The Rise of OpioidBased Prescription
Drug Abuse:
New Causes for Concern
Presented By:
Who is Psychemedics?
The world’s leading drug testing company using hair since
1987. Our clients include Fortune 500 Companies, Police
Forces & Courts, Schools & Parents, and International
Programs.
Richard Clay
Vice President – National Accounts
(877) 517-2033
DURING THIS SESSION YOU WILL LEARN ABOUT:
• Prescription Opioids – what are they and how
do they work?
• Signs of Abuse/Impairment
• Steps involved in developing and maintaining a
drug free workplace
• The tools available to keep drug users from
entering the workplace undetected
AN INCREASING PROBLEM

Prescription drug abuse in the nation’s fastest growing drug problem and classified as an
epidemic. (Centers for Disease Control and Prevention)

Between 1998 and 2008 the use of prescription medications rose 61%.
(National Center on Addiction and
Substance Abuse at Columbia University)

The use of Schedule II Opioids – some of the most powerful pain relievers available – increased
by a staggering 380%! (National Center on Addiction and Substance Abuse at Columbia University)

The DAWN study reported a 111% increase in the estimated number of emergency department
visits for nonmedical use of opioid analgesics from 2004-2008 (from 144,600 to 305,900), and a
29 percent jump from 2007-2008.

Results from more than 5.5 million drug tests reveal an 18 percent jump in opiate positives in
the general U.S. workforce in a single year (2008 to 2009), and a more than 40 percent climb
from 2005 to 2009. (http://www.news-medical.net/news/20100917/Opiate-usage-increases-in-workplace-and-ER.aspx)

Post-accident drug tests found opiates up to four times more often than pre-employment tests,
suggesting that these drugs may be playing a role in workplace accidents.
(http://www.news-medical.net/news/20100917/Opiate-usage-increases-in-workplace-and-ER.aspx)
WHAT ARE OPIOIDS & HOW DO THEY WORK?
Opioids (also called narcotics) are drugs that alleviate pain, depress body functions and reactions,
and when taken in large doses, cause a strong euphoric feeling
What Are the Signs of Opioid Use?
• Mental dullness
• Lethargy and drowsiness
• Going back and forth from alert to drowsy
• Cold, moist skin or "gooseflesh"
• Scratches frequently
• Slurred speech
• Constricted pupils that fail to respond to light
• If injected, needle tracks or scars
• Paraphernalia (syringes, medical droppers, bent spoons, metal bottle caps, foil packets)

The opioid class of narcotics include morphine, codeine, and heroin. Synthetic opiates are hydrocodone,
hydromorphone (DilaudidR), oxycodone (OxycontinR , PercodanR), meperidine (DemerolR) and propoxyphene
(DarvonR, DarvocetR) and methadone.

Effects: Narcotics increase pain tolerance. As a result, people could more severely injure themselves or fail to
seek medical attention after an accident due to the lack of pain sensitivity.

Opioids are considered Schedule II drugs under the Controlled Substance Act because they have a strong
potential for abuse or addiction.
Centers for Disease Control and Prevention
November /2011 Report
 More people die in America every year from prescription drug abuse than die from heroin and
cocaine combined.
 Enough narcotics are prescribed every year to medicate each and every adult in America every day
for a month.
 According to the CDC (Centers for Disease Control and Prevention), over 20,000 Americans die each
year of prescription drug abuse - 14,800, or 74%, due to misuse of opioid pain medications.
 New Mexico has the highest death rate, followed by West Virginia, Nevada, Utah and Alaska.
 The highest abuse rate is in Oklahoma, followed by Oregon, Washington state, Rhode Island and
Kentucky.
 The highest death rates tend to be in either rural or impoverished counties.
“This problem crosses all walks of life, crosses all socio-economic classes. Crosses all races and
gender, national origin, age.”
- Dr.Thomas Frieden, Director of the CDC 2011
OPIOID USE IN THE WORKPLACE
The Effect
 The apathy caused by opioids can translate into an "I don't really care"
attitude towards performance.
 Driving: The physical effects as well as the depression, fatigue, and
slowed reflexes impede the reaction time of the driver, raising the
potential for accidents.
 Although opiates have a legitimate medical use in alleviating pain,
workplace use may cause impairment of physical and mental
functions.
 Unwanted side effects such as nausea, vomiting, dizziness, mental
clouding, and drowsiness place the legitimate user and abuser at
higher risk for an accident.
 Injured employees prescribed opioids and given larger and larger
doses may merely increase their tolerance for the drugs without
achieving improvements in function or decreased pain, leading to
more lost work days and increased workers’ comp costs.
http://www.doi.gov/archive/nbc/eps/SignsSymptoms.html
Reasons for Increase in Prescription Drug Abuse
• Availability of online pharmacies increase ability to obtain prescription drugs.
• Technology has lead to better prescription forgeries that go undetected by
pharmacies.
• Increase in the manufacturing of pharmaceutical medications including pain
relievers, anti-anxiety medications and insomnia drugs.
• Increases in availability of medical insurance has led to increases in medical
visits for the purpose of obtaining prescription medication for purposes of
abuse.
• High volume practice schedules leave many physicians unaware of risk
behavior in their patients.
• Abusers often visit multiple physicians to obtain prescriptions for opioid-based
pain relievers increasing each user’s supply for sale or personal use.
RISKS OF HIRING A DRUG USER
Drug Abusers:
• Work less than 70% of the time and have more absences
• Are involved in accidents 3.6 times more than other workers
• Are 5 times more likely to file a workers’ compensation claim
• Use 8 times more hospital days and 3 times more sick benefits than other
workers
• Are responsible for 80% of theft in the workplace
Drug use in the workplace costs employers approximately
$81 billion annually in lost productivity.
- The U.S. Department of Labor - 2009
WHAT CAN YOU DO?
Don’t Hire a Problem!
 Implement The Most Effective Method For Identifying Repeat Drug Users
Drug Testing Methods and their Window of Detection
Hair Testing Identifies Historical Patterns of Substance Abuse
Prescription Lab Positive Count (VECTOR Total)
Compared to MRO Positive Count
3 500
2,953
3 000
2,879
2 500
2 000
Lab Positives
MRO Positives
1 500
1,322
1 000
969
1,053
847
518
500
200
442
305
0
2008
2009
2010
2011
*Prescription Drugs Displayed: Hydrocodone, Hydromorphone and Oxycodone
11
2012
Opiate Positive Rate(VECTOR Total)
Compared to % Lab Total Positives
Opiate Positive Rate
70%
61%
60%
62.5%
55%
50%
50%
40%
30%
Opiate Positives
30%
20%
10%
0%
2008
2009
2010
2011
*Drugs Displayed: Hydrocodone, Hydromorphone, Oxycodone, Codine, Morphine & 6-MAM
*Based on 18,553 Positive Tests
12
2012
Positive Rate by Drug Breakout(VECTOR Total)
Past 5 Years Including Current Year to Date
Positive Rate
39,50%
8,30%
5,00%
1,00%
Codine
Morphine
0,40%
1,00%
6-MAM
Oxycodone
Positive Rate
*Total Lab Positives: 18,553
13
Hydrocodone
Hydromorphone
Summary – Expanded Opiates in Drug Tests
• Expanded Opiates drug positivity rate in the general U.S. workforce up 20%
over the past 5 years.
- Hydrocodone positives increased 59% during this time period.
- Hydromorphone positives increased 66% during this same time period.
• Today, 2nd only to marijuana (urine) cocaine (hair) in workplace positivity
• Random positivity, 2x higher than pre-employment
• Post-accident positivity, 3-4x higher than pre-employment
- Quest Diagnostics Drug Testing Index 2011
Reducing Risk for Employers
1.
Develop a drug-free workplace policy and make it visible in the workplace.
2.
Screen potential employees for drug use using the most effective testing method to
identify repeat drug users that includes the expanded opiate panel
3.
Maintain a post-accident drug screening policy.
4.
Train all supervisory personnel to recognize the signs of potential abuse and maintain
standardized reasonable suspicion testing policies.
5.
Document every incident in writing and enlist another manager as a witness when
confronting an employee with a potential problem abuse.
6.
Maintain a good Employee Assistance Program (EAP.) Remember drug addiction is a
medical disability. Increased options for treatment increase likelihood of abusers
seeking help.
The World’s Leading Drug Testing Company Using Hair
Since 1987

Wholly dedicated to testing for drugs of abuse

Public company listed on NASDAQ (PMD)

Over 25 years of successfully serving corporate clients

Seven US patents granted on our technology as well as foreign patents

Thousands of corporate clients from a broad cross-section of domestic/international markets
Why Psychemedics?
TRUSTED BY
Fortune 500 Companies
Third-Party Administrators
International Programs
Police Forces & Courts
Government Agencies
Schools & Parents
► 5-10 Times Higher Detection
► Proprietary Technology
► Unmatched Legal Track Record
► 3 Month Detection Window
► FDA Cleared Hair Tests
► Eliminates Cheating Tactics
► Non-Intrusive Collections
Q&A