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So how is the state of the industry? It is very good and there are many changes and challenges to come.

One thing is certain: drug use and abuse

is not declining. Te most recent statistics from Substance Abuse and Mental Health Services Administration (SAMHSA) annual household survey1


• Overall, the use of illicit drugs— including marijuana—among Americans aged 12 and older increased from 9.4% in 2013 to 10.2% in 2014.

• In 2014, 27.0 million people aged 12 or older used an illicit drug in the past 30 days

• In 2014, roughly 8.4 percent of Americans age 12 and older were current users of marijuana—up from 7.5% in 2013.

• Tere were 139.7 million previous month alcohol drinkers aged 12 or older in 2014, including 60.9 million who were binge alcohol users and 16.3 million who were heavy alcohol users According to a new market report

published by Transparency Market Research, “Drugs of Abuse Testing Market (Sample Based Testing—Urine, Saliva and Hair Onsite and laboratory Testing)—Global Industry Analysis, Size, Share, Growth, Trends and Forecast, 2013–2018,”2

the global drugs of

abuse testing market was valued at USD 2.6 billion in 2012 and is expected to grow to reach an estimated value of USD 3.4 billion in 2018. Te report stated “[t]his rise in the consumption of illicit drugs has led to the demand for drugs of abuse testing. Testing of drugs of abuse can be done at home, educational institutions, or workplace, or at the laboratory using many superior

44 datia focus

techniques to achieve accurate results.” Te market research report also stated that urine is the largest specimen sample segment and it is projected to continue to grow. Mergers and acquisitions continue to be

the norm in our industry. In 2012, LabCorp completed the acquisition of MEDTOX Scientific, Inc. Also in 2012, eScreen merged with Pembrooke Occupational Health and soon aſterward eScreen was purchased by Alere. In 2014, Bode Technology Group, Inc. and its division Chromosomal Labs (DNA identification testing) became a wholly-owned subsidiary of LabCorp. DISA Global Solutions has acquired University Services an MRO service formally run Dr. Benjamin Gerson. In February of this year, Abbot Laboratories agreed to buy Alere for $5.8 billion. On the TPA side, WorkforceQA out of Salt Lake City, Utah has made several acquisitions and mergers over the last few years including Employers Drug Program Management (EDPM), Interactive Medical Connections (IMC), Compliance Safety Systems (CSS) and Intermountain MRO Services (IMRO). As the Loreta Lynn song goes, “We’ve

Come a Long Way Baby.” Early on, urine drug testing at laboratories was the dominant specimen type and testing methodology. Today there are many testing types and methodologies. While urine testing at a laboratory is still by far the most recognized type of testing, instant testing with urine or oral fluid, hair follicle testing, and oral fluid testing at a laboratory are now common methods used in workplace drug testing. Instant drug testing devices are currently

used by employers at their places of business throughout the United States; they are also used at many collection sites. Oſten referred to as rapid testing or point of collection testing (POCT), this testing methodology can reveal negative drug test results in about five minutes, which enables employers to get applicants on the job and existing employees back to work more quickly. Specimens producing non-negative

results should be sent to a laboratory for confirmation testing and then review and verification by a certified medical review officer (MRO); failure to do this may place the employer at risk for potential legal action if they have taken adverse action against an applicant or employee based on the instant non-negative result alone. Both drug testing collection sites and employers should use caution when choosing which instant testing devices they utilize; it is very important that they are approved by the U.S. Food and Drug Administration (FDA) for workplace testing. Te FDA clearance process includes a detail of the appropriate procedures for the use of instant testing devices including the requirement of sending non-negative initial screens to the laboratory for confirmatory testing. Hair follicle testing is becoming

increasingly popular. In fact, several large trucking companies are now performing hair follicle testing in an addition to the DOT required 5-panel urine lab based testing. Other industries that have embraced hair testing include oil and gas, gaming and auto manufacturing. Hair testing has an approximate 90-day look back period and is difficult for donors to to cheat or adulterate. Laboratories have increased the menu of panels available for hair testing beyond the typical 5-panel hair test that was previously available. Expanded opiate testing is now available for hair, and some laboratories are offering hair testing for additional drugs panels including: Benzodiazepines, Barbiturates, Methadone, Propoxyphene, Meperidine, Tramadol, Fentanyl and others. In the near future, hair follicle testing may

be allowed in the DOT mandated drug and alcohol testing program. In December of 2015, Congress passed legislation known as ‘‘Fixing America’s Surface Transportation Act’’ or the ‘‘FAST Act.’’ With this legislation, hair testing has been authorized in conducting DOT pre-employment testing for use of a controlled substance and DOT random testing for the use of a

summer 2016

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