The newest manual for any health care professional responsible for setting up and running drug collection and alcohol screening. This newest manual is an adaptation of the newest Federal Register current through August, 2001. Material covered is easily read and understood to eliminate errors in collection and use of Chain of Custody forms. This enables the Collector and Donor to be comfortable in the process of Drug Collection and assured that there has been no breach in any of the collection steps.

INTRODUCTION pg. 1
Terminology
Agencies Involved with DOT Drug and Alcohol Testing
Vocabulary and Terms Used in This Manual

TYPES OF TESTING pg. 7
DOT Verses Non-DOT Drug and Alcohol Testing

HISTORY OF DRUG ABUSE pg. 8
Combating Drug Abuse
Laws Directed at Reducing Drug Abuse
Should We Legalize Drugs?

SUBSTANCE ABUSE pg. 10
Statistics
Classifications and Types of Abusers
Number of Users
Drug Retention Time
Why Do People Abuse Drugs?
What Are the Results of Substance Abuse?
Employees who use drugs are:
How Can Someone Tell Who is Using?

ROUTINE DRUG SCREENING pg. 16
Drugs routinely screened

CONTROLLED SUBSTANCE ACT pg. 17
Schedules of Controlled Substances
Schedule I
Schedule II
Schedule III
Schedule IV
Schedule V

FEDERALLY MANDATED DRUG TESTING PROGRAM pg. 19
Federally Mandated Drug Testing Regulations
Who is affected?
Objectives of the Rule
Summary of the Rules

CRIMINAL JUSTICE SYSTEM pg. 21

COMPONENTS OF A DRUG-FREE WORKPLACE pg. 22

INITIAL SCREENING pg. 23
Immunoassay

CONFIRMATORY GC/MS pg. 24
What is GC/MS
Drug Testing Records
What Documentation Must the Laboratory Keep
And For How Long?

HHS DRUG TESTING CUTOFF CONCENTRATION pg. 26
Drug/Initial Test/Confirmatory
Validity Testing

SUMMARY DRUG SCREENING pg. 28

URINE COLLECTION PERSONNEL pg. 29

TRAINING SUMMARY IMMUNOASSAY ANALYST pg. 30

ALCOHOL TESTING PROGRAM pg. 31
The Testing Program
Vocabulary
Starting Dates
Large
Small
A Breath Alcohol Testing Site

BREATH ALCOHOL TESTING pg. 33
Two Types of Breath-Testing Devices
Breath Tests, Unlike Blood and Urine Tests
Breath Tests Have Certain Problems

EVIDENTIAL BREATH TESTING (EBT) pg. 34

BREATH ALCOHOL TECHNICIAN (BAT) & (STT) pg. 35

BREATH TESTING FORM AND LOGBOOK pg. 37
Form
Log Book

BREATH ALCOHOL SCREENING TEST pg. 38
Begin without Delay

SALIVA ALCOHOL SCREENING DEVICE (ASD) An STT Must Do the Following pg. 40

BREATH ALCOHOL CONFIRMATION TEST pg. 41

INVALID TESTS pg. 43

MAINTENANCE OF RECORDS CONCERNING EBT’s & BAT’s pg. 44
Time Frame For Record Keeping

PROBLEMS IN ALCOHOL TESTING pg. 46
Refusals

CONFIDENTIALITY AND RELEASE OF INFORMATION pg. 47
General Rule

BLOOD ALCOHOL TESTING pg. 48
Synonyms
Reference
Critical Values
Absorption
Blood and Urine Alcohols

BLOOD ALCOHOL COLLECTION pg. 50

INVALID BLOOD ALCOHOL TEST pg. 51

STAGES OF ALCOHOL INFLUENCE pg. 52
Blood Alcohol/Stage of Alcohol Influence/Clinical
Sign/Symptom

VIOLATIONS pg. 54

RANDOM TESTING RATE pg. 55

LEGAL DRUG COLLECTION pg. 56
Forensic Urine Specimen
Collector
Record Keeping
Collection Procedures

URINE COLLECTION PROTOCOL pg. 58
Collection Checklists
Split Sample Collection
Parallel Collections
Separate Specimens
Non-regulated Tests
Urine Collection Kit

COLLECTION SITE OFFICE EQUIPMENT pg. 61
Desk
File
Locker
Supply Storage
Security and Integrity

DONOR PROBLEMS THAT CAN BE ENCOUNTERED pg. 63
Less than 45 mL of Urine
DOT specimens
Non-DOT specimens
Donor Requiring Medical Attention
Failure to cooperate
“Shy Bladder” Syndrome
Refusal to Take a DOT Specimen

DONOR’S CHECKLIST pg. 66

COLLECTOR’S CHECKLIST pg. 67
Before Collection
The Collection
Step 1
Step 2
Step 3
Step 4
Step 5
After Collection

INVALIDATION CRITERIA pg. 75

CIRCUMSTANCES FOR A WITNESSED COLLECTION pg. 76

AUTHORIZATION FOR WITNESSED COLLECTION pg. 77

CONSENT FOR WITNESSES COLLECTION pg. 78

SPLIT SPECIMENS pg. 79
Mandatory Use of Split Specimens

SAMPLE VOLUME pg. 80

STORAGE OF SPLIT SPECIMENS pg. 81
How Long Does the Laboratory Retain Specimens after Testing?

COLLECTION OF A SPLIT SPECIMEN pg. 82
Specimen
Procedure
NOTE
Test Results
The Laboratory is required to:

PROBLEM SOLVING pg. 85

SAMPLE TAMPERING PREVENTION pg. 86
Criteria Used to Establish Specimen Adulteration

ADULTERATANTS pg. 87
Normal Physiological Range

RISK MANAGEMENT pg. 88
Way to Reduce Risks of Legal Action

THE FUNCTION OF THE MRO pg. 89
The MRO’s Primary Function

MEDICAL REVIEW OFFICER OPERATING PROCEDURES pg. 90

MRO VERIFICATION OF A POSITIVE TEST pg. 91
These are:
What Does the MRO Tell the Employee at the Interview
What Basis Does the MRO Verify Results Involving Marijuana, Cocaine, Amphetamines
The Basis to Verify a Positive Opiate Test
How Does the MRO Obtain Information?
How Does the MRO Verify an Adulteration or Substitution?

MRO’S REPORT OF DRUG TEST RESULTS pg. 95

MEDICAL REVIEW OFFICER PUNCHLIST pg. 96

APPENDIX
LIST OF APPENDICES pg. 97
A - K