Richard Evers. Research and Development Manager, Synergy Health. The Workplace War on Drugs: Historical and Modern Warfare

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1 Richard Evers Research and Development Manager, Synergy Health The Workplace War on Drugs: Historical and Modern Warfare

2 History of the War on Drugs + Origins of Workplace Drug Testing + SAMHSA + Drug Testing in the United Kingdom + Parliamentary Report/Statistics + Opiates + Legal Highs

3 The War on Drugs + Nixon Administration Slogan in Drug Abuse Prevention and Control Act + Repealed mandatory minimum sentences for cannabis possession + Began Federal Demand Reduction programs + Drug Treatment Programs + Appointed first Drug Czar (Robert DuPont) Drug Enforcement Administration formed

4 Vietnam + US military begins drug testing (Nixon, July 1971) for rehabilitation after tours of duty DoD amnesty program results in 16,000 soldiers admitting a problem + September 1971 survey of returning soldiers: % of military had used heroin, opium, speed or barbiturates + Heroin was constantly and universally available + April 1974 Random testing

5 USS Nimitz + 26 th May 1981 off coast of Florida + EA6B Prowler surveillance aircraft crashed on landing + 14 dead, 45 injured + 3 planes destroyed, 9 damaged + Cost $150,000,000 + Flight crew tested positive for cannabis

6 President Reagan + December Authorised punitive action on results of drug tests + Just Say No (1986) + Executive order th September Drug Free Federal Workplace

7 Chase, Maryland + 4 th January Conrail engines passed a signal and moved onto the main line, then stopped + Amtrak train 94 filled with holidaymakers hit the Conrail train at 108mph + 16 dead and many injured + Conrail drivers were smoking cannabis in the cab + Congress approves Random drug testing

8 Exxon Valdez + 24 th March 1989, Prince William Sound, Alaska + 11,000,000 barrels of oil, largest in the US (until Deepwater Horizon) + Multiple causes + Failed radar system + Short staff + Excessive hours + Captain accused of being alcoholic + Blood Alcohol 10 hours after collision was No preservative used

9 Drug Testing Legislation Mandatory Guidelines for Federal Workplace Drug Testing Programs (1988) +Scientific and Technical Requirements +Certification of Laboratories Model Plan for a Comprehensive Drug-Free Workplace Program (1989) +Specifies Cocaine, Marijuana (cannabis), Opiates, Amphetamines and PCP

10 SAMHSA Substance Abuse and Mental Health Services Administration +NIDA National Institute on Drug Abuse + Drug research facility +Responsible for the Federal Workplace testing programs +Promotes rehabilitation and Employee Assistance Programs

11 Staten Island Ferry, Ferry hit pier at full speed + 11 killed + 71 injured + Pilot taking Tramadol + Damage to victims in excess of $54m + Ferry Director imprisoned for 366 days

12 San Francisco Bay Bridge, M/V Cosco Busan hit the pier in fog + 53,500 gallons of fuel oil spilt + $3.6m repair bill + $70m environmental clean-up + Pilot tested BEFORE accident and negative for SAMHSA 5 and Alcohol + Pilot was taking: - + Lorazepam, Diazepam, Modafilin, Propoxyphene, Hydrocodone and Pentazocine (narcotic analgesic)

13 Eltham Well Hall + 11 th June Eltham, South London + Curve (20mph speed limit) taken at 65mph + Driver and 6 passengers killed, 126 injured + Driver BAC 2.78 (probably drinking in cab)

14 Cannon Street + 8 th January :58 from Sevenoaks + Commuter train failed to stop + Hit buffers at 10mph + 2 killed, 524 injured + Causes + Old train carriages + Driver had cannabis in his system

15 Transport and Works Act Safety of Railways etc. + Simpler route to parliamentary approval of major projects + Part 1, Chapter 1 + Introduced drink and drugs legislation to the railways

16 UK Legislation + Misuse of Drugs Act (1971) + Class A, B and C drugs + Criminal Justice treatment of drugs + Misuse of Drugs Regulations (1985 and 2001) + Schedules I to V + Healthcare requirements for drugs

17 UK Laboratory Guidelines for Workplace Drug Testing (2001) + Prepared by laboratories, taking comments from: - + Suppliers + Regulatory Bodies, and + Key Clients (HM Prisons, Railtrack) + Defined processes still followed today + Followed by EU Guidelines in 2002

18 UK Reports + Drug Testing on Trial (2003) + All Party Parliamentary Drug Misuse Group + 6 officers including David Cameron MP + Drug Testing in the Workplace (2004) + Independent enquiry + Drugscope + Joseph Rowntree Foundation + New Economics Foundation

19 UK Guidelines + Wider range of drugs + Dihydrocodeine + LSD + Methaqualone + Benzodiazepines + Barbiturates + Methadone + Buprenorphine + Allows use of LC-MS + Less proscriptive + Not backed by the law

20 Standard Tests + Synergy Health UDS3 drug screen + Opiates + Amphetamines + Cocaine + Benzodiazepines + Cannabis + Barbiturates + Methadone + Tests for the principle abused drugs in the UK at this time

21 Reasonable suspicion?

22 M5 coach crash, March Driver parked coach in the slow lane after breaking down + Coach hit by lorry at 54mph + 2 dead, 39 injured + Roadside breath test 46µg/100mL + Evidential breathalyser 2 hours later below the limit + Drink-drive conviction 12 years ago after falling asleep and crashing bus

23 Drug Use in the UK + British Crime Survey + Lifetime Cannabis use ~ 35% + Last month Cannabis use + Lifetime use of Class A drugs

24 Opiates + Heroin + Morphine + Codeine and Dihydrocodeine + Poppy seeds US SAMHSA raised opiate cut-off from 300 to 2,000ng/ML + Reduced number of false positive opiate results + SAMHSA Guidelines on opiate use + Familial use + MRO results on codeine

25 Poppy Seeds + Determination of metabolites of poppy seeds + Noscapine + Papaverine + Thebaine

26 Changing Drug Use + Barbiturates + Buprenorphine + Ketamine + Legal Highs + Steroids

27 The changing face of medicine + Non-opiate painkillers + Propoxyphene + Oxycodone + Tramadol + Fentanyl + Heroin rehabilitation treatment + Reduced number of false positive opiate results + Buprenorphine + Tranquillisers + Barbiturate use down + Benzodiazepine use up

28 Spice JWH Synthetic Cannabis + Increasing popular in prisons as it avoids drug tests

29 Mephedrone Huge press publicity + Several deaths attributed to miaow miaow + Classified by the Home Office in 2010

30 Novel Psychoactive Substances new substances detected in new substances by April Very difficult for labs to keep up with users + Drug Identification + Reference materials + Immunoassays + How can policies be worded to include these substances

31 Synergy Health Routine Drug Screen (2014) + Remove Barbiturates + Add Ketamine and Buprenorphine + Other drugs by request + Anabolic Steroids + Legal Highs + Specified drugs + Tramadol + PCP + LSD + Methaqualone + Barbiturates

32 Thank you for listening Are there any questions?