AOCOPM 2024 Midyear Educational Conference-346719

346719 - Article 20

Pdf Summary

The document, authored by James L. Ferguson, D.O., DFASAM, dives into recent and ongoing changes in the drug testing guidelines regulated by the Department of Health and Human Services (HHS) and the Department of Transportation (DOT). As part of its objectives, the document highlights the understanding of regulatory changes in drug testing, including those affecting Medical Review Officers (MROs), and contrasts forensic and clinical testing for substance misuse.<br /><br />Changes have been made to the testing panels, such as the inclusion of specific opioids and MDMA/MDA as analytes. Moreover, the DOT has issued conformity with HHS guidelines but has unique protocols, requiring public feedback before adopting conforming regulations.<br /><br />Significant new protocols include the handling of safety notifications related to prescription drugs during the testing process, which now allows MRO staff to contact pharmacies for verification. The handling of oral fluid as a sample type for testing has undergone procedural updates despite ongoing delays due to FDA clearance. Moreover, the SAMHSA has proposed mandatory guidelines for hair testing, which are pending implementation.<br /><br />Notably, big picture changes in opioid cutoff levels have been established for urine and oral fluid testing to better identify unauthorized usage. These include streamlined procedures for dealing with shy bladder and dry mouth scenarios, recommending alternative specimen collection methods. MROs must navigate these changes with discrete procedures for reporting and liaising with employers concerning drug safety issues.<br /><br />The document concludes with practical advice for MROs, emphasizing the importance of understanding these complex changes, establishing solid operational protocols, and fostering confidence through ongoing learning and adaptation. It offers resources for further education and suggests setting up systems for communication and compliance with employers.

Keywords

drug testing guidelines

Department of Health and Human Services

Department of Transportation

Medical Review Officers

forensic vs clinical testing

opioids and MDMA/MDA

safety notifications

oral fluid testing

hair testing guidelines

opioid cutoff levels