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Welcome to the OccuNews!
In this issue...
We want to focus on drug testing, and answer some commonly asked questions:
  • What is Medical Review and how does the process work?
  • How are employees trying to cheat drug tests? What can I do about it?

  If you have additional questions about drug screening or criminal background checks, click here to contact us!

Medical Review: The Process of Verifying Positive Drug Screens
You received a positive drug screen result for an employee, now what?

Receiving a positive drug screen result from an applicant or employee's test can create anxiety for an employer. A lot of questions may arise: Are they taking a valid prescription? Are they taking it correctly? What if the applicant says the result is incorrect? Should this result affect the hiring decision?
Fortunately, there is a process in place to protect the employer from making the wrong decision when receiving a positive test result - Medical Review.
Medical Review: The Department of Transportation and some states have specific MRO requirements, but for a majority of states the decision of whether or not have an MRO policy is left to the discretion of the employer.
What is an MRO? A Medical Review Officer is a licensed physician who has special training in substance abuse testing. The MRO is responsible for reviewing results generated by an employer's drug testing program and evaluating the medical explanations of specific test results.
How do you use the MRO process?
In most states, you have an option to either send all positive results directly through medical review, or request medical review when you deem necessary. By sending the results through review, employers remove themselves from making decisions on whether an applicant/employee is taking medically necessary drugs, and is taking them appropriately. Your third party administrator or laboratory will have an MRO available for review of your results.
How the Process Works
The MRO will contact the donor, usually making 3 attempts in 3 days and closing out the report if there is no response. Assuming the donor and MRO connect, the MRO will discuss with the applicant what over-the-counter and prescription medicines the applicant is currently taking. If they are taking prescription drugs, the MRO will request a copy of the prescription to verify the date, the name on the prescription, and drug and dosage prescribed. After receiving this information, if the prescription is valid and correlates with the results, the MRO will report a negative result. If any of those things do not match up, or a valid copy of a prescription is not provided by the applicant, the result will be reported as positive.
Medical Review does carry an additional fee, but is a valuable protection for employers who want to make the best hiring decisions for their organization.

  Questions? Contact us at 888-833-5304

Cheating on a Drug Test (or at least trying!)
When it comes to drug testing, there are always going to be people that try to cheat the system.

Here are some of the common ways applicants or employees try to cheat on their urine drug test, and ways to prevent it.
Diluting the specimen - Donors will either drink a large volume of water prior to the test or add water, products or chemicals to the urine. (Test results will come back "Dilute" and most employers will have the applicant repeat the test.)
Substitution - It has become increasingly common for applicants to sneak in a synthetic urine, or someone else's urine to substitute the specimen. During the chain of custody process the donor is required to empty all pockets, so the substitute specimen may be hidden beneath clothes or taped to the body.
Oxidizing adulterants - According to the Substance Abuse and Mental Health Services Administration (SAMHSA) an oxidizing adulterant is a substance that acts alone or in combination with others to oxidize drugs or drug metabolites in order to prevent detection in the sample. Examples of oxidizing agents are bleach, iodine, peroxide, nitrites and other chemicals which the donor may add to the specimen while in the restroom stall. Lab will report results as "adulterated".
So what is an employer to do?
First, make sure your laboratory is SAMHSA-certified (Occuscreen uses only SAMHSA-certified labs) and that the collection site strictly follows chain of custody procedures to help control the possibility of substitution/adulteration.
Laboratories such as Quest Diagnostics and LabCorp use Specimen Validity Testing to detect substitution, adulteration or dilution, which will disqualify the analysis from being completed.
If you continue to get dilute and adulterated specimens within your applicant or employee pool, consider switching to lab-analyzed oral fluids drug testing.

An oral fluid specimen is collected on-site, witnessed, and sent to the laboratory for analysis. Substituted or adulterated specimens are not an issue as the collection is witnessed by a manager following chain of custody procedures. Consumption of fluids prior to the test does not affect the specimen. The donor is also supervised for 10 minutes prior to the collection and not allowed to drink, eat, chew gum or smoke during that time, to ensure a clean specimen.
If you have concerns about drug test cheating, please contact us with your questions. We are happy to discuss the options with you!

We hope you will let us know if you have additional topics or questions you'd like to see in our quarterly newsletter! Just let us know so we can be helpful. Thank you for your business and support.


Pamela Mack