View the Q&A from our Drug and Alcohol Policy Development Workshop.Read more
During our Drug and Alcohol Policy Development Workshop held on 29 November 2023, numerous questions were asked, some of which we did not have time to answer during the session. Below are all the questions asked, along with our responses.
Should you have any additional questions, please don’t hesitate to reach out to us at email@example.com or 1300 795 227.
Performing the testing of wastewater, is that something you can carry out on all sites? Is it an easy test to complete?
Wastewater testing can be performed effectively at any site. All that is required is to get access to the effluent outflow or the wastewater holding tanks for sampling. If required, Safework Health can send our staff to your sites and assess what needs to be done for testing and advise on the optimum testing regime tailored to your needs. Wastewater testing requires as a minimum that the number of staff at the site at the time of testing be made available. The effluent flow rate would be helpful but is not critical, as it can be approximated from the staff numbers assuming the average number of toilet visits and the average Australian toilet flush volume. Each sampling episode is easily done by taking ~300mL of wastewater from the effluent stream. Reports will be available within 7 working days of receipt of the sample.
Do we need to notify the employees that we are going to conduct wastewater testing?
There is no requirement – either legally or by custom, in Australia or internationally – to inform a site that wastewater testing is being or is planned to be performed. Wastewater testing is a whole-site testing procedure and does not impact the individual workers. Results reveal the magnitude of drug use at a site collectively and cannot identify the individual workers involved, so no case can be made for generally informing a site that testing will take place.
Do you see a time when we will have standards for hair testing?
It is generally believed the European SoHT (Society of Hair Testing) recommendations will be adopted as the international standard for hair testing by the EU over the next 2 to 3 years – specifically the 2022 Consensus on Hair Testing. The current delay is due to problems reconciling French guidelines with German practice. Once the EU has given its imprimatur, the US and Australia will follow suit to comply with international best practice guidelines.
Can you share that evidence base for >1 per year drug and alcohol testing programs reducing accidents by X%?
In progress. The review of the literature will be made available on 12 December 2023.
Do the laboratory test results reflect how long ago the worker is likely to have taken THC? Namely, can the result be converted into a rough timeline of when the THC was used?
No exact figure can be given. Urinary THC (provided the donor’s physiological details are supplied) may potentially supply the most accurate (albeit rough) estimate.
The oral fluid detection window for THC is roughly 8-12 hrs for standard doses of medicinal cannabis, ~ 12-18 hours for a NIDA-standard low dose 5mg THC cigarette, 18-24+hrs for a NIDA moderate dose 10mg THC cigarette. By use of the detection window a crude estimate of the maximum time since use can be made.
Urine detection windows are more complex. THC is a lipid-soluble molecule which partitions into the body fat. The more frequent the use of cannabis, and/or the more adipose tissue a donor has, the longer the detection window for THC – ranging from 3 to 5 days for a standard NIDA cigarette in a donor with normal BMI to 7 days for an obese donor with a BMI > 28.
By factoring in the height/weight and age of the donor and the stated frequency of use, a rough estimate of the time since use (i.e., more than ‘x’ hours but less than ‘y’ hours before collection) can be made for a range of THC doses, as well as determining whether a particular urinary THC level is consistent with the donor’s stated dosage and declared time since use. It should be noted these estimates are rough and not exact and that, while oral fluid THC correlates well with THC-associated impairment (if it’s not detected, the donor’s not affected), urinary THC levels do not correlate with impairment.
Meet Maree, a dedicated Occupational Health Nurse in our Brisbane clinic.Read more
Meet Maree, an Occupational Health Nurse at our Brisbane clinic. With 20+ years of nursing experience, Maree has found immense fulfilment in her role here since joining Safework Health in March 2023.
When not at work, Maree is all about staying active with reformer Pilates, running, paddle boarding, and kayaking. She also enjoys family time with her three beautiful grandchildren.
Meet Our Growing Team
Find out more about Safework Health’s national occupational health team.
Join our webinar and discover the keys to crafting a customised drug and alcohol policy that perfectly suits your business. Register now!Read more
Are you concerned about workplace substance abuse and the legal responsibilities it entails? We invite you to our upcoming webinar, where we’ll equip you with essential insights and tools to create a comprehensive Drug and Alcohol Policy tailored to your business’s unique needs.
Date: Wednesday, 29 November
Time: 1 PM AEDT
The event will be made available on-demand to all registrants, so even if you can’t make the live show, please register.
In this webinar, we will explore:
- Legislative Requirements and Fiduciary Duty-of-Care: We’ll dive into the legal obligations and fiduciary responsibilities related to workplace drug testing.
- Assessing Your Workplace Needs: Learn how to assess your workplace to determine the extent of substance abuse issues and identify specific needs.
- Developing a Written Policy: We’ll provide guidelines and a template to help you create a robust and effective drug-free workplace policy.
- Implementing Drug Testing: Discover how to choose the right test mix and testing strategy to suit your business’s requirements, including considerations for frequency and types of testing.
- Education & Training: Explore the importance of providing education and training for employees and additional training for supervisors and other relevant staff.
- Employee Assistance Program (EAP): Gain insights into setting up and assessing your EAP to support employees dealing with substance abuse issues.
Meet Our Webinar Speaker
Dr Phil Tynan, National Chief Toxicologist
Dr Tynan, a renowned Toxicologist, and retired Clinical Biochemist Pathologist, offers a wealth of industry experience. He specialises in substance abuse testing, supports Safework Health in developing new assays and procedures, and provides expert advice to clients. With publications in peer-reviewed journals, Dr Tynan is available for result consultation, expert witness testimony, and court appearances.
Explore the impact of fentanyl and oxycodone in Australia, uncover evolving trends, and discover workplace testing methods.Read more
Fentanyl and oxycodone, the key players in the opioid epidemic sweeping across the United States, have begun to reshape the landscape of opioid use in Australia. While usage rates here remain lower than in the US, recent studies reveal a shift in opioid consumption patterns.
In this engaging article, we delve into the world of fentanyl and oxycodone, exploring their impact on Australia, tracing the evolving usage trends, and shedding light on effective workplace testing methods for detecting their presence.
Fentanyl vs Oxycodone
Fentanyl and oxycodone are powerful and highly addictive opioids commonly used for pain management.
What is Fentanyl?
Fentanyl is a synthetic opiate drug that is 80 to 100 times more powerful than morphine.
It is used medically as an intravenous anaesthetic and analgesic. However, it is most often encountered as a transdermal (skin) patch to relieve long-term pain, or to supply relief to cancer patients and the elderly. The drug is often misleadingly marketed as ‘safe’.
These patches are frequently discarded when they are around two-thirds used as the quality of pain relief tends to drop over time. Unfortunately, these ‘used’ patches can be reused by addicts when they extract the fentanyl gel. This practice is called ‘dumpster diving’ because they often search for old patches in the garbage. They then distil the pure drug from the patches and often recrystallise the drug to form “Rock.” Fentanyl distillates can be smoked, or the patches can be used directly – either being pasted on the body or chewed.
Traditionally fentanyl powder is often mixed with low-quality heroin. Heroin supplies from Central Asia are drying up. This is pushing users to experiment with fentanyl.
Additionally, increasing amounts of fentanyl are being imported into Australia. Just last year, the Federal Police in Melbourne seized a shipment of fentanyl equivalent to 5 million individual doses.
What is Oxycodone?
Like fentanyl, oxycodone is a synthetic opiate often sold as Oxycontin or Endone which, when taken by mouth, is one-and-a-half times more potent than morphine.
Medically, it is used for managing moderate-to-severe acute or chronic pain and is normally sold as a controlled-release tablet to be taken every 12 hours. As with all opioids, oxycodone induces euphoria and is addictive.
Oxycodone is one of the most abused pharmaceutical drugs in the US and is significantly abused in Australia, although not (as yet!) at levels approaching those in the US.
Once a person becomes physically dependent on oxycodone, they experience strong cravings for the drug, leading to continued use despite the ongoing physical harm. They are also at risk of suffering severe withdrawal symptoms, which can include panic attacks, nausea, muscle pain, insomnia, and flu-like symptoms.
Overdoses can easily be fatal. When not fatal, they can cause spinal cord infarction and ischaemic brain damage that resembles a bad stroke. Oxycodone also interacts badly with many other prescribed drugs – especially some anti-HIV medications – which can substantially slow the rate of clearance of the drug from the body.
Combining Opioids With Stimulants
Oxycodone and fentanyl are now being increasingly used in combination with stimulants – especially of the amphetamine class (which includes Meth).
There is a long history of people combining opioids with stimulants, such as ‘goofballs’ combining methamphetamine with heroin and ‘speedballs’ which are a heroin plus cocaine mixture. Australia already has a widespread Meth problem, and the number of cases where opioids were combined with Meth is rising.
Oxycodone and Fentanyl Usage Trends in Australia
There is a growing opioid abuse culture in Australia.
Even in 2008, the National Drug & Alcohol Research Centre reported that 91% of injecting drug users in Australia report having used Oxycodone. 23% admitted to using it in the last 6 months.
Fentanyl use has been rising in Australia, especially over the last 4 years – most notably on the Sunshine Coast in Queensland. Programs to stop fentanyl use have been only partly successful as addicts often switch over to oxycodone.
Oxycodone and fentanyl use in Australia is substantially higher in regional areas than in urban and capital areas, but the overall use rate is significant in both areas.
Worksite drug testing has shown that the use of these drugs varies substantially over the week. In remote sites, importation may occur only on specific days – which is then reflected in higher capture rates over the next 24-48 hours.
Cracking down on one opioid – such as oxycodone – only appears to encourage users to switch to another opioid: specifically, fentanyl. This was seen in the closing years of the last decade in Queensland where a crackdown on oxycodone led to a rise in fentanyl abuse.
Surging Popularity of Fentanyl and Oxycodone: Examining the Pros and Cons
What is the danger if oxycodone and fentanyl use are on the rise?
Both fentanyl and oxycodone carry a high risk of making users dependent on the drugs, and both have what is called a narrow therapeutic window: a dose sufficient to bring on a high is not much less than the dose required to give a potentially lethal overdose.
The appeal of fentanyl and oxycodone is that the drugs are pharmaceutical – so they have a high purity, and users are less worried about contamination. The drugs are highly potent – ‘more bangs for the buck’ – and because of their rapid uptake cause a ‘quick high’ (especially fentanyl).
The advantage from a medical perspective is that fentanyl can be taken when a patient has an impaired liver, to treat neuropathic pain, and the patches can be used when a patient is nauseous, vomiting or has difficulty swallowing. For the user, the big attraction is that fentanyl is the fastest-acting opioid available.
Fentanyl is cheap – so it is a popular opioid for abuse. Unfortunately, it also has the most prolonged respiratory depression (suppression of the breathing reflex) of any opioid – which arguably makes it the most lethal.
Workplace Drug Testing: Detecting Oxycodone and Fentanyl Use
Common workplace drug testing methods include:
- Urine Drug Testing – Oxycodone and fentanyl can be detected in a specifically requested assay in urine. Urine is the superior sample for both drugs, as the detection window is much greater than oral fluid – up to 4 days.
- Oral Fluid Drug Testing – Oxycodone is included in routine oral fluid screening tests, unlike fentanyl which is not included in these tests. The detection window for oral fluid is 36 hours.
- Wastewater Drug Testing – Wastewater drug testing is the best way to get a snapshot of the extent of actual opioid use at a workplace but should include weekend coverage as use varies greatly day-to-day.
Safework Health offers the convenience of on-site instant drug testing at your workplace or at any of our nationwide clinics. Additionally, our extensive network includes a suite of NATA-accredited drug testing laboratories.
Notably, Safework Health stands out as one of the select few laboratories in Australia capable of conducting urine testing specifically for oxycodone and fentanyl.
Feel free to reach out to us today for a discreet and confidential consultation.
Meet The Author
Dr Phil Tynan, National Chief Toxicologist
Dr Tynan, a distinguished Toxicologist and a retired Clinical Biochemist Pathologist, brings a wealth of industry knowledge and experience. He is considered an expert in testing for substances of abuse.
Dr Tynan primarily supports Safework Health in developing new drug assays and procedures. He also offers guidance to clients and expert clinical advice as needed.
Dr Tynan is a published toxicologist in internationally peer-reviewed journals and is available to provide advice and expert opinion regarding results, expert witness testimony and appearances at courts and tribunal hearings.
Learn what isocyanates are, health hazards, and the importance of health monitoring programs.Read more
Isocyanates are highly reactive compounds used in industries like adhesives and coatings. Exposure can lead to health problems such as asthma and skin sensitisation.
To help keep your workers safe and healthy, we have created a comprehensive guide. This guide covers essential information about isocyanates, including what they are, the health hazards associated with their exposure, and the importance of implementing a health monitoring program.
What Are Isocyanates?
Isocyanates are a group of highly reactive organic compounds used in the manufacture of:
- adhesives and glues
- coatings lacquers and varnishes
- spray paints
- elastomers and foams
- floor / roof screeding
- hardwearing plastics
- medical dressings
Isocyanates are toxic until they react with other chemicals to form the hardened or ‘cured ‘polyurethane product. Fully-cured polyurethanes are non-toxic, unless they are heated or abraded, which makes them give off isocyanates and other toxic substances.
Understanding Isocyanate Exposure
Isocyanates can enter the lungs when workers inhale isocyanate vapours, mists or aerosols. They can also be absorbed when a worker’s skin is exposed to liquids, resins, or droplets. Even workers who don’t handle isocyanates directly, but work near others who are using isocyanates, can still be exposed.
Isocyanate exposure can occur throughout the manufacturing process, from initial surface application to cutting or curing.
Exposure is common in many industries including painting, printing, automotive manufacture, construction, furniture production, and mining.
Isocyanates Health Effects
Isocyanate exposure is associated with numerous health problems. Exposure can cause asthma, skin sensitisation, skin or mucous membrane irritation, and, rarely, a lung reaction called hypersensitivity pneumonitis.
They are one of the leading causes of occupational asthma in Australia. The condition commonly presents as:
- chest tightness and shortness of breath
The symptoms can occur at work, or much later after work, and the asthma can be made much worse by repeated exposure.
Once a worker has been sensitised, even very low-level exposures might produce a potentially life-threatening asthma attack, which may end their career. Exposure to isocyanate aerosols can lead to hypersensitisation which can give rise to ‘bagpipe lung’ (also known as extrinsic allergic alveolitis or hypersensitivity pneumonitis).
Sensitisation by skin contact can cause allergies that can affect both the skin and/or the lungs. Acute exposure to these chemicals can cause irritation to the eyes, skin, and mucous membranes of the nose and the throat, occasionally accompanied by headaches and itching. Sensitisation can occur at isocyanate concentrations lower than those that may give rise to irritation.
Most isocyanates are not carcinogens – the exception is TDI (toluene diisocyanate) which has been found to cause cancer in some laboratory animals (although it has never actually been demonstrated in humans). Isocyanates are not associated with human fertility or pregnancy problems nor with abnormalities of foetal development.
Exposure Testing and Control Measures
To safeguard workers’ health and minimise the risks associated with exposure, control measures and biological monitoring programs are essential.
Since isocyanates can act as skin and respiratory sensitisers, and to control the risk of future health issues in the workplace, exposure to isocyanates should be kept as low as reasonably practicable.
If adequate control measures are in place – such as closed ventilation systems (spray booths, enclosed moulding machines), air-fed respiratory protection and personal protective clothing/gloves – these conditions, and episodes of isocyanate exposure, are easily preventable.
Biological Monitoring Program
Isocyanate Biological Monitoring (BM) is especially necessary for workers involved with:
- motor vehicle repair paint use
- foam blowing
- hard polyurethane manufacture
- glues and adhesives
- floor screeding
- underground mining.
BM is a simple and cost-effective way to check that workplace control measures are sufficient, being effectively applied and exposure is being adequately controlled.
BM assesses worker exposure to isocyanates, confirms control measures, and prevents health risks. While not a diagnostic tool for isocyanate-related conditions, it helps identify occupational exposure when symptoms arise. BM also gauges skin absorption, especially with glove use. It’s user-friendly, providing personalised results to promote better work habits.
BM aggregates all routes of exposure, inhalation, skin absorption and ingestion, so a result cannot identify the actual source/route of exposure. It will, however, show the need for corrective action to be taken.
Safe Work Australia’s Guidelines for Isocyanate Exposure Monitoring
Safe Work Australia recommends that Biological Monitoring programs for workers using or exposed to isocyanates should include:
- Initial baseline BM upon the commencing employment
- Periodic BM review, generally performed after 6 weeks of commencement (of isocyanate exposure)
- Regular 6-monthly BM every six months. If after 12 months, no adverse health issues are reported this should then switch to annual testing
- Terminal BM performed at the end/termination of the period of isocyanate exposure.
How Is Isocyanate Exposure Testing Performed?
A post-exposure urine sample should be taken, ideally within an hour of the end of exposure, especially for those tasks involving:
i) heating of polyurethane
ii) use of:
- HDI (hexamethylene diisocyanate, used in two-pack spray paints)
- TDI (toluene diisocyanate, used in adhesives and foam blowing)
This is recommended as the above-mentioned isocyanates are all rapidly excreted.
End-of-shift testing should be performed with:
i) Encountering abrasion of polyurethane
ii) Exposure to MDI (methyl phenylene diisocyanate)
If significant skin exposure is a possibility, pre-shift next-day samples should also be considered (due to the delayed absorption through the skin).
BM samples mostly reflect that day’s exposure (reflecting the short half-life of excretion), and generally do not illuminate long-term exposure. For this reason, it is recommended that several samples are taken initially to ensure that ‘normal practice’ is captured.
The urine samples should be sent ideally the same day or the next day to Safework Health for analysis. If shipping is delayed, samples should be stored frozen, if possible, prior to despatch.
How do you interpret results?
Interpretation of results requires an appreciation of the work practices, tasks and controls used by an individual worker on the day of sampling.
Results will fit one of three broad categories:
- No detection — with no evidence of exposure to the requested isocyanates (no further action required and repeat testing in 1 year)
- Low-level exposure — meaning that exposure was detected but the levels were within the BMGV (control measures and their use should be checked but repeat testing is not required immediately; the result may be due to intermittent behaviours, such a visor-flipping, if the investigation shows no systematic concerns); and
- Exposure exceeds the BMGV — this requires action be taken to check the control measures and their use and to resample workers once any issues have been resolved (if results remain elevated, further investigation is required but workers do not need to be removed from tasks). Where work practices or exposure controls are significantly altered then retesting should be considered to ensure that exposure levels have not increased as a result.
Safework Health’s Biological Monitoring Service
Safework Health’s NATA accredited isocyanate urine testing service can detect your workers’ exposure to this harmful chemical. We offer a rapid 5-day turnaround for results, an accurate and cost-effective testing method, and national coverage.
Contact our friendly team today to find out how we can keep your workers safe and healthy.
Urine drug testing is the most common drug testing method used in occupational health.Read more
Many employers prioritise the safety and well-being of their employees by employing this method due to its speed and accuracy in detecting drug traces in urine samples.
A urine drug test aids both employers and employees in preventing hazardous situations that could potentially lead to accidents and fatalities.
What Drugs Does a Urine Drug Test Detect?
Pros And Cons Of Urine Drug Testing
While urine drug testing has its advantages, it’s important to note that each method has its own strengths and limitations.
The choice of testing method should be based on factors such as the specific drugs being tested for, the detection window required, the ease of sample collection, and the overall testing goals.
Advantages of a Urine Drug Test
- Wide Detection Window: Urine testing typically has a longer detection window compared to saliva testing. Drugs and their metabolites can be detected in urine for a more extended period, making it suitable for detecting past drug use.
- Ability to Detect a Wide Range of Substances: Urine testing can detect a broader range of substances compared to saliva testing, making it a preferred choice for comprehensive drug testing panels. It can detect both drugs and their metabolites.
- Cost-Effective: Urine drug testing is often more cost-effective than hair testing, which can be more labour-intensive and expensive to process.
- Immediate Results for On-Site Testing: For on-site testing, urine tests typically provide quicker results compared to sending samples to a laboratory, making them suitable for immediate decision-making.
- Established and Reliable Method: Urine drug testing is a well-established and widely used method with a long history of reliability and accuracy.
Limitations of a Urine Drug Test
- Invasiveness: Collecting a urine sample can be considered invasive, as it requires individuals to provide a urine specimen. Some people may find this process uncomfortable or embarrassing.
- Ability to Cheat or Tamper: Some individuals may attempt to cheat or tamper with their urine samples to produce false-negative results. This can be done through various methods, such as dilution, adulteration with substances like bleach or vinegar, or using synthetic urine.
- Need for Adequate Toilet Facilities: Urine drug testing necessitates access to suitable and private toilet facilities where individuals can provide urine specimens. In some settings, ensuring the availability of these facilities can be challenging, especially in remote or mobile testing scenarios.
Urine Drug Testing Detection Times in Australia
The detection times for drugs in urine can vary depending on several factors, including the specific drug, the frequency of use, and an individual’s metabolism. In Australia, here are approximate detection times for some commonly tested drugs:
- Amphetamine Type Substances (methamphetamine, amphetamine, MDMA, MDA): 2 – 4 days
- Benzodiazepines: 7 days – 3 weeks
- Cannabis: 3 – 14 days (30 – 40 days with obesity)
- Cocaine: 3 – 5 days
- Opiates (heroin, morphine, codeine): 3 days
Urine Drug Testing Procedures in Australia
In most cases, employees in Australia undergo urine drug tests at their workplace under the supervision of qualified Drug and Alcohol Collectors. However, in some instances, employees may be required to visit a testing clinic.
During the test, a Collector will provide the patient with a specimen cup and instructions for proper specimen collection, which involves capturing mid-stream urine. The specimen is then handed over to the Collector for labelling and processing.
The actual drug testing occurs in the laboratory. To ensure the reliability of a urine drug test, lab technicians must maintain a strict chain of custody, meticulously documenting the handling and storage of the urine specimen until disposal. If the initial test results are positive, additional tests are conducted to confirm the outcome. For a definitive result, both tests must match.
Safework Health’s Urine Screening Services
Safework Health has over 100 certified Collectors across Australia who can perform an instant urine drug test on-site at your workplace or at one of our clinics.
We also offer a range of urine drug test kits that conform with Australian and New Zealand Standard AS/NZS 4308:2008.
Contact us today to learn more.
Explore the impact of industrial manslaughter laws on workplace drug and alcohol management.Read more
In recent years, there has been a growing recognition of the importance of workplace safety and the need to hold individuals and companies accountable for their actions.
This has led to the introduction of industrial manslaughter laws in various parts of Australia, including South Australia. These laws aim to ensure that those who are reckless or grossly negligent in breaching work health and safety duties and causing the death of another person face severe consequences.
Under the new laws in South Australia, individuals can face up to 20 years’ imprisonment, while companies can be fined up to $18 million if they are found guilty of industrial manslaughter.
New Laws Spotlight Workplace Drug and Alcohol Management
With the introduction of the new laws, there is increased attention on the management of drugs and alcohol in the workplace.
Employers must have comprehensive plans in place to manage these substances effectively. This includes implementing drug and alcohol policies and procedures, providing education and training on the dangers of substance abuse, and conducting regular drug and alcohol testing.
The Importance of Drug and Alcohol Policies and Procedures
One of the key aspects of managing drugs and alcohol in the workplace is having robust policies and procedures in place. These policies should outline the expectations and responsibilities of both the employer and employees regarding substance abuse. They should clearly state the consequences of violating the policy and provide guidelines for reporting any concerns related to drug or alcohol use.
By having clear policies and procedures, employers can establish a safe and healthy work environment. It ensures that all employees are aware of the rules regarding drugs and alcohol and understand the potential risks associated with their use.
Providing Education and Training on the Dangers of Substance Abuse
Education and training play a crucial role in creating awareness about the dangers of drug and alcohol abuse in the workplace. Employers should provide comprehensive training programs that highlight the potential risks, the impact on job performance and safety, and the legal implications of substance abuse.
Through education and training, employees gain a better understanding of the consequences of their actions and are more likely to make informed decisions regarding drug and alcohol use. It also helps to reduce stigma and encourages individuals to seek help if they are struggling with addiction.
The Role of Drug and Alcohol Testing
One of the most effective ways to ensure workplace safety and compliance with drug and alcohol policies is through regular testing. Drug and alcohol testing can help identify individuals who may be under the influence while on the job, reducing the risk of accidents, injuries, or fatalities.
There are various methods of drug and alcohol testing, including urine, oral fluid, hair and breathalyser tests. Each method has its advantages and limitations, and employers should choose the most appropriate method based on their specific needs and requirements.
By implementing regular drug and alcohol testing, employers send a strong message that the use of drugs and alcohol in the workplace is unacceptable. It acts as a deterrent and helps maintain a safe and productive work environment for all employees.
Ask us how we can help your workplace comply with industrial manslaughter laws and ensure a safe and productive work environment.
View the Q&A from our Medicinal Cannabis in the Workplace webinar.Read more
During our Medicinal Cannabis in the Workplace webinar held on 9 August 2023, numerous questions were asked, some of which we did not have time to answer during the session. Below are all the questions asked, along with our responses.
Should you have any additional questions, please don’t hesitate to reach out to us at firstname.lastname@example.org.
With regards to pre-employment testing. If someone has declared they’re taking medicinal cannabis, are we able to notify to determine cbd:thc ratio?
The laboratory does not currently determine the level of CBD present in a sample. This could be relevant for oral fluid where detection is more closely aligned with impairment. While we have nothing to announce at this stage, we are constantly working to improve our service offerings to clients.
We have a Zero Tolerance policy which was previously provided to us by Safework Health. Should this be updated/replaced by a Zero Harm policy and can Safework help with a template for this?
Your drug and alcohol policy should be tailored to your requirements. There are some industries where a zero-tolerance approach is correct, for example where public safety is involved or where there is a high risk of catastrophic failure in the event of an accident or incident. Your policy can be reviewed in light of your requirements.
Could it be considered discrimination not to employ people with a medicinal cannabis prescription?
Yes, it is possible that it may be considered discrimination if the deciding factor in the decision was their medicinal cannabis prescription.
Any feedback on how the insurers (motor vehicles) are viewing potential changes to road use and (potential) impairment?
Currently, the presence of THC in blood can be used as evidence for prosecution purposes and may also affect vehicle and personal injury insurance claims. We would suggest contacting your insurer to determine their policy on medicinal cannabis in relation to their insurance products.
Is there a way to determine if the medication is being misused? i.e. a level above which the result must be misused? Are you able to test and differentiate between prescribed dosage and use against misuse of cannabis?
There are methods of determining if the result of a confirmed drug test are in-line with levels expected. The determination can be complex and will require additional information on the donor and their age/sex/height/weight. Dosage and frequency of use and time since last dose. Urine THC levels can be used as a rule-out assay – i.e., this level is or is not consistent with the stated dosage.
So, since THC accumulates with use, and doing a series of tests would allow you to determine if the THC is being used in therapeutic values, would employers be required to do a series of tests before making a determination about whether an employee is using their medication appropriately and legally?
The testing regime is up to the employer, and how their policy handles medications. It may be beneficial to monitor an employee who has recently started taking medicinal cannabis to establish a baseline response. Interpretation of results should be performed by someone with appropriate training and experience.
If a GP provides a letter and the worker then misuses the medication, and isn’t being regularly tested as the GP has provided confirmation of the prescribed meds and then is involved in an incident and found to be affected by the medication, where does liability sit – with the worker, the employer or the GP?
A fiduciary duty of care implies all these agents share some responsibility for the worker’s designation as being ‘fit-for-work’. There is an expectation however, that the reviewing Medical Officer’s opinion will be paramount – so if the GP says the worker is fit, the primary responsibility would lie with the MO. Note that if the worker abuses the prescribed dosage (i.e., takes excess) and shows clear evidence of impairment, then the workplace must assume primary responsibility for not intervening and instituting some for a review/Testing On Suspicion/Testing for Cause.
What if there is no option in terms of other duties and the employee is taking THC?
In such a case, it is important that the worker’s prescribed THC regimen is reviewed by a doctor – ideally an OHS physician or at least the worker’s prescribing MO certifying that the worker is fit for work. Medicinal THC should ideally only be taken >8 hrs before working – especially when dealing with safety-critical areas. CBD has no significant impairing effects apart from occasional tiredness within < 2 hrs of use. Workers taking THC should also be careful not to take benzodiazepines < 10 hrs prior to working, as THC enhances the sedative effect.
Is there going to be clear guidance on CBD in safety critical roles and workplaces?
CBD, unlike THC, is NOT associated with impairment, apart from (i) transient drowsiness experienced by a minority of workers only within the first 2 hours after use; and (ii) possible worsening of low blood pressure (hypotension) in people with pre-existing low blood pressure. Essentially – CBD is safe.
Could we just get a letter from their doctor to state if they can continue doing their normal duties – similar to a suitable duties/restricted duties plan?
A letter from the prescribing Doctor declaring they are fit for work is a good first start, however depending on their role/responsibilities there may still be an issue if a non-negative result is returned for THC.
What is stopping someone who is a regular user to go online and get a medical subscription for work purposes?
Medicinal cannabis should only be prescribed where no other valid form of treatment is available. There is anecdotal evidence that people have moved from illicit/black-market cannabis to medicinal cannabis prescriptions.
When asked about medicinal cannabis use, now being “legal” and how we treat this in the workplace, I equate it with alcohol – its legal, but we don’t allow people to come to work under the influence. Is this is a fair analogy, or would you recommend something else?
Yes, this is a fair analogy, as a society we have determined that a 0.05 BAC is an acceptable risk to health and safety. At some point an equivalent level will likely be set for THC. It is worth noting that even at 0.05 BAC there is a level of impairment present.
Are we saying there shouldn’t be a concern of impairment or safety risks if someone has been prescribed CBD through TGA and has a prescription and is taking the prescribed medication? If it is not through the TGA and just a prescription from a local GP or online, would this be different?
All medicinal cannabis prescriptions in Australia are provided through the TGA’s Special Access Scheme (SAS) and must be filled by a Pharmacist. Consultations can be held online, but the prescription must be filled in person. When taken as prescribed, CBD should not have a concern of impairment. It is worth noting that there is a window of around 2 hours post use where CBD can cause sleepiness. This should be taken into consideration by the prescribing doctor.
What would you determine as a safety critical role assessment?
This would depend on the employer’s Drug & Alcohol Monitoring Policy – it would be their decision as to what activities constitute a high-safety risk, and what level of risk they deem acceptable (i.e., zero-use/tolerance vs harm reduction). Safety-risk assessments would include a review of the worker’s current medications and health status (any possible complicating medical conditions).
Are mining companies moving towards Zero Harm re THC in this regard?
Yes – there is a general tendency to move towards ‘zero harm’ policies over simple ‘zero tolerance’. This means the focus is set on impairment rather than detection of an episode of prior use (w.r.t. THC – not amphetamine/meth where any detectable amount is consistent with being affected).
Is there a code of practice being developed to govern the changes in industry? There is certainly greater Fair Work issues at play other than just operating impaired.
Not currently, but industry policy groups, Health & Safety Forums and relevant industry OHS committees are seeking advice about addressing the issue. Most employer groups are seeking consultation from drug testing agencies about the issue and are incorporating provisions to their Drug & Alcohol Management Policies to ensure that medicinal cannabis use can be managed within the framework of handling prescription medication whilst maintaining workplace safety. The various State and Commonwealth legislatures are reviewing the legal situation, so the current situation may change.
Would it be acceptable that there is a requirement to declare use of medicinal cannabis to a health professional at a remote operational site?
It is important to maintain privacy for the employee, however trained medical professionals should be authorised to receive this information and provide advice in relation to an employee’s fitness for duty.
On prescribed cannabis, are they labelled the category they fit into? 1, 2, 3 etc?
Medicinal cannabis products are not directly labelled with the category, but this can be determined from the stated level of THC and/or CBD. Please contact Safework Health if you would like help with determining the category.
Just to confirm, if someone provides a negative result on an oral fluid test then we can be comfortable that they are not impaired?
Yes, if an on-site oral fluid test is negative there is no reason to suspect impairment by THC.
Is it possible to determine through a set level of THC/CBD would impact cognitive function in a worker? Or level of impairment?
There have been numerous studies attempting to correlate a level of THC with impairment. To the best of our knowledge there is no consensus on what level of THC constitutes impairment across all people. Additional studies will be required to do this.
How does the TCH Free CBD prescription vs Traces of THC in CBD Prescriptions?
Category 1 (>98% CBD) should have levels of THC well below that detectable by either oral fluid or urine screens. The allowable limits are set to cover manufacturers of medicinal cannabis products, since complete removal of THC cannot be guaranteed. If/when medicinal cannabis preparations receive TGA approval, the requirements around other components will likely tighten.
And are people under any obligation to disclose they have a prescription?
This depends on the specific work contract involved. If the contract includes a provision to inform the appropriate supervisor if they’re taking prescribed medications which might potentially lead to impairment, then they would have to do so. However, there is no general legislated obligation to disclose.
Impairment seems an irrelevant argument. The line in the sand is the level set by the Standard isn’t it?
Employers have an overriding fiduciary duty of care to maintain a safe workplace and minimise the risk of injury and death among their workers, regardless of the provisions of the Standard – so amending their DAMPs is advisable.
If we were to rely on a Dr letter stating “fit for normal duties”, surely this would need to from an Occupational Physician who understands industry work roles and what they entail?
Ideally, yes – or by any accredited Toxicological authority. However, it may not be practical (limited availability) and a thorough review by a competent GP (with appropriate toxicological advice) would be sufficient in the majority of cases.
How does THC Free CBD vs THC traces compare in use and legality especially in Health Professionals?
There are no restrictions placed on CBD use – it is not associated with impairment. This requires that the THC content of the medication be < 2%.
What is the rigor on checks / balances by TGA on the providers of CBD?
Currently the TGA does not assess the validity of the purity/content claims for the overwhelming majority of medicinal cannabis preparations and relies on the manufacturer purity claims. For this reason it is advisable that workers be encouraged to use only reputable brand preparations – e.g. Cannatrek etc.
What’s the age limit for using?
The lower age limit – save in exceptional cases such as reducing nausea from chemotherapy for cancer – is 18 yrs. There is no upper limit for medicinal cannabis prescription.
Watch this webinar to learn how to manage medicinal cannabis and its impact on the workplace.Read more
Watch this webinar to learn how to navigate the dynamic realm of medicinal cannabis and its impact on the workplace.
With the legalisation of medicinal cannabis and shifting attitudes towards its use, it’s crucial for businesses to stay informed and adapt their policies accordingly.
Watch this interactive webinar to gain valuable insights and practical strategies to effectively manage medicinal cannabis-related challenges in your workplace.
- What medicinal cannabis is, prescription rates, and potential impacts
- Real-world case studies showcasing how Australian businesses have begun managing medicinal cannabis
- Best practices for implementing policies and ensuring workplace safety
If you’re interested in learning more about how to manage medicinal cannabis in your workplace, please email email@example.com or call 1300 795 227.
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