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New guidelines for drug testing on the horizon in the US

Oral fluid tests, hair tests, and additional opiate prescription medication tests could be part of DOT-regulated drug testing programs in the not too distant future. The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) is moving forward with proposed changes that could impact DOT regulated companies and even non-DOT workplaces in Canada and the U.S. SAMHSA is the branch of U.S. government that establishes the scientific and technical guidelines for workplace drug testing and the standards for certification of workplace drug testing laboratories. In this post, we take a look at SAMHSA’s proposed changes in brief.

DOT-regulated employers should remember that right now these are proposed regulations, not the rule. However, because the DOT must follow the scientific guidelines of SAMHSA for DOT-regulated drug testing, DOT regulated employers in Canada and the U.S. should be aware of the important issues SAMHSA is considering.  If the proposed regulations are approved, DOT regulated employers and drug testing service providers will have to comply with all provisions.  The new guidelines around urine and oral fluid drug testing could very likely serve as a standard for general workplace (non-DOT regulated) programs in Canada too and it is likely these changes would be reflected in the Canadian Model for Providing a Safe Workplace.

Urine Lab-Based Drug Testing

SAMHSA’s proposed revisions to urine drug testing standards include changing the initial and confirmatory drug test analytes and methods, revising the cutoff for reporting a specimen as adulterated based on low pH, and revising the requalification requirements for individuals serving as MROs. There are many complex issues being reviewed, and in order to avoid confusion over the details, it will be best to wait for the final rulemaking before describing any new requirements.

In addition, SAMHSA is also considering expanding the drugs that must be tested for through urine to include additional opiate prescription medications (i.e. hydrocodone, hydromorphone, oxycodone, oxymorphone), and has developed proposed guidelines for these drugs. Currently, 5-panel lab-based urine drug testing is the only type of drug testing for which SAMHSA has established scientific and technical guidelines, including recommended cutoff levels. Under SAMHSA’s proposed guidelines, these additional prescription medications could also be tested for through oral fluid.

Oral Fluid Lab-Based Drug Testing

SAMHSA has issued proposed standards and technical requirements for oral fluid collection devices, initial oral fluid drug test analytes and methods, confirmatory oral fluid drug test analytes and methods, and processes for review by a Medical Review Officer (MRO).

It is important for non-DOT regulated employers to note that SAMHSA’s proposed oral fluid confirmation test cutoff level for THC is lower than for those workplace programs that try to identify likely impairment within 4 hours prior to the test.  The lower SAMHSA cutoff level translates into a longer time window of detection, meaning, in turn, that the test cannot be used to verify impairment in immediate proximity to the test.  As with urine testing, the primary intent is to identify risk-taking behaviour, not impairment. However, that being said, we won’t know the exact cutoff that will be used until it is officially published in the final rulemaking.

Hair Lab-Based Drug Testing

SAMHSA recently indicated it intends to review and develop standards for hair testing.  If SAMHSA approves hair testing as a viable method for drug testing, it would likely become an acceptable method of drug testing for DOT regulated employers. As with oral fluid testing, DOT would still need to officially approve its acceptability for its testing program when the time comes through its own rulemaking or applicable statement. There is already a bill on the table in the U.S. Senate that if passed would allow DOT-regulated employers to use hair testing as an alternative to urine drug testing; however, acceptable scientific testing standards for such testing would still have to be created and introduced.

What’s Next?

To help evaluate the credibility, applicability, and viability of these changes, SAMHSA is requesting information from industry stakeholders and the general public regarding its proposed oral fluid testing and enhanced urine testing rules, and has also requested comments on the potential use of hair samples for drug testing (SAMHSA is inviting comment on hair sample collection, specimen preparation, analytes, cutoffs, specimen validity, and initial and confirmatory testing).  The process for all these testing methods and enhanced testing panels involves evaluating the scientific supportability by studying their scientific methodology and forensic defensibility.

At this time, no official DOT “need to comply by” or “approved to use” dates have been released for the proposed inclusion of oral fluid testing or the enhanced opiate testing panel.  Hair testing is currently under its initial consideration review, and it will likely take some time for it to reach the current near final approval position of oral fluid testing.

The DriverCheck team is currently reviewing all proposed regulations and is preparing to issue comments where appropriate. Our comments, if made, will be posted in the News section of our website next month. If you would like to issue your own comment, you can do so here.