MRO Services

Substance Abuse Policy Development

The U.S. Government has sponsored ongoing studies of drug use which serve as the basis for drug screening in the workplace. The most notable of the studies include the National Household Survey on Drug Abuse, 1992 and 1995 and a U.S. Postal Service Study, 1992.

The studies have shown that 6% of employed individuals report current illicit drug use. Although drug use crosses all age, sex, race and income/job boundaries the most common profile is the young, male with lower education and pay.

The impact of drugs in the workplace have consistently shown increase the following: 1) job turnover; 2) absenteeism; 3) accidents and injuries; 4) health care utilization; 5) lost productivity; 6) theft/security; and 7) training

Companies have reported savings of $3 - 18 for every dollar spent on substance abuse programs, in addition to lower absenteeism, fewer accidents and illnesses, lower medical and sick leave claim costs and increased productivity.

Should We Drug Test?

Are you seeing any of the following patterns:

• High rates of First Aid/OHSA Recordable accidents in the workplace
• Premiums for Group Health and/or Workers' Compensation increasing at rates higher than the industry standard
• Employee absenteeism problems
• High utilization of Employee Assistance Program

The Basic Statistics

Illicit drug users are:

• 2.5 times more likely to have absences > eight days
• 3.6 times more likely to be involved in a work accident
• 5 times more likely to be injured in an accident off work
• 5 times more likely to file a Work Comp claim.

Components of a Drug-Free Workplace Program

1. Formal Written Policy
2. Employee Assistance Program
3. Management Training
4. Worker Education
5. Methods for Detecting Illicit Drug Users (i.e. drug testing)

Although having a substance abuse testing policy has many benefits, such a program requires a substantial amount of work to create and maintain. The most important question is whether there is administrative staffing available to run the program. Such a program can have a financial impact depending on the services offered. If retention is the objective issues involving employee rehabilitation and income/benefits need to be sorted out ahead of time. The hiring process is another area where the drug screening process needs to reflect the needs of the employer.

Education/Training

This is the most important step of policy development. This should occur in a multi-level process and should include the following:

Education of the workers

• Types of testing included
• Specifics about the testing process (how notification occurs, the service provider and process)
• Consequences of not complying
• What happens with a positive test (MRO and SAP processes, return to work and random testing)

Education of company management

• Same information given to workers + the role they will play in carrying it out
• Signs and behaviors to be aware of
• How to approach the worker in a reasonable suspicion situation
• Legal requirements of substance abuse testing

Implementation

Typically most employers will introduce their substance abuse testing program to workers and give them notification of the date testing will begin. Along with the notification employers will educate workers on the background for developing the policy.

Feedback from workers at this stage may help to clarify issues with the policy decreasing potential legal challenges in the future.

If possible, employers are encouraged to coordinate their EAP to offer confidential assistance to workers who step forward for counseling/treatment prior to the final implementation date. This act promotes buy-in from workers who are looking for support from their employer in addressing their issues and immediately enhances safety of the workplace by the identification of potential problems.

Medical Review Officer Services

MRO services are a vital component of an effective substance abuse testing program. The physician MRO provides the following services in addition to the MRO function:

• Substance abuse policy development
• Training to meet DOT or state regulations
• Referral source for Substance Abuse Professional (SAP) services
• Interpretation of employee policy
• Direction on return-to-work issues following a positive test

The Medical Review Officer Process involves the following:

1. Developing a system for processing drug screen results. The MRO will oversee ancillary staff in various activities including a) matching the chain of custody forms with the results; b) reporting of negative results; c) statistical reporting; d) blind specimen processing; and e) developing a documentation system.
2. Contacting all donors with positive drug screens.
   • After identifying the donor, the drug screen result is discussed to see if a medical explanation exists.
   • In the event there is a valid medical explanation, information to confirm the explanation via verbal discussion with treating dentist/physician/pharmacist and/or written documentation. The employer will be notified that the result was negative unless a fitness-for-duty issue exists.
   • In the event that no valid medical explanation exists, the MRO provides information on options for split-specimen testing and substance abuse counseling and treatment. The employer will be notified of the positive result.
3. After completing the review of results with the donor, the designated employer representative (DER) is notified of the result. The chain of custody form will be completed and sent to the employer.