Tag: Pre-Employment Screening

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! 

By Jennifer Crump

What is an Enantiomer?

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.

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KEY TAKEAWAY: Here are some key elements to keep in mind as an employer when you select a drug and alcohol testing provider.

By Jennifer Crump

There is an abundance of available options for organizations looking to launch a drug and alcohol screening program as part of their workplace drug and alcohol policy. In fact, the sheer number of companies offering these types of services can be intimidating — as an employer, you want to ensure you’re making the right choice for your workforce. [To learn more about how drug testing can benefit your workplace, check out “7 Reasons Your Company Should Invest in Drug Testing”]. After all, while there are many screening companies out there, not all drug and alcohol screening companies are the same. Whether you are just starting your search, are switching providers, or are simply looking to enhance your existing screening, here are a few key elements to consider.

Current and Future Needs

Before you begin to investigate the various offerings of testing companies, start with an assessment of your current needs with respect to drug testing. Will you want to test on-site, or do you prefer an off-site location for your employees? Where will your drug testing programs fit into your processes, and what is their intended purpose? Are they for new hires? Are you trying to proactively prevent substance abuse in your workplace, or do you want to have something in place for post-incident testing? 

And, don’t stop with your current needs. Consider your future requirements as well. Will you need a drug testing provider who has the capacity to scale alongside you as your organization grows? These are all important elements to consider as you narrow down your search.

Logistics 

Your drug testing program must be safe, secure, and reliable. That means choosing a supplier for whom collection process integrity is paramount. For example, can your potential partner articulate what constitutes a correctable flaw and a fatal flaw in the testing process, and the correct procedures in each instance? 

There is no room for error or data breaches when it comes to drug testing, so your provider must also be trustworthy and have transparent processes that guarantee necessary procedures such as a chain of custody. They must also have professional, accurate systems that support the following: 

• Privacy protection
• Thorough collection processes
• Rigorous evaluation standards
• Secure and comprehensive positive test procedures
• Extensive reporting options

The Types and Purposes of Tests Offered By The Company

Unless you have very narrow testing needs, you will want to consider the variety of testing a provider offers and their level of expertise in each. For example, do they offer testing options for urinalysis, hair follicle, and oral fluid? Does the provider have the capacity to test for the variety of drugs you want to test for? [To learn more about one of the most common types of drug tests, check out “8-Panel Drug Testing: The Most Popular Workplace Drug Test”]. 

Employers utilize drug testing for various purposes. Each requires different processes and must adhere to different rules, from collection to testing to reporting. Potential drug test providers should be capable of providing services for: 

• Random testing
• Pre-employment testing
• Pre-access testing
• Post-incident testing
• Reasonable cause testing
• Return-to-duty and fit-for-duty testing
• Follow-up testing

Finally, if you are or may be subject to Department of Transportation (DOT) testing, the company you contract with should have experience in DOT, non-DOT, and Canadian Model focused drug testing. 

Flexibility of Testing Delivery

Another key factor to consider is how your employees will be tested. Do you want to send your workers to a lab for testing, or would you prefer to set up in-house testing? There are several options available to employers. Providers can deliver point-of-care or rapid testing at the worksite, and mobile testing services can provide a similar service with a prepackaged setup. Traditional lab-based services are another option. 

There are advantages and disadvantages for each. It’s ultimately a matter of what is the best choice for your particular workforce’s needs. You want to be sure that your provider has the capacity and experience to deliver the testing program that works for your workplace. 

Extended Supports

Your drug testing program should not be solely focused on the tests themselves. It also requires initiatives related to education, training, and other services, such as mental health support, to assist your workers in dealing with addiction and substance abuse. You may also need to employ the services of Substance Abuse Professionals or Medical Review Officers. Of course, you can contract for all of these services separately, but working with a full-service drug testing company means you can work with a single service level agreement and enjoy the safety and security of a seamless process. 

Technology

Technology is enhancing every aspect of drug testing. From ensuring random testing is genuinely random to providing automated reports and data. Other technologies can provide you with an automated dashboard and appointment bookings, along with alerts and reminders. Even chain of custody approaches is changing as technology improves. 

Make sure the drug testing provider you go with is committed to staying on top of the latest in the industry. That way, they’ll be able to provide your company with technology designed to enhance your program.

Partnerships/ Networks

Drug and alcohol testing companies leverage partnerships and networks to enhance and extend their services. Look carefully at these partnerships and consider how and if they can advance your drug testing program. Every drug testing provider provides something a little different. Focus on the totality of the services and tools they can deliver on their own and in conjunction with their partners. 

Why SureHire?

SureHire stands above its competition as a full-service occupational testing company serving more than 8,000 clients in over 1,200 locations across the globe. That experience and expertise will help ensure your drug and alcohol testing program runs smoothly and remains in compliance. When you work with SureHire, you have access to the vast accumulated knowledge of their many experts and you can rest assured that they’ll leverage innovative technology to give you the most accurate results.

SureHire provides a variety of testing services in addition to drug and alcohol testing as well, such as audiometric and lung testing, allowing you to handle all your workforce’s testing needs with one reliable provider.

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TAKEAWAY: Get a primer on the 8-panel drug test, the test type that has become the default selection for many employers in their workplace drug testing programs. 

By Jennifer Crump

Keep your workplace safe and drug-free!

SureHire offers a broad range of testing options that include the 8-panel drug test as well as DOT random testing, non-DOT random testing, laboratory testing and mobile testing options. We also provide support for employer-based drug testing programs that include Reasonable Suspicion Training for supervisors and support for employees suffering from substance abuse, including access to dedicated Substance Abuse Professionals (SAPs).

Learn how SureHire can help you create a culture of safety excellence! 

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The pandemic has contributed to a disturbing rise in drug use, particularly fentanyl, cannabis, and methamphetamines, according to Statistics Canada. This spike in use may also be contributing to an equal increase in overdose-related injuries and fatalities across Canada. Employers concerned about the safety and well-being of their workers may be considering implementing a drug testing program to identify issues before they become serious safety risks and to help them identify employees who may need help. Learn more in 7 Reasons Your Company Should Invest in Drug Testing.

Currently, about 10% of Canadian workplaces with over 100 employees have drug testing programs in place. However, in British Columbia, where employers are struggling with increasingly high rates of substance abuse, 18% of employers have now implemented drug testing programs. 

One of the most popular of these tests is the 8-panel urine drug test. Delivered as either a point of care test (POCT) or a lab test, it is the standard used in the Canadian Model for Providing a Safe Workplace (Canadian Model). However, the oral fluid test is also considered acceptable for post-incident testing, reasonable cause testing and random testing

Which Substances Does the 8-Panel Drug Test Detect?

8-panel drug tests are among the most common in Canada and the only panel drug test approved for use by the Canadian Model for post-incident, reasonable cause, and random testing. As the name implies, this panel tests for 8 drugs, including: 

• Amphetamine
• Cocaine
• Methamphetamine
• Phencyclidine (PCP, angel dust, and other terms)
• Cannabis/marijuana
• MDMA (methylenedioxymethamphetamine, also known as ecstasy or molly)
• Opioids (heroin *fentanyl can be added to this panel on request)
• Oxycodone (Roxicodone and OxyContin)

Point of Care Testing vs. Lab-Based Testing

8-panel testing is either a lab-based test or a point of care test (POCT), also known as express testing. 

Lab-based testing involves technicians collecting samples, which they then send to a laboratory for testing. While these tests are often considered more accurate and reliable than point of care tests, it is essential to note that the point of care test does not have higher initial cut-offs than the lab-based test. 

Point of care tests can deliver results quickly, often within minutes, while it may take several days to send samples to a lab and receive results. Thus, the desired timelines for your drug testing may influence which particular testing method you’d prefer to implement for your workforce. Point of care tests also tend to be more convenient for workers and less expensive to administer for employers. 

Initial testing via point of care test can be confirmed with a subsequent laboratory test to eliminate the possibility of a false positive and help ensure legal defensibility for any actions taken by the employer. Employing a Medical Review Officer (MRO) can also protect the company. 

What Does “Cut-off Level” Mean?

The cut-off level is the level of concentration of a drug within a person’s system that indicates a safety risk. Companies can set acceptable cut-off levels and typically include them in their workplace drug and alcohol policy. 

Most cut-off levels are based on the Canadian Model or the U.S. Department of Transportation concentration limits. Setting cut-off levels ensures both the safety and fitness for duty of employees. It also ensures that all workers are treated equally when it comes to drug testing. 

There are generally 2 cut-off levels. The first is the screening concentration. If the sample exceeds this limit, the lab or tester submits it for a confirmation test. Cut-off levels for this confirmation test are generally slightly lower. There are different cut-off levels for urine testing and oral fluid testing. Here is a quick overview of the screening and confirmation levels employed in the Canadian Model. 

8-Panel Urine Drug Cut-off Limits

8-Panel Oral Fluid Drug Screen Cut-Off Levels

What are Windows of Detection? 

The approximate window of detection for commonly abused drugs depends on the type of test and drugs tested for. It can also be affected by usage. For example, in casual marijuana use (once per week), the THC metabolite is detectable for approximately 3 to 4 days. However, with chronic use (every day), tests can detect THC for several weeks. 

The liver metabolizes drugs into more water-soluble forms that can be excreted in urine by the kidneys. Many drugs, including opioids, are entirely excreted in the urine within 2 to 3 days. Others, such as PCP, stay in the bloodstream longer and are converted to metabolites that are then slowly excreted. They can be detected for up to a week in urine. Still, others, such as specific barbiturates and benzodiazepines, can be detected for several weeks. 

Oral fluid testing offers a much shorter window of detection; typically 12 to 24 hours, but is an excellent method for detecting current impairment. 

How Are Results Interpreted?

Companies following DOT standards will have their results sent to a Medical Review Officer (MRO). The MRO will then interpret the results, report on them, and recommend next steps. There is no such requirement in Canada; however, companies following the Canadian Model will usually employ an MRO to receive and interpret drug testing reports in confidence. The MRO will then discuss the test results with the employee and seek reasons for positive, adulterated, substituted, or invalid results. 

Once the MRO makes a determination, they will report the results to the employer or employer designate as 

• Negative
• Negative with safety advisory 
• Refusal to test and why 
• Cancelled with or without further direction 
• Positive

Negative with safety advisory means that although the worker has legitimate reasons for testing positive for a drug, such as a particular prescription, they may still pose a safety risk to themselves, fellow workers or the public.

KEY TAKEAWAYS: A drug testing program is an effective way to keep your employees healthy and safe. A company’s workforce should be able to trust their colleagues with safety, which sometimes requires a detailed plan of action.

Drug use, particularly opioid use, is spiking in Canada, and it is not just an urban problem. Many rural communities are seeing an increase in both drug use and overdose deaths, a phenomenon that has been exacerbated by the COVID-19 pandemic and shows no sign of slowing. Experts blame an increasingly potent and toxic supply of opioids filtering out from cities like Toronto. This is a huge problem for employers who are also dealing with the fallout of the increase in alcohol consumption and recreational drug use that accompanied the pandemic.

In response, the Canadian Nuclear Safety Commission (CNSC) recently implemented mandatory drug and alcohol testing requirements for its high-security nuclear sites across Canada. Other public agencies may follow suit, and it may be time for both private and public companies to consider investing in a drug testing program. Here’s why.

1. Mitigate Safety Risks

There is no question that drug use in the workplace increases safety risks for your workers and the public. It’s been definitively linked to increased work-related accidents and injuries by organizations such as the Substance Abuse and Mental Health Services Administration (SAMHSA) and others.

The use of illicit drugs or abuse of prescription drugs impacts a worker’s judgment, alertness, perception, and even motor coordination, making it more likely they will suffer an accident or make a poor decision. It may be particularly concerning for those in safety-sensitive positions.

These poor decisions do not just put that solitary worker at risk. They can put all of your workers and the public at risk too. Safety concerns are the primary reasons for the drug testing mandates governed by the Canadian Nuclear Safety Commission (CNSC) and US organizations such as the US Department of Transportation (DOT).

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2. Boost Productivity and Performance

Drug testing aims to reduce substance use, substance abuse, and the adverse effects it can have on job performance and productivity. Drug abuse on the job can lead to poor decision-making, tardiness, sleeping on the job, and a loss of focus. Reducing drug use through a robust drug testing program can eliminate these effects and ensure your workers are alert, efficient, and can comprehend dangerous situations. Clear heads also mean better motor coordination and improved emotional states. Additionally, drug testing can help your company reduce the absenteeism that is a direct result of the after-effects of drug use.

3. Manage Costs

Accidents, lost productivity, and human error are all costly problems often associated with drug use. A drug testing program can serve to mitigate these costs in 2 ways. First, it can act as a deterrent, discouraging both individual use at work and the possibility of an epidemic of use that can occur when drug abuse is unchecked. Secondly, drug testing allows you to identify problems earlier in the process and provides you with an opportunity to offer both treatment and support. Both of these can help your company reduce the costs of drug use in your workplace. These costs for society and workplaces are substantial, reaching over $46 billion annually in Canada. In the US, drug issues cost employers over $100 billion every year.

4. Improve Company Image and Culture

Pervasive drug use can negatively impact your company culture, leading to a lack of trust among employees and a feeling of vulnerability. It can lower company morale, leading to higher turnover or a lack of employee loyalty. However, it isn’t just your company culture that can be affected by a drug use issue in the workplace. Increased errors or safety concerns can impact public perceptions of your organization as well. When company morale is lowered, you can lose good workers, and when your public image is affected, you could lose sales, both of which can have disastrous consequences for your business or organization.

5. Improve Employee Heath

All too often, employees view drug testing as a punitive measure, but drug testing is actually about protecting your employees. While a positive drug test result is not proof of a drug problem, it can indicate one. A well-rounded drug testing program provides an opportunity to offer rehabilitation and other employee assistance benefits, potentially as part of an Employee Assistance Program (EAP). It can also offer the opportunity to provide accommodations until recovery is complete. All of this keeps your workers safe and ensures productivity.

6. Address Workplace Violence and Illegal Activities

Drug use can lead directly to other illegal activities, such as selling illicit drugs. Drug use and prescription abuse are directly linked to increased workplace violence and harassment. Mitigating drug use in the workplace through a drug testing program demonstrates your unwillingness to tolerate the effects of drug abuse, including workplace violence and illegal activities. It shows your employees that you place a high value and priority on their ability to come to work in a safe space. Employers should also consider developing a written policy to take advantage of the benefits of background checks while avoiding many of the pitfalls that accompany them.

7. Reduce Company Liability

Drug testing can help reduce company liability and risk, particularly as it relates to safety concerns. Employers may be able to identify issues before they turn into serious problems. A drug testing policy reduces volatility and demonstrates a reasonable effort to mitigate problems.

In Conclusion

The ballooning drug use problem does not have to become a problem for your company. A drug testing program can help you catch and mitigate potential risks and ensure your workers get the help they need.

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A well-documented drug and alcohol policy provides a framework for dealing with issues surrounding workplace substance abuse and pre-existing medical conditions. You should consider your drug and alcohol policy as a component of your overall safety program. SureHire has close to 20 years of experience partnering with companies from many industries across Canada. In that time, we have witnessed 9 keys that our partners with successful policies share. So what are the 9 keys to an effective drug and alcohol policy?

9 Keys to an Effective Drug and Alcohol Policy

1. Identify the purpose of the drug and alcohol policy.

The obvious purpose of a drug and alcohol policy is to prevent people from coming into work while impaired. This purpose should also take the following desired outcomes into consideration:

• What goals will this policy help your company achieve?
• Do you want a safer workplace?
• How about a decrease in injuries?
• Less downtime caused by accidents and near misses?

TIP: A good policy should align with and contribute to the overall safety goals of your company.

2. Ensure Human Rights compliance.

In Canada, an individual’s drug or alcohol dependency is considered a disability. As a result, you can neither terminate nor deny employment based on the presence of this disability. A well-written policy should consider the Employer’s Duty to Accommodate in situations where a disability through addiction is in place.

3. Outline the roles and responsibilities of supervisors and employees.

Having a successful policy means that both supervisors and employees are aware of and understand their roles and responsibilities in terms of what is expected of them when at work. As such, your policy should clearly outline the job tasks, duties, and chain of command to help employees understand what you expected of them, the tasks they may be faced with, and the individual(s) they should contact in times of need.

4. Don’t forget to address medicinal marijuana.

With the new landscape in the Canadian environment, employers need to include clear language regarding the use of cannabis for medicinal purposes in a safety-sensitive environment to remove any uncertainty from the employee’s perspective.

5. Clearly state the reasons for testing.

Employers should ensure that all employees understand why, when, and how testing would take place. It is important to outline the circumstances that would be deemed “testable” because it gives everyone an understanding of when it is appropriate for testing to occur.

6. Identify the consequences for employees who refuse testing or test positive.

As an employer, it is important that you create a list of consequences that is accessible, visible, and easily understood by employees. Doing this ensures everyone is aware of what would happen to them if they chose to refuse a test. If (by chance) an employee claimed they didn’t know of any such rules, you would simply have to reference the policy where it is all stated.

7. Be clear about self-disclosure and accommodation.

Your policy should provide the requirement for an employee to disclose should they have a problem with drug or alcohol abuse. You then have the responsibility to assist them in seeking access to resources (such as an SAP) to begin rehabilitation.

8. Identify how you will store results and what you will do to ensure confidentiality.

This is very sensitive information of a private nature. As an employer, it is important that you take great care to ensure you are not sharing this information inappropriately.

• Who has access to the results and in what circumstances?
• How does your Third-Party Administrator (TPA) deliver the results to ensure that only the right people have access?
• How does your TPA ensure your employee’s private and confidential information is protected throughout the chain of custody?

When you outline the answers to the questions above within your policy, it helps improve employee confidence in the policy.

9. Review and evaluate your policy.

Outdated policies can put both the employer and employees at risk. Companies should develop appropriate and measurable indicators to capture the impact and effectiveness. Employers should also ensure to educate all employees on any changes to the policy and share regular reminders company-wide to keep their policy top of mind and promote a safety-first work culture.

A good policy is a foundation for a successful program that helps companies meet their safety goals, so let us help you in creating the best!

Looking for a Drug & Alcohol testing provider? Or do you need assistance in developing an effective policy? SureHire offers quality services in Canada and the US. Learn more about Drug and Alcohol testing, find a location, or contact us today to speak to a member of our team!