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Testing beyond the standard 5-panel: Is it right for your workplace?

With Ottawa adopting a national strategy to tackle prescription drug abuse, some employers wonder if they should follow suit. Workplace testing for prescription medications and other drugs beyond the standard 5 panel can be effective and necessary in many cases because it can help identify potential safety risks that would otherwise go undetected. This post will help you make an informed decision on whether your workplace could benefit from additional testing.

Defining the Need for Going Beyond The Standard Drug Test

The first step is to determine if there is a clearly defined need to test for additional drugs. Ask yourself why you want to add drugs to the standard 5 panel:

  • Is there a risk associated with the use of these additional drugs?
  • Is the work being performed at your site(s) so safety sensitive that you want to ensure your employees aren’t using other commonly used prescription or over-the-counter/off-the-shelf medications that could affect safety?
  • Is there any indication that abuse of medications or other drugs not tested for in the 5 panel is taking place at your workplace or in the community?
  • Does your Company Policy or Collective Bargaining Agreement accommodate additional drug testing panels?

For some employers, demand to test beyond the 5 panel is coming from international parent organizations applying their policies to their Canadian divisions, or as a requirement for contractors.

What Are The Various Panel Options?

Extended panel testing is available through analytical testing laboratories, or through in-the-field Point of Collection kits (only can be used for employers who are not bound by U.S. Department of Transportation regulations).

There is some confusion in the drug testing industry around what constitutes a 5-panel, 7-panel, 10-panel, and 12-panel drug test:

  • Standard 5-panel: Marijuana, Cocaine, Opiates (Codeine, Morphine, Heroin), PCP (phencyclidine), Amphetamines (Amphetamine, Methamphetamine, Ecstasy)

Beyond the standard 5-panel, and subject to scientific availability from testing laboratories and manufacturers of POCT kits, a number of different substances can be tested for, either contained within the general families of drugs included in the 5-Panel, or derived from new families of substances.  Common examples of these additional drugs include:

  1. Oxycodone (a semi-synthetic Opiate not included in the standard Opiates panel)
  2. Benzodiazepines
  3. Barbiturates
  4. Methadone
  5. Propoxyphene

The 10-panel to 12-panel most often includes the drugs tested for in the standard 5-panel plus some or all of the drugs listed above.

This list is not exhaustive though, and subject to scientific availability, employers can add any number of drug classes to their testing panels. Some employers require a total toxicology screen, which can detect more than 20 drugs and/or drug metabolites, including but not limited to the following medications:

  • Meperidine
  • Diphenhydramine/Dimenhydrinate
  • Phenylpropanolamine
  • Ephedrine/Pseudoephedrine
  • Nortriptyline
  • Desipramine
  • Doxepin
  • Citalopram
  • Topiramate
  • Gabapentin
  • Methylphenidate
  • Phenothiazines
  • Fluoxetine/Norfluoxetine 

For POCTs, are pre-set kits or custom kits recommended?

It depends on the drugs for which you require testing.  Custom kits are generally more expensive.  Pre-determined 10- or 12-panel POCT kits are also effective, but you should review the panels periodically to ensure the drugs you are testing for still exist. The manufacturers create kits based on what they believe are the most commonly misused or abused drugs or medications at the time and occasionally, some test panels become outdated from time to time because some of the drugs or medications may not be manufactured anymore or are no longer available on the street.  One example of this is Propoxyphene – it is no longer manufactured in Canada.

How do laboratories test for drugs beyond the 5 panel?

Where possible, analytical laboratories accredited by the U.S. Department of Health and Human Services (HHS) use the best science available (including immunoassay screening and mass spectrometry confirmation testing) to test for additional drugs, thereby mirroring the gold standard methods used for U.S. DOT’s regulated testing program.

How Much Does Expanded Drug Testing Cost?

Although prices vary between providers, generally the direct cost difference between a 5-panel and an expanded drug panel is relatively small (however, it depends on how many additional drugs you are testing for and whether you are doing lab-based or using POCT kits).

Companies should be aware that there are indirect costs of expanding the testing program.  For example, if testing for additional drugs leads to more non-negative test results, your company will incur more fees for laboratory confirmation and MRO services and you may incur additional wages for replacement workers (assuming your workers are pulled off work after a non-negative test). It will be up to you, the employer, to determine if the benefits outweigh the costs.

If your organization would like to learn more about going beyond the 5-Panel or simply understand the options of workforce drug testing, let us know! Feel free to reach out to us through our contact page or on Twitter @DriverCheckCA!