Origination Date: October 7, 2011 Revision Date: Release Authorized by: Danny Trahan, Safety Director June 2012 Manual Rev 4 TEST ADMINISTRATOR’S GUIDE SECTION I 1. The purpose of the Substance Abuse Prevention Program is to have a drug-free and therefore safe workplace for our employees. 2. This guide provides general information that should be helpful as you begin substance abuse testing at your site/facility as required by your substance abuse prevention program. 3. There are legal ramifications in many areas of substance abuse testing. Testing technology and laws are changing rapidly. 4. This guide is not all-inclusive, so you may have questions that are not covered here. If so, contact P2S HSE Substance Abuse Prevention Program Administrator Kendra Winchester (225) 202-5747. SUBSTANCE ABUSE PREVENTION PROGRAM MANUAL A Substance Abuse Program is mandatory for all P2S sites/facilities. The Substance Abuse Prevention Program Manual is your textbook for drug testing at your location. If you read it carefully, you will find answers to most of your questions. Like all high level manuals, this is a management document. Keep it in your office or other secure area. Let other designated managers become familiar with it, such as the site personnel/Human Resources (HR) Manager and the site HSE Representative. These persons may be helping to implement and carry out the program with you. If you have a question about the manual or a question for which the manual does not give an answer, call the P2S HSE Substance Abuse Administrator before acting. Remember the Substance Abuse Prevention Program is site specific and cannot be carried from one site to another. STATEMENT OF POLICY FOR APPLICATIONS This statement should be attached to or a part of applications for new hires. This statement notifies applicants that they will be drug tested if an offer of employment is made to them. Some may read it and leave knowing they cannot pass such a test. We are letting potential employees know what we expect of them and of our commitment to a drug-free and safe worksite. This statement does not need to be signed by anyone. STATEMENT OF UNDERSTANDING / SITE LETTER All employees and candidates for hire are to be informed that P2S is a drug–free workplace. All employees who are within the scope of Policy HR-1505 will be required to sign a Statement of Understanding acknowledging their agreement to abide by the terms and conditions of policy. CONSENT TO URINALYSIS This form is a legal document that records identification of the subject about to be tested. P2S Health, Safety & Environmental Copyright © 2012, P2S. All Rights Reserved Page 1 Origination Date: October 7, 2011 Revision Date: Release Authorized by: Danny Trahan, Safety Director June 2012 Manual Rev 4 Under no circumstances should a test subject be asked about medications prior to a test. Only if the results are confirmed non-negative by a SAMSHA-certified laboratory, may the subject be questioned about what he/she has been taking, and then only about drugs in the category in which the sample tested non-negative. The consent form, Chain of Custody documentation, and the test results should be kept in a separate, secure file with limited access. FOR CAUSE OR REASONABLE SUSPICION The decision to test for cause or reasonable suspicion is based on supervisor observation. Should an employee be suspected of being under the influence of drugs or alcohol, a Description of Suspicious Behavior Form should be completed. This form requires the signatures of 2 supervisors or 2 members of the site. The description must be based on observed signs and not by hearsay or rumor. Always keep in mind: the behavior that raises suspicion should present itself in the workplace and/or affect the work of the employee. SECTION II ALERE QUICK TEST GUIDELINES FOR SAMPLE COLLECTION This section is for the persons designated to perform the collection of samples for testing at your site. You should designate at least 2 such people. Make sure that all such designated persons are trained, certified, and thoroughly familiar with the entire process. This is an important procedure and mistakes can lead to liability. The important thing is to take one’s time in filling out the documentation and to take the subjects one at a time through the entire process before starting on the next subject. Any questions about this should be directed to the P2S HSE Substance Abuse Administrator, Kendra Winchester (225) 202-5747. Should you use a clinic or other outside source for collection, be sure that those persons are familiar with P2S’s policies, practices, procedures, and HSE forms, laboratory forms, and DOT Urine Specimens Collection Guidelines. Outside sample collections should be arranged through the P2S HSE Substance Abuse Administrator, Kendra Winchester (225) 202-5747. Strict procedures must be followed in the collection of urine samples in order to ensure the integrity of the sample and to provide an accurate and legal chain of custody. These procedures prevent mix-ups, tampering, and misplaced documentation. The documentation furnished by the approved testing laboratory may vary in some small details, but the principles are the same. GENERAL Before any collection can be made, the site or collection location must have a site specific Substance Abuse Prevention Program that has been developed and approved by the P2S HSE Substance Abuse Administrator. Any other testing is against corporate policy. Each location must designate a restroom facility that will be used for urine specimen collection. It is not necessary to set aside facilities exclusively for collection, but the designated facilities should be the only place collection is performed. The facility should provide privacy as well as P2S Health, Safety & Environmental Copyright © 2012, P2S. All Rights Reserved Page 2 Origination Date: October 7, 2011 Revision Date: Release Authorized by: Danny Trahan, Safety Director June 2012 Manual Rev 4 security against tampering. A bluing agent should be placed in the bowl, and water in faucets, etc., turned off during testing. The facility should be free of bleach, cleaning agents and other material that could be used to dilute or alter a sample. Regular inspections of the designated facilities must be made to prevent the presence of such material. The facility should also be in close proximity to the area where documentation will be completed. TRAINING P2S’s illicit substance and alcohol abuse awareness training program provides management, supervisors, and employee’s education on the dangers of drug and alcohol abuse, drug identification, symptoms and methods of drug and alcohol use. It also provides information on P2S’s policies and procedures concerning drug and alcohol abuse in the workplace and penalties to be imposed for violation of the policy. The training program emphasizes the practical factors in dealing with substance abuse and the available substance abuse counseling, rehabilitation, and employee assistance programs. This training program is for field project site management and supervisors and is highly encouraged for all field project employees. BEFORE TESTING Subjects to be tested should be individually directed to the collection area. The collection process requires strict concentration and sequential procedures. Trying to deal with several subjects simultaneously leads to confusion and may result in mishandling of samples. Therefore, the entire collection process must be completed for each subject before proceeding with the next subject. COLLECTION PROCEDURE Collection Facility – Adhere to DOT Guidelines On Site Testing – Follow Laboratory Procedure 1. With the subject, review the Consent to Urinalysis and Chain of Custody (COC) Form. Complete the identification information at the top. 2. Have the subject provide picture identification. This prevents any attempt to have a “clean” person give a sample in place of the proper person. This should be accomplished by driver’s license, state ID card, or company ID card. For employees being tested for random or for-cause testing, the supervisor’s identification of the subject will be sufficient if other identification is not available. 3. Collector completes Section C (Name/I.D.) on the chain of custody form by writing in the subject’s last name, first name and job number in available spaces. P2S Health, Safety & Environmental Copyright © 2012, P2S. All Rights Reserved Page 3 Origination Date: October 7, 2011 Revision Date: Release Authorized by: Danny Trahan, Safety Director June 2012 Manual Rev 4 4. Collector completes Section D (Donor SSN or Employee ID No.) with social security number. 5. Collector completes Section E by checking the reason for the test. 6. Subject completes Step 5. 7. Subject’s outer garments and personal belongings are to be left outside collection area. Wallet may be retained. 8. Instruct subject to wash hands before collection. 9. Open the quick screen collection kit in front of the subject and give it to the subject. No personal observation should be made during the process unless the first sample is suspected to be tampered with; and then only indirect observation is allowed. The two possible reasons for indirect observation are: temperature is not in the acceptable range or the test results show low specific gravity or low creatinine. If indirect observation is necessary, ALWAYS have subject and observer of the same sex. Make sure that the subject takes no personal belongings into the stall, such as purse, lunchbox, etc. Make a visual search of the subject before they enter the facility to see if there are any bottles, etc., on them. Ask the subject to empty the pockets before going to the facility. The subject must retain possession of his/her wallet. Accompany the subject to the facility. 10. Have the subject provide a sufficient sample of at least 60 ml into the calibrated collection container with temperature strip. 11. Check specimen temperature and record results in Step 2, acceptable range 90-100° F 32°/38°C. 12. In full view of the subject, collector places the security seal over the top and down both sides of each specimen bottle. 13. Instruct subject to date and initial the security seal that have been affixed to the specimen bottle. (Refer to your respective laboratory’s instructions for this). Complete the Laboratory Order Form/Chain of Custody form. Extreme care must be taken to assure that all required information is completed and correct. Mixed-up social security numbers, an omitted signature, etc., will result in a rejection of the sample by the laboratory. 14. If on site testing procedures are to be done, adhere to strict guidelines provided by the Laboratory Product being used for testing. 15. If on site collection is being performed, adhere to DOT Collection Guidelines. If the test result is NEGATIVE: Fax the chain of custody to the P2S HSE Substance Abuse Administrator Kendra Winchester Fax: (225)-753-1462. Discard specimen. P2S Health, Safety & Environmental Copyright © 2012, P2S. All Rights Reserved Page 4 Origination Date: October 7, 2011 Revision Date: Release Authorized by: Danny Trahan, Safety Director June 2012 Manual Rev 4 Mail original to Kendra Winchester, 456 Highlandia Drive, Baton Rouge, LA 70810. If the test results are NON-NEGATIVE: Place the original chain of custody form and the sealed sample into the biohazard bag for transport to the laboratory via express transport. Place the biohazard bag in the box and then place the box in the Fed Ex Clinical Pak with pre-printed laboratory labels for overnight delivery. Drop off at the nearest Fed Ex collection site or call Fed Ex for pick up. Fax a copy of the paperwork immediately to Kendra Winchester Fax: (225) 753-1462 or email to Kendra.winchester@p2sworld.com and Kathy.bradley@p2sworld.com so results can be monitored. Note: Under no circumstances should you ask the subject about medication he/she may be taking before the drug test. Note any medication information provided by the employee voluntarily should be listed in the Remarks section of the chain of custody form. Send all documentation to HSE Substance Abuse Administrator, Kendra Winchester, for file retention after faxing. This information is not for general access. In the event of a confirmed non-negative result, the employee should be offered the opportunity to explain the non-negative results, identifying any drug he/she has taken that are in the same category of the non-negative result. SECTION III GENERAL SUBSTANCE ABUSE SCREENING INFORMATION Who is subject to substance abuse screening on my job? At P2S, all employees, both hourly and salaried, are subject to the drug testing requirements on your job. Temporary employees furnished by an agency are to be tested before coming to work for P2S. Contractor/subcontractor employees are also subject to testing. When do I test new hires? It is P2S’s preference to have all individuals screened and negative results received before access to P2S or Client property. Do salaried transfers get a drug test? Salaried transfers will be tested before their transfer to your job site if there is no drug screen performed in the last 90 days. If a transfer fails the drug test, the transfer will not be made. All testing must comply with corporate policy. P2S Health, Safety & Environmental Copyright © 2012, P2S. All Rights Reserved Page 5 Origination Date: October 7, 2011 Revision Date: Release Authorized by: Danny Trahan, Safety Director June 2012 Manual Rev 4 What if an hourly employee is promoted to a salaried position? All candidates for hire to a salaried position in P2S are to be chemically screened before the actual hiring can be done. Since hourly employees are terminated then hired as salaried, they must be screened before the change in status can be effective. This also works the same way from salaried to craft positions. What if the subject says he or she can’t void at the appointed time? The test is a requirement for employment. Should someone indicate inability to void at the specified time, have them wait in the office area where they can be observed. Let them drink water (no more than 3 8-ounce glasses within a 3-hour period. Usually within an hour or two the person will be able to void. If an acceptable sample cannot be obtained by the sites documented time limit, testing must cease, and the HSE Substance Abuse Administrator (Kendra Winchester (225) 202-5747 must be notified. The HSE Substance Abuse Administrator or Safety Manager must direct the employee to obtain, within 5 working days, an evaluation from a licensed physician who has expertise in the medical issues raised by the employee’s failure to provide a sufficient specimen. If the referring physician determines a medical condition precluded, or probably precluded, the employee from providing a sufficient amount of urine, the test must be cancelled. If the referring physician does not determine a medical condition interfered with the provision of a sufficient amount of urine, this is considered a refusal to test. Any questions concerning this issue should be addressed with the HSE Substance Abuse Administrator. Who should confront an employee with a non-negative result? On P2S project sites, non-negative results are reviewed by the P2S Medical Review Officer. The MRO must determine whether there is a legitimate medical explanation for the confirmed positive, adulterated, substituted, or invalid test results. The MRO must conduct a verification interview with the employee. The MRO is also responsible for informing the employee of his/her right to have the specimen retested. The MRO may communicate test results directly to the employer. The MRO who transmits the results to the employer must ensure the security and limited access to the transmission. The HSE Substance Abuse Administrator is the person for MRO to contact. The results are a confidential document and should be kept in a secure location. Human Resources will be notified of any confirmed positive results which will result in termination and removal of employee from the jobsite (to be coordinated confidentially between Human Resources, Safety, and Site Upper Management). What if the person denies ever taking drugs? We have confidence in the laboratories we use for our drug testing. A drug test is not a determinant of whether someone is an addict or user; it is a determinant of whether the individual has certain detectable levels of drugs in his/her system. Using the laboratory methods we require, we have never had a result proven erroneous. As long as there was no mix-up of the sample before getting to the lab, we will stand behind the results. The employee does, however, have a right to appeal results and/or have specimen retested. P2S Health, Safety & Environmental Copyright © 2012, P2S. All Rights Reserved Page 6 Origination Date: October 7, 2011 Revision Date: Release Authorized by: Danny Trahan, Safety Director June 2012 Manual Rev 4 Do “over-the-counter” drugs show up on the drug test? Some may show up on the initial screen, but very few will affect the GC/MS confirmation. However, in some people, antihistamines may indicate a non-negative for amphetamines. This is because some nasal sprays contain small amounts of amphetamine. Heavy use may ingest the system with sufficient amphetamine to show non-negative. In seasons conducive to colds and flu, pay close attention to the cold medication that the subject may be taking, even if it is a nonprescription drug. Also, some non-prescription drugs may contain amounts of barbiturates such as Primatene tablets containing Phenobarbital. These may show up on confirmation as non-negative. Call P2S HSE Substance Abuse Administrator if you are at all unsure. Does cocaine used in mouth and nose surgery show up on a drug test? This is very possible, especially if the surgery is just before the drug test (2-3 days). While no one can legally have a prescription for cocaine, it is used as a packing for nasal and mouth surgery to stop blood flow when stitches are impractical. The cocaine enters the bloodstream and will show up if the person is tested within 2-3 days of the packing. This is why the MRO asks the subject, if they have visited a physician or dentist in recent weeks. If so, and the drug shows on the test, the person will be given an opportunity to bring a statement from the doctor or dentist that sets forth the medication given for MRO review. What termination codes do I use? For failing a chemical-screening test or refusing to take a required test or to submit to a search use Code FCS. What is the difference between an hourly employee failing and a salaried employee failing? All salaried employees who fail a drug test are entitled to the services of the company Employee Assistance Program (EAP) as an alternative to termination. This should be handled by your field HR representative or Corporate HR if a field representative is not available. If they choose to get help from the EAP, they may be removed from your job but not from the company. If an hourly worker fails a drug test, he/she will be terminated. There will be no exceptions. However, he/she is entitled to the services of the EAP and may apply for a period of up to 30 days from date of termination. The hourly worker may reapply with the company after 90 days for first offense. What do I do if an hourly worker comes and asks for drug abuse help before failing a drug test? P2S HSE wants to help employees as much as possible. If an hourly worker asks for help before submitting a sample for testing, the site supervisor or site HR Representative should contact Corporate HR and/or Legal for guidance before discussing with the employee or directing the employee to EAP. The employee may not be able to continue work while receiving help, but if possible, allow him/her to work. If not, allow the employee to voluntarily quit for personal reasons. If P2S Health, Safety & Environmental Copyright © 2012, P2S. All Rights Reserved Page 7 Origination Date: October 7, 2011 Revision Date: Release Authorized by: Danny Trahan, Safety Director June 2012 Manual Rev 4 the employee is successful in fighting the problem, hire him/her back if you have a position available. This does not apply to employees who have already taken a drug test or been notified they are selected for a random test. If an employee is terminated for failing a drug test, is he/she eligible for unemployment compensation? Laws vary from state to state. All inquiries of this nature should be directed to Corporate Human Resources for further action. If an employee fails a drug test, will he/she be eligible for rehire? The employee will be eligible for re-hire with P2S after 90 days for first offense, but not necessarily at the same site. Some clients do not allow rehiring of an employee who has failed a drug test at that site. If your client has no policy on that, P2S policy states that any employee who fails a substance abuse screening test may reapply in 90 days for first offense. That means you must let the person reapply, but does not mean you must rehire the person. He or she must be considered as are other applicants and the most qualified applicant hired. Other considerations would include the Nuclear Regulatory Commission rule that will not allow anyone who has failed a drug test to work at an operating nuclear site for 5 years or sites who use consortiums (DISA, ASAP, NASAP, etc.) who mandate rehabilitation requirements. If you are unsure as to any such requirements at your site, call the P2S HSE Substance Abuse Administrator. Multiple offenses require longer suspension requirements. What happens if an employee quits work before the test results are received? If the test was random or done because of suspicion, the termination will be governed by the results of the test. Likewise, if an employee quits before a random test or a test “for cause,” the termination will depend on whether the employee knew he/she was about to be tested. If the employee knows of the test, then quits, the employee will be terminated for refusal to submit to substance abuse screening (Code FCS). If, however, the employee does not know of the impending test, the voluntary quit will stand. If an employee takes a test for any reason and then quits before the results are completed, they will be considered FCS only upon an MRO confirmed positive result. What if an employee or applicant tests non-negative for a prescription drug and the prescription is in someone else’s name? If an applicant or employee produces a prescription that is in someone else’s name, or tells you “I took one of my wife’s pills,” the test will be considered non-negative. Only if the applicant/employee has a “legitimate medical reason” (backed up by a doctor’s statement saying the doctor approved him/her taking his wife’s prescription before the test, for example) will the result be considered negative. This is an area that should be handled carefully. If you have questions or need assistance, call P2S HSE Substance Abuse Administrator. P2S Health, Safety & Environmental Copyright © 2012, P2S. All Rights Reserved Page 8 Origination Date: October 7, 2011 Revision Date: Release Authorized by: Danny Trahan, Safety Director June 2012 Manual Rev 4 What if an employee has a prescription for a drug that might affect his ability to perform his job safely? Should any employee have a prescription for any barbiturate, benzodiazepine, or opiate, HSE/HR should discuss with the employee the potential effect of the drug at work and, if necessary, have the employee provide a note from the prescribing physician stating that, in his/her opinion, it is safe for the employee to work construction while taking the particular drug. This is a safety precaution in that even properly prescribed and used drugs may adversely affect a worker in the construction field. What if an employee’s sample indicates low specific gravity? Should any employee’s test results be returned with a low specific gravity reading, a second sample should be obtained and should be taken under indirect observation. Also, ask the employee if they are taking any prescription diuretics or have any medical problems that would result in a low specific gravity specimen. Note: Direct observation is prohibited unless mandated by a consortium or DOT screening. Prohibited conduct includes, but is not limited to: The manufacture, possession, distribution, selling, concealment, or use of illicit substances while at work, while on company or client property, or when operating company equipment or vehicles (including leased or rented vehicles). The manufacture, possession, distribution, selling, concealment, or use of alcohol while on duty (on or off company property), while on company or client property, or when operating company equipment or vehicles (including leased or rented vehicles). Exceptions for serving alcohol at authorized company functions must be in writing by the HSE Regional Manager, the senior vice president, HR and Administration or their designees. Testing positive for an illicit substance or alcohol is in violation of this Program. Refusal or failure to submit to illicit substance or alcohol screening upon request. Attempting to subvert/avoid a test by means of sample substitution, adulteration, intentional insufficient specimen quantity, or other. Such circumstances include, but are not limited to: (a) absence of all body hair, with the exception of a valid medical explanation (such as alopecia universalis or chemotherapy) or professional sport requirement, (b) refusal to submit a sufficient breath test in the absence of a valid medical explanation (such as severe debilitation COPD), (c) substitution and/or falsification of urine or other test, and/or (d) insufficient urine after following the DOT protocols for collection and shy bladder. Not reporting any legally prescribed or over-the-counter medication taken which could adversely affect the employee’s ability to perform the job safely to P2S HSE or HR before beginning work To the extent allowed by law, employees are required to report any drug conviction to the P2S Site HSE Representative or the Site Hr Representative within 5 days. Employees who operate project equipment or drive project vehicles are required to report any alcohol conviction relating in any way to driving (such as driving under the influence, driving while intoxicated, and possession) to the P2S Site HSE Representative or Site HR Representative within 5 days. For purposes of P2S Health, Safety & Environmental Copyright © 2012, P2S. All Rights Reserved Page 9 Origination Date: October 7, 2011 Revision Date: Release Authorized by: Danny Trahan, Safety Director June 2012 Manual Rev 4 this program, a conviction means that an employee is found guilty, pleads guilty, or pleads ‘nolo contendere’ (no contest). Failing to report conduct of others in violation of the Substance Abuse Prevention Program may result in disciplinary action up to and including immediate termination. SECTION IV DRUGS OF ABUSE AND DRUG TESTING AMPHETAMINES Amphetamines are prescription stimulants which are medically used to treat narcolepsy (sleeping sickness) and obesity (diet pills). Common names for these include Dexedrine, Spancap, Biphetamine, Delcobese, Mediatric, Benzedrine, Preludin, Ritalin, and Sanorex. Methamphetamine, a more powerful amphetamine, may come in the form of Desoxyn or Methampex. Abusers are attracted because these drugs cause euphoria, increased alertness, and excitation. They also increase pulse rate and blood pressure. Adverse effects include insomnia, restlessness, palpitations, confusion, and dilation of pupils of the eyes, psychosis, convulsions, and death. Other substances that may show up on a test as amphetamines include decongestants, such as Vicks inhalers, ephedrine, Sucrets Decongestant Formula, as well as some blood vessel dilators. A non-negative result for the sub-group methamphetamine should be addressed at once, since illegal “meth,” also known as “crank” or “ice,” is becoming a widely used drug and produces extremely dangerous and violent behavior in the user. However, a non-negative for methamphetamine does not rule out the possibility of legal drug use, since often amphetamines show up both as amphetamine and methamphetamine. If you have a question about a nonnegative result for amphetamines, call your testing laboratory representative or P2S HSE Substance Abuse Prevention Program Administrator. This is especially important in cold weather or when many people are taking cold remedies. Again, cold or sinus medication could trigger a non-negative result. METHAMPHETAMINE Methamphetamine is an addictive stimulant drug that strongly activates certain systems in the brain. Methamphetamine is chemically related to amphetamine, but the central nervous system effects are greater. Both drugs have some limited therapeutic uses, primarily in the treatment of obesity. Methamphetamine is made in illegal laboratories and has a high potential for abuse and addiction. Street drugs are referred to by many names, such as “speed,” “meth,” and “chalk.” Methamphetamine hydrochloride, clear chunky crystals resembling ice, which can be inhaled by smoking, is referred to as “ice,” “crystal,” “glass,” and “tina.” P2S Health, Safety & Environmental Copyright © 2012, P2S. All Rights Reserved Page 10 Origination Date: October 7, 2011 Revision Date: Release Authorized by: Danny Trahan, Safety Director June 2012 Manual Rev 4 Methamphetamine is taken orally or intranasal (snorting the powder), by intravenous injection, and by smoking. Immediately after smoking or intravenous injection, the methamphetamine user experiences an intense sensation, called a “rush” or “flash,” that lasts only a few minutes and is described as extremely pleasurable. Oral or intranasal use produces euphoria—a high, but not a rush. Users may become addicted quickly, and use it with increasing frequency and in increasing doses. BARBITURATES Barbiturates are depressants, also known as “downers” or “barbs.” These drugs are used as sedatives, anti-hypnotics, and anti-convulsants. They must be prescribed by a physician. Examples of common barbiturates include Amytal, Tuinal, Butisol, Pyridium Plus, Nembutal, Doriden, Placidyl, Equanil, Noludar, Miltown, Luminal, Seconal, and Phenobarbital. Barbiturates cause sedation, loss of inhibitions, and induction of sleep. They are usually accompanied by a warning against mixing them with alcohol and against operating machinery while taking them. The abuse potential for barbiturates is usually high. Adverse effects of prolonged use or abuse include drowsiness, confusion, disorientation, slurred speech, nausea, suppression of breathing reflexes, and physical addiction. No substances are known to produce false non-negative results on a confirmed drug test. However, some over-the-counter medications such as Primatene tablets, contain Phenobarbital, so it is very important to ask the subject if he/she is taking any over-the-counter medications. If you are unsure about a barbiturate non-negative result, call your laboratory representative or P2S HSE. BENZODIAZEPINES Benzodiazepines are prescription depressants that also are used by doctors as sedatives, hypnotic, and tranquilizers. Common benzo drugs include Ativan, Valium, Librium, Dalmane, Serax, Xanax, Tranxene, Diazepam, Restoril, Centrax, Halcion, and Paxipam. Benzodiazepines produce most of the same effects as barbiturates such as relief of anxiety, sedation, and induction of sleep. Benzodiazepines are the most abused prescription drug type in the world. Many people take them even if prescribed for another person. Adverse effects include drowsiness, fatigue, decreased activity level, dizziness, fainting, impaired ability to concentrate, disturbed vision and hearing, physical addiction, and general disorientation. No substances are known to give false non-negative drug test results for benzodiazepines. If you are not sure if the drugs listed by the employee/applicant are in this category, call your laboratory representative or P2S HSE. COCAINE Cocaine is a white granular powder that is available primarily through illegal means. No prescription can be written for it. Its only medical usage is as packing for nasal or mouth surgery. Here it is applied by the physician and not prescribed for the patient. Cocaine can be “snorted” P2S Health, Safety & Environmental Copyright © 2012, P2S. All Rights Reserved Page 11 Origination Date: October 7, 2011 Revision Date: Release Authorized by: Danny Trahan, Safety Director June 2012 Manual Rev 4 up the nose in its powder form, dissolved in water and injected into the body by needle, or mixed with other common ingredients and smoked in pipes as “crack.” Cocaine, which is a natural stimulant, causes an intense feeling of euphoria, increased ability to concentrate, alertness, sexual stimulation, and heightened sociability. It is a stimulant, so the effects of cocaine and amphetamines are similar, but in cocaine these effects are more intense. Cocaine also causes restlessness, nervousness, tremor, convulsions, and disturbances in heart rhythm, psychological dependence, heart attacks, strokes, and death. No substances are known that will give a false non-negative result for cocaine. However, the use of cocaine by a doctor as a local anesthetic or to stop bleeding after nose, mouth, or throat surgery may show in a drug test. It is important to ask the subject if they have been to the doctor or dentist for any minor surgery when they fill out the Prescription Medication/Consent Form. CANNABINOIDS (MARIJUANA) Cannabinoids include the drugs marijuana, hashish, and hash oil. These are all derivatives of cannabis sativa, which is the marijuana plant. Marijuana is also called pot, weed, grass, smoke, reefer, and other localized nicknames. Marijuana is occasionally used in treatment of nausea and vomiting due to cancer chemotherapy. Marijuana is also used in the management of anorexia and nausea with Acquired Immunodeficiency Syndrome (AIDS). A doctor will write a prescription for the drug to be filled at a pharmacy just like other prescription drugs. The doctor will not refer the patient to the local street corner, as some employees will have you believe. Users experience euphoria, intensified sensual perceptions, loss of inhibitions, and a general feeling of relaxation. Habitual use can cause paranoia, loss of coordination and perception, impairment of memory and basic motor skills, lung disease, cancer, and psychological dependence. No substance is known to produce false non-negatives of marijuana on a drug test. “Passive inhalation” is often used as the excuse for a non-negative result. This is the term for casually inhaling some marijuana smoke from someone else nearby smoking pot. Studies have proven that passive inhalation will not show up in a GC/MS confirmation at the levels we require. Also, since the chemical that gets the smoker high, THC, is absorbed into the fatty tissue of the body, marijuana can be detected days or even weeks after use, depending on the amount of use, the purity of the marijuana, and the person’s metabolism. We are not determining when someone used the drug, only that the person has amounts of the drug in their body above our allowable levels. OPIATES Opiates are the true narcotic drugs. Most are derivatives of opium or are synthetic substitutes. These are the true pain-killing drugs and all have an extremely high potential for physical addiction. Some are also prescribed as cough suppressants and as treatment for diarrhea. P2S Health, Safety & Environmental Copyright © 2012, P2S. All Rights Reserved Page 12 Origination Date: October 7, 2011 Revision Date: Release Authorized by: Danny Trahan, Safety Director June 2012 Manual Rev 4 Legal opiates are prescribed for extreme pain relief such as after surgery or an injury. Legal opiates include morphine, codeine, pectoral syrup, Tylenol with codeine, Empirin Compound with codeine, Robitussin A-C, Dilaudid, Demerol, Mepergan, LAAM, Percodan, Tussionex, Fentanyl, Lomotil, and others. Many of these do not require a prescription but may be purchased by signature, such as Paregoric, Robitussin A-C, and others. States vary in what is allowed to be purchased by signature without prescription, so be careful in dealing with non-negatives in this category. Heroin is also an opiate and will show on a drug test as the subgroup morphine. Heroin is an illegal drug, so no prescription for it will be authentic. The opiate drugs produce euphoria, sedation, and relieve pain. Harmful effects include drowsiness, apathy, confusion, nausea, respiratory depression, constricted pupils, physical addiction, and death. Drug test results for opiates will be non-negative either for codeine or morphine or both. This is because the drug family undergoes chemical changes in the body. The drug detected in the urine may not be in the same form as the drug taken. For example, both heroin and codeine are converted to morphine before excretion in the urine. A prescribed dose of codeine may show up as non-negative for codeine, for codeine and morphine, or for morphine. If the person receives a non-negative in the opiate category and has a prescription for an opiate drug, consider it acceptable IMPORTANT NOTE: In some cases, regular ingestion of poppy seeds will show up as nonnegative for opiates. This is a rare occurrence but should a test subject have no prescription for an opiate drug after testing non-negative, inquire if the subject eats poppy seeds. For assistance in the category, call your laboratory representative or P2S HSE. PHENCYCLIDINE Phencyclidine, also known as PCP or “angel dust,” is a livestock anesthetic that has no permissible use for humans. It is a synthetic, white, odorless, crystalline powder that causes hallucinations, seizures, and delirium. Easily manufactured by illegal means, it is perhaps the most dangerous “street” drug in use today. PCP can be “snorted” into the nose, used intravenously, or smoked. Its effects are rapid, usually seen in 45 - 120 minutes and lasting 12 to 48 hours. It is usually eliminated from the body within 4-7 days. The effects of PCP include nausea, loss of coordination and perception, distorted vision, indifference to pain, muscle rigidity, and a catatonic state. Higher doses can lead to coma, respiratory depression, and death. Continued usage of even small doses can cause psychosis. The drug causes the user to become irrational and often causes violent behavior. A non-negative confirmation test for PCP usually means usage within the past week. The drug does not appear naturally and there is no legal means of obtaining it. There is no other substance that will show up on a confirmed non-negative for PCP. Therefore, a non-negative is absolute. P2S Health, Safety & Environmental Copyright © 2012, P2S. All Rights Reserved Page 13 Origination Date: October 7, 2011 Revision Date: Release Authorized by: Danny Trahan, Safety Director June 2012 Manual Rev 4 If you have a result that is non-negative for PCP, there is no prescription that can be produced. Call P2S HSE for assistance in handling the removal of the employee. P2S Health, Safety & Environmental Copyright © 2012, P2S. All Rights Reserved Page 14 Origination Date: October 7, 2011 Revision Date: Release Authorized by: Danny Trahan, Safety Director June 2012 Manual Rev 4 RELEVANT CONTACTS Evaluation, treatment, and rehabilitation may be provided by P2S SAP under contract, or SAP not affiliated with P2S. Substance Abuse Program Administrator’s contact information: Name: Kendra Winchester Title: HR / SAP Administrator Address: 456 Highlandia Drive Baton Rouge, LA 70810 Phone: 225.755.2825 (Office) 225.202.5747 (Cell) 225.753.1462 (Fax) Name: Kathy Bradley Title: Risk Administrator / SAP Administrator Support Address: 4800 Sugar Grove Blvd, Ste 450 Stafford, TX 77477 Phone: 281.817.9574 (Office) 713.254.5036 (Cell) 281.476.9506 (Fax) P2S Health, Safety & Environmental Copyright © 2012, P2S. All Rights Reserved Page 15