Drug use by the American workforce is on the rise - the percentage of employees testing positive for drugs increased over the last three years to a 10-year high of 4% in urine specimens. However, urine lab positive rates are not keeping up with self-reported illicit drug use. Escalations in self-reported illicit drug use rates are being driven by increased marijuana use. As states and municipalities relax restrictions on marijuana use, employers find themselves caught between old rules like zero-tolerance policies and the new laws. Listen to Dr. Todd Simo, Chief Medical Officer at HireRight as he takes a look at evolving drug screening trends and best practices you can employ for a drug-free workplace in 2017. In this webinar, you'll learn: - Self-reported drug use rates - Lab positive rates by specimen - States with medical & recreational marijuana statutes - Drug screening tips to enhance your drug-free workplace

1. The Changing Face of Drug Screening –
Trends & Best Practices for 2017
Todd Simo, M.D. – Chief Medical Officer
#HireRightWebinar

2. HireRight ® Copyright © 2017. All Rights Reserved
Legal Disclaimer
HireRight has prepared these materials for informational
purposes only. These materials are not intended to be
comprehensive, and are not a substitute for, and should not be
construed as, legal advice.
HireRight does not warrant any statements in these materials.
Employers should direct to their own experienced legal counsel
questions involving their organization’s compliance with or
interpretation or application of laws or regulations and any
additional legal requirements that may apply.
#HireRightWebinar

3. Your Host
HireRight ® Copyright © 2017. All Rights Reserved
Dr. Todd Simo
Chief Medical Officer
HireRight
Follow Dr. Simo on Twitter
@Dr_ToddSimo
#HireRightWebinar

4. Agenda
 Positive Rates
» Self reported illicit drug use
» Lab positive trends year over year
– Lab positive rates by specimen
» Juxtaposition of MRO verified positive rate by specimen
 Marijuana Trends
» Medical marijuana
» State decriminalized marijuana
4 HireRight ® Copyright © 2017. All Rights Reserved #HireRightWebinar

5. Self Reported Illicit Drug Use in the Past Month
 NIDA data for age group 26 years old and older
5
7.3%
8.3%
8.2%
2013 2014 2015
HireRight ® Copyright © 2017. All Rights Reserved #HireRightWebinar

6. Self Reported Illicit Drug Use in the Past Month
 NIDA data for age group 26 years old and older
 By drug class
6
5.6%
6.6% 6.5%
0.5% 0.5% 0.6%
0.3% 0.3% 0.5%
2.1% 2.1% 2.0%
2013 2014 2015
Cannabinoids Cocaine
Methamphetamines Prescription medications
HireRight ® Copyright © 2017. All Rights Reserved #HireRightWebinar

7. Lab Positive vs. Self Reported Drug Use Rates
 Quest Diagnostics data vs. NIDA data
7
7.3%
8.3% 8.2%
3.7% 3.9%
2013 2014 2015
NIDA Urine
HireRight ® Copyright © 2017. All Rights Reserved
?
#HireRightWebinar

8. Lab Positive vs. Self Reported Drug Use Rates
 Quest Diagnostics data vs. NIDA data
8
7.3%
8.3% 8.2%
3.7% 3.9%
6.7%
7.7%
2013 2014 2015
NIDA Urine Oral fluid
HireRight ® Copyright © 2017. All Rights Reserved
? ?
#HireRightWebinar

9. Lab Positive vs. Self Reported Drug Use Rates
 Quest Diagnostics data vs. NIDA data
9
7.3%
8.3% 8.2%
3.7% 3.9%
7.7%
9.6%
2013 2014 2015
NIDA Urine Hair
HireRight ® Copyright © 2017. All Rights Reserved
? ?
#HireRightWebinar

10. Lab Positive Rate by Specimen
 Quest Diagnostics data
HireRight ® Copyright © 2017. All Rights Reserved10
3.5% 3.7% 3.9%
5.5%
6.7%
7.7%
5.6%
7.4%
9.6%
2012 2013 2014
Urine Oral fluid Hair
#HireRightWebinar

11. HireRight MRO Verified Positive Rate
2.2%
4.0%
5.0%
1.9%
6.0% 5.8%
Urine Oral fluid Hair
FY15 FY16
HireRight ® Copyright © 2017. All Rights Reserved11 #HireRightWebinar

12. NIDA Data & Lab Positive Rate by Specimen
 Conclusions
» Escalation in self reported illicit drug use is being driven by increased
marijuana usage
» Urine lab positive rate is not keeping up with the self reported illicit
drug use rate
» Lab positive rates for alternate specimens is tracking with the self
reported illicit drug use rate
» MRO verified positive rates for alternate specimens is significantly
higher than the urine positive rate
» Based upon previously cited data, a one point increase in MRO
verified positive rate confers a cost avoidance of $14K per one
hundred tests
HireRight ® Copyright © 2017. All Rights Reserved12 #HireRightWebinar

13. HireRight ® Copyright © 2017. All Rights Reserved13
Medical Marijuana
States that have Medical Marijuana statutes in
place
» Legacy: 24 States - AK, AZ, CA, CO, CT, DE, HI, IL, ME,
MD, MA, MI, MN, MT, NV, NH, NJ, NM, NY, PA, OR, RI,
VT, WA, and Washington DC
» New: 4 States – AR, FL, ND, and OH
 Green = statute addresses need to accommodate when possible
 Red = Regulation/case law explicitly states that employers DO
NOT NEED to accommodate medical marijuana use
 Black = Regulation silent in regard to need to accommodate
#HireRightWebinar

14. HireRight ® Copyright © 2017. All Rights Reserved14
Medical Marijuana
#HireRightWebinar

15. HireRight ® Copyright © 2017. All Rights Reserved15
Decriminalized Recreational Marijuana
Red = States with decriminalized recreational use prior to Nov. 2016 election
Pink = States that passed statutes for decriminalization of recreation use in the Nov. 2016 election
#HireRightWebinar

16. Why Is Medical Marijuana Used Today?
 Original intention
» To help people with extremely serious (often terminal) diseases to
live more comfortably
– Generally terminal patients
• End stage AIDS
• Cancer
• Severe debilitating neurologic diseases
 Today
» Most medical marijuana users list “chronic pain” as the reason they
use marijuana
– Several state studies identify over 90% of medical marijuana users identify
chronic pain as reason for their use
– Average age is under 50 years old
HireRight ® Copyright © 2017. All Rights Reserved #HireRightWebinar

17. President Trump
 Donald Trump has made supportive statements for
marijuana legalization in the past
» His statements in regard to recreational use have not been favorable
 The potential inclusion of politicians who are
traditionally conservative on drug policy in his future
administration — such as his nominee for Attorney
General, Sen. Jeff Sessions — has caused some
legalization support to mellow
» "I'm mostly concerned by the people around Donald Trump," said
Executive Director of the Drug Policy Alliance Ethan Nadelmann —
the man considered the major powerhouse behind marijuana
legalization in the country
HireRight ® Copyright © 2017. All Rights Reserved #HireRightWebinar

18. Best Practices - Recommendations
 Drug Free Workplace Programs (DFWP)
» Consider alternate specimens
– Both hair and oral fluid have substantially higher “hit” rates
» Specimen selection is dependent upon DFWP configuration
– Pre-employment only
• Hair
– Long detection window
– Robust incumbent testing program with static facilities
• Oral fluid
– Unable to easily subvert & no lost time from work
– Other programs
• Variable – consider using a consultant who can help configure your program
HireRight ® Copyright © 2017. All Rights Reserved18 #HireRightWebinar

19. Best Practices - Recommendations
 Decriminalized Marijuana
» Know the states you employee people in
– Some states require you to consider accommodation
» Know your risk tolerance / employee profiles
– Safety sensitive vs. non-safety sensitive
– Risk adverse vs. not risk adverse
» Know the regulatory rules which apply to your company
– Is your company subject to following federal drug screening rules?
» Consider oral fluid testing
– Short detection window mimics period in which marijuana is impairing
HireRight ® Copyright © 2017. All Rights Reserved19 #HireRightWebinar

20. HireRight ® Copyright © 2017. All Rights Reserved20
QUESTIONS
#HireRightWebinar