Drug Testing Index

Drug TestingIndexTM

Lessons Employers Can Learn

Employer Webinar

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Agenda

•  What is the Drug Testing Index™

•  Key Findings

•  Urine Positivity Rates

•  Oral Fluid Positivity Rates

•  Hair Positivity Rates

•  Summary

•  Questions

| 2 Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

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Drug Testing Index™ (DTI) Specimen Demographics

Source

• Routine, hair, oral fluid and urine specimens submitted for workplace drugs of abuse testing – Workplace – Rehab/Criminal Justice excluded – Point-of-care (POCT) confirmations excluded (excludes high positivity)

•  Laboratory positive data (prior to Medical Review Officer review) – Does not indicate whether there is an “alternative medical explanation” – Includes employer/MRO blinds

•  Two Major Groups – Federally Mandated, Safety-Sensitive Workforce – U.S. General Workforce

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National Survey of Drug Use and Health (NSDUH)

•  Annual survey of the civilian, non-institutionalized population of the United States aged 12 years old or older

•  Presents national estimates of rates of use, numbers of users, and other measures related to illicit drugs, alcohol and tobacco products

•  Self-reported use

•  Approximately 67,500 persons are interviewed in NSDUH annually

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Common Matrices in Drugs of Abuse Testing

•  Urine testing – Detects recent use (previous 24-72 hours)

•  Oral fluid testing – Detects recent use (previous 24-48 hours)

•  Hair testing – Detects a pattern of repetitive use (up to 90 days, based on testing proximal

1.5” head hair)

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Key findings

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Key Findings in First-Half of 2012 vs. 2011

•  Pre-Employment U.S. General Workforce positivity up 5.7%

•  Random U.S. General Workforce positivity down 5.8%

•  Marijuana continues as most commonly detected drug

•  Oral fluid finding more marijuana positives (up 26%) – 70% more positives in oral fluid than in urine in the first-half of 2012

•  Cocaine positivity continues to decline

•  Amphetamines positivity continues to increase – Driven by Amphetamine positives

| 7 Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

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Urine positivity rates

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Annual Positivity Rates Urine Drug Tests

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Positivity Rates by Testing Category Urine Drug Tests

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Positivity Rates by Testing Reason Urine Drug Tests – For Federally-Mandated, Safety-Sensitive Workforce

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Positivity Rates by Testing Reason Urine Drug Tests – For General U.S. Workforce

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Impact of Drug Testing Programs (Data from the National Survey of Drug Use and Health)

0%

2%

4%

6%

8%

10%

12%

14%

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Employer  DrugTesting  Program  

No  Employer  DrugTesting  Program

Illicit Drug Use in Previous 30 Days

United States Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Office of Applied Studies. National Survey on Drug Use and Health, 2002-2011. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor]

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Positivity Rates by Drug Category Urine Drug Tests – For Federally-Mandated, Safety-Sensitive Workforce, as a Percentage of All Such Tests

| 14 Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

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Positivity Rates by Drug Category Urine Drug Tests – For U.S. General Workforce, as a Percentage of All Such Tests

| 15 Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

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Amphetamines Positivity Urine Drug Tests

| 16 Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

Federally-Mandated U.S. Workforce

0

0 .1

0 .2

0 .3

0 .4

0 .5

0 .6

0 .7

0 .8

0 .9

2008 2009 2010 2011 Jan-­‐Jun2012

Amphetamine Methamphetamines

%

0

0 .1

0 .2

0 .3

0 .4

0 .5

0 .6

0 .7

0 .8

0 .9

2008 2009 2010 2011 Jan-­‐Jun2012

Amphetamine Methamphetamines

%

%

%

%

%

%

%

%

%

%

%

%

%

%

%

%

%

% %

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Positivity Rates, 6-Acetylmorphine (Heroin Metabolite) Urine Drug Tests

| 17 Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

0

0 .005

0 .01

0 .015

0 .02

2008 2009 2010 2011 Jan-­‐Jun  2012

Federally-­‐Mandated

General  Workforce

%

%

%

%

%

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Oral fluid positivity rates

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Positivity Rates By Testing Category Oral Fluid Drug Tests - For U.S. General Workforce

| 19 Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

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Positivity Rates by Drug Category Oral Fluid Drug Tests - For U.S. General Workforce, as a Percentage of All Such Tests

| 20 Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

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Marijuana Positivity Rates Urine and Oral Fluid– U.S. General Workforce

| 21 Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

0

0 .5

1

1.5

2

2.5

3

3.5

4

2008 2009 2010 2011 Jan-­‐Jun  2012

Urine

Oral  fluid

%

%

%

%

%

%

%

%

%

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Possible Drivers for Marijuana Positivity Differences

•  Oral fluid collections are observed – Curbs evasive donor behavior

•  New collection and testing technology with Oral-Eze®

– Sample adequacy indicator informs collector when there is desired sample volume

– Different/improved buffer preservative solution

| 22 Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

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Hair positivity rates

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Positivity Rates by Testing Category Hair Drug Tests - For U.S. General Workforce

| 24 Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

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Positivity Rates by Drug Category Hair Drug Tests - For U.S. General Workforce

| 25 Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

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Positivity Rates by Testing Reason Hair Drug Tests - For U.S. General Workforce

| 26 Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

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Summary

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In Conclusion

•  Drug users tend to work for employers without a drug testing program

•  Data from the DTI and NSDUH suggests that drug testing is a deterrent to drug use by employees and applicants

•  DTI data and some media reports suggest that it may be harder to find drug-free applicants

•  Widening gap between oral fluid and urine marijuana positivity

•  New oral fluid testing technology may help in identifying more marijuana users

•  Hair testing continues to have a positivity rate more than 1.5x higher than urine

•  Random positivity in both urine and hair have declined

•  Amphetamines positivity continues to increase

•  Cocaine positivity continues to decrease

| 28 Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

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Questions

R. H. Barry Sample, Ph.D., D-FTCB Director of Science and Technology barry.x.sample@QuestDiagnostics.com

QuestDiagnostics.com/DTI

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