for the specimen to be shipped to a certified laboratory for further analysis.
It takes approximately 5 to 7 additional business days to ship the specimen, test it, and have the MRO review the laboratory test results and issue a final result.
Your Experts in Occupational Testing
Have questions about our drug testing processes? We have a knowledgeable team ready to answer any questions you may have.
Canadians are facing increased stresses, pressures, and health challenges, leading some individuals to turn to alcohol and drugs as a coping mechanism. Recent data from...
TAKEAWAY: Workplace addiction is a real issue that can impact employees in several ways. It adversely affects workplace safety and productivity, proving costly for business...
TAKEAWAY: What is fentanyl, why is it used, and why are employers adding it to their drug detection program? Get answers to these frequently asked questions...
TAKEAWAY: The opioid crisis in North America continues to balloon, much of it driven by fentanyl. According to CDC data, deaths involving synthetic opioids other than methadone (primarily fentanyl) have continued to rise, with 56,516 overdose deaths reported in 2020. Canada has a fentanyl problem of its own. Of all accidental overdose deaths in the first quarter of 2022, 85% involved fentanyl.
Fentanyl is a synthetic opioid used legally to treat severe pain and is often prescribed following surgery. However, it is also produced and used illegally. It is also often prescribed to patients suffering chronic pain who may have become tolerant to other opioids. Scientists believe fentanyl to be 20 to 40 times more potent than heroin and 100 times more powerful than morphine.
Like other opioids, fentanyl binds to the body’s opioid receptors in the central nervous system, which controls pain and emotions. It reduces feelings of pain by interrupting the way nerves signal pain between the brain and the body. However, over time it can also change how the brain works, reducing sensitivity and creating a dependence on the drug.
Fentanyl can be prescribed as an injection, a skin patch, or as lozenges that are sucked like cough drops. Illegally produced synthetic fentanyl is produced in labs and is usually sold as a powder, dropped onto blotter paper, put in eye droppers and nasal sprays, or made into pills.
How is fentanyl abused and what are the risks associated with it?
Illegal fentanyl is both cheap to produce and much more potent than other street drugs. It is also difficult to detect and can look exactly like prescription medication. All of this also makes it far more dangerous. Drug dealers often mix fentanyl with other drugs, such as heroin, to increase their effectiveness and because it is odourless and tasteless, users may not even realize they are taking it. The drug dealers who produce synthetic fentanyl seldom know or control how much fentanyl goes into each pill so users cannot be sure of what they are taking.
Because of its potency, the risk of accidental overdose is high with fentanyl. And even small amounts of this drug can be lethal. In a recent study, the U.S. Drug Enforcement Administration found that 42% of pills tested for fentanyl contained at least 2 mg of fentanyl, considered a potentially lethal dose.
What are the signs of fentanyl abuse, and what should you do if you suspect someone is abusing it?
A worker abusing fentanyl may exhibit signs of paranoia, social withdrawal, lack of motivation, delusions and personality changes. They may also become increasingly impulsive.
Some of the physical symptoms include:
Confusion
Depression
Difficulty walking
Muscle stiffness
Slowed or altered heart rate
Laboured breathing
Weakness
Dizziness, light-headedness and fainting
Shaking
Sleepiness
Slurred speech
Swollen arms and legs
Weight loss
Visual hallucinations
Nausea and vomiting
Itching and scratching
Pinpoint pupils
If you suspect someone is abusing fentanyl there are several things, you can and should do.
Document everything, including complaints and anecdotes from fellow workers and observations from supervisors.
Meet with the employee in person and note any apparent signs of use or intoxication.
Have a supervisor or HR representative observe the employee directly.
Remove the suspected user from any safety-sensitive position that could put themselves or others at risk.
If reasonable suspicion of use is determined, arrange for immediate testing.
How can fentanyl addiction be treated, and what are the long-term effects of abuse?
Fentanyl abuse can result in devasting long-term mental and physical effects, some of which can be irreversible. Workers may show poor judgement and mood swings, have difficulty controlling impulsive behaviour or develop depression or suicidal thoughts. Ironically, long-term fentanyl use can actually worsen pain in some patients, particularly if taken at high doses. Because of its potency, the risk of overdose and death is much higher with fentanyl than with other drugs. Physically, there are numerous long-term effects, including:
Risk of anoxic injury or damage to body tissues from decreased oxygen supply
Multiple organ system damages
Poor nutrition and weight loss
Insomnia
Sexual dysfunction
Irregular menstruation
How can you prevent fentanyl abuse in your workplace?
Employers should start by helping remove the stigma surrounding addiction to encourage workers to seek help when needed. They can also foster an accepting workplace environment by integrating substance misuse prevention into existing workplace health and wellness programs, providing access to confidential screening tools and supports and educating workers on healthy ways to manage pain and stress.
Other ways employers can help to prevent fentanyl abuse in the workplace include:
Reducing injury risk through education and other controls
Sponsoring take-back events to encourage workers to dispose of unused prescriptions and not share them with fellow workers
Purchasing naloxone to have on-site and train supervisors and others in how to use it
Ensuring health benefits and easy access to Employee Assistance Programs (EAPs)
Monitoring workers’ compensation claims for the possible need for pain education
Tailoring health and wellness programs to tackle substance abuse directly and include education on the effects of fentanyl as well as the signs of addiction
Training supervisors to recognize possible signs of fentanyl misuse, addiction and overdose
Add Fentanyl to Your Testing Process
Fentanyl can be tested for as an add-on to any of the following SureHire tests: Urine Express Panel 5, 8 or 13; Urine Lab Based 5, 8 or 13; or Oral Fluid Lab Based 8 or 13.
SureHire can also provide additional assistance to employers through education, training, and support, including reasonable suspicion training for supervisors.
Employers cannot initiate reasonable suspicion testing without first going through the 5-step process. Reasonable suspicion training provides critical information about how to initiate reasonable suspicion testing, including the 5-step process and other tools that employers can use to help manage the misuse of alcohol and drugs in the workplace.
We are thrilled to announce that today, May 6, 2024, SureHire Occupational Testing has officially acquired COHR Health, a well-known leader in occupational health services.
Read on…
In this case study, we will explore how mining companies can use various types of occupational tests to reduce Total Recordable Incident Rates (TRIR) long term.
Canadians are facing increased stresses, pressures, and health challenges, leading some individuals to turn to alcohol and drugs as a coping mechanism. Recent data from...
TAKEAWAY: Workplace addiction is a real issue that can impact employees in several ways. It adversely affects workplace safety and productivity, proving costly for business...
TAKEAWAY: What is fentanyl, why is it used, and why are employers adding it to their drug detection program? Get answers to these frequently asked questions...
Browse our catalogue of expertly developed online training courses—designed to keep your team safe, compliant, and up-to-date with the latest industry best practices.
