Positive Drug Tests for Cocaine, Amphetamine Increase Among High-Risk Workers

New, more rigorous government drug testing rules with lower cutoffs appear to have led to an increase in positive cocaine and amphetamine testing in the safety-sensitive, or high risk, work force, according to data from Quest Diagnostics.

The findings, based on 1.6 million federally mandated, safety-sensitive work force drug tests completed by Quest Diagnostics between January and December 2011, reveal a 33-percent increase in cocaine positives and a 26-percent increase in amphetamines positives among safety-sensitive workers.

"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 Cutoff Requirements

On Oct. 1, 2010, the U.S. Department of Transportation (DOT) harmonized with the U.S. Department of Health and Human Services' (DHHS) decision to institute lower initial and confirmation cutoff levels for amphetamines and cocaine, and added other substances including heroin and ecstasy, to the required drug testing panel. Workers subject to these new requirements include private-sector workers for whom routine drug testing is mandated by the DOT as well as those federal employees in testing-designated positions.

After the implementation of the new cutoff requirements, federally mandated safety sensitive workers tested positive for cocaine at the highest level (0.32 percent) since 2008 and methamphetamine positivity was at the highest level (0.14 percent) since prior to 2007. This increase suggests that the new requirements may have played a role in identifying more than 1,300 additional cocaine positives and more than 1,400 additional amphetamines positives in Quest's federally mandated safety sensitive tests performed in 2011.

Cocaine and amphetamines (amphetamine and methamphetamine) are stimulants, typically used to increase alertness and relieve fatigue. Stimulants also are 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.

"Our data suggest that new federal requirements may be helping employers ensure that the workers they put behind the wheel are those ready to perform their duties safely," added Sample.

General Work Force Findings

Key findings from the Drug Testing Index data concerning the general U.S. work force include:

· Amphetamines positives are up 16.7 percent from 2010 and up 75 percent since 2007.
· Cocaine positivity is up 8 percent from 2010 in the general work force, also partially driven by some private sector employers adopting the new federal standard.
· Positivity rates for oxycodone from more than 500,000 tests in the general U.S. work force are 10 percent higher than in 2010 and up 25 percent since 2007.
· Positivity for opiates in the general work force is up nearly 7.7 percent from 2010 and up 20 percent since 2007.
· Positivity for propoxyphene in the general work force was down 84.7 percent from 2010. (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/home/physicians/health-trends/drug-testing.

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