Thursday, January 29, 2015
Almost One-Third of Women of Childbearing Age Fill Prescriptions for Opioid Painkillers January 27th, 2015 Almost one-third of women of childbearing age had an opioid painkiller prescription filled each year from 2008 to 2012, according to a new government study. These drugs can increase the risk for birth defects, The New York Times reports. The study, by the Centers for Disease Control and Prevention (CDC), found 39 percent of women ages 15 to 44 on Medicaid, and 28 percent of women of the same age group with private insurance, filled an opioid prescription in a pharmacy each of those years. “These are dangerous drugs that are addictive, and we are substantially overusing them,” said CDC Director Dr. Thomas Frieden. He noted that women often do not know they are pregnant in the early weeks of a pregnancy, which is a crucial time for organ formation. If they take opioid painkillers, they could be “unknowingly exposing their unborn child,” he said. Opioid painkiller exposure can raise the risk for defects in a baby’s brain, spine, heart and abdominal wall, the article notes. Babies whose mothers take opioids during pregnancy are also at risk of neonatal abstinence syndrome. A baby with the syndrome experiences symptoms of withdrawal from medications or drugs taken by a mother during pregnancy. The researchers said it is not known why women on Medicaid had higher prescription rates than women with private insurance. “The higher opioid prescribing rates among Medicaid enrollees might be due to differences in the prescription medications covered under their health insurance plan, differences in use of health care services, or differences in the prevalence of underlying health conditions among Medicaid enrollees compared with persons covered by private health insurance,” the CDC noted in a news release. Oxycodone, hydrocodone and codeine were the most frequently prescribed opioids for women with either public or private insurance.
Posted by Marianne Karg at 11:06 AM
Thursday, January 22, 2015
Federal Judge to Rule on Whether Marijuana is Schedule I Drug /By JOIN TOGETHER STAFF JANUARY 15TH, 2015 A federal judge will rule later this year on whether marijuana should continue to be classified as a Schedule I drug, alongside LSD and heroin, according to the Associated Press. U.S. District Judge Kimberly J. Mueller agreed to consider marijuana’s drug classification under the 1970 Controlled Substances Act. She held a five-day fact-finding hearing in late 2014. Final arguments are scheduled for February. Her decision to hold the hearing was in response to a pretrial defense motion in a federal case against alleged marijuana growers, the article notes. Schedule I drugs are defined as drugs with no currently accepted medical use and a high potential for abuse. “Schedule I drugs are the most dangerous drugs of all the drug schedules with potentially severe psychological or physical dependence,” the Drug Enforcement Administration notes on its website. If Mueller ruled that marijuana is not a Schedule I drug, it would apply only to the defendants in the case. It would almost certainly be appealed, according to the article. If the U.S. 9th Circuit Court of Appeals ruled the law was unconstitutional, all the Western states would be affected. Lawyers for the defendants in the case say the federal marijuana law violates the Constitution’s guarantee of equal protection under the law. They argue the government enforces marijuana law unevenly by permitting marijuana to be distributed in states where it is legal, while cracking down in states where it is illegal. Zenia K. Gilg, a lawyer for the growers, said the scientific understanding and public acceptance of marijuana have greatly increased since courts last considered the federal classification.
Tuesday, January 6, 2015
DEA Cracks Down on Potent Marijuana Product Called “Wax” in California /By Join Together Staff Jan 6, 2015 The Drug Enforcement Administration (DEA) is cracking down in California on a potent marijuana product called “wax,” according to ABC News. Wax is legal—and popular—in Colorado. Wax is a distillation of marijuana said to be so potent that a single hit will keep a person high for more than a day, the article notes. A person making wax uses the flammable substance butane to strip out the THC, the chemical in marijuana that causes a high. “There is no weed out there that possesses the punching power that the wax does,” an anonymous undercover DEA informant told ABC News’ “Nightline.” “And it’s like smoking 20 joints of the best grade of weed that you have into one hit of the wax.” Gary Hill of the DEA’s San Diego office said, “We have seen people have an onset of psychosis and even brain damage from that exposure to that high concentration of THC. Our concern is that this is going to spread before we get it under control.” In Colorado, wax is legal for anyone over the age of 21. It is sold in recreational marijuana dispensaries. A three-day contest called the X-Cup, held in Denver, is designed to determine who can make the most potent batch of wax.
Posted by Marianne Karg at 10:10 AM
Friday, December 12, 2014
Nearly 60 Percent of American Adults Have Problem Holiday Drinking The December holiday season may mean much merriment, but according to this survey, 59 percent of American adults who attend holiday parties drink too much and engage in potentially serious and dangerous behavior. The online survey, conducted by Harris Poll and commissioned by Caron Treatment Centers, polled 2,000 American adults over the age of 18. Some of the most concerning statistics pertain to parents with children under the age of 18 living at home. Of parents age 21+ who attend and drink at parties, one in four (26 percent) admit to driving home from a party after drinking too much. One in five (21 percent) have blacked out and couldn’t remember anything after drinking too much at a party. “Alcohol is still one of the deadliest drugs in our society,” said Doug Tieman, Caron’s president and CEO. “Our culture has normalized substance abuse to the extent that many people don’t perceive significant consequences as cause for concern even though they can indicate serious problems. Many of the unintended victims, of course, are our children. We all need to be accountable for our behavior. But, if you are an alcoholic, it’s unlikely that you can change your behavior without significant help. You will need support to develop the skills and tools to lead a happy and productive life without alcohol.” In addition, 55 percent of adults who attend holiday parties have seen someone drive even though they appeared to be impaired and 32 percent admit they drove impaired themselves. Surprisingly, 40 percent of adults over the age of 65 who drink at parties admit to driving while impaired compared to just 21 percent of 21-34 year olds. Even though they are breaking the law, parents with children under the age of 18 still living at home, are still providing them with alcohol. • 48 percent said it’s acceptable for 18-20 year olds to have at least one drink at a family holiday party if they are not driving. • 12 percent said it is acceptable for an 18-20 year old to drink any amount at a family holiday party if they are not driving. “Serving alcohol to minors is not only illegal, but sends a permissive message and can lead to serious and even deadly consequences,” said Dr. Harris Stratyner, PhD, Regional Clinical Vice President of Caron Treatment Centers in New York. “It’s never safe for an underage person to drink, even when ‘supervised,’ as drinking puts them at risk for emotional, physical, and psychological problems. Drinking at a young age may also cause brain, liver, and growth problems, and make someone more likely to develop an addiction later in life.” The survey showed that many Americans have misconceptions about alcoholism. • 37 percent believe most alcoholics cannot hold down a full-time job. • 72 percent agree that most alcoholics drink every day. • 10 percent strongly agree with the statement: “Alcoholics could stop drinking if they wanted to, but they lack the willpower.” “With the popularity of social media and frequent use of mobile video/photo uploads, it’s important to recognize that any person’s actions while under the influence could be seen by a wide net of people,” said Dr. Stratyner. “The consequences can impact lives both personally and professionally.” If you believe that you, a friend or family member may have a problem with alcohol, the National Institute of Health has a tool that may be able to help. Go to http://rethinkingdrinking.niaaa.nih.gov/ to Rethink Your Drinking.
Posted by Marianne Karg at 10:02 AM
Thursday, November 6, 2014
Recreational Marijuana Legalized in Oregon and Alaska NOVEMBER 5TH, 2014 Oregon and Alaska voted to legalize recreational marijuana use on Tuesday. In Washington, D.C., residents voted to allow possession of marijuana, but not retail sales of the drug, Reuters reports. Marijuana remains illegal under federal law. Oregon and Alaska will follow Colorado and Washington state which legalized recreational use of marijuana in 2012. Preliminary results indicate 54 percent of Oregon voters supported the marijuana measure, which takes effect in July 2015. Retail marijuana stores could open in 2016. In Alaska, 52 percent of voters supported legal marijuana, according to preliminary results. Once the election is certified, a state commission would have nine months to come up with regulations. Stores would be likely to open in 2016. The Washington, D.C. measure could be halted by the U.S. Congress, which has constitutional oversight of the nation’s capital, the article notes. Under the measure, adults 21 and older could possess up to two ounces of marijuana and grow up to six plants. Voters in Florida defeated a constitutional amendment to allow medical marijuana. In Maine, proposals to legalize the possession of small amounts of recreational marijuana passed in South Portland and failed in Lewiston. Opponents of legalization in Oregon said they will advocate for stricter laws aimed at limiting access to marijuana by children. Kevin Sabet, co-founder of anti-legalization group Smart Approaches to Marijuana, said his group intends to build a broader coalition to counter pro-marijuana groups in 2016. “Tonight is going to inspire us to do better and to try harder and go after the donors we have to go after in order to level the playing field,” Sabet said. “The more people that hear about legalization, the more people are uncomfortable with it. For us it’s about getting our message out.”
Thursday, October 23, 2014
Study Finds Positive Drug Test from Secondhand Marijuana Smoke Unlikely OCTOBER 22ND, 2014 A new study finds it is unlikely that a person exposed to secondhand marijuana smoke will test positive for marijuana themselves. While it is possible that extreme marijuana smoke exposure could produce a positive urine test, this occurrence is likely to be rare and limited to the hours immediately after exposure, according to researchers from Johns Hopkins University. Six experienced marijuana users smoked marijuana with different concentrations of THC, the drug’s psychoactive ingredient, in a sealed chamber. Six non-smokers were seated next to the smokers. In two sessions, the participants were in a room with no ventilation, while in the third session they were in a ventilated room. The non-smokers’ urine was tested 13 times over the next 34 hours. Urine levels of THC surpassed typically detectable levels in only one participant, four to six hours after exposure. When the researchers used a more sensitive test, which is usually not used in workplace drug testing, they could detect lower THC levels, but only for 24 hours. Non-smokers in the ventilated room did not come close to meeting the threshold for a positive drug test, Newsweek reports. /By JOIN TOGETHER STAFF
Posted by Marianne Karg at 2:59 PM
Tuesday, September 23, 2014
Recreational Marijuana Sales Surpass Medical Cannabis in Colorado SEPTEMBER 11TH, 2014 Sales of recreational marijuana have surpassed sales of medical marijuana for the first time in Colorado, according to an analysis of state tax revenues. Whether recreational marijuana will become a profit center for the state remains in question, Time reports. The state’s recreational marijuana shops opened in January. The state tax on medical marijuana is 2.9 percent, compared with 10 percent for recreational marijuana sold in state stores. In July, the state received $838,711 from medical marijuana taxes, and $2.97 million from recreational marijuana taxes. Consumers bought an estimated $28.9 million worth of medical marijuana at dispensaries, and $29.7 million worth of recreational marijuana at state recreational marijuana stores. The July sales figures boost legalization proponents’ argument that recreational marijuana will be profitable for Colorado, the article notes. In July, an editorial in The Denver Post noted medical marijuana purchases easily outpaced retail marijuana sales. The editorial noted it is relatively easy to get certified to obtain medical marijuana, and that the number of people with certifications grew from 110,979 at the beginning of the year to 116,180 at the end of April. A portion of medical marijuana users “almost certainly belong” in the retail market, the editorial stated. “Medical marijuana privileges should be confined to genuine patients, particularly now that the retail option exists, and not to those merely seeking a break on price because the taxes are lower,” the newspaper wrote. In July, Dr. Larry Wolk, head of the Colorado Department of Public Health and Environment, told The Denver Post he was concerned there may not be much incentive for people to switch from medical marijuana to retail marijuana. /By JOIN TOGETHER STAFF
Posted by Marianne Karg at 2:12 PM
Thursday, September 11, 2014
DEA Will Allow Unused Narcotic Painkillers to be Returned to Pharmacies The Drug Enforcement Administration (DEA) announced Monday it will allow unused narcotic painkillers such as OxyContin to be returned to pharmacies. Until now, pharmacies were not allowed to accept unused opioid painkillers. The Controlled Substances Act required patients to dispose of the drugs themselves or give them to law enforcement during twice-yearly national “take-back” events. Consumers will also be permitted to mail unused prescription medications to an authorized collector, in packages that will be available at pharmacies and locations including senior centers and libraries, The New York Times reports. The new regulations are designed to curb the prescription drug abuse epidemic, the DEA said. “These new regulations will expand the public’s options to safely and responsibly dispose of unused or unwanted medications,” DEA Administrator Michele Leonhart said in a news release. “The new rules will allow for around-the-clock, simple solutions to this ongoing problem. Now everyone can easily play a part in reducing the availability of these potentially dangerous drugs.” The regulations will take effect in one month, the article notes. In addition to OxyContin, the rule will include stimulants such as Adderall and depressants such as Ativan. The program will be voluntary for pharmacies. The DEA will require locations accepting drugs to permanently destroy them, but will not specify how they do it. The “take-back” events removed 4.1 million pounds of prescription drugs from circulation in the past four years, according to the DEA. During that time, about 3.9 billion prescriptions were filled. “They only removed an infinitesimal fraction of the reservoir of unused drugs that are out there,” said Dr. Nathaniel Katz of Tufts University School of Medicine in Boston, who studies opioid abuse. “It’s like trying to eliminate malaria in Africa by killing a dozen mosquitoes.” Flushing drugs down the toilet, or throwing out prescriptions in the trash, are discouraged because they could harm the environment. /By Join Together Staff September 9th, 2014
Posted by Marianne Karg at 12:20 PM
Monday, September 8, 2014
Medical marijuana and workplace safety Amid a flurry of new laws, more questions than answers exist Tom MusickAugust 24, 2014 Key points ■State laws vary, but employers still have the right to enforce drug-free workplace policies and dismiss workers if they can prove impairment on the job, experts say. ■The issue remains in flux as legal battles play out in state courts across the country. ■Research is limited on the subject, but two medical organizations recently formed a task force to study workplace health and safety issues associated with marijuana. Julie Carter is well aware of the burgeoning movement to legalize medical marijuana. It’s debated at jobsites. It’s splashed across headlines. It’s discussed among safety professionals. And no matter your stance on the issue, one thing is certain: It’s not going away anytime soon. “I think it’s going to be a hot-button issue for some time yet because things are changing so rapidly,” said Carter, director of environmental, health and safety at Roy Anderson Corp., a Gulfport, MS-based construction company. “As a corporation, we are maintaining that we have the right to a drug-free workplace. Those are our policies, period.” Yet when it comes to recent medical marijuana laws and what they might mean for workplace safety, the predominant punctuation is a question mark. The language of each law varies, leaving all parties involved having to navigate a legal maze when it comes to employers’ and workers’ rights. As of press time, 23 states and the District of Columbia had passed laws allowing the use of medical marijuana, and two of those states – Colorado and Washington – had passed laws permitting the recreational use of marijuana. (See map.) All of those laws stand in contrast to federal law, which prohibits marijuana as a Schedule I controlled substance in the same category as LSD, heroin and ecstasy. The federal government has said it will not prosecute people who abide by their state’s marijuana laws. As to whether employers can ban its use by workers – including those with prescriptions to use medical marijuana outside of the workplace for chronic diseases and conditions such as cancer, glaucoma, multiple sclerosis and Crohn’s disease – the answer depends on each state and its courts. In some states, including Washington, Oregon and Michigan, judges have ruled on the side of employers. In other states, including Minnesota, Arizona and Delaware, lawmakers have added specific protections for workers with medical marijuana prescriptions, shielding them from adverse action by employers based solely on a positive test result. “There are a lot of layers to it,” said Vance Knapp, a lawyer who represents employers in Colorado and Arizona for Denver-based Sherman & Howard LLC. “What we’re seeing is sort of a hodgepodge of rules and regulations from state to state to state.” Safety implications Marijuana is a mind-altering drug that contains more than 400 chemicals, according to the Drug Enforcement Administration. One of those chemicals, THC, is believed to be the main cause of psychoactive effects as it travels from the bloodstream to the brain. For a crane operator, pipe fitter, welder, truck driver or anyone else in a safety-sensitive position, the drug can pose dangers. The short-term effects of marijuana include distorted perception; loss of coordination; and problems with memory, learning and problem-solving, according to DEA. Workers should treat medical marijuana the same as other prescription drugs such as Vicodin or Percocet, which can impair mental and physical abilities and affect worker safety, said Rosalie Liccardo Pacula, a senior economist with Santa Monica, CA-based nonprofit research institute RAND Corp. Workers also should know the rules of their state and their employer, particularly if they are subject to Department of Transportation regulations or if their employer has federal contracts – both of which can supersede protections in state laws. Other variables exist, such as a wide range in potency levels of THC in different types of marijuana. Someone who ingests marijuana that has a higher THC content may become more impaired and, in turn, less safe. “We’re not talking about a single substance when we talk about marijuana,” said Pacula, who serves as co-director of the RAND Drug Policy Research Center. “It’s the equivalent of saying ‘alcohol’ and encompassing hard liquor with low-alcohol-content stuff. We need our laws and policies to be more mindful of that.” Meanwhile, many safety professionals have become more diligent about observing employees during stretch-and-flex drills, lunch breaks and other encounters. “In some of the states where medical marijuana is legal, we have been increasing our awareness and making sure that we look at our employees,” Carter said. “Get a visual on them. [Be aware] if they seem not on their game, if they seem distracted – for any reason, but especially for that. We have this saying. We call it, ‘Eyes on hands, mind on task.’ When you’re stoned, you’ve got none of that going on.” Employers’ rights versus workers’ rights If an employer can prove a worker is impaired on the job, then that employer can take action regardless of the residing state. But what if a worker shows no impairment but tests positive for marijuana? Does the employer have the right to fire that worker as part of its drug-free workplace policy? Knapp’s short answer consists of two words: “Yes, but …” His long answer covers a slew of recent court cases, most notably Colorado’s Coats v. Dish Network. The plaintiff in that case, Brandon Coats, is a quadriplegic licensed to take medical marijuana. After Coats failed a drug test, Dish Network fired him from his job as a customer service representative. Coats sued the company, but the state’s Court of Appeals sided with Dish Network. At press time, the case was pending in the Colorado Supreme Court. “I’ve been advising my clients that you can have a zero-tolerance drug policy in your workplace, but there is that risk that there’s going to be litigation,” Knapp said. “The issue for employers, especially employers who are engaged in safety-sensitive activities, is that they have to be concerned about, ‘Can I still discipline an employee that has trace amounts of THC in their bloodstream?’ … When it comes down to the particulars of what you can or cannot do under your particular state law, that’s when you really need to contact your employment counselor.” Employers have been doing exactly that in Minnesota, which in May became the 22nd state to legalize medical marijuana. On the surface, the language in Minnesota’s law might make it the most employee-favorable law in the country, said Dale Deitchler, a Minneapolis-based attorney who specializes in labor law with Littler Mendelson. “In states where employment is not addressed, employers have the upper hand,” Deitchler said. “In states where employment is addressed, there’s no clear-cut winner coming out of this, and companies are going to have to understand that if there’s a legal challenge, they’re going to have to make new law.” Searching for answers As more states legalize some form of marijuana use, researchers and medical professionals are doing their best to keep pace by studying the drug’s effects. Earlier this year, the American College of Occupational and Environmental Medicine and the American Association of Occupational Health Nurses announced plans to create a collaborative task force to study workplace health and safety issues associated with the use of marijuana and other drugs. Dr. Kathryn Mueller, president of ACOEM, said the task force’s goal is to avoid politicized rhetoric and analyze scientific information to help physicians and employers. “For safety-sensitive jobs, I think that people are not going to allow marijuana to be used on the job because it’s going to be a problem, most likely,” Mueller said. “The question remains, if you are using medical marijuana in some way, does that preclude you from all jobs that are available?” The answer, as with almost everything else regarding medical marijuana, is up for debate. “I suspect this is something that is going to get resolved by lawyers in court, and it will take a little while,” Pacula said. “But right now, there appears to be a lot of variation in how states are addressing it because they haven’t really been thinking about it. It’s all very new.” Tom Musick Associate Editor
Posted by Marianne Karg at 10:32 AM
Wednesday, September 3, 2014
Employers’ new challenge: drug testing employees for synthetics Companies, testing facilities need to cope with rise in synthetic drug use By Trish Mehaffey, The Gazette Published: August 31 2014 | 12:01 am in News, CEDAR RAPIDS — Manufacturers of synthetic drugs such as K-2 stay one step ahead of the law by changing the chemical make up when one substance is banned. That isn’t only a problem for law enforcement but also for employers as they strive to create safe workplace environments. Employers are now faced with the dilemma of paying an added expense to test employees for synthetic cannabinoids and cathinones, which differ from the regular drug tests. However, those tests may not be reliable because when the products are altered to skirt the law, new drug testing panels have to be developed to detect the recently created products. Iowa Division of Narcotics Enforcement Special Agent Dan Stepleton said the trend of synthetic cannabinoids and cathinones isn’t going away. “We have the convenience shops and head shops selling under control, but they are just getting smarter about it,” Stepleton said last week. “They don’t have it out in the open, and the regular customers know to ask for it.” Stepleton said the manufacturers change the man-made chemicals sprayed on the materials to produce that “high” practically every week. “Outlaw one and there 15 new ones,” he said. There were two recent convictions of distributors and three more are pending trials in this district’s federal court. In the wake of one death and five overdoses attributed to synthetics, the city of Cedar Rapids just amended an ordinance to fine and criminally charge anyone selling or buying products. Eastern Iowa businesses that require drugs screens as part of the pre-employment process were asked if they were adding additional testing for synthetics, but many declined to comment and wouldn’t discuss their policies. However, Dennis LaGrange, a Mercy Medical Center counselor and licensed social worker, said about 50 percent of company supervisors he works with are aware of K-2 — a synthetic cannabis — but others had no knowledge of these illicit drugs. He provides drug and alcohol education for businesses, along with helping them set up their drug-free workplace policies. In the past year, LaGrange has gone to 30 local companies to provide on-site workplace drug education training and offered about eight trainings at Mercy for smaller companies. Dale Woolery, associate director of the Governor’s Office of Drug Control and Policy in Des Moines, said employers and human resource managers have been asking for information or education on synthetics for the last few years. “It’s challenging for the workplace to keep up with the laws and the companies making the testing products, but a few years ago we couldn’t even detect synthetics,” Woolery said. “Technology is catching up.” Woolery said the total number of synthetic drug compounds listed as Schedule I controlled substances in Iowa now stands at 64, plus five classes of synthetic cannabinoids. QPS Employment Group, a staffing agency with 12 branches across the Iowa, including Cedar Rapids and Iowa City, places employees in many manufacturing and other companies. Its regional vice president, Jim Roy, has discovered many aren’t aware the standard 10-panel drug tests don’t detect synthetics. “When they find out there’s more cost to add synthetics, not many are willing to pay the cost,” Roy said. Gary Bucher, owner of ARCpoint Labs in Des Moines, said the standard 10-panel tests range from $50 to $60 per person. To add the two synthetic tests, it would be twice that amount. He has interest from employees wanting to test for synthetics, but that cost deters them. His labs have done testing for parents who request it and for treatment agencies, though. The standard 10-panel tests only detect marijuana, cocaine, amphetamines (methamphetamine), opiates (heroin), phencyclidine (PCP), barbiturates, methadone, propoxyphene, methaqualone (quaaludes) and benzodiazepine (Xanex), noted Dr. Shirley Pospisil with St. Luke’s Work Well Clinic. Pospisil said the clinic has tested 59 employees for K-2 this year from a company participating in Work Well and all came back negative. She said she wasn’t that familiar with synthetic drugs, except from reading the research, but they can cause irreparable damage and even death in some cases reported here and across the country. According to a DEA fact sheet, synthetic cannabinoids can cause severe agitation and anxiety, elevated blood pressure, tremors and seizures, hallucinations and suicidal and other harmful thoughts or actions. Synthetic cathinone — similar to amphetamines — use is associated with increased heart rate and blood pressure, chest pain, extreme paranoia, hallucinations and violent behavior. Local labs such as Weland in Cedar Rapids hasn’t tested synthetics for employers, only drug treatment programs, and C.J. Cooper and Associates in Hiawatha only tests synthetics for law enforcement and the Iowa Department of Corrections. Dr. Robert Hatcher with Iowa City Drug and Alcohol Testing said he hadn’t tested for employers but he’s had some inquiries from parents about testing their teens — but no one has followed through. But the reliability of the tests is an issue, said Justin Grodnitzky, a criminalist with the Iowa Division of Criminal Investigation. The testing panels could be six months behind what authorities are seeing on the street. Another challenge is that the synthetic drugs process through the system faster, some within two hours — unlike marijuana and some other drugs. “Employers have to make informed decisions when it comes to testing,” said Barry Sample, director of Science and Technology for Employers Solutions of Quest Diagnostics in Madison, N.J. His company provides drug testing education to employers across the country and, he said, they all are dealing with those same issues. He has been providing education about synthetics since 2010. “I think most employers are aware of synthetics and recognize the threat,” he added. He doesn’t think it’s necessarily practical for employers to test for synthetics as part of the pre-employment process. Sample recommends they should test if there is “reasonable suspicion.” For more information on Synthetics or Reasonable suspicion testing & training contact Mobile Medical Corporation 888-662-8358 ext. 201
Monday, August 25, 2014
ER Visits Involving Sleep Drug Overmedication Almost Doubles /By Join Together Staff August 12th, 2014 The number of emergency department visits involving the sleep drug zolpidem (the active ingredient in Ambien) almost doubled over four years, according to a new government report. Zolpidem-related ER visits rose from 21,824 in 2005-2006, to 42,274 in 2009-2010, the Substance Abuse and Mental Health Services Administration (SAMHSA) found. In 2010, females accounted for two-thirds of zolpidem-related ER visits involving overmedication. The largest number of visits related to overmedication with the drug involved patients ages 45 to 54. More than half of zolpidem-related ER visits also involved other prescription drugs, including other anti-anxiety and insomnia medications and narcotic pain relievers. In addition, 14 percent of visits involved alcohol combined with zolpidem. Almost half of ER visits related to zolpidem overmedication resulted in either a hospital admission or a transfer to another medical facility. About one-quarter of these more serious cases involved admission to a critical or intensive care unit, the report noted. CBS News reports that hospital ER visits involving drug-related suicide attempts in people ages 45 to 64 doubled from 2005 to 2011. In 2010 there were almost 5 million drug-related visits to emergency departments throughout the country, according to SAMHSA. In 2013, the Food and Drug Administration (FDA) required manufacturers of drugs containing zolpidem to reduce the recommended dose by half for females, in response to increasing numbers of reports of adverse reactions. The FDA suggested drug makers also reduce the recommended dose for men. Zolpidem’s side effects can include daytime drowsiness, hallucinations, dizziness, agitation and sleepwalking. When combined with other substances, the sedative effects of zolpidem can be dangerously enhanced, SAMHSA noted in a news release.
Posted by Marianne Karg at 11:45 AM
Tuesday, July 29, 2014
Workplace Drug Testing — Helping Stop Accidents Before They Happen Posted Jul 29, 2014 Many people who have made it to the final stages of the job application process are familiar with pre-employment drug screening. Post-accident, random, return to duty, and reasonable suspicion are also reasons why an organization might drug test its employees. Why all the testing? To put it plainly, drugs and jobs just don’t mix. The National Council on Alcoholism and Drug Dependence, Inc. (NCADD) lists some job performance issues no employer wants to see at their sites: • Inconsistent work quality • Poor concentration and lack of focus • Lowered productivity or erratic work patterns • Increased absenteeism or on the job “presenteeism” • Unexplained disappearances from the jobsite • Carelessness, mistakes or errors in judgment • Needless risk taking • Disregard for safety for self and others- on the job and off the job accidents • Extended lunch periods and early departures Now, you can imagine that bullet point about “disregard for safety” struck a nerve. As safety professionals, you do your best to create a workplace safety culture that gets everyone home safe after their shift. You try to control potential dangers and make sure everyone knows what they need to know to safely perform all their job duties. Adding impaired workers into the mix only makes matters so much more difficult for employers, co-workers, and the abusers themselves. A workplace testing program, and employees who understand the rationale behind it, can help alleviate many of these concerns. NCAAD provides a downloadable fact sheet filled with stats that make the case for workplace testing: • Up to 40% of industrial fatalities and 47% of industrial injuries can be linked to alcohol consumption and alcoholism. • 21% of workers reported being injured or put in danger, having to re-do work or to cover for a co¬worker, or needing to work harder or longer due to others' drinking. • Absenteeism among alcoholics or problem drinkers is 3.8 to 8.3 times greater than normal and up to 16 times greater among all employees with alcohol and other drug-related problems. Drug-using employees take three times as many sick benefits as other workers. They are five times more likely to file a worker's compensation claim. • Shortfalls in productivity and employment among individuals with alcohol or other drug-related problems cost the American economy $80.9 billion in 1992, of which $66.7 billion is attributed to alcohol and $14.2 billion to other drugs. A 2011 poll by the Society for Human Resource Management (SHRM) in collaboration with and commissioned by the Drug & Alcohol Testing Industry Association (DATIA), offers these findings for consideration as well: • A fifth of organizations (19 percent) reported seeing an improvement in productivity. • Four percent of employers said they had high absenteeism rates (more than 15 percent) after implementing drug testing programs compared to 9 percent before beginning programs, a decrease of more than 50 percent. • Six percent of organizations saw workers’ compensation incidence rates of more than 6 percent after implementing programs compared to 14 percent before starting drug testing programs, a decrease of more than 50 percent. • For employers with drug testing programs, 16 percent reported a decrease in employee turnover rates, while 8 percent reported an increase, after the implementation of a drug testing program. Mobile Medical Corporation provides testing and training that will educate the employer and employee on: • When testing needs to occur, including pre-employment, random, post accident, reasonable suspicion, return to duty, and follow-up testing • Why testing for alcohol and other drugs is required for transportation workers • Importance of maintaining a drug- and alcohol-free workplace Call Today: 888-662-8358 for more information
Posted by Marianne Karg at 3:38 PM
Thursday, July 17, 2014
One in five workers drunk on the job by Janie Smith | 04 Jul 2014 Workplace drug testing gets a fair amount of media coverage, but there is a potentially far larger issue that employers need to be aware of – alcohol. A survey conducted by the Australian Drug Foundation found that nearly one in five employees had performed work duties while drunk or tipsy. A similar number admitted to pulling a sickie due to the effects of alcohol, while about 40% said they’d gone to work while still feeling the effects of their drinking. According to the foundation, alcohol and other drugs cost Australian businesses $6 billion per year in lost productivity and absenteeism, with alcohol use contributing to five per cent of workplace deaths and 11 per cent of accidents. Phillip Collins, the foundation’s head of workplace services, told HC that employers needed to realise that drinking was not an “at-home issue”, even though the majority of alcohol is consumed outside of office hours. “People don’t really understand the knock-on effect of alcohol. They think you can have a party at night and come to work the next day and be fully functional. But the truth is, alcohol takes a lot longer to get out of the system than people recognise. It impacts your performance.” Collins said studies showed that a blood alcohol concentration of 0.09, nearly double the legal driving limit of 0.05, caused a massive drop-off in cognitive skills and huge variations with regards to motor skills. “If you’re in a factory doing some assembly, there are big error rates that can occur. Or if you’re a manager doing cognitive work, you can make poor judgements. You might not feel over the limit or under the weather, but cognitively and motor skills-wise, you can actually be quite impacted.” He said organisations needed to have a robust alcohol and drug policy that wasn’t just a behavioural statement, but was ingrained in the business. It needed to cover things like what employees did in a social setting, how they interacted with clients and what the drinking cut-off rate was. “Are you going for zero tolerance, are you going for a three-strike policy? There are a lot of things in the policy that need to be addressed, not simply a throw-away line to say, ‘Hey, we’re banning alcohol’. “In certain settings, that’s actually a very difficult thing to do. If you’re in a sales environment, you may be called upon to entertain a client or to have a meeting over lunch or dinner and if you have a zero tolerance policy on alcohol, that’s not workable.” Collins said organisations had to look at the reality of their business to make sure its drug and alcohol policy was a good cultural fit and it was able to continue to do business while providing a safe working environment. Communicating the policy was also key, he said. “A lot of policies are created and put on the shelf where they collect dust and nobody actually knows about them until something goes wrong.” Reiterating the policy was particularly important around high-risk times like Christmas and the “silly season” period, when parties were more common. Legally speaking, dealing with employees who came to work under the influence was up to the organisation, said Collins. “Apart from them not being able to break any laws – so if they’re over the limit of 0.05 they can’t drive – there’s no legislation that tells an organisation, ‘This is what you have to do’. It’s really up to the organisation to set those boundaries.” Managers also needed to be educated on how to identify that someone is intoxicated. “You don’t want to identify someone who might look intoxicated but is actually on prescription medication. Organisations have to become a bit smarter about what they do and there hasn’t been any real skill set that’s been put into the HR space that allows everyone to be upskilled.” Are your employees up to speed with the company’s drug and alcohol policy?
Posted by Marianne Karg at 4:58 PM
Tuesday, July 15, 2014
Women and PPE: Finding the right fit Employers need to keep women in mind when purchasing PPE Thomas J. Bukowski June 22, 2014 ■PPE such as gloves, fall-arrest harnesses and safety boots that are designed for men may not fit women because of differences in average body dimensions. ■Some experts insist that employers should provide separate PPE for men and women rather than unisex PPE, which may not fit a woman properly. ■Employers should seek out distributors that offer a full range of PPE for both men and women, stakeholders say. Personal protective equipment is one of the last lines of defense for workers against injuries. However, in certain industries such as construction, women are less fortunate than men when it comes to finding gear that fits properly. “I am a woman under 5 feet [tall] and I can tell you, there isn’t much PPE that fits me properly.” – Leah Curran, an employee with New Castle, DE-based Tri-Supply & Equipment “I have had many difficulties in providing my female workers with properly fitting PPE. Anywhere from women’s fire-retardant clothing to gloves appropriate for the job.” – Jeannette Fletter, environmental, health and safety manager for Belectric, a Newark, CA-based renewable energy sources provider “When I first started and needed to wear a hard hat, I’d have to try three or four different models before finding one I was comfortable with.” – Jennifer Grande, safety coordinator with Collins, NY-based Gernatt Asphalt Products Inc. OSHA cites the lack of a full range of PPE sizes and types at the retail, wholesale and distributor levels – as well as employers’ limited knowledge of PPE designed for women – as some of the reasons for the difficulty women encounter with PPE. Another issue may be the low number of women in industries requiring PPE. According to OSHA, in 2010 about 9 percent of workers – or 818,000 – in the construction industry were women. Of those, only about 200,000 worked as laborers or in other positions at construction sites. “Since the industry is majority employed by men, the majority of PPE is going to fit men, but that doesn’t mean PPE shouldn’t be made to fit women,” said Curran, who also is the incoming safety chair for the Fort Worth, TX-based National Association of Women in Construction. “Women may face safety risks because PPE and clothing are often designed for the average-sized [man].” Ill-fitting equipment PPE cannot protect a worker from hazards if it does not fit. Equipment designed for men may not fit women properly due to differences in body size, height and composition, said Hongwei Hsiao, chief of the Protective Technology Branch with NIOSH’s Division of Safety Research. “Women are not just [the] ‘small size’ of men; their body configurations … are different from those of men,” Hsiao said. Grande pointed to gloves and hard hats as examples of how poor fit can affect safety. “If gloves don’t fit right – if they are too big – they’re clumsy, and you may not be able to do your job as well,” she said. “If your hard hat falls off every time you look up, that’s not a good thing either – you may need to use one hand to hold it on.” According to Ziqing Zhuang, the respiratory protection research team leader of the Technology Research Branch at the NIOSH National Personal Protective Technology Laboratory, women may have a hard time finding protective clothing, fall-arrest harnesses and gloves that are not too large. Safety boots may be one of the most difficult pieces of PPE for female workers to find, Zhuang said, and he disagrees with a common notion that women should simply wear a man’s boot that is “two sizes smaller.” According to a 2006 publication from the Industrial Accident Prevention Association and the Ontario Women’s Directorate, a typical woman’s foot is both shorter and narrower than a typical man’s foot, so a smaller boot may be the right length but not the right width. PPE tips for women A publication developed by the Industrial Accident Prevention Association and the Ontario Women’s Directorate in 2006 offers tips for women workers looking for personal protective equipment that fits. •Earplugs – Disposable, foam earplugs are more likely to fit women, who typically have smaller ear canals. •Hard hats – Adding a chin strap can help hard hats or caps fit better and not fall off. •Safety goggles – Beware of goggles that state “one size fits all” – some may be too large for a woman’s face and could allow objects, fluids or other hazardous materials to enter through gaps in the seals. •Protective clothing – Taking a man’s garment and modifying it to fit a woman, such as rolling up sleeves or pant legs, can be dangerous because the excess material can become caught in machinery. •Safety gloves – Ensure all exposed skin is covered; the gloves allow for a safe grip so tools will not easily slip out of the hands; and the finger length, width and palm circumference of the gloves match those of the hands.
Posted by Marianne Karg at 10:41 AM
Thursday, June 26, 2014
Marijuana Use on the Rise in U.S. but Decreasing Globally: U.N. Report /By JOIN TOGETHER STAFF JUNE 26TH, 2014 Marijuana use is increasing in the United States as Americans change their attitude about the drug’s risks, according to a new report by the U.N. Office on Drugs and Crime (UNODC). Globally, marijuana use seems to be decreasing. The number of Americans ages 12 or older who used marijuana at least once in the previous year increased to 12.1 percent in 2012, from 10.3 percent in 2008, Reuters reports. More Americans are seeking help for marijuana-related disorders. It is too early to understand the impact of the legalization of recreational marijuana in Washington state and Colorado, the report noted. “For youth and young adults, more permissive cannabis regulations correlate with decreases in the perceived risk of use, and lowered risk perception has been found to predict increases in use,” the UNODC wrote. The report also noted there has been a surge in opium production in Afghanistan, and a fall in the global availability in cocaine. Worldwide output of heroin increased last year. Overall, drug use prevalence is stable around the world, the report concluded. About 5 percent of the world’s population ages 15 to 64 used an illicit drug in 2012. “There remain serious gaps in service provision. In recent years only one in six drug users globally has had access to or received drug dependence treatment services each year,” Yury Fedotov, Executive Director of UNODC, said in a news release. He added that about 200,000 drug-related deaths occurred in 2012.
Posted by Marianne Karg at 12:43 PM
Tuesday, June 17, 2014
Harvard Scientists Studied the Brains of Pot Smokers, and the Results Don't Look Good By Eileen Shim April 16, 2014 Harvard Scientists Studied the Brains of Pot Smokers, and the Results Don't Look Good Image Credit: AP The news: Every day, the push toward national legalization of marijuana seems more and more inevitable. As more and more politicians and noted individuals come out in favor of legalizing or at least decriminalizing different amounts of pot, the mainstream acceptance of the recreational use of the drug seems like a bygone conclusion. But before we can talk about legalization, have we fully understood the health effects of marijuana? According to a new study published in the Journal of Neuroscience, researchers from Harvard and Northwestern studied the brains of 18- to 25-year-olds, half of whom smoked pot recreationally and half of whom didn't. What they found was rather shocking: Even those who only smoked few times a week had significant brain abnormalities in the areas that control emotion and motivation. "There is this general perspective out there that using marijuana recreationally is not a problem — that it is a safe drug," said Anne Blood, a co-author of the study. "We are seeing that this is not the case." The science: Similar studies have found a correlation between heavy pot use and brain abnormalities, but this is the first study that has found the same link with recreational users. The 20 people in the "marijuana group" of the study smoked four times a week on average; seven only smoked once a week. Those in the control group did not smoke at all. "We looked specifically at people who have no adverse impacts from marijuana — no problems with work, school, the law, relationships, no addiction issues," said Hans Breiter, another co-author of the study. Using three different neuroimaging techniques, researchers then looked at the nucleus accumbens and the amygdala of the participants. These areas are responsible for gauging the benefit or loss of doing certain things, and providing feelings of reward for pleasurable activities such as food, sex and social interactions. "This is a part of the brain that you absolutely never ever want to touch," said Breiter. "I don't want to say that these are magical parts of the brain — they are all important. But these are fundamental in terms of what people find pleasurable in the world and assessing that against the bad things." Shockingly, every single person in the marijuana group, including those who only smoked once a week, had noticeable abnormalities, with the nucleus accumbens and the amygdala showing changes in density, volume and shape. Those who smoked more had more significant variations. What will happen next? The study's co-authors admit that their sample size was small. Their plan now is to conduct a bigger study that not only looks at the brain abnormalities, but also relates them to functional outcomes. That would be a major and important step in this science because, as of now, the research indicates that marijuana use may cause alterations to the brain, but it's unclear what that might actually mean for users and their brains. But for now, they are standing behind their findings. "People think a little marijuana shouldn't cause a problem if someone is doing OK with work or school," said Breiter. "Our data directly says this is not so
Posted by Marianne Karg at 11:36 AM
Friday, June 13, 2014
Research on Marijuana’s Role in Car Crashes Expands as Drug Availability Grows /By Join Together Staff June 10th, 2014/ As marijuana becomes more readily available, a growing number of researchers are studying the possible link between marijuana and fatal car crashes, USA Today reports. A study published earlier this year by Columbia University researchers found marijuana contributed to 12 percent of traffic deaths in 2010. The study of almost 24,000 fatal car accidents found marijuana was linked to three times as many traffic deaths compared with a decade earlier. According to a 2010 survey by the National Highway Traffic Safety Administration (NHTSA), one in eight high school seniors said they drove after smoking marijuana. Almost one-quarter of drivers killed in drug-related crashes were younger than 25, the article notes. In addition, almost half of fatally injured drivers who tested positive for marijuana were under age 25. The National Institute on Drug Abuse (NIDA) and NHTSA have been conducting a three-year study to determine how inhaled marijuana impacts driving performance. NIDA notes on its website, “Considerable evidence from both real and simulated driving studies indicates that marijuana can negatively affect a driver’s attentiveness, perception of time and speed, and ability to draw on information obtained from past experiences. Research shows that impairment increases significantly when marijuana use is combined with alcohol.” NIDA notes it is difficult to measure the exact contribution of drug intoxication to driving accidents, because blood tests for drugs other than alcohol are inconsistently performed, and many drivers who cause accidents are found to have both drugs and alcohol in their system, making it hard to determine which substance had the greater effect. Lawmakers in Washington state, where recreational marijuana use is now legal, are trying to determine how police officers can identify drivers impaired by marijuana use. There is no consensus on what blood level of THC, the active ingredient in marijuana, impairs driving, the newspaper notes. Breathalyzers cannot be used for marijuana.
Posted by Marianne Karg at 11:56 AM
Thursday, May 15, 2014
Painkiller Overdose Deaths Have Tripled: Government Report By Join Together Staff | May 15, 2014 | Overdose deaths from prescription narcotics tripled from 2009-2010, compared with a decade earlier, according to a new government report. Almost half of Americans are taking one or more prescription medications, the report found. An estimated 10.5 percent are prescribed painkillers. The Centers for Disease Control and Prevention (CDC) report found among people ages 15 and older, painkiller use led to 6.6 deaths for every 100,000 people in 2009-2010, compared with 1.9 deaths per 100,000 in 1999-2000. According to the CDC, 17.7 percent of Americans take prescription medication for cardiovascular disease; 10.7 percent take cholesterol-lowering medication; 10.6 percent take antidepressants; and 9 percent take anti-acid reflux drugs, Time reports. The report found a large jump in the percentage of Americans taking prescription medication, according to HealthDay. From 2007 to 2010, about 48 percent of people said they were taking a prescription drug, up from 39 percent from 1988 to 1994. About 90 percent of adults ages 64 and older took prescription medication in the past month, while 25 percent of children did so. About 10 percent of Americans said they had taken five or more prescription drugs in the previous month. The rising use of medications has unintended consequences, including prescription drug abuse and antibiotic resistance. “Isn’t that the case with all forms of medical technology?” said Julia Holmes, Chief of the Analytic Studies Branch at the CDC’s National Center for Health Statistics. “It results in great benefit to people who are ill and disabled, but there’s always the potential for inappropriate use.”
Posted by Marianne Karg at 11:54 AM
Thursday, May 8, 2014
DEA Arrests at Least 150 People in Synthetic Drug Operation in 29 States By Join Together Staff | May 8, 2014 | The Drug Enforcement Administration (DEA) announced Wednesday it conducted a major crackdown on synthetic drugs that involved the arrest of at least 150 people in 29 states, and the seizure of more than $20 million in products and cash. Hundreds of thousands of packets of synthetic drugs were seized. The operation comes a week after more than 100 people in Texas became ill from synthetic marijuana, the Los Angeles Times reports. “There’s a cluster of people with severe anxiety, some with seizures, that could be because of synthetic cannaboids,” Dr. Miguel Fernandez, Director of South Texas Poison Center, told the newspaper. “I would caution people not to use them because they are not like typical marijuana.” Law enforcement officials and prosecutors have found it difficult to win convictions against makers of synthetic drugs, who are constantly changing the chemistry of the products to stay one step ahead of the law. In order to convict a synthetic drug maker, officials must prove the person sold the drug, and that the drug was substantially similar to a specifically banned substance. All a drug maker has to do is make small chemical changes to the products so they are not considered “analogues,” or chemical compounds that are similar to banned drugs. Last year, the DEA and authorities in three other countries announced the arrests of dozens of people involved in trafficking designer drugs such as bath salts and synthetic marijuana. In the United States, the enforcement operations took place in 49 cities, and targeted retailers, wholesalers and manufacturers. The operations included more than 150 arrest warrants and almost 375 search warrants. In 2013, the Substance Abuse and Mental Health Services Administration reported 29,000 emergency department visits nationwide in 2011 resulting from use of synthetic marijuana, up from 11,000 in 2010.
Posted by Marianne Karg at 11:37 AM
Monday, May 5, 2014
Two States to Consider Banning Powdered Alcohol By Join Together Staff | May 1, 2014 | Legislators in Minnesota and Vermont have introduced measures that would ban powdered alcohol, The Washington Post reports. The federal Alcohol and Tobacco Tax and Trade Bureau approved labels for a powdered alcohol product called “Palcohol,” but earlier this month said the approval was a mistake. Lipsmark, the company that makes Palcohol, has resubmitted an application, the article notes. Lipsmark says it plans to offer powdered alcohol in six varieties, including rum, vodka, Cosmopolitan, Mojito, Powderita and Lemon Drop. According to the company, a package of Palcohol weighs about an ounce and can fit into a pocket. It warns people not to snort the powder. Minnesota state Representative Joe Atkins this week introduced a bill that would ban powdered alcohol sales in his state. A similar bill is being considered in Vermont. Some health experts are afraid the product could be easily misused or abused. “Virtually every possible use for powdered alcohol is nefarious, not to mention potentially dangerous,” Atkins said in a news release. “The different flavorings make it appealing to children and students who could easily sneak packets into school. This powder could also be inhaled or snorted, bringing a whole new world of problems into play. With how quickly this is moving, we shouldn’t wait until next session to deal with this issue. We need to move quickly to protect public health.” Vermont state Senator Kevin Mullin, who introduced the measure to ban powdered alcohol in his state, told VPR News, “You can’t buy a bottle of gin at the liquor store if you’re 16. But there’s nothing that I can see in Vermont statute that would prohibit you from buying powdered alcohol, if it was available. So think about kids walking around with packets of powdered alcohol in their pocket – hard to detect.”
Posted by Marianne Karg at 3:10 PM
Wednesday, April 23, 2014
Countering the Myths About Methadone By Edwin A. Salsitz, MD | August 6, 2013 | Filed in Addiction, Healthcare, Prescription Drugs & Treatment Methadone maintenance has been used in the United States for approximately 50 years as an effective treatment for opioid addiction. Yet many myths about its use persist, discouraging patients from using methadone, and leading family members to pressure patients using the treatment to stop. Dr. Vincent Dole of Rockefeller University in New York, who pioneered the use of methadone as an opioid addiction treatment, found his patients no longer craved heroin. They were able to return to work and school, and participate in family life and community affairs. As methadone’s use grew, the federal government decided it should only be dispensed in licensed treatment programs, which would provide a whole range of services such as counseling, vocational help and medical and psychiatric treatment. This creation of the clinic system developed into a double-edged sword. On the one hand, it was advantageous to have many services available in the methadone clinic, but very stringent regulations came along with the clinic concept, including the requirement that patients come to the clinic daily for their methadone. Clinic hours often conflict with patients’ work schedules, and make it very difficult to take a vacation. In some areas of the country, the clinics are few and far between, requiring traveling many miles each day. The biggest and probably most important obstacle has been the stigma associated with being seen entering or exiting a methadone clinic. In an attempt to reduce that stigma, I present the six most common myths about methadone and explain why they are incorrect. Myth #1: Methadone is a substitute for heroin or prescription opioids. Methadone is a treatment for opioid addiction, not a substitute for heroin. Methadone is long-acting, requiring one daily dose. Heroin is short-acting, and generally takes at least three to four daily doses to prevent withdrawal symptoms from emerging. Myth #2: Patients who are on a stable dose of methadone, who are not using any other non-prescribed or illicit medications, are addicted to the methadone. Patients taking methadone are physically dependent on it, but not addicted to it. Methadone does not cause harm, and provides benefits. People with many common chronic illnesses are physically dependent on their medication to keep them well, such as insulin for diabetes, inhalers for asthma and blood pressure pills for hypertension. Myth #3: Patients who are stable on their methadone dose, who are not using other non-prescribed or illicit drugs, are not able to perform well in many jobs. People who are stable on methadone should be able to do any job they are otherwise qualified to do. A person stabilized on the correct dose is not sedated, in withdrawal or euphoric. The most common description of how a person feels on methadone is “normal.” Myth #4: Methadone rots teeth and bones. After 50 years of use, methadone remains a safe medication. There are side effects from taking methadone and other opioids, such as constipation and increased sweating. These are usually easily manageable. If patients engage in good dental hygiene, they should not have any dental problems. Myth #5: Methadone is not advisable in pregnant women. The evidence over the years has shown that a pregnant woman addicted to opioids has the best possible outcome for herself and her fetus if she takes either methadone or buprenorphine. A pregnancy’s outcomes are better for mother and newborn if the mother remains on methadone than if she tapers off and attempts to be abstinent during pregnancy. Methadone does not cause any abnormalities in the fetus and does not appear to cause cognitive or any other abnormalities in these children as they grow up. Babies born to mothers on methadone will experience neonatal abstinence syndrome, which occurs in most newborns whose mothers were taking opioids during pregnancy. This syndrome is treated and managed somewhat easily and outcomes for the newborn are good—it is not a reason for a pregnant woman to avoid methadone treatment. Mothers on methadone should breastfeed unless there is some other contraindication, such as being HIV-positive. Myth #6: Methadone makes you sterile. This is untrue. Methadone may lower serum testosterone in men, but this problem is easily diagnosed and treated. These myths, and the stigma of methadone treatment that accompanies them, are pervasive and persistent issues for methadone patients. They are often embarrassed to tell their other physicians, dentists and family members about their treatment. They may feel they are doing something wrong, when in fact they are doing something very positive for themselves and their loved ones. These misperceptions can only be corrected with more education for patients, families, health care providers and the general public. Edwin A. Salsitz, MD, FASAM, is Medical Director, Office-Based Opioid Therapy at Beth Israel Medical Center in New York.
Thursday, April 3, 2014
Frequency of Energy Drink Use Linked with Risk of Abusing Prescription Drugs By Join Together Staff | April 3, 2014 | College students who consume energy drinks are more likely than their peers who don’t use them to abuse prescription drugs, a new study concludes. The more energy drinks a student consumes, the greater their risk. The study included undergraduate and graduate college students, who completed a web-based survey about their pattern of energy drink and prescription stimulant use. They were asked about medications prescribed to them, as well as drugs they took without a prescription. The more energy drinks students consumed, the likelier they were to illicitly use prescription stimulants. All students who had a valid prescription for stimulant medications said they mixed energy drinks with their stimulants. This is discouraged, because it can increase side effects, News-Medical.net reports. The findings are published in Substance Abuse. “This article includes a needed review of the neurological effects of energy drink ingredients. It also provides practitioners with important information about the dangerous interactions that can occur when energy drinks are mixed with prescription stimulants or other pharmaceutical drugs,” lead author Dr. Conrad Woolsey said in a news release. “Ginseng, for example, should not be mixed with anti-depressant medications or prescription stimulants because this can cause dangerously high levels of serotonin (i.e., serotonin syndrome), which is known for causing rapid irregular heartbeats and even seizures.”
Posted by Marianne Karg at 1:27 PM
Thursday, March 20, 2014
Vaporizers Gain Popularity Among Marijuana Smokers By Join Together Staff | March 18, 2014 | A growing number of marijuana smokers are choosing to use vaporizers, which are similar to e-cigarettes, according to USA Today. The popularity of the devices is changing the way marijuana is packaged and sold in states where it is legal. The vaporizers, known as “vape pens,” are compact and portable. Steve DeAngelo, a marijuana entrepreneur and activist who founded the Harborside Health Center medical marijuana dispensary in Oakland, California, says his dispensary does about half of its business in raw marijuana leaf or flowers. The rest are sold as edibles or concentrates, some of which are prepackaged for use in vape pens. “The percentage of raw (pot) flowers we sell has been dropping steadily,” he said. “The percent of extracts and concentrates … has been rising steadily.” Some vape pens use concentrated marijuana extractions, while others use marijuana leaves and flowers. “This really portends the next generation of marijuana use,” John Lovell, a Sacramento attorney and lobbyist for the California Narcotics Officers’ Association and California Police Chiefs Association, told the newspaper. His group is concerned about the high-strength concentrates used in vape pens. Concentrates can be composed of as much as 80 percent or 90 percent THC, the psychoactive ingredient in marijuana. Others are concerned that vape pens allow teens to smoke marijuana without being detected, because the pens leave no odor.
Posted by Marianne Karg at 4:17 PM
Thursday, February 27, 2014
Advocates Urge FDA to Revoke Approval of Painkiller Zohydro By Join Together Staff | February 26, 2014 | More than 40 addiction treatment, health care and consumer groups are urging the Food and Drug Administration (FDA) to reverse its decision to approve the prescription painkiller Zohydro ER (extended release), CNN reports. The drug is a pure form of the painkiller hydrocodone. The FDA approved Zohydro ER in October for patients with pain that requires daily, around-the-clock, long-term treatment that cannot be treated with other drugs. Drugs such as Vicodin contain a combination of hydrocodone and other painkillers such as acetaminophen. Zohydro ER is set to become available in March, the article notes. In December 2012, a panel of experts assembled by the FDA voted against recommending approval of Zohydro ER. The panel cited concerns over the potential for addiction. Zohydro is designed to be released over time, and can be crushed and snorted by people seeking a strong, quick high. The opioid drug OxyContin has been reformulated to make it harder to crush or dissolve, but Zohydro does not include similar tamper-resistant features. In a letter to FDA Commissioner Dr. Margaret Hamburg, the coalition of health groups, wrote, “In the midst of a severe drug epidemic fueled by overprescribing of opioids, the very last thing the country needs is a new, dangerous, high-dose opioid. Too many people have already become addicted to similar opioid medications, and too many lives have been lost.” The health groups include the American Society of Addiction Medicine, Public Citizen Health Research Group, Phoenix House, the Hazelden Foundation, and Physicians for Responsible Opioid Prescribing. In December, 28 attorneys general wrote to Commissioner Hamburg, saying they believe the approval of Zohydro ER “has the potential to exacerbate our nation’s prescription drug abuse epidemic because this drug will be the first hydrocodone-only opioid narcotic that is reportedly five to ten times more potent than traditional hydrocodone products, and it has no abuse-deterrent properties.”
Posted by Marianne Karg at 12:37 PM
Thursday, February 6, 2014
DEA Joins Investigation Into Source of Deadly Heroin That Killed 22 In Western PA By Join Together Staff | January 29, 2014 The Drug Enforcement Administration has joined an investigation into the source of a batch of heroin that killed 22 people in western Pennsylvania, The Wall Street Journal reports. The heroin involved in some of the deaths contained the synthetic opiate fentanyl, often used during surgery. “We do have a good idea where it’s coming from,” Pennsylvania Attorney General Kathleen Kane said of the drug mix. “We’re trying to find the source and get them off the street before there are any more deaths.” Dr. Karl Williams, medical examiner for Allegheny County, said 15 overdose deaths in the county appeared to be linked to heroin and fentanyl. In an average week, there are five overdose deaths in the county. More nonfatal overdoses were also reported. Officials found bags of heroin mixed with fentanyl at the scene of overdose deaths stamped with the names “Theraflu” and “Bud Ice,” the article notes. While most heroin is a tan color, these bags of powder were pure white, Williams said. “Clearly, someone has mixed up a big dose of it,” he said. Some local law enforcement and health officials are concerned that warning drug users about the dangerous heroin mix will encourage them to seek it out for a more potent high. “A lot will chase it, and demand goes up,” Neil Capretto, Medical Director of Gateway Rehabilitation Center told the newspaper. “They will think those who died were just careless.”
Posted by Marianne Karg at 12:51 PM
Friday, January 24, 2014
Drug use among U.S. workers declined 74% over past 25 years According to new analysis Drug use among U.S. workers declined dramatically over the past 25 years, although the rate of positive test results for certain drugs, including amphetamine and opiates, continues to climb, according to an analysis of workplace drug test results released by Quest Diagnostics, a provider of diagnostic information services. The release of the special 25th anniversary Drug Testing Index (DTI) coincides with the anniversary of the passage of the Drug-Free Workplace Act in 1988. The Act requires federal contractors and all federal grantees to agree to provide drug-free workplaces as a precondition of receiving a contract or grant from a federal agency. Although the Act did not require mandatory drug testing, federal agencies subsequently promulgated drug testing regulations affecting "safety-sensitive" employees and other federal employees. Many private employers also created policies consistent with the federal requirements in order to minimize the hazards of drug use in the workplace. The DTI analysis examined more than 125 million urine drug tests performed by Quest Diagnostics forensic toxicology laboratories across the United States as a service for government and private employers between 1988 and 2012. The analysis examined the annual positivity rate for employees in positions subject to certain federal safety regulations, such as truck drivers, train operators, airline and nuclear power plant workers (federally mandated safety-sensitive workers); workers primarily from private companies (U.S. general workforce); and the results of both groups together (combined U.S. workforce). The index reports the percentage of results that tested positive for the presence of a drug or its metabolite, an adulterant, or that involved a specimen that was deemed to be unacceptable for testing ("positivity"). The company's testing services identify approximately 20 commonly abused drugs, including marijuana, opiates, and cocaine. Key findings from the analysis: • The positivity rate for the combined U.S. workforce declined 74 percent, from 13.6 percent in 1988 to 3.5 percent in 2012. • The positivity rate for the federally-mandated safety-sensitive workforce declined by 38 percent, from 2.6 percent in 1992 to 1.6 percent in 2012. • The positivity rate for the U.S. general workforce declined by 60 percent, from 10.3 percent in 1992 to 4.1 percent in 2012. • Despite the declines in overall drug use, the DTI analysis also found that the positivity rate for certain segments of drugs has increased. Positivity rates for amphetamines, including amphetamine and methamphetamine, has nearly tripled (196 percent higher) in the combined U.S. workforce and, in 2012, were at the highest level since 1997. The positivity rate for amphetamine itself, including prescription medications, has more than doubled in the last 10 years. Positivity rates for prescription opiates, which include the drugs hydrocodone, hydromorphone, oxycodone, and oxymorphone, have also increased steadily over the last decade - more than doubling for hydrocodone and hydromorphone and up 71 percent for oxycodone - reflective of national prescribing trends. This data is consistent with other studies, including a 2012 Quest Diagnostics Health Trends analysis of more than 75,000 test results from patients tested for compliance through the company's prescription drug monitoring services. This report found that the majority of Americans misused their prescription medications, including opioids and amphetamine medications. The DTI report also found that changing positivity rates often mirrored larger developments in drug use in the U.S. For instance, a decline in drug positives for methamphetamine observed in 2005 roughly coincided with federal and state efforts to crackdown on so-called "meth labs" and put over-the-counter medicines (such as ephedrine and pseudoephedrine) behind the pharmacy counter.
Posted by Marianne Karg at 11:21 AM
Thursday, January 23, 2014
Surge in Synthetic Marijuana Emergency Room Visits Reported in Denver By Join Together Staff | January 23, 2014 Emergency rooms in Denver, Colorado reported a surge in visits related to synthetic marijuana in the late summer and early fall, according to the Los Angeles Times. Experts say similar patterns may emerge in other parts of the country. Between August 24 and September 19, area emergency rooms saw 263 patients, mostly young men, with symptoms related to synthetic marijuana. Most patients were treated in the emergency room, but seven were admitted to intensive care units. In a letter in this week’s New England Journal of Medicine, Dr. Andrew A. Monte of the University of Colorado School of Medicine writes synthetic marijuana appears to be growing more potent. “Although the effects of exposures to first-generation synthetic cannabinoids are largely benign, newer products have been associated with seizures, ischemic stroke and cardiac toxicity, possibly due to potency,” he wrote. Synthetic marijuana is sold under names including K2, Spice and Black Mamba. It is made with dried herbs and spices that are sprayed with chemicals that induce a marijuana-type high when smoked, the article notes. The products are widely available, despite laws prohibiting them. “These substances are not benign,” Monte said. “You can buy designer drugs of abuse at convenience stores and on the Internet. People may not realize how dangerous these drugs can be — up to 1,000 times stronger binding to cannabis receptors when compared to traditional marijuana.” In September, the Colorado Department of Public Health and the Centers for Disease Control and Prevention announced they were investigating whether three deaths and 75 hospitalizations were caused by synthetic marijuana. Short-term effects of using synthetic marijuana include loss of control, lack of pain response, increased agitation, pale skin, seizures, vomiting, profuse sweating, uncontrolled/spastic body movements, elevated blood pressure, heart rate and palpitations.
Posted by Marianne Karg at 2:52 PM
Friday, January 10, 2014
Colorado Addiction Treatment Centers Brace for More Teens Referred for Marijuana Use By Join Together Staff | January 7, 2014 | Addiction treatment centers in Colorado are bracing for an increase in teens referred for marijuana use, ABC News reports. The state began legal sales of recreational marijuana for adults last week. While only people 21 and older are allowed to purchase marijuana, some experts are concerned the law will allow the drug to more easily fall into the hands of teens. Dr. Christian Thurstone, who heads the teen rehabilitation center Adolescent STEP: Substance Abuse Treatment Education & Prevention Program, said 95 percent of patient referrals to the program are for marijuana use. In preparation for the new law, Dr. Thurstone has doubled his staff. He told ABC News that marijuana can be harmful for some teens, particularly those suffering from mental illness. He said that after Colorado legalized medical marijuana in 2009, teens began to use much higher potency products. “Our kids are presenting more severe addictions; it takes them longer to get a clean urine drug screen,” he said. Higher-potency marijuana can increase the risk of psychotic episodes in some teens, Thurstone added. “Anecdotally, yes, we’re seeing kids in treatment here who have paranoia and seeing things and hearing things that aren’t there,” he said. “Adolescent exposure to marijuana [raises] risk of permanent psychosis in adulthood.” Ben Court, an addictions expert at the University of Colorado Hospital Center for Dependency, Addiction and Rehabilitation, has also seen an increase in patients addicted to marijuana since the state approved medical marijuana. He says the younger people are when they start consistently using marijuana, the more likely they are to become addicted. “Most people are going to smoke weed and it’s not going to be an issue. By 18 to 24, your odds are less than 1 in 10 that you’re going to be addicted,” he said. “If you start under 18, it’s 1 in 6.”
Posted by Marianne Karg at 11:24 AM
Tuesday, December 31, 2013
Alcohol-Related Car Crashes More Likely on New Year’s Eve Than Christmas Fatal car crashes are more likely to be caused by alcohol on New Year’s Eve, compared with Christmas, according to the National Safety Council. Bloomberg reports between 2007 and 2011, over the New Year’s holiday period—6 p.m. December 31 through 11:59 p.m. January 1—there were an average of 108 traffic deaths a day, with about 42 percent linked to alcohol. In contrast, there were 93 alcohol-related deaths between 6 p.m. December 24 and 11:59 p.m. December 25, with 35 percent linked to alcohol. This year, the group estimates that during Christmas, there will be 105 traffic deaths and 11,200 injuries requiring a medical professional, and 156 traffic deaths and 16,700 injuries during New Year’s. “The difference between the two holidays is that everybody on New Year’s Eve is going out to parties and at their parties, they’re having the alcohol,” Capt. Nancy Rasmussen, Chief of Public Affairs for the Florida Highway Patrol, told Bloomberg. Christmas is more of a “stay-in-the-house, do-the-family thing, so there’s less drinking,” she added. Traffic deaths are more likely during the July 4, Memorial Day and Labor Day weekends than New Year’s, Thanksgiving or Christmas, the article notes. These warmer-month holiday periods average 140 traffic deaths each per day. The National Safety Council advises drivers not to get behind the wheel even if they think they’re “just a little buzzed.” Designate a non-drinking driver, or take a cab, and refuse to ride with an impaired driver, even if it’s a friend or spouse. By Join Together Staff | December 20, 2013 |
Posted by Marianne Karg at 2:31 PM
Friday, November 15, 2013
NO EASY ANSWER TO OPIOID ADDICTION EPIDEMIC By Join Together Staff | November 13, 2013 There are no easy answers to solving the opioid addiction epidemic, according to experts at the American Association for the Treatment of Opioid Dependence annual meeting this week. Thomas McLellan, CEO of the Treatment Research Institute, told NBC Philadelphia a multi-faceted approach is needed. “You don’t have any alternatives [to opioids]. The only alternative is a non-steroidal anti-inflammatory; well it’s got liver toxicity and it’s not all that potent. There’s nothing between that and a very powerful opioid,” said Dr. McLellan, who served as the Deputy Director of the White House Office of National Drug Control Policy. “This is one of those problems that society has to manage. You can’t do away with it. Not with 70 million older Americans who vote and are aging and need them. You can’t ban them.” Doctors don’t have proper training to understand opioid addiction, Dr. McLellan noted. “They prescribe too much. They don’t manage them. About 70 percent of all the overdose deaths occur within 48 hours after the first prescription or after the first refill,” he said. He and Dr. Jeannemarie Perrone, Director of Toxicology in the Hospital of the University of Pennsylvania’s Emergency Medicine Department, recommend that doctors follow national guidelines from the American Academy of Pain Management. These guidelines recommend that patients sign a usage contract, and submit to an annual toxicology screening test to confirm they are taking the medicine and not taking other drugs before the doctor issues a prescription. Patients also need to be part of the solution to opioid abuse, Dr. McLellan says. “It has to be the joint responsibility of the patients to take medication as prescribed. Don’t give them to your sister, don’t leave them in your medicine cabinet, don’t take more than you need,” he added.
Posted by Marianne Karg at 1:09 PM
Tuesday, November 5, 2013
WEED AND WEAPONS: WORKPLACE CHALLENGES BASED ON NEW LAWS By Mark A. Lies II & Kerry M. Mohan INTRODUCTION OSHA requires employers to provide a safe workplace for employees, which includes, among other things, ensuring employees are not impaired in a manner that creates a safety hazard to the employee and other employees, as well as protecting employees from workplace violence. However, new laws regarding medicinal marijuana and the right to carry firearms, including concealed firearms, have created additional uncertainty and anxiety for employers, human resource and safety professionals, and supervisors. These new laws have created uncertainty over a number of issues, including, but not limited to, when an employer can test an employee for suspected marijuana use, whether an employer can lawfully discipline employees for marijuana use, whether an employer can prohibit employees from bringing personal firearms to the workplace, and whether an employer can prohibit an employee from bringing personal firearms in company vehicles. This article addresses potential liability issues employers may face regarding employee drug use and testing and firearms in the workplace. Because each state has its own laws regarding these two issues, we have formatted the article to be questions and answers to provide basic knowledge on these issues. The authors have assisted employers in identifying the specific requirements of state law in these areas and advising about compliance requirements in particular situations. WEED IN THE WORKPLACE Q. Is medical marijuana legal where I live? So far, 20 states and the District of Columbia have enacted laws that decriminalize or authorize, to varying degrees, the use of marijuana for medical purposes. Those states are Alaska, Arizona, California, Colorado, Connecticut, District of Columbia, Delaware, Hawaii, Illinois, Maine, Massachusetts, Michigan, Montana, Nevada, New Hampshire, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, and Washington. Under federal law, use of marijuana for medicinal purposes is still unlawful. Q. Can an employer prohibit its employees from using medical marijuana? Most states permit an employer to establish reasonable rules regarding the use of medicinal marijuana. However, the states with the most recent medicinal marijuana acts, such as Delaware, Illinois, and Arizona, have explicitly prohibited employers from discriminating against medicinal marijuana users on that basis alone. In those states, an employer is permitted to prohibit medicinal marijuana use and discipline an employee for failing a drug test if it would put the employer in violation of federal law or would cause the company to lose a federal contract or money. Q. Are medicinal marijuana users protected by disability discrimination laws? Medicinal marijuana users have continually challenged policies prohibiting marijuana use on the basis of disability discrimination. Thus far, federal courts have found that marijuana use is not protected under the Americans with Disabilities Act (ADA) because marijuana use remains unlawful under federal law. Employers must be aware that if an employee discloses that he/she is legally authorized to use medicinal marijuana that such disclosure could also involve revelation of an underlying “disability” that is protected under the ADA. Thereafter, if the employer decides to take any form of adverse employment action against the employee, it must be prepared to demonstrate that the adverse action was based upon a legitimate business reason having no relationship to an actual or perceived disability. In addition, because states (and many municipalities) have their own anti-discrimination laws, an employer may run afoul of a state’s disability discrimination law by disciplining medicinal marijuana users for off-the-clock use. Finally, many state privacy laws can protect employees for lawful conduct outside of working hours at long as such conduct does not create a hazard or violate any legal obligations at the workplace. Q. Can an employer discipline an employee for having marijuana at the worksite or for being under the influence of medicinal marijuana while at work? Yes. Even the most pro-user medicinal marijuana statutes permit employers to properly discipline employees who are found to have medicinal marijuana at work or who are under the influence of or impaired by medicinal marijuana while at work. Q. How can an employer determine whether an employee is under the influence of medicinal marijuana? Obviously, medicinal marijuana use is easy to spot when an employee smokes or ingests marijuana in front of a supervisor, which is certainly not the typical scenario. However, determining whether an employee is under the influence or “impaired” may be difficult to do under the circumstances, and may be even more difficult for untrained staff. Thus, employers must train supervisors, managers, and foremen on how to identify behavior that demonstrates potential impairment and the proper procedures for responding to and investigating alleged instances of impairment. Further, employers should develop a written definition and understanding as to what constitutes an “impaired” employee. For instance, Illinois’ recent medicinal marijuana statute provides a comprehensive definition of when an employee is considered “impaired” when (s)he: manifests specific, articulable symptoms while working that decrease or lessen his or her performance of the duties or tasks of the employee’s job position, including symptoms of the employee’s speech, physical dexterity, agility, coordination, demeanor, irrational or unusual behavior, negligence or carelessness in operating equipment or machinery, disregard for the safety of the employee or others, or involvement in an accident that results in serious damage to equipment or property, disruption of a production or manufacturing process, or carelessness that results in any injury to the employee or others. The Illinois definition of “impaired” provides a broad spectrum of behavior that employer can consider to be suspicious, and employers should consider whether to adopt this definition for their own internal workplace drug programs. Many states have similar definitions that could be incorporated in the policy. If the employer has properly trained the supervisor on this type of definition and the supervisor properly documents the behavior that has been observed, the employer will be in a position to defend any adverse employment action that it may take against the employee. GUNS IN THE WORKPLACE Likewise, the subject of guns in the workplace raises certain issues. Q. What is a carrying concealed weapons law? A carrying concealed weapons (“CCW”) law sets forth the requirements for an individual to carry a concealed firearm in public. CCW laws vary by state and provide varying restrictions of where an individual can carry a firearm. For instance, many CCW laws prohibit firearms from being carried onto schools, hospitals, government buildings, and places that serve alcoholic beverages. Illinois has 23 identified places where concealed firearms are prohibited. Q. Do CCW laws affect workplaces? Yes. CCW laws vary state by state, and this is particularly true with their application to workplaces. Accordingly, employers must conduct a state-by-state analysis to determine what rights and restrictions employers may have to limit or exclude the carrying of firearms at the workplace, onto company premises, or in company vehicles. Q. Can an employer prohibit the carrying of firearms by employees? Many states have no law limiting an employer’s authority to limit the possession and carrying of firearms at the workplace, on company premises, or in company vehicles (i.e., Arkansas, California, Massachusetts, and New York). In those states, an employer can typically prohibit the carrying of firearms by employees. However, many other states, including Illinois, Michigan, Texas, and Florida, limit an employer’s right to prohibit employees from carrying firearms in certain circumstances when the employee possesses a lawful CCW license. Q. Can an employer prohibit an employee from carrying a firearm into the workplace? Of the states regulating an employee’s right to carry a firearm into the workplace, almost every one permits an employer to prohibit the carrying of the firearm in the actual workplace (i.e., factory, construction site, offices). Those states, however, also require that the employer clearly and conspicuously notify employees that firearms are prohibited, which is typically done through a sign of specified design and size. For example, the required signage in Illinois is specified to be 4” x 6” and must have the following symbol: Q. Can an employer prohibit employees from having a firearms in their personal vehicles in the company’s parking lot? Even though many states permit an employer to prohibit the carrying of firearms in the actual workplace, those same statutes often permit employees to carry firearms in their personal vehicles, even if they are located on an employer’s premises, such as a company parking lot. Depending on the state, however, the employer may be permitted to require that the employee place the firearm out of sight and/or lock the firearm inside the glove box, truck, or secured area within the vehicle. An employer may also be permitted to require employees carrying firearms to park their vehicles at a separate, but nearby, parking lot. Q. Can an employer prohibit an employee from carrying a firearm in a company-owned vehicle? Most, but not all, states, permit an employer to prohibit an employee carrying a firearm in a company-owned, leased, or rented vehicle. Q. Can an employer prohibit other devices that could be used as a weapon from being brought into the workplace? Yes. Employers should seriously consider prohibiting employees from bringing other devices, such as MACE and Pepper Spray, into the workplace. These devices have been used by employees against co-employees and have resulted in serious injury or death. CONCLUSION New medicinal marijuana and CCW laws have increased uncertainty and anxiety for employers nationwide. For instance, what may be lawful in one state is unlawful in another. Or, what is lawful under federal law may be unlawful under state law. For these reasons, employers must be aware of each state’s specific medicinal marijuana and workplace CCW laws to determine what rights and restrictions employers may have in ensuring a safe and healthy workplace and should consider: • developing separate policies to deal with each of these potential hazards that complies with the particular state law • train employees, with documentation, on the employer’s policies regarding the possession, transportation and storage of weapons and in the case of medicinal marijuana, the consumption, use and penalties for impairment • train supervisors in the requirements of these policies, particularly how to identify the signs and symptoms of impairment and how to properly document such observations • conduct a competent and documented investigation and discipline employees who violate these policies in a consistent manner and, in the case of violation of medicinal marijuana usage, ensure that any discipline is not based upon a known or perceived underlying disability If the employer follows these guidelines, it can greatly limit its exposure to these liabilities.
Posted by Marianne Karg at 12:24 PM
Tuesday, October 22, 2013
Are Attitudes about Marijuana Changing in America In recent months, there have been notable developments in the national debate about use, abuse and the putative medicinal uses of marijuana. For many bystanders, there appears to be a tectonic attitudinal shift underway. The U.S. seems to be creeping towards a more acceptant stance on the use of pot. Especially with the millennials, there is a dissonance with this newly evolved marijuana perspective. Scientific research has offered up several very rigorous examinations of marijuana's impacts on human neuroanatomy. It's becoming abundantly clear that marijuana use in early years can lead to some severe mental illness in adulthood. We also are pretty clear on the fact that THC, the psychoactive ingredient in marijuana is an addictive substance-people can and do become physically dependent on pot. Regular smokers of marijuana are usually physically dependent on it; in other words, were a regular user to suddenly stop smoking "weed", he/she would experience physical withdrawal. And the withdrawals will persist for weeks, even months following the last bong hit. Marijuana is not a drug to be fooled with, just ask a marijuana addict who is now sober. Despite the slew of cautionary studies linking marijuana to a variety of psychiatric phenomenon, there seems to be a steady drum beat for decriminalization and expanded medical use. Over the last few years public health officials, addiction specialists and politicians have opined that the criminal justice system needs a paradigmatic shift, one that pushes it towards a treatment bias for those who come to the criminal justice system behind a drug possession arrest. In the U.S. attorney general's opinion, prisons are full of non-violent drug addicts whose only crime was to be in the wrong place at the right time with a pocket full of drugs. Of course that is a fast and oversimplification of the situation, but the AG's opinion stands in stark contrast to all attorneys general who have preceded him. We've also heard from the governor of New Jersey and his call for utilization of medical marijuana to treat some forms of childhood epilepsy. He has said that he is favor of medical marijuana use in his state, he just wants there to be adequate controls instituted to manage it. Gallup and Pew research polls show that Americans are almost evenly split on the idea of relaxed marijuana laws. Several states (Washington and Colorado) have recently downgraded personal marijuana possession and have essentially legalized the use of the drug; there are more restrictions on tobacco in those states than there are controls on marijuana. At a time where abuse of prescription drugs is skyrocketing, marijuana continues to make inroads in the daily lives of Americans. With up to 3 out of 10 Americans being regular users of the drug, marijuana is on an inexorable path towards decriminalization and then ultimately, legalization. For those who believe that this is a bad idea, the time has come to take action. Our democratic form of government still works. It's time to communicate with state representatives about this phenomenon. If concerned folks don't speak up, and if they don't vote, they won't have any more ground to stand upon and complain.
Posted by Marianne Karg at 10:08 AM
Friday, October 4, 2013
POCT ORAL FLUID DRUG TESTING AND STATE LAWS THAT REGULATE USE By Bill Current One of the hot issues in this year's annual drug testing industry survey conducted by WFC & Associates was oral fluid drug testing. It stands to reason seeing as the federal government is inching its way through the process of writing regulations that will eventually permit lab-based oral fluid testing. The over-arching effect of this process is that many people are also asking about rapid-result oral fluid testing in addition to lab-based testing. However, it's important to note that the two testing methods can be very different in some key ways. Oral fluid testing, compared to urine testing, is easier to collect, considered by many to be less invasive, and much more difficult, if not impossible, to adulterate. Oral fluid can be used to reveal the presence of the same drugs detected with urine testing. The window of detection can be shorter with oral fluid compared to urine, but it begins almost immediately after ingestion of a drug making it ideal for reasonable suspicion and post-accident testing. The biggest difference, though not the only difference, is with rapid-result testing you get, well, a rapid result. For some companies and organizations an immediate result is important and it's worth whatever trade-offs that may be involved in not getting a lab-based result. There are two critical questions that must be thoroughly explored by any company planning to use rapid-result/POCT oral fluid testing: 1) is the device being considered FDA-cleared, and 2) are oral fluid testing and rapid-result testing permitted in the states where you are located? The answer to both questions must be "yes" before a company can implement a rapid-result oral fluid testing program. Remember, when it comes to state drug testing laws there are states with mandatory laws that apply to all employers who wish to conduct drug testing in a particular state, and states with voluntary laws that only apply to employers who are participating in a program that offers certain benefits to employers who comply with the state-regulated program. (There are also a handful of state with no drug testing statutes.) With that in mind, following is the status of POCToral fluid drug testing and state drug testing laws. States That Prohibit Oral Fluid Testing. The good news is that oral fluid drug testing is legal in virtually every state. Among states with mandatory drug testing laws only three prohibit oral fluid testing in the workplace: Hawaii, Maine and Vermont. Additionally, the territory of Puerto Rico requires urine testing. States That Prohibit Rapid-Result Testing. There are four states that prohibit rapid-result testing in the workplace and, as such, also prohibit rapid-result oral fluid testing. These states are: Kansas, Minnesota, New York and Vermont. (New York actually permits POCT but makes it nearly impossible for the average employer to qualify to use POCT devices on-site.) States That Require FDA-cleared Devices. Additionally, some states only permit FDA-cleared POCT devices for workplace testing. In Louisiana, Maryland, Montana, New Jersey and Oklahoma you can use POCT oral fluid testing as long as the device being used is FDA-cleared. All other devices would not be permitted in the workplace. States with Voluntary Laws that Prohibit Oral Fluid Testing. Finally, among states with voluntary drug testing laws, these states do not permit any type of rapid-result or POCT devices in the workplace: Alaska, Florida, Mississippi, Ohio, South Dakota and Tennessee. Outside of the voluntary law in these states employers are not restricted from using POCT devices. Keep in mind that other procedural requirements in a state drug testing law typically apply to all forms of drug testing. For example, when a state regulates how collections must be conducted or how test results must be reported, these requirements will likely apply to oral fluid testing or POCT just as they do to lab-based urine testing. All of the state law information referred to in this article only applies to drug testing. Even if a particular state prohibits oral fluid drug testing it may very well permit saliva alcohol testing. Also, this article only pertains to workplace drug testing. Non-workplace organizations that conduct drug testing usually are not required to comply with the same drug testing laws as employers. Oral fluid testing and rapid-result testing are very common in the criminal justice and treatment markets, among others.
Posted by Marianne Karg at 10:16 AM