1. DrugTesting
IndexTM
Lessons Employers Can Learn
EmployerWebinar

2. Quest Diagnostics
Agenda
• What is the Drug Testing Index™
• Key Findings
• Urine Positivity Rates
• Oral Fluid Positivity Rates
• Hair Positivity Rates
• Summary
• Questions
| 2Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

3. Quest Diagnostics | 3
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
Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

4. Quest Diagnostics
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
| 4Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

5. Quest Diagnostics | 5
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)
Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

6. Quest Diagnostics
Key findings

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

8. Quest Diagnostics
Urine positivity rates

9. Quest Diagnostics
Annual Positivity Rates
Urine Drug Tests
| 9Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

10. Quest Diagnostics
Positivity Rates by Testing Category
Urine Drug Tests
| 10Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

11. Quest Diagnostics
Positivity Rates by Testing Reason
Urine Drug Tests – For Federally-Mandated, Safety-Sensitive Workforce
| 11Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

12. Quest Diagnostics
Positivity Rates by Testing Reason
Urine Drug Tests – For General U.S. Workforce
| 12Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

13. Quest Diagnostics
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
Drug
Testing
Program
No
Employer
Drug
Testing
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]

14. Quest Diagnostics
Positivity Rates by Drug Category
Urine Drug Tests – For Federally-Mandated, Safety-Sensitive Workforce, as a Percentage of All Such Tests
| 14Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

15. Quest Diagnostics
Positivity Rates by Drug Category
Urine Drug Tests – For U.S. General Workforce, as a Percentage of All Such Tests
| 15Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

16. Quest Diagnostics
Amphetamines Positivity
Urine Drug Tests
| 16Lessons 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-­‐Jun
2012
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-­‐Jun
2012
Amphetamine Methamphetamines
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
% %

17. Quest Diagnostics
Positivity Rates, 6-Acetylmorphine (Heroin Metabolite)
Urine Drug Tests
| 17Lessons 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
W orkforce
%
%
%
%
%

18. Quest Diagnostics
Oral fluid positivity rates

19. Quest Diagnostics
Positivity Rates By Testing Category
Oral Fluid Drug Tests - For U.S. General Workforce
| 19Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

20. Quest Diagnostics
Positivity Rates by Drug Category
Oral Fluid Drug Tests - For U.S. General Workforce, as a Percentage of All Such Tests
| 20Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

21. Quest Diagnostics
Marijuana Positivity Rates
Urine and Oral Fluid– U.S. General Workforce
| 21Lessons 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
%
%
%
%
%
%
%
%
%

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

23. Quest Diagnostics
Hair positivity rates

24. Quest Diagnostics
Positivity Rates by Testing Category
Hair Drug Tests - For U.S. General Workforce
| 24Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

25. Quest Diagnostics
Positivity Rates by Drug Category
Hair Drug Tests - For U.S. General Workforce
| 25Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

26. Quest Diagnostics
Positivity Rates by Testing Reason
Hair Drug Tests - For U.S. General Workforce
| 26Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™

27. Quest Diagnostics
Summary

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

29. Quest Diagnostics
Questions
R. H. Barry Sample, Ph.D., D-FTCB
Director of Science and Technology
barry.x.sample@QuestDiagnostics.com
QuestDiagnostics.com/DTI
Lessons Employers Can Learn from the Quest Diagnostics Drug Testing Index™ | 29