Our guest: Tim Reid, Business Development Director for Phamatech Labs’ U-VERIFY™
In this episode, we delve into the world of forensic toxicology testing with Tim Reid, Business Development Director for Phamatech Labs’ U-VERIFY™ drug testing service. Phamatech Labs is a SAMHSA and College of American Pathologists (CAP) forensically accredited laboratory specializing in forensic toxicology testing services and rapid testing devices.
Tim explains the innovative DNA verification process in urine drug testing, detailing how it works and how DNA samples are obtained for verification. The conversation moves on to Phamatech’s improved turnaround times for test results, comparing their unique approach to standard lab practices.
Tim provides valuable education on lab testing procedures, explaining the difference between presumptive and confirmatory tests. He discusses why Phamatech goes straight to confirmatory testing for individuals in recovery programs and those suspected of drug diversion, highlighting the benefits of this approach.
A portion of the conversation focuses on panel selection for drug testing, particularly addressing why fentanyl is not included in basic panels despite its prevalence. Tim offers insights into the reasons behind this omission and discusses the importance of selecting appropriate panels for specific testing needs.
The episode concludes with Tim’s recommendations for facilities looking to implement drug testing for pre-employment screening and suspected diversion cases, providing guidance on tailoring testing approaches to different scenarios.
This informative discussion sheds light on the complexities of drug testing and the innovative solutions Phamatech Labs offers to enhance accuracy and efficiency in the field of forensic toxicology.
Transcript:
Terri
Welcome back, listeners, to Drug Diversion Insights. My guest today is Tim Reid with Pharmatech Labs Business Development. He’s the director there for their you Verify drug testing service. Pharmatech Labs is a SAMHSA and College of American Pathologists forensically accredited laboratory which specializes in forensic toxicology testing services and rapid testing devices for the government, criminal justice and professional health monitoring programs. A couple of things in particular caught my attention when I spoke with Tim recently and that is the reason that I asked him to be a guest on the podcast. Drug testing is something that some of us don’t know a lot about, especially because we’re not on that end of, you know, what happens when we’re looking for diversion. But it’s important to understand.
Terri
And the first thing that caught my attention is that Pharmatech Labs offers DNA verification of urine drug test specimens through their you Verify service. And the second is that they seem to have a more rapid turnaround time. So Tim’s going to unpack this for us. But, but let me first start by welcoming you, Tim.
Tim
Hi, Terri, thanks for having me.
Terri
Hi. And I want to ask you to give us a little bit about your background and tell us about your journey to where you are now.
Tim
Yeah, thank you. Yes. So my background in education was in pharmacy. So I studied pharmacy at the University of Sydney in Australia. Maybe by now some listeners have realized that I am Australian. So in Australia I studied pharmacy, then worked as a registered or certified clinical pharmacist and then moved to the US in the start of 2018. At that point I transitioned into the diagnostic space, specifically the toxicology space for a laboratory that I worked for until the start of this year. That laboratory did offer a DNA verified urine drug test through some technology that they, I would say, had pioneered. And then at the start of this year, I moved across to Pharmatech after that previous company had closed.
Tim
So through about five years of industry experience and then also my previous experience in pharmacology pharmacy space, I’ve been able to learn a lot about not only the technical side of the product and the laboratory, but also how that can impact various programs across the country that you’ve mentioned.
Terri
Sure, yeah. You kind of bring it all together with your pharmacy background. What insight can you give us into the company? Was there. I always like to learn about how companies are formed. Was there a particular reason the owner got into this space or did it just kind of happen organically?
Tim
Yeah. Pharmatech was founded in the early 90s, 1991 predominantly started off by developing, inventing and then manufacturing rapid testing devices. Not long after that, the owner, who is still the owner and founder today and CEO, realized that although rapid testing devices, rapid cups as most people would know them, the instant testing cups, have a place in drug testing, the laboratory confirmation or the more detailed, more accurate laboratory test was still needed. And so in conjunction with the rapid testing products that Pharmatech was providing, they did build out, as you mentioned, a high complexity laboratory that from its inception has been SAMHSA and CAP accredited. So that was really the owners initiation into the toxicology space.
Tim
Primarily Pharmatech has served criminal justice and government agencies both on the pre employment, the dot, which is Department of Transportation testing and also the higher risk, higher need criminal justice sectors. And then how Pharmatech has come to be involved in the health facility diversion sector is actually through a colleague of mine who used to work in a hospital system. He had some former colleagues that had reached out to him saying that they were struggling with a few things we may talk about today in terms of service levels from laboratories that they were using. And based on how Pharmatech was doing their testing, we had some conversations with this health system who then they actually recommended us to start trying to connect with some other health systems. And that also led us to attend the International Health Facility Diversion association conference this year.
Tim
And so that’s how we came to this industry was really from some networking, but also from a current health system who is really struggling with some of the drug testing processes in their facilities.
Terri
Okay, but you’ve been involved with the professional health monitoring programs for a while, correct?
Tim
Correct. So at my previous company, prior to its closure, I had really developed that business sector. From my point of view, the product or the you verify product, the DNA verified urine drug testing service does allow or overcome for a lot of challenges that participants in the professional health monitoring space face as well as programs who are monitoring those participants as well. And so there have been numerous professional health programs that have used the DNA verified urine drug testing over the last three to four years.
Terri
Okay, all right, great. All right, well let’s jump into a couple of your differentiators then. Let’s talk about DNA testing first. How does that work? How do you get that DNA sample that you’re going to your control, you’re going to compare it to from that participant. Just walk us through how that works.
Tim
How it works in terms of the collection process is there is a one time cheek swab that we call the participant. The person doing the drug test has to perform this one time cheek swab. Is observed by another human. However, as you can imagine, Terri, it’s a little less invasive watching someone do an oral fluid swab rather than produce urine from the body. Yeah, that swab we do collect saliva. We do not perform any drug testing on that saliva. And that’s an important note to understand because there are oral fluid drug testing devices. The saliva that we collect from that one time swab, we do extract, profile, analyze and profile a limited subset of that participant’s DNA. And we can go into the details here in a little bit.
Tim
And at that point the participant can also then go into a bathroom completely unobserved, unwitnessed, and produce a urine specimen. And when the urine specimen that is unobserved is submitted with that one time swab to the laboratory, we are verifying the DNA that’s found in that urine specimen with that observed cheek swab. The technology side of like how do we do it at the laboratory? Pharmatech is using a fairly standard forensic DNA verification kit per se that you can buy from a number of different lab vendors or manufacturers. We specifically use a Thermo Fisher DNA verification kit. So it’s very much proven technology and highly accurate to make sure that we are identifying the urine correctly to the desired participant.
Terri
Okay, that makes sense. So when you say a one time, when you’re talking about the monitoring programs where people are being monitored more than once, you’ve already got that on file. They don’t need to do that again.
Tim
Correct. That’s, that’s the beauty of the. One of the beauties of the technology or the testing is that the one, once the one time cheek swab is collected, every subsequent or even that first urine, but every subsequent urine test, it is just the unobserved urine test that can be collected by the participant really from anywhere at any time across the country. And so that as if you start to conceptualize how that could impact how current drug testing is done, particularly for working healthcare providers who have busy schedules, who have unusual work hours, if they’re working in hospital systems, having the flexibility with the accountability of being able to do urine testing in that way has huge potential impacts both for the participant and the monitoring organization as well.
Terri
So because you have that on file, does that mean then that. And we’ll just talk about healthcare professionals. But this could be for anybody in any monitoring program, obviously. But they could just use a home kit and send it in. They don’t have to go into a lab. You can tell that it’s a current lab specimen. You see that the DNA matches. And so they could do that instead of going into a facility.
Tim
That’s correct. So we have the U VERIFY technology or the DNA verification technology. And that testing service can be used in a facility which we would say is in person collection, but to remove the observed urine portion of that testing process. However, we also offer a fully remote turnkey solution where we actually ship drug testing kits or collection kits directly to a participant’s nominated address when they are instructed to provide a test or provide a urine specimen, whether that’s randomly or at a routine time. They actually can do that from wherever they are, as long as they have one of those drug testing kits on them. Those drug testing kits have prepaid return shipping labels in them.
Tim
And so that participant simply has to provide the urine on that day, they’re instructed and make sure that they get that return package that comes directly back to the laboratory, to the nominated courier within the expected amount of time. And that can vary per program. Most programs require the participant to submit that to the courier on the same day by 5pm, but it can vary.
Terri
Okay, so let’s talk about ways around the DNA verification. There are, you know, I mean, you can buy fake urine. I don’t know how all that, all of that works, but I don’t know if it’s possible to buy their synthetic. Right. Which wouldn’t have any DNA in it at all. Could the participant then just spit in their urine to give the DNA testing? Or how does all of that work? How is there a way around it?
Tim
Yes. I mean, I would say yes, as in people can try a wide variety of things to try and tamper or deceive the test. We always tell our clients and prospective clients that although every laboratory would love their test to be 100% accurate or cheat proof or tamper proof, no test ever will be so there if the participant did try to buy synthetic urine. If your listeners are not familiar with synthetic urine, it is a purposely manufactured product that you can buy from most smoke shop vape shops or online on Amazon. It’s not very expensive. Those products are, while marketed as novelty products, they are manufactured to essentially have normal specimen validity tests, which are the current measurements that laboratories perform to see whether or not a valid human urine specimen has been submitted.
Tim
What data shows is about 98 to 99% of these products will actually have completely normal specimen validity tests. So if they are not identified at the time of collection, laboratories simply will not identify them in the laboratory. And so that’s why human observation or a human observed collection is typically Mandated by a lot of health facilities or health systems, criminal justice agencies, government agencies, and, or if you look at Department of Transportation testing, they do mandate that observed collection has to occur. If someone was to use one of those, I should say, products, it’s not going to have any substances in it. So they’re going to achieve their goal of masking whatever non compliant substances they have consumed. It won’t have DNA in it.
Tim
So if they don’t attempt to put their own DNA in it by adding some blood, some spit, as you mentioned, we will also detect it. And so we actually perform Pharmatech performs an additional test which is maybe less engaging to consumers or people, which is where we actually test for synthetic urine. We actually shine a light. We use spectroscopy technology. And so when we shine the UV light in at the specimen, because synthetic urine doesn’t have any of the waste products of the body in it actually absorbs and reflects that light very differently to human urine. And so we have known profiles of what human urine should look like with that absorbance compared to that of synthetic urine.
Tim
And so we do have two additional ways on top of validity, standard validity testing to ensure the participants are being, I guess, truthful and submitting an authentic specimen. That was a lot. So sorry about that.
Terri
Yeah, no, that’s good. That’s good information. And can you tell if it’s DNA that came from spit or blood versus urine?
Tim
So I would say that’s more interpretive or subjective. And based on the nature of this podcast, and from an educational standpoint, I wouldn’t say it’s a definitive yes, but we do have internal data that can give us ideas whether it’s from saliva and, or whether it’s authentic organic urine DNA, if that’s kind of the right language to use there. So that one, there’s a little more interpretive. But typically what we see is when someone uses synthetic urine, it fails our synthetic urine test and then they could have a positive DNA match. But that’s a clear flag that they’ve added their own DNA in there, whether it’s via spit or blood. At that point it may not matter.
Terri
Right, okay, yeah, that makes sense. What about if somebody, let’s say, has been successful in their recovery for a few months and then they have a relapse, they get called up for their random testing and they’re doing it from home because they have your kits and they have saved urine. You know, let me just put a little bit aside just in case I relapse. Can you detect that? That, that’s old urine. I don’t know how that works. I’m not very knowledgeable in the whole laboratory thing.
Tim
Correct. So the short answer is yes. And without giving away all the different ways of, you know, potentially giving participants ideas of how to do it, what I can conclusively say, and it’s very well documented, is DNA in urine degrade quickly once the urine is excreted from the body. So if you go online, there’s plenty of literature around analyzing the presence, the quantity, the quality of DNA that’s present in urine. As you maybe can imagine, urine isn’t always the best specimen type or the best environment for anything to survive and be stable. And so that way what we do identify is if a participant attempts to use stored urine or old urine that they believe has no substances in it, while there may be some DNA left in it, there’s insufficient DNA left in that urine specimen for us to do the verification.
Tim
And so there is using the kits that we use from Thermo Fisher, it does require a minimum amount of DNA to be present in that urine specimen for us to be able to then analyze and profile the certain DNA markers that we’re looking for. And in degraded urine, in old urine, in urine that’s potentially been exposed to high heat through microwaving or boiling that spill specimen, adding certain acids to it, which bleaches, which have been done in the past, that can severely degrade the DNA and will be identified at the laboratory.
Terri
Okay, great. So we’re kind of back to. It can make things more convenient for those in a monitoring program to just do it from home and not have to go somewhere. And I would imagine, and we don’t have to get into this, but I would imagine less expensive, it’s correct.
Tim
So particularly for working individuals who are in a random testing program, taking time off work, delaying going to work in the morning and then going to a third party collection site or maybe even their own lab facility in the hospital facility. That take can take a lot of time. There’s also issues, as most of your listeners will be familiar if they use third party collection sites is staffing and labor shortages are affecting that industry as well as all industries. And so once the participant gets to the collection site, is there, number one, is it open and number two, is there the necessary staff to perform an observed collection while they’re there.
Tim
And then if they’re having to wait an hour to do that, the lost wages and or the potential stigma they face at the collection site and going back to work, you know what’s the. What’s the damage or what’s the value that. That can. I wouldn’t say the value. What’s the. Yeah, the damage that can put on the participant.
Terri
Right. Yeah. So looking at it as a big picture, it sure would be nice to do it from home. Okay.
Tim
Or do it at the health facility and not have to send. If you’ve got a participant or an employee that’s under suspicion, a case is brought forward. Many health facilities have to organize to send that participant off site or bring on a third party mobile collector to perform that collection. And that’s very costly. And so being able to have the internal teams do a legally defensible test that is taking into consideration the participants rights and their privacy and confidentiality by not having to subject them to a human observed collection and do that test as quick as possible, really can benefit both parties.
Terri
Right. So that’s the perfect segue. Right. We’ve been kind of focused on the monitoring programs, but there’s also a use for it in a facility for suspected diversion and doing that initial drug test. So that’s where the second advantage that I want to talk about, and we’ll talk more about this, you using it for someone within a facility that you suspect. But it’s the turnaround time. You put people on leave, you get that drug test and then you’re waiting and you’re waiting and you’re paying for that leave. Right. Depending on the outcome. And then that person is also waiting too. So explain to me how your lab shortens the turnaround time. And that might require Some Lab Testing 101 education for everybody that isn’t familiar with it. How do you do it and why doesn’t everybody do it this way? Why are you faster?
Tim
So the. There’s really two main ways that lab drug testing or urine drug testing can be done. It’s through a rapid device that is what would be like an instant cup. Someone produces urine into that cup, you wait five minutes typically, and then the little panels on the outside of that cup will show a line. Whether it’s positive or negative, that technology does provide an instant result. And so in terms of turnaround times, nothing can beat that. However, the trade off with that technology and that device is the accuracy levels are much lower. And also you can only test for a much limited panel of either drug classes. And there are some drug specific drug molecules that technology or device allows you to test for. The key in the diversion world is it’s not legally defensible.
Tim
So or in any world, even in, particularly in the criminal justice world, is criminal justice. Or any monitoring program or agency that’s using those tests cannot proceed using that drug test result to really have any consequence on that participant. So if the participant says well I think that result is false, that’s where the program, the monitoring agency or program has to send off either that specimen itself for what they call confirmatory testing or they do another collection of urine shortly after and send that off for a urine confirmatory test. That brings us to the lab testing piece. And so when a program sends a urine specimen off to the laboratory, it can undergo really one of two different tests. It can undergo what is called an immunoassay presumptive test, which is really an extension of the point of care cup.
Tim
It’s the same technology, the same science that’s being used. However, it’s a little more accurate because it is being performed, formed by lab based machines. And then you also, as I mentioned, have what they call confirmatory testing which is typically performed by what is known and I won’t go into the weeds of these machines but are known as lcms or gcms. So liquid chromatography or gas chromatography, mass spectrometers, these machines are the confirmatory tests. So when you get a result from an LC Ms. Or a GCMS they are legally defensible. They’re 99.99% accurate and that is really industry standard or industry wide. And they’re molecule or substance specific. So the monitoring agency is going to get a result that says this specific substance is the one that is positive and this is the concentration that it was found in the urine.
Tim
How we do turnaround times a little faster is most of the industry, when they send it off to a laboratory still does that presumptive immunoassay screen only if something is found positive they will then reflex that order a confirmatory test which can add a lot of time to getting the final legally defensible, most accurate result. Pharmatech has chosen to go immediately to the confirmatory result. So instead of potentially waiting 5 to 10 to 15 business days to get a legally defensible actionable result, we get it to our clients within three business days. It can vary between two and three business days, but we just say three business days as the expectation. The next question is, well how does Pharmatech do that? We’ve chosen to set our laboratory up a little bit differently.
Tim
We also are a specialist toxicology laboratory, so I’m not going to Mention any names of other laboratories just purely because I don’t think that’s necessary. But if anyone is listening who uses a large nationwide laboratory that also does other pathology tests as well, there’s also an element of like, where’s the priority? And so they only have limited lab capacity. They’re performing hundreds of other pathology tests.
Terri
Sure.
Tim
And so typically they just don’t have the setup to perform confirmatory testing at high volumes because they almost need to run the test through the screen because that’s where they’ve built out most of their lab machinery is to go through that process. Whereas Pharmatech, being a smaller but also a specialist toxicology lab, has some more flexibility there. We aren’t the only lab like that. I would tell the listeners that there are other laboratories that are, I would say mid market specialist toxicology laboratories. They have the option to kind of set up or change how they set their labs up. I can’t comment on whether they have or haven’t, but it is worth exploring if any of your listeners use other laboratories like that.
Terri
Okay, yeah, that makes sense. And that explains to me I was had the privilege of being able to attend drug court and one of the reports came back that there was positive, the urine was positive or I don’t recall what. And the participant had claimed that they took ibuprofen. And you know, my first thought was huh, ibuprofen you like, you know, it interacts with, can present itself as something else. And so of course I’m trying to Google real quick, you know, does it. And the judge decided to send it off for confirmation, which I thought, well, what does that mean? They’re going to, you know, give another sample and then they just run it again and you know, it’s going to say the same thing. Or you tell them to not take ibuprofen for a certain period of time.
Terri
So that explains it then that’s a little bit more of a drill down to be more detailed and more specific.
Tim
Correct. And I do have something to share that might just help the listeners who are going to watch this podcast, just a document that kind of gives an overview of what I just explained. But that is, you brought up a really good point, Terri, that if we look at, and I’ll zoom in on this just a little bit, if this works, if we look at the different methods we have in the red, the presumptive screening, which as I mentioned is either a point of care or a rapid test and also an in lab test, if we go down to the specificity column, and also, or the row and then also the cross reactivity.
Tim
Both the presumptive screening methods do have fairly low specificity, low to moderate, and also are very prone to cross, what is known as cross reactivity or what maybe the participant and the layperson knows as a false positive. And that is the ibuprofen that they’re taking causes a benzodiazepine positive test and they get the result. The program, the monitoring agency gets the result and says you aren’t meant to be taking benzodiazepines. And the participant says, well I definitely am not. And so the reason for that is not necessarily anything to do with the monitoring agency and, or the laboratory making an error. It’s just a limitation of the science and how that reaction occurs in those little devices that can cause that molecule. That ibuprofen molecule looks similarly enough to a benzodiazepine molecule, for example, where it causes that reaction to occur.
Tim
And the little line to pop up on the rapid cup that says, hey, you’re positive. If you go to confirmation testing and it’s LC Ms. Listed there, it could be gcms. You’ll notice that there is no kiosk reactivity. And I’m happy to kind of give a broad overview of why that’s the case. But what I can say is most of the resources that a participant will find online about oh, if I have a meth positive and they truly have been non compliant, what could I say? I took sure that it’s all related to the presumptive screening. And so you will not find any resources online that specifically talk about any Krios reactivity for LCMS or GCMS testing because broadly speaking it just doesn’t exist. So I hope for any listeners you know that.
Terri
Yeah, does it work in reverse as well? Like are we protecting people by going straight to the LCMS rather than doing the screening?
Tim
Yeah. So I mean for me personally, coming from the clinical pharmacy world as a practicing pharmacist and then into kind of the diagnostic space, a lot of the, I guess conversations that I’ve had over the last five years is really re educating monitoring programs how to view drug testing. And that’s exactly right. One of them is, well, in a way for your compliant participants, you’re actually improving or protecting them from being accused of doing something that they did not. And you’re also protecting your program, agency, entity, department from accusing an employee of doing something that they did not, which can erode a lot of trust very quickly. I mean, if I was accused of doing that, and I was in a monitoring program, it would be pretty devastating.
Tim
And then you have to wait two weeks for the laboratory to confirm the initial result was wrong. You know, that’s a long two weeks to wait for. And that’s not just for drug testing, any sort of pathology test. I’m sure all your listeners and maybe yourself in your network have had friends who are waiting on lab tests of some sort. And that kind of waits. Waiting period is very daunting and uncomfortable.
Terri
Right, okay. Yeah, that makes perfect sense. Okay, so let’s talk about, you know, a big thing in the diversion, suspected diversion space is make sure when you send off the specimen, you’re requesting the correct panel. And fentanyl is typically what I hear like, oh, and it happened just recently with somebody that I know, he was working with a facility, and it was a particular, I think it was anesthesia provider that kept coming back negative. But they were pretty sure there was something going on and had tested multiple times and that person had passed every time. And when this other person was engaged to look at it’s like, we don’t have fentanyl on your panel. I mean, who would not have fentanyl on a panel for anesthesia provider? Right.
Terri
But how does this happen where the panel is not comprehensive, it doesn’t have fentanyl, typically the one I hear. So give us a little bit of education on that. The panel that is selected.
Tim
So I’ll state the obvious, maybe to many of your listeners who pharmacists themselves are in pharmacy departments, that fentanyl is much more potent than other opioids that have been abused or in the past or available in their health facilities. That does have quite an impact then, on the standard opioid panel that is included in an in lab or even a point of care cup rapid screen. So what I didn’t mention when we had that table up before was another big difference between drug testing methods is what is kind of called the cutoff. So each substance or drug class has a low cutoff. They actually have a high cutoff. But that’s another discussion point that isn’t necessarily relevant for today’s discussion. But the low cutoff is the threshold of the required amount of drug in the urine specimen for it to trigger positive.
Tim
Both presumptive and confirmatory testing has a low cutoff for everything that they test for. Because of this science, the actual methodology that presumptive testing uses, it has higher cutoffs for almost all substances, which means it requires more of the drug or drugs to be present in the urine to even trigger a positive result when compared to that of lcms or gcms. Testing for opioids, specifically, you have many opioids that are included in the drug testing panel. That’s typically called opiates or opioids. And most listeners, if they looked at what they’re currently doing, their cutoff will be 300, which is 300 nanograms per milliliter. They were all developed not well before fentanyl was invented, but well before fentanyl really came on the radar as something that was being either voluntarily or involuntarily abused or used by anyone across the world at this point.
Tim
The issue with fentanyl is its potency is so much stronger that the dosings, the dosing is in micrograms compared to milligrams. And so once that those micrograms are ingested into the body, metabolized and then deposited in the urine, you can expect to see far less fentanyl or nor fentanyl in the urine, or I should say the concentration to be far less than your standard opioids. And so laboratories had already built out all their lab infrastructure. They manufactured the cups and validated these tests to have a 300 nanogram cutoff. Well, it’s very difficult for laboratories and the manufacturing supply chain just to alter that opioid panel to now include fentanyl, which typically will need cutoffs at 5 to 10. And I can’t tell you on the spot what the factor of reduction that is, but it’s very significant.
Tim
You’re not talking about a slight reduction in cutoff. It’s a huge reduction. So most labs that can now test for fentanyl or most rapid cups have a separate panel. So you’ll have an opioid panel and you’ll also have a fentanyl panel. A lot of programs just haven’t looked at or reviewed their drug testing for a long time to ask the question to themselves, are we testing for fentanyl? And has that fentanyl panel been added to our standard testing panel? And that’s why a lot of programs may think, oh, we never see fentanyl positive. Well, that’s unfortunately, because they’re probably not testing for it. And as for why their lab may or may not have alerted them to that’s really up to their relationship with the laboratory that they use.
Tim
But typically we see, and as you said, like, it’s more so that the facility or the person or the program just isn’t testing for Fentanyl, because they somewhat rightly assume that it’s in the opioid panel because it is an opiate.
Terri
Mm. Yeah. You would think any lab would tell them, hey, do you want to include Fen, at least ask the question? Because they should know what the whole purpose of, you know, you need to catch it all. Okay, you know, I asked you, and I think I asked you this before, propofol. Do you have propofol as part of your. You have a huge panel and you test. It doesn’t matter. The facility doesn’t need to instruct you to test. You test for everything that’s on your panel. Is that correct?
Tim
That is correct. So, I mean, our standard panel comes with approximately 70. I think it’s 73 substances. But if a facility doesn’t want to test for some of them, they can customize it. I would say we do not currently test for propofol. And that’s something that’s on our agenda right now, is to explore bringing that on. Because that is typically, particularly in this world, in the health facility world, the access to propofol is pretty easy.
Terri
Right, Right. Okay. If a facility wanted to use your services for pre employment very different than suspected diversion, would you suggest that they do the same confirmatory test or is there a place for the presumptive tests? What are your thoughts on that?
Tim
It’s a really good question and we could, I could talk for a long time on this, but yes, I mean.
Terri
That is podcast number two.
Tim
Yeah, I would not reckon necessarily recommend the you verify very comprehensive test for pre employment. It’s the reason being, and what I think I would ask, or just initiate your listeners to think about is what is the purpose of pre employment testing versus reasonable suspicion, or if we go a step further on the professional health monitoring side, where there’s either been a proven case of diversion, substance abuse misuse from a healthcare provider, that is a very different purpose or intent of testing those individuals versus a pre employment test. And how that impacts the type of testing that you need or you maybe should do is the assumption you’re making when you pre employment. When you test someone for pre employment, you are assuming that individual does not suffer from, number one, a substance use disorder and or has not diverted any medications.
Tim
And so it’s really just a broad overview to see, pardon me, if that employee has taken any substances outside of work, potentially that may make them either a danger or liability or less productive in the workplace when you’re going towards more the reasonable suspicion and then someone who is in active recovery that has a known substance abuse or misuse diagnosis. That’s more of a higher risk, higher need testing, where more comprehensive testing would be recommended. And unfortunately, that’s where the lines have been blurred over many decades of department of transport testing, which has a very limited panel. The government legislates exactly what cutoffs, what substances, how the testing is done. That’s essentially pre employment testing where you’re assuming the person who’s doing the test is not going to be positive or have any substances detected in their urine.
Tim
That’s very different to like a criminal justice drug court environment where you’re trying to help a person with a known substance abuse diagnosis stay in recovery and rehabilitate their life and potentially identify any relapse at the earliest possible time. So you can make treatment adjustments to make sure that you keep that individual engaged. And so that’s an important differentiation. There’s a lot of different services that laboratories offer and it just depends on really the purpose of the drug test. I think it’s an important thing to remember.
Terri
Sure, that makes perfect sense. And your kits, just as somebody can have them at home, I would imagine a facility, if they were using your service, they would just have the kits on hand at the facility for whichever test they were going to do when it was needed.
Tim
Correct. So that’s the be. That’s another benefit of this service is we’ve built it so the same kit is the one that we would send directly to a participant if we wanted to do the fully remote version. But it’s also the same kit that we would essentially stock in each or in a health facility’s locations. And many of your listeners would likely work in health facilities that have multiple locations. They could put a few kits in each department in each of those locations.
Tim
So if there is any need to use them at any time of day, on any day of the week, the nominated employees that are trained to administer those kits can grab one of those, complete the urine collection that is the test, and then send that off to the laboratory to begin testing and have those results back as quickly as possible.
Terri
Right. Okay. Yeah, that makes sense. Okay, well, this is great information. And for the listeners out there, if there are any other topics from a laboratory and testing perspective that you would like to learn about. Tim, you’re a great resource and you articulate it all very well. So please chime in with your comments because maybe we could convince Tim to come back and answer some other questions, if there are any other questions. And don’t forget to hit the subscribe button because then you can see all of the new episodes that come out. You’ll just be notified about that. Thank you, Tim. This was, I know, very informative for me and I learned a lot. And I’m sure that many of the listeners out there also learned a lot from today’s episode.
Tim
Thanks for having me, Terri.
Terri
Absolutely. You have a great rest of your week.
Tim
Thanks a lot.
