Search found 928 matches

by Robert Swotinsky MD
Thu Feb 11, 2021 3:30 pm
Forum: Drug and Alcohol Testing
Topic: Donor requesting additional reconfirmation
Replies: 2
Views: 365

Re: Donor requesting additional reconfirmation

Generally, donors do not have an option for multiple reconfirmation analyses. The attorney can seek additional testing and, if he/she is granted that right by the courts or by the employer, the attorney or you can contact the laboratory directly to arrange it. I understand the distinction between ha...
by Robert Swotinsky MD
Wed Jan 20, 2021 10:06 pm
Forum: Drug and Alcohol Testing
Topic: DOT random not yet driving and no CDL/CLP
Replies: 2
Views: 159

Re: DOT random not yet driving and no CDL/CLP

Review it like a DOT test. You could reach out to the employer re: DOT v. non DOT, but it sounds like they've already decided they want this to be a DOT test, and it's their decision.
by Robert Swotinsky MD
Thu Jan 14, 2021 9:15 pm
Forum: Drug and Alcohol Testing
Topic: Give quantitative laboratory results to the employer?
Replies: 1
Views: 1309

Re: Give quantitative laboratory results to the employer?

There is no regulation or guidance saying NOT to release such information on a case by case basis. (You may recall that the feds don't want routine reporting of concentrations.) I'd go ahead and release the concentration. Usually, having it in black and white helps settle any questions.
by Robert Swotinsky MD
Thu Jan 14, 2021 9:10 pm
Forum: Drug and Alcohol Testing
Topic: Foreign Rx
Replies: 1
Views: 307

Re: Foreign Rx

If there is some degree of ongoing relationship w/the doctor in Brazil, then the foreign prescription is acceptable (assuming that it matches up w/the test result). Some old federal guidance noted that customs officials limit the amount of controlled substances that a person can bring into this coun...
by Robert Swotinsky MD
Fri Nov 20, 2020 8:15 am
Forum: Fitness-for-duty (e.g., preplacement) exams, non-DOT
Topic: Pre employment & Methadone
Replies: 1
Views: 1229

Re: Pre employment & Methadone

If the electrician job involves high voltage, working unprotected at heights, or other particularly hazardous environments, you may want to inquire in more detail. Ask for a couple of office notes and the most recent two or three compliance monitoring drug tests. While you mention a negative drug te...
by Robert Swotinsky MD
Wed Nov 11, 2020 6:22 pm
Forum: Drug and Alcohol Testing
Topic: Buprenorphine positive oral fluid test with interesting reason provided by donor
Replies: 1
Views: 620

Re: Buprenorphine positive oral fluid test with interesting reason provided by donor

The medical literature does not describe positive buprenorphine results from inadvertent exposure. The medical literature does describe buprenorphine, including street (nonprescribed) buprenorphine, as a drug taken by opioid-dependent people to help ward off withdrawal symptoms. A SAP could offer su...
by Robert Swotinsky MD
Mon Oct 26, 2020 2:29 pm
Forum: Drug and Alcohol Testing
Topic: Amphetamine, methamphetamine, medical marijuana
Replies: 1
Views: 788

Re: Amphetamine, methamphetamine, medical marijuana

Yes, ask for d & l isomers if they have not already been performed. The methamphetamine is not explainable by the use of Adderall (amphetamine). Methamphetamine is metabolized to amphetamine. But, amphetamine is not metabolized to methamphetamine. That's why you need to get d & l isomers - to help f...
by Robert Swotinsky MD
Thu Sep 10, 2020 8:49 pm
Forum: Drug and Alcohol Testing
Topic: 6th Edition Update
Replies: 3
Views: 1657

Re: 6th Edition Update

The MROCC recertification examination has been updated as new regulations, science, and practices evolve. The MROCC exam has been updated since I wrote the 5th ed in 2014 -2015. I help write the MROCC exam. But, I'm just one of a team who do that, and the others are experts in MRO related topics but...
by Robert Swotinsky MD
Wed Sep 09, 2020 10:00 pm
Forum: Drug and Alcohol Testing
Topic: 6th Edition Update
Replies: 3
Views: 1657

Re: 6th Edition Update

The 6th ed and CME program should be available by the end of the year. It's in copyediting right now.
by Robert Swotinsky MD
Tue Sep 01, 2020 8:05 pm
Forum: Drug and Alcohol Testing
Topic: CBD:THCA Ratios
Replies: 1
Views: 1561

Re: CBD:THCA ratios

I think the question is, How reliable is it so use the THCA-to-CBD ratio to determine if the THC came from CBD?

A positive test result for CBD can demonstrate that the person ingested CBD. There is no consensus on the use of THCA-to-CBD ratios to rule in, or rule out, the use of THC.