Revisiting the Standard Drug Panel

In the following article, written by the 2008 DATIA board chairman Eric Hess, the necessity of screening beyond the basic five is outlined. In the not so distant past, a drug test for (fill in the blank) was all that was needed. Prescription drug abuse is now at an all-time high—they are the most commonly abused substances, following marijuana. Hess dives in to addresses the near necessity to test for more substances.

The ‘standard’ drug panel.

We need to revisit how we define it, and over the years, I’ve been pretty vocal about the issue. The non-medical use of prescription drugs is at an all-time high, second only to marijuana use as the most prevalent category of drug abuse, according to the National Survey on Drug Use and Health. The same study revealed that nearly 8 percent of the U.S population was engaging in illicit drug use.

Education on the topic is critical. As an industry, we must take the lead and educate our clients about revising the standard panel to add commercially-prescribed and abused narcotics. Clients often ask me about the reported drop in positive drug tests, wondering if the substance abuse problem in the workplace has been tamed. But, the question has evolved into two separate issues that often get confused. First, all of the positivity studies I have read strictly focus only on specific drugs the client has asked to be tested, with no behind-the-scenes analysis on all screening possibilities. So yes, as far as the standard five-panel goes, it appears that abuse of these drugs is decreasing.

But, is drug abuse down? Consider this: According to Rxlist data, in 2005 hydrocodone was prescribed three times more frequently than any other controlled substance. And, hydrocodone and oxycodone were the most frequently encountered analgesic narcotics in submissions to federal, state and local labs by a two-thirds majority according to 2007 mid-year report data from STRIDE/ National Forensic Laboratory Information System (NFLIS). As most of you know, the standard five-panel does not test for synthetic opioids nor does it test for Ecstasy or other popular, commonly-abused drugs.

In short, drug abuse is not necessarily down. Instead, the drugs of choice among abusers are simply changing, making the standard five-panel an outdated, increasingly ineffective tool. Here’s another twist—roughly 34 rogue internet pharmacies were identified in a 2006 report from the Drug Enforcement Agency Automation of Reports Consolidated Orders System(ARCOS). The report also revealed that these 34 pharmacies dispensed as much hydrocodone as 1,118 average DEA registered pharmacies.

After years of educating clients about value of drug testing, most of our clients get it. They understand the benefits of a drug free workforce. Now, as our industry evolves in step with society, it’s our responsibility to continue that education. And, while I’m the first to admit that it’s impractical to test for every derivative of commonly abused drugs, it is high time we educate our clients on the fact that they may not be testing for the very drugs they want to keep out of the workplace.

We live in a rapidly changing world that offers a lot of good, but it also dumps a lot of bad things at our doorstep. We must adapt our position on the standard five-panel test or risk being the last buggy whip maker in town. The professionals who comprise the membership of DATIA are the nation’s finest collection of business leaders, academics and clinicians – we are the heartbeat of the drug free movement in America. The entire market is looking to us to lead the way and set new standards. We must rise to the occasion.”

*The above article is from DATIA’s FOCUS Magazine, October 2008.