Workplace Drug Testing Turning Up More Cocaine & Amphetamine Positives
Workplace drug testing cutoff levels changed in 2010.
On October 1, 2010, the U.S. Departments of Transportation (DOT) and Health and Human Services (DHHS) instituted lower initial and confirmation cutoff levels for amphetamines and cocaine, for use in required drug testing of safety-sensitive workers. These include private-sector workers, such as truck and bus drivers, for whom drug testing is mandated by the DOT, as well as federal employees in testing-designated positions. The rules changes also added other substances, such as heroin and ecstasy.
“We all know how devastating a single accident can be when an impaired driver gets behind the wheel,” said Dr. Barry Sample, Director of Science and Technology for Quest Diagnostics Employer Solutions. “The risk to public safety can heighten dramatically when that person is flying the plane we’re boarding, operating the train or bus we take to work, taking our children to school, or transporting the products we buy across the country.”
New workplace drug testing cutoff levels yield increased numbers of positive drug test results.
New data from Quest Diagnostics reveal a 33% jump in positive tests for cocaine in the safety-sensitive workforce. Amphetamines positives among this group also rose by nearly 26%, continuing an existing upward trend. These statistics are based on 1.6 million federally mandated safety-sensitive workforce drug tests performed by Quest Diagnostics between January and December 2011.
After implementation of the new cutoff requirements, cocaine positives for federally mandated safety sensitive workers hit the highest level (0.32%) since 2008 and methamphetamine was the highest (0.14%) since before 2007. This increase suggests the new requirements may have helped identify more than 1,300 additional cocaine positives and more than 1,400 additional amphetamines positives in the 1.6 million federally required safety sensitive tests performed by Quest Diagnostics in 2011.
Grounds for concern about amphetamines and cocaine.
The increase in amphetamines positives likely reflects both an increase in the use of prescribed amphetamine drugs (such as those used in medical treatment for attention deficit hyperactivity disorder, or ADHD) and the lower cutoff in drug testing. Identifying amphetamine use in safety-sensitive positions – whether prescribed or illicit – is important to worker and public safety.
Cocaine and amphetamines (amphetamine and methamphetamine) are stimulants, usually used by safety-sensitive workers to increase alertness and relieve fatigue. Stimulants are also used for euphoric effects or may be used to counteract the “down” feeling of tranquilizers or alcohol. Possible side effects of stimulants include increased heart and respiratory rates, elevated blood pressure, dilated pupils and decreased appetite.
High doses may cause irregular heartbeat, loss of coordination or collapse. Indications of possible misuse may include excessive activity, talkativeness, irritability or nervousness. Amphetamines are derived from a chemical compound that is structurally a sympathomimetic amine, considered a psychostimulant, and approved by the FDA to treat narcolepsy and ADHD. Amphetamines act primarily by triggering the release of norepinephrine, dopamine, and serotonin from presynaptic neurons.
Because of their potential for abuse, they are scheduled by the FDA in the most restrictive classification for a drug with medical usefulness.
Dr. Donna Smith, a principal architect of the regulations for the DOT’s drug and alcohol testing programs during her DOT tenure from 1989-1994 commented on the findings, stating:
Amphetamines, including prescribed medications that also carry a reputation for diversion for illicit use, and cocaine, well known as an illegal drug of abuse, are powerful stimulants. Identifying their use is an important safety issue in the workforce subjected to Federally mandated testing. The Quest Diagnostics data show increased detection of cocaine use not identified by the previous cut-off levels, and increased identification of the use of amphetamines.
Additional findings from Quest drug test data collected between January-December 2011
- Positive test rates for oxycodone from more than 500,000 tests in the general U.S. workforce are 10% higher than in 2010 (1.0% vs. 1.1%) and up 25% since 2007.
- Positive test rates for opiates in the general workforce are up nearly 7.7% from 2010 (0.39% vs. 0.42%) and up 20% since 2007.
- Positive test rates for propoxyphene (Darvon) in the general workforce was down 84.7% from 2010 (0.38% vs. 0.06%). Propoxyphene was pulled off the market in November 2010 because the drug was found to put patients at risk for potentially serious or even fatal heart rhythm abnormalities.
For more information on the Quest Diagnostics Drug Testing Index and the 2011 tables, visit http://www.questdiagnostics.com/employersolutions/drug_testing_index_es.html.
About the Quest Diagnostics Drug Testing Index
The Quest Diagnostics Drug Testing Index is published as a public service for government, media and industry and has been considered a benchmark for national trends since its inception in 1988. It examines positivity rates – the proportion of positive results for each drug to all such drug tests performed – among three major testing populations: federally mandated, safety-sensitive workers; the general workforce; and the combined U.S. workforce.
