Page 20 - OHS, March 2020

DRUG TESTING
An Overview of SAMHSA’s New Oral Fluid Testing Guidelines
SAMHSA’s mandatory guidelines have served as the blueprint for many state drug testing laws and policies since 1988. But new methods for oral fluids testing will mean big changes.
BY JACKIE PIRONE
Workplace drug testing may never be the same. After 30 years of only permitting lab-based urine testing, the Substance Abuse and Mental Health Services Ad- ministration (SAMHSA) published its final Manda- tory Guidelines for Federal Workplace Drug Testing Programs using Oral Fluid on Oct. 25, 2019 in the Federal Register. The new regulations only apply to federal workplaces, at this time, but the impact is sure to reach beyond the initial scope of the regulations.
Consider this: SAMHSA’s mandatory guidelines have served as the blueprint for many state drug test- ing laws, corporate drug testing policies, and the le- gal argument for how to drug test the right way since the original guidelines were published in 1988. Even though alternative testing methods—including hair testing, instant-result devices, and, yes, lab-based oral fluid testing—have been around for many years, they have not put a significant dent in the market share of lab-based urine testing in the workplace. According to SAMHSA, that’s about to change.
In the original Notice of Proposed Rulemaking (NPRM) for oral fluid testing, as well as in the final regulatory language made public in October 2019, SAMHSA projected that about seven percent of fed- eral drug tests would transition from urine to oral fluid in the first year. Furthermore, the agency pre- dicted that in four years, 25 to 30 percent of all federal workplace drug tests would be conducted utilizing oral fluid. But if that was all, the overall impact of the Oral Fluid Mandatory Guidelines (OFMG) on the drug testing industry would be minimal, at best.
However, SAMHSA also predicted the same tran- sition rate for the drug tests mandated by the U.S. De-
partment of Transportation (DOT) (approximately 6 million annually) and the Nuclear Regulatory Com- mission (NRC) (about 155,000 per year). Projecting a 25 to 30 percent transition rate for DOT and NRC represents a significant impact on the industry.
But what about the approximately 40 million workplace drug tests not regulated by the federal gov- ernment? If we realize the same transition rate, which is well within the realm of possibility, we suddenly have a fundamentally transformed drug testing in- dustry. This is just in time as state after state not only legalizes marijuana but also looks to place restrictions on employers’ rights to test for THC and/or hold ap- plicants and employees accountable when they test positive.
The chief argument behind most of these legal ac- tions is the inability to claim someone is “impaired” solely based on the result from a drug test with a win- dow of detection of days or weeks. Oral fluid, with its tighter window of detection (think hours rather than days), gives an almost immediate result that would show a person’s peak levels of intoxication at the time of the test on the job. It’s a faster approach for more timely results.
But let’s not get ahead of ourselves. SAMHSA be- gan teasing providers and employers years before the marijuana legalization movement really took off. The dedicated staff and experts at SAMHSA and the Drug Testing Advisory Board, as well as the all-star teams at DOT and NRC, deserve a tremendous amount of credit for patiently resolving every concern from within and outside the government and persevering long enough to finally issue regulations for a com- pletely different drug testing method. While these new guidelines are not a direct response to what’s hap- pening with marijuana laws across the country, they do align well with the controversial trend toward full legalization.
So, if these new regulations are not the federal government’s response to legalization, then why did SAMHSA spend years on this project? Why after 30 years did an agency not known for change or flex- ibility (no offense intended), suddenly turn an entire industry on its head? There were actually many good reasons, but three seem to stand out the most: com- batting adulteration, cutting the time and costs of a typical drug test, and the science of the technology behind lab-based oral fluid testing.
14 Occupational Health & Safety | MARCH 2020
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