There is no doubt we’re well past a crisis point when it comes to drug use in this country – especially due to the abuse of prescription opioids (which is having direct highway safety repercussions) and efforts to “decriminalize” marijuana.
According to the National Safety Council (NSC), unintentional opioid overdose deaths alone totaled 37,814 in 2016 due to drugs that include prescription opioid pain relievers such as oxycodone, heroin, and illicitly-made fentanyl. That’s out of total U.S. overdose deaths of 64,000 in 2016, which is expected to rise 21% once 2017’s figures are tallied and is even higher than deaths from motor vehicle crashes.
That’s truly a frightening statistical marker.
And though there’s been a long and largely successful push to lessen the stigma of recreational marijuana use, it’s still a drug – like alcohol – that significantly impairs a person’s ability to operate motor vehicles, commercial trucks, and other equipment in a safe manner.
Thus truck drivers – like airline pilots and other transportation workers – can be fired for using it, even though it may be now legal for them to use it where they live.
The real issue, though, is how drug use impacts safety and the bottom line costs of running a business, especially in the freight sector.
Dr. Todd Simo, chief medical officer at HireRight, conducted an interesting webinar this week to look at some of those issues – especially when it comes to the type of drug tests trucking companies can use to screen their workforce.
First, he noted that the “self-reported” use of drugs is rising pretty sharply, according to the National Institute on Drug Abuse (NIDA), climbing from 7.3% in 2013 to just under 9% by 2016.
“There’s been a creep up in the percentage in people self-reporting that in the last 30 days they took an illicit drug,” he said. “That’s primarily being driven by use of marijuana – and it’s not all that surprising as there seems to be an acceptance of that in today’s society.”
He said there are now 28 states with medical marijuana statutes in place, with 11 of them requiring that “some accommodation” needs to be made when possible for workers who claim to need it for medical reasons, though transportation companies don’t need to do that for safety reasons.
Only four states – Alaska, Washington, Oregon, and Colorado – have “decriminalized” marijuana, with four others waiting in the wings.
Simo said the issue and that use of marijuana, even under for “medicinal” purposes, is widening and that brings with it safety and costs risks for businesses.
“The original intent of medical marijuana laws was to help terminally ill people at the end stage of life: people with AIDS and terminal cancer,” he explained.
“But today over 90% of the diagnoses for medical marijuana prescriptions is for ‘chronic pain,’ not cancer or AIDS. And when the laws first came out, the average age of those users was 50 and above. Now the average age is in the upper 20s,” Simo said. “Don’t get me wrong; I am pro-medical marijuana compassionate care. But I have problem when people are using it in their prime working years.”
He noted that there are three reasons for that: 1) Chronic marijuana users are five times to likely to file claims for workman’s compensation injuries; 2) They have three times higher medical costs, and; 3) They only work at 67% predicted efficiency – a number driven by absenteeism, which runs “north of 20 times per year” on average.
Thus detecting drug use via a screening process and disqualifying and applicant before they start work saves a company an average of $14,000 per occurrence, Simo said – largely due to avoiding the costs noted in the three factors above.
He added that the Department of Transportation (DOT) began including opioids as part of the drug screening tests required for transportation workers as of January 1 this year and Simo thinks that inclusion will bump up the “hit rate” for drug detection.
“More analysis equals more laboratory “positives” and we think we’ll see a 0.9% increase in positive DOT drug tests,” he said. “Right now the positive rate is about 2% of all tests and so that should increase to 2.9%; that’s an over 30% jump. That means more medical reviews and more delays than we are used to seeing from a laboratory testing perspective.”
Simo also noted that new forms of drug testing – such as using hair or oral fluids as opposed to just urine tests – are running into some headwinds.
“HHS [the Department of Health and Human Services] has wanted to write a rule for oral fluid testing since 2015 – but’s it is still not able to get it out the door,” he explained.
“And hair testing is something HHS does not like. From my discussions with them, the issue is that hair is not a ‘homogenous’ substance: it is different in color, texture, and length. People ‘do something’ to it as well: they wash, curl, and straighten it. So it is not as uniform as oral fluid or urine testing. On top of that, the three laboratories that conduct hair testing all do it a different way.”
It doesn’t help that darker hair can actually attract and “hold” more chemicals. For example, Simo noted that higher levels of codeine – which is used in cold medicine – can be deposited in darker hair, which can trigger a lab positive and medical review.
All of this serves as backdrop for a much bigger effort taking place in the trucking industry – the creation of a national “clearinghouse” for drug and alcohol tests.
The final rule – passed in December 2016 – requires motor carriers, medical review officers, third-party administrators, and substance abuse professionals to report information about drivers who:
- Test positive for drugs or alcohol;
- Refuse drug and alcohol testing; and
- Undergo the return-to-duty drug and alcohol rehabilitation process.
Additionally, motor carriers will be required to annually search the clearinghouse for current employees, and during the pre-employment process for prospective employees, to determine whether a driver violated drug or alcohol testing requirements with a different employer that would prohibit them from operating a commercial vehicle.
Federal Motor Carrier Safety Administration (FMCSA) regulations require employers to conduct pre-employment drug testing and random drug and alcohol testing and motor carriers are prohibited from allowing employees to perform safety-sensitive functions, which include operating a commercial truck, if the employee tests positive on a DOT drug or alcohol test.
In accordance with the Privacy Act of 1974 (5 U.S.C. § 552a), a driver must grant consent before an employer can request access to that driver’s clearinghouse record and before FMCSA can release the driver’s clearinghouse record to an employer. But after registering with the clearinghouse, a driver can review his or her information at no cost, the agency noted.
But while it is supposed to go “live” in the 2019-2020 timeframe, Simo said the work to build the “clearinghouse” or database hasn’t started yet.
“A third party is to build it but the RFP [request for proposal] has not been released,” he said. “FMCSA has also said third parties will be able to tap into database on behalf of motor carriers and present their findings to them. But what that [process] will ultimately look like is still to be determined.”
That delay is also putting off what many believe will be an inflection point of change in trucking that could prove bigger than that of the recent imposition of the electronic logging device (ELD) mandate.
John Larkin – director and head of transportation capital markets research for Stifel Capital Markets – noted late last year that an “emerging theory” is that the trucking drug and alcohol clearinghouse could ultimately have a bigger impact than ELDs, though he expects it to be at least two or more years before it will have an impact.
“We believe that even at fleets known for safe driving operations there will be instances of drivers no longer being able to drive because of past
DUI [driving under the influence] or DWI [driving while intoxicated] infractions; those issues are too widespread to not touch every large fleet, in our estimation,” he said in a research brief.
“The drug and alcohol clearinghouse is expected to be implemented starting in early January 2020. But, according to Annette Sandberg, the founder of TransSafe Consulting, very little progress has been made on building a database of offenders,” Larkin added. “Therefore, we wonder whether that deadline is ultimately pushed back even though it appears that there is very little appetite to repeal it entirely.”
It’s just one more item fleet executives need to keep their eyes upon in the weeks and months ahead.