DRUG TESTS BRING WORRIES OF ACCURACY

"I go to extraordinary lengths before I call a positive." -- Dr. David
Berg, Medical review officer

The water-cooler talk is true: Poppy seeds can produce a positive test for
heroin, and cold medicine can suggest methamphetamine.

But medical experts say workers have little to worry about as changes in
Iowa's drug-testing law go into effect today.

That's because the new law requires medical review officers to evaluate
drug tests. They act as judges, determining whether the positive test is a
result of illegal drug use or a legitimate medical cause.

"I'm there to protect people from false positives as much as I'm there to
find drug (evidence) for their employers," said Dr. David Berg, an MRO and
director of occupational medicine for the Des Moines office of HealthSouth.
"I go to extraordinary lengths before I call a positive."

Accuracy is a concern as private-sector employers gain more power to test
employees for drugs and alcohol. Occupational health clinics and
laboratories say the law could lead to more business, but they don't expect
a rush starting today.

Business groups have been pushing for a change for years, and some
construction companies and other safety-sensitive employers are moving
quickly to start testing, said James Aipperspach, president of the Iowa
Association of Business and Industry. But most are still learning about
the changes and deciding what options to take.

Employers are not required to test. They could randomly test workers for
alcohol and other drugs. They could test if they have reasonable suspicion
that a worker is under the influence. They could require workers to get
treatment after a confirmed positive drug test, or they could fire them.
Critics say the law gives employers more power than police. They also
question the reliability of testing, and say the workers would have little
recourse if they falsely test positive.

The new law protects employers from liability unless they clearly should
have known a false positive test result was in error and ignored the
correct test result.

The Iowa Civil Liberties Union isn't saying whether it will fight the law.
But lawyers and legislators have talked to the group about a challenge,
said executive director Ben Stone.

Random testing could result in more false positives, said Craig Zwerling, a
University of Iowa professor and expert on drug-testing.

Statistics vary widely on the likelihood of false positives, depending on
the test and the lab. Civil libertarians say 5 percent is a conservative
estimate.

Medical experts acknowledge that false positives aren't impossible. But
they say urinalysis, the most common means of drug testing, has

improved.

The Iowa Methodist Medical Center laboratory's testing is more than 99
percent reliable, said Rich Snyder, who supervises drug testing.

The lab uses a combination of gas chromatography and mass spectrometry,
which is considered by most experts to be the most precise procedure for
the detection of banned substances. The new Iowa law requires such a
technique to be used to confirm positive tests.

Employees can request a second confirmatory test at another lab, at their
expense. If that test comes back negative, the employer must reimburse the
employee.

But tests still read some innocuous substances as illegal drugs. Because of
the poppy seed problem, the federal government is raising the threshold for
the detection of opiates in urine. Additional tests can be done to
determine whether a Vicks inhaler is causing a methamphetamine positive,
experts say.

Medical review officers also look at more than the test, searching for
evidence of needle tracks or asking whether the person is on a prescription
drug.

Testers also watch for adulterated samples. An industry is booming on the
Internet, providing drug users with tips and products to taint their tests.
Snyder said most of the methods, such as mixing the urine with bleach or
soap, are easy to catch.

Medical review officers also are on guard for every excuse imaginable.
They've heard them all, including the one gold-medal snowboarder Ross
Rebagliati gave when he tested positive during the Olympics. Second-hand
marijuana smoke will produce a positive test only in extreme cases,
research has shown.

"There's no way," Berg scoffed.

Reporter Lynn Hicks can be reached at hicksl@news.dmreg.com or (515) 284-8211.