Hi sayrasmile,
Given that ms contin and elavil (amitriptyline) do test positive for
opiates, the question isn't the validity of the test, but rather, what
to do now. Your first line of defense is the Medical Review Officer
(MRO). When the positive results were found, he should have contacted
you (before the results were given to your employer) and scheduled an
interview, the purpose being to ascertain the cause of the positive
results (are you taking any prescriptions, etc).
1) Were the positive results reviewed by a Medical Review Officer
(MRO) in an interview with you before the results were sent to your
employer?
Medical Review Officer (MRO):
"Federal regulations require that specimens testing positive on both
assays undergo a "medical review" by a licensed physician. The medical
review officer's job is to:
- serve as an "ombudsman" between the employer, employee and the lab,
- determine whether the positive test may have resulted from
legitimate medical drug use, and/or
- review laboratory procedures so as to rule out the possibility of error.
http://www.wps.org/pubs/attorneys-guide.html
Medical Review Officer
"All positive confirmatory tests must be reviewed by a licensed
physician or doctor of osteopathy before being certified as positive.
Within 48 hours of a positive confirmatory test, the physician or
osteopath reviewing the results must contact the employee and offer
the employee an opportunity to discuss the results. The physician or
osteopath must also interpret and evaluate the positive drug tests for
legal drug use and report any results caused by prescription
medication as negative."
http://www.drugfreeworkplace.org/alaska_sample.htm
What Happens When a Drug Test Is Positive?
"A Medical Review Officer (MRO) is a specially certified medical
doctor with training in the interpretation of positive drug tests.
Under federal guidelines, a worker testing positive must have an
opportunity to talk about the results with an MRO or appropriate
physician to see if there might be another explanation besides drug
use. In fact, the MRO may not declare the test positive unless there
has been an attempt to contact the specimen donor. Most MROs try to
call the employee by telephone. If a ?reasonable attempt? to contact
the employee is unsuccessful, the MRO may declare the drug test a
verified positive. In other words, it is up to the employee to
convince the MRO that there might have been another reason why he or
she tested positive."
http://www.leftseat.com/AME/health4pilots/default.htm
"As noted previously, one of the purposes for a donor interview is to
allow a donor the opportunity to provide an alternative explanation
for a non-negative drug test result. For the explanation to be
accepted, the donor must provide acceptable supporting documentation
to the MRO. If the alternative explanation for a positive,
adulterated, or substituted result is acceptable and supported by
documentation as outlined below, the MRO must verify the result as
negative."
"An employee who is the subject of a drug test may, upon written
request through the MRO and the Federal agency, have access to any
records relating to his or her drug test, any records relating to the
results of any relevant certification, review, or revocation of
certification proceedings, and access to a documentation package. A
donor or Federal agency will occasionally request the testing
laboratory to provide a complete package of analytical data, chain of
custody records, and other administrative documents associated with
the testing of a particular specimen. This package is generally
referred to as a "data package" or "litigation package." The request
must always be submitted to the laboratory through the MRO."
http://workplace.samhsa.gov/DrugTesting/MedicalReviewOfficers/MROMannual100104.htm
2) Were you given an "Opportunity to Rebut"?
Opportunity to Rebut
"If the employee requests in writing a chance to explain a positive
result within 10 working days after the employee is notified of the
result, the employer must provide this opportunity, in a confidential
setting, within 72 hours of receiving the employee's written request
or before taking adverse employment action. "
http://www.drugfreeworkplace.org/alaska_sample.htm
3) Civil Remedies-Judicial (false positive only)
Civil Remedies-Judicial
"An employee may bring a civil action for damages only if the
employer's action was based on a false positive result which the
employer knew or clearly should have known was in error but ignored
the true test result because of reckless or malicious disregard for
the truth or a willful intent to deceive or be deceived."
http://www.drugfreeworkplace.org/alaska_sample.htm
>>>
Medical Review Officer (MRO) Manual
"The final review of results is an essential component of any drug
testing program. A positive laboratory test result does not
automatically identify an employee or job applicant as an illegal drug
user, nor does a laboratory result of invalid, substituted, or
adulterated automatically identify specimen tampering. An individual
with a detailed knowledge of possible alternative medical explanations
must interpret non-negative results in the context of information
obtained from the donor interview. HHS requires the Medical Review
Officer (MRO) to fulfill this important function.
Chapter 4. The MRO Review and Reporting Process
The MRO must review all non-negative test results (i.e., positive,
adulterated, substituted, invalid) and all negative and dilute
specimens before reporting the results to the Federal agency's
designated representative. Negative specimen results may be reviewed
and reported by staff under the direct, personal supervision of the
MRO.
The MRO process consists of:
* Administrative review of documents,
* Interview with the donor (as required),
* Handling retest requests (as required),
* Result interpretation and verification, and
* Reporting of results to the Federal agency's designated representative.
B. Donor Interview
The MRO must contact the donor and interview the donor when the
donor's specimen is reported by the laboratory as non-negative (i.e.,
positive, adulterated, substituted, invalid).
The MRO must attempt contact as soon as possible after receiving the
report (usually within 24 hours). The MRO copy of the Federal CCF will
contain daytime and evening telephone numbers for the donor."
The Interview Process
1. Request the donor to provide information that will verify the
donor's identity (e.g., employee identification number, SSN) to ensure
that it agrees with the information documented on the Federal CCF.
(This step may be done by staff under the MRO's supervision; however,
the MRO must personally perform all other steps of the interview
process as listed below).
2. Inform the donor, prior to obtaining any information, that
confidential medical information provided during the review process
may be disclosed to the Federal agency.
3. Inform the donor of the laboratory reported test result(s).
4. Take action based on the donor's response:
a. If the donor admits use of an illegal drug consistent with
the test results or admits that he or she tampered with the specimen,
advise the donor that the test result will be reported to the Federal
agency.
b. If the donor does not admit use of an illegal drug or
specimen tampering, ask the donor if there is any possible medical
explanation for the test result:
o If the donor provides a possible medical explanation
(e.g., claims that a positive result was due to a legally prescribed
medication or that the drug use was associated with a valid medical
procedure), require the donor to provide appropriate supporting
documentation within a specified time.
o If the donor has no valid medical explanation for the
result, advise the donor that the test result will be reported to the
Federal agency.
5. For positive, substituted, or adulterated results: Inform the donor
that he or she may have the specimen retested at a second certified
laboratory. The retest request must be made within 72 hours of the
interview with the MRO. (Note that donors are not allowed to request
retesting of specimens reported as invalid.)
a. If the donor requests a retest, use the procedures described
in Section C (Handling Retest Requests) to direct the laboratory to
send the retest specimen to another certified laboratory for
confirmatory testing.
b. If the donor does not request a retest, document that the
donor was informed of and declined the opportunity for a retest."
Donor Explanation
As noted previously, one of the purposes for a donor interview is to
allow a donor the opportunity to provide an alternative explanation
for a non-negative drug test result. For the explanation to be
accepted, the donor must provide acceptable supporting documentation
to the MRO. If the alternative explanation for a positive,
adulterated, or substituted result is acceptable and supported by
documentation as outlined below, the MRO must verify the result as
negative.
Prescriptions
If the donor claims to have taken a prescribed medicine that contains
either the drug reported positive or a substance that can metabolize
to that drug, the donor must provide one of the following:
* A copy of the prescription,
* The medicine container with the appropriately labeled
prescription (or the label from the container), or
* A copy of the medical record documenting the valid medical use
of the drug during the time of the drug test.
The MRO may contact the prescribing physician or the pharmacist who
filled the prescription to verify the information provided by the
donor.
* When a laboratory reports a specimen as positive for codeine
and/or morphine and the quantitative results for both codeine and
morphine are less than 15,000 ng/mL:
o If there is clinical evidence of illegal use of any opium,
opiate, or opium derivative (e.g., morphine/codeine) listed in CSA
Schedule I or II, the MRO verifies the result as positive.
o If there is no clinical evidence of illegal use, the MRO
verifies the result as negative.
* When a laboratory reports a specimen as positive for codeine
and/or morphine and the codeine and/or morphine result is greater than
or equal to 15,000 ng/mL:
o If the donor does not present a legitimate medical
explanation for the presence of morphine or codeine (e.g., a valid
prescription), the MRO verifies the result as positive. Consumption of
food products is not a legitimate medical explanation for the donor
having morphine or codeine at or above this concentration.
o If the donor presents a legitimate medical explanation for
the presence of morphine or codeine (e.g., a valid prescription), the
MRO verifies the result as negative.
* When a laboratory reports a specimen as positive for the heroin
metabolite (6-acetylmorphine), this is proof of heroin use. The MRO
verifies the result as positive.
D. Donor Rights to Information
An employee who is the subject of a drug test may, upon written
request through the MRO and the Federal agency, have access to any
records relating to his or her drug test, any records relating to the
results of any relevant certification, review, or revocation of
certification proceedings, and access to a documentation package. A
donor or Federal agency will occasionally request the testing
laboratory to provide a complete package of analytical data, chain of
custody records, and other administrative documents associated with
the testing of a particular specimen. This package is generally
referred to as a "data package" or "litigation package." The request
must always be submitted to the laboratory through the MRO.
A standard data package provided by an HHS-certified laboratory
consists of the following items:
* A cover sheet that provides a brief description of the drug
testing procedures and specimen validity tests performed on the
donor's specimen
* A table of contents page that lists by page number all documents
and materials in the package
* A copy of the Federal CCF with any attachments and a copy of the
electronic report (if any) generated by the laboratory
* A brief description of the initial drug tests and initial
specimen validity tests (e.g., instrumentation, batch quality control,
and test data format)
* A brief description of confirmatory drug tests and confirmatory
validity tests (e.g., instrumentation, batch quality control, and test
data format)
* A copy of the resume or curriculum vitae for the certifying
scientist that certified the test result
* A copy of the resume or curriculum vitae for the laboratory's
Responsible Person(s)
* Donor specific information including:
o Internal chain of custody records for the specimen,
o Memoranda (if any) generated by the laboratory,
o Copies of the initial drug and specimen validity test data
for the donor's specimen with all calibrators and controls identified
and copies of all internal chain of custody documents related to the
initial tests, and
o Copies of the confirmatory drug and specimen validity test
data for the donor's specimen with all calibrators and controls
identified and copies of all internal chain of custody documents
related to the confirmatory tests.
Morphine: MS Contin TabletsŪ
http://workplace.samhsa.gov/DrugTesting/MedicalReviewOfficers/MROMannual100104.htm
Voluntary Law Affecting Drug and Alcohol Testing:
Employer Benefit an of Compliance
"No cause of action may be brought against any employer that has
established alcohol- or drug-testing program in accordance with the
law for adverse employment actions taken in good faith based on a
positive drug or alcohol test. Compliance with the law creates a
rebuttable presumption that the test result is valid. No cause of
action may be brought against an employer unless the employer's action
was based on a false positive, and the employer knew or clearly should
have known that the result was in error, but ignored the truth because
of reckless or malicious disregard for the truth or a willful intent
to deceive or be deceived. No cause of action may be brought against
an employer for defamation, libel, slander, or damage to reputation
unless the following four conditions are met: (1) the test results
were disclosed to a non-privileged person; (2) the information was a
false positive test result; (3) the information was disclosed
negligently; and (4) all elements of an action for defamation of
character, libel, slander, or damage to reputation are met. Employers
cannot be held liable for false negatives, failures to test, or
termination of a testing or prevention policy."
Testing Procedures
Specific Requirements
Written Policy
All drug and alcohol testing must be conducted according to the terms
of a written policy which has been distributed or made available to
all employees in the same way the employer ordinarily disseminates
personnel policies. The policy must include: (1) a statement of the
employer's drug and alcohol policy; (2) a description of the employees
and/or prospective employees subject to testing; (3) the circumstances
in which testing may be required; (4) the substances that may be
tested for; (5) a description of the testing methods and collection
procedures, including an employee's right to have a confirmatory drug
test reviewed by a licensed physician or doctor of osteopathy
following an initial positive drug test; (6) the consequences of a
refusal to submit to a test; (7) any adverse personnel action that may
be instituted against the employee because of the testing procedure or
results; (8) the right of an employee to request and obtain written
test results, and the obligation of the employer to provide these
results within five working days of the written request, if the
written request is made within six months after the date of the test;
(9) the employee's right to explain a positive test result in a
confidential setting, if requested; and (10) a statement of the
employer's policy regarding confidentiality of test results. "
http://www.drugfreeworkplace.org/alaska_sample.htm
>>> What to do
Document everything you do in a log book, a sort of diary of all of
your actions. Start by reviewing everything up to this point and then
keep track of all of your actions, day by day. Write it in pen (if you
make a mistake, cross it out rather than tearing it out). If you end
up in court, you will have a good record of events.
If you already have had an interview with an MRO without success:
1. Request an official letter from your doctor which clearly lists the
prescriptions he prescribed, *before* your drug test.
2. Gather together your pharmacy receipts and prescription bottles
(dated before your drug test).
3. Request a "documentation package" from the MRO as described in "D.
Donor Rights to Information" above.
4. Consult legal counsel.
If you did not have an interview with an MRO:
1. Request a copy of the results from your ex-employer.
2. Request an official letter from your doctor which clearly lists the
prescriptions he prescribed, *before* your drug test.
3. Gather together your pharmacy receipts and prescription bottles
(dated before your drug test).
4. Request an interview with the MRO listed on the copy of results.
5. If you are refused, consult legal counsel.
I sincerely hope this helps. If you have any questions, please post a
clarification request *before* closing/rating my answer and I'll be
happy to reply. Please remember that GA research is for information
purposes only and is not meant as a substitute for legal advice.
Thank you,
hummer
Google Search Terms Used:
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