You Can’t Fool Us! Catching the Cheaters 8 th Annual FTA Drug and Alcohol Program National Conference Presented by: Lorri Smith, C-SAPA April 2013

PURPOSE  Recognize the need for awareness  Identify common ways used to circumvent testing  Learn how to avoid opportunities for cheating  Understand the role of those who have a stake in the program  Know how you impact the integrity of the testing program

SCOPE OF THE PROBLEM  November 2007, GAO reports "DOT’s drug testing program is vulnerable to manipulation by drug users, especially given the wide availability of products designed to beat drug tests” (GAO T)  “How to Pass a Drug Test” - 3/ ,000,000 hits on “Bing”  Buy clean urine for drug test – 3/ ,800,000 hits on “Bing” - Some offer “double your money back”!

GAO UNDERCOVER RESULTS

PREVENTING CHEATING “Whose job is it anyway?”  Supervisor  DAPM/DER  Jerry Powers  Collector  DOT  Donor  Employer  Medical Review Officer  Laboratory  FTA Auditors  Employees/Peers  Breath Alcohol Technician  DHHS  ???????

THE ANSWER IT’S A TEAM EFFORT

ACTION – 8/08  Mandatory Validity Testing on all DOT specimens instituted  DOT changed procedures for performing collections under direct observation to include raising & lowering of clothing by the donor in cases of temperature out of range, suspicion of tampering, or when directed by the MRO

ACTION – 4/09 Direct Observation required on all DOT Return-to-Duty and Follow-Up tests

ACTION  DOT’s 10 Steps to Collection Site Security and Integrity

ACTION  Various state laws on defrauding a drug test are more prevalent: New Jersey, Florida, Kentucky Louisiana, Texas North Carolina, Virginia, South Carolina, Pennsylvania, Nebraska, Arkansas, Illinois, Maryland, Oklahoma  Drug Testing Integrity Act of 2011 H.R February 15, 2011

United States Attorney Robert S. Cessar announced, April 8, 2010: The owners of a California company that sold products to help people cheat on drug tests were sentenced today in federal court in Pittsburgh on their convictions for conspiracy to defraud the United States in connection with its duty to drug test employees and conspiracy to sell drug paraphernalia. From the FBI Website Pittsburgh Division ACTION

Gerald Wills, a resident of San Pedro, California, was sentenced to six months in prison followed by three years supervised release. Robert Dennis Catalano, a resident of Huntington Beach, California, received a sentence of three years’ probation. Puck Technology, Inc., a corporation of Signal Hill, California, received a sentence of forfeiture of all its assets and dissolution. United States District Judge David Cercone imposed the sentences on Gerald W. Wills, age 67, of San Pedro, California; Robert Dennis Catalano, age 65, of Huntington Beach, California; and Puck Technology, Inc., a national Internet business located in Signal Hill, California. From the FBI Website Pittsburgh Division ACTION

METHODS TO AVOID DETECTION  Stop using (abstention) or switch  Add fluid to the specimen or ingest large amounts of fluid (dilution)  Bring in another person’s urine (substitution)  Add chemicals to the urine (adulteration)

ABSTENTION  Stop using prior to the test  Switch to a different drug that is not part of the testing panel  Pre-employment tests most vulnerable

ADVICE FROM THE WEB “For best results, “abstain” for a minimum of 48 hours before the test. Of course, the longer you wait, the better your chances are.”

HOW TO BEAT THIS CHEAT?  Limit time between notification and the test  Incorporate a company policy (where permitted by state law) to test for additional drugs  Probationary testing or testing after offer but prior to performance of safety sensitive duties

DILUTION (HYDRATION)  Most popular method  “Water-loading”, “Flushing”, “Detoxing”  Use of diuretics, Lasix, vitamins  Must urinate frequently before providing sample (cause of shy bladder?)  Adding water to the sample

PRODUCTS USED

DILUTE SPECIMEN “A urine specimen with creatinine and specific gravity values that are lower than expected for human urine.” Creatinine is >2 and <20 mg/dL AND the Specific Gravity is > and <1.003 (***Creatinine is > 2 and < 5mg/dL, requires notification from the MRO that another collection must take place immediately under direct observation)

DILUTE SAMPLES (40.197)  Do you have a policy?  Employer must establish policy associated with dilutes (b)(2)(ii)  May require employee to take a second test (b)(2)  Must be observed if MRO directs employer (b)(1)  Give employee as little notice as possible  2 nd dilute sample result is acceptable  If employee declines constitutes refusal

HOW TO BEAT THIS CHEAT?  Limit time between notification and the test  Monitor arrival time at clinic  Audit your collection site’s shy bladder procedures and collection site security for securing water sources  Implement retesting for dilute samples  Discuss with your MRO or TPA how dilute samples are reported

ADULTERATION  Adulteration  “ A urine specimen that has been altered, as evidenced by test results showing either a substance that is not a normal constituent for that type of specimen or showing an abnormal concentration of an endogenous substance.”

OXIDIZING ADULTERANT “A substance that acts alone or in combination with other substances to oxidize drugs or drug metabolites to prevent the detection of the drug or drug metabolites, or affects the reagents in either the initial or confirmatory drug test”

COMMON ADULTERANTS Nitrites (Klear, Whizzies) Glutaralderhyde (UrinAid, Clear) Bleach Pyridinium Chlorochromates PCC (UrineLuck) Hydrogen Peroxide Peroxidase (Stealth) Mary Jane SuperClean 13 (soap) Visine

INVALID TEST “The MRO called me and said that the test on my employee was invalid. What does that mean?”

HOW TO BEAT THIS CHEAT?  Limit the time between notification and the test  Ensure your collection site: is secure of products that could be usedas adulterants checks the restroom before and after each test has employee empty pockets, etc.  Discuss with your MRO/lab procedures for identifying adulterants

SUBSTITUTION “A urine specimen with creatinine and specific gravity values that are so diminished or so divergent that they are not consistent with normal human urine.” Creatinine is < 2 mg/dL AND Specific Gravity is

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SYNTHETIC URINE

CHEATERS GET CREATIVE… asdfs adf Cane Binoculars Books Cell Phone Flask Books

FROM THE WEB Concealed container: Simply conceal the urine. The first time you're alone with the container they give you, dump in your concealed urine. Be sure you can quietly open the container; the lab personnel may be just outside the door listening. You may be required to change into a gown. If so, a condom or douche bag holding the sample and taped around the thigh can be concealed under the gown.concealed urine

9.1.1 Concealed Container – CONT You can also run a plastic line from a flexible container and tape it to your urination equipment (to be gender neutral), and even piss under supervision. Females have been known to keep a condom with the urine sample in the vagina, and prick it with a sharp fingernail to p#$% under supervision. Be sure to keep the sample between 91 and 97 degrees.

HOW TO BEAT THIS CHEAT?  Limit time between notification and the test  Monitor arrival time at collection site  Review your clinic’s procedures for checking the temperature of samples and directly observed collections  If feasible, escort the employee to the collection site  Perform on-site collections

44  Man who got shot to avoid drug test  Microwaving urine, blew up  Leaves in Urine  Man positive due to bedbugs  Man who faked heart attack DESPERATE PEOPLE

HOW TO ENSURE INTEGRITY OF YOUR PROGRAM  Adhere to the rules  Collection site audit  FTA conference session  FTA checklists on website  Communication with the MRO/TPA  Establish and enforce procedures  Trust but verify  Follow your instinct

46 REFERENCE MATERIALS  DOT 49 CFR Part 40 (revised effective 10/1/2010)  DOT Urine Specimen Collection Guidelines (revised effective 10/1/2010)  DOT Agency Rules (e.g., Part 655 for FTA)  DOT video – Collection Site Security & Integrity  FTA conference sessions

THANK YOU! Please feel free to take a closer look at the items on the display table I will be available for questions after the session or at