Drug Users Need Not Apply10 Ways Oral Fluid TestingBenefits Employers

Employer Webinar

Quest Diagnostics

Agenda

•  Overview

•  History of Oral Fluid Drug Testing

•  Future of Oral Fluid Drug Testing

•  10 Benefits of Oral Fluid testing for Employers

•  Summary

•  Questions

| 2 Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers

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Oral Fluid Testing Overview

•  The oral fluid drug testing market is worth about $45MM annually.

•  Quest Diagnostics introduced Oral-Eze® to the market in 2011.

•  In oral fluid drug testing, the oral fluid is typically collected on a cotton pad. The pad is then placed in a transport tube containing a buffer preservative solution. A chain of custody process is completed and then the specimen is transported to a laboratory for screening and confirmation (if required).

•  Oral fluid testing is popular in retail, grocery, staffing, manufacturing and other industries.

Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers

Quest Diagnostics

History of Oral Fluid Drug Testing

•  Started in the early 1990s

•  Began in the retail space

•  Retail, Staffing, Manufacturing

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Future of Oral Fluid Drug Testing

September 2011, DTAB unanimously recommends

–  Adding oral fluid as a permitted specimen type in Federal drug testing programs

–  HHS consider adding prescription Schedule II Drugs (e.g. oxycodone) to Federal drug testing programs

January 2012

–  SAMHSA administrator accepts DTAB’s recommendations

–  DOT endorses the opportunity to improve transportation safety by addressing illicit use and abuse of the prescription drugs

–  Start of Process – Neither HHS nor DOT have changed their requirements.

State Regulations

•  For workplace drug testing, there are only two states and one territory that prohibit the use of oral fluid testing – Hawaii, Maine, Vermont and Puerto Rico.

•  Some voluntary worker’s compensation programs only permit urine testing – Check your state!

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10 Ways that Oral Fluid Testing

Benefits Employers

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1. Detects Recent Drug Use

•  Oral fluid testing –  Detects recent use (previous 24-48 hours)

–  Suited for pre-employment, random, post-accident, reasonable suspicion testing and return-to-duty drug testing

•  Urine testing –  Detects recent use (previous 24-72 hours)

•  Hair testing –  Detects a pattern of repetitive use (up to 90 days, based on testing proximal 1.5” head hair)

Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers

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2. Excellent Drug Detection (Especially for Marijuana)

•  Oral fluid collections are observed – Curbs evasive donor behavior

•  New Oral-Eze® collection and testing technology

– Sample adequacy window tells you when the correct amount of oral fluid has been collected

•  Oral fluid detecting more marijuana positives – Oral fluid positives increased 26% in the first-half of 2012

– 70% more positives in oral fluid than in urine in the first-half of 2012

Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers

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Positivity Rates By Testing Category Oral Fluid Drug Tests for U.S. General Workforce

0%

1%

2%

3%

4%

5%

6%

2008 2009 2010 2011 Jan-Jun 2012

Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers

Source: 03/13 Quest Diagnostics Drug Testing Index™

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Overall Positivity Rates (U.S. General Workforce)

0%

1%

2%

3%

4%

5%

6%

2003 2004 2005 2006 2007 2008 2009 2010 2011 Jan-Jun2012

Urine

Oral fluid

Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers

Source: 03/13 Quest Diagnostics Drug Testing Index™

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Marijuana Positivity Rates (U.S. General Workforce)

0%

1%

2%

3%

4%

5%

2003 2004 2005 2006 2007 2008 2009 2010 2011 Jan-Jun2012

Urine

Oral fluid

Source: 03/13 Quest Diagnostics Drug Testing Index™

Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers

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3. Difficult Test to Cheat

“Can an oral fluid drug test be beaten?”

Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers

•  We have not found any adulterants that can beat the test

•  Observed collections curb evasive donor behavior making oral fluid testing virtually adulteration proof

•  Nothing in the donor’s mouth (gum, tobacco, food, drink) for a minimum of ten minutes before collecting the specimen

•  Quest Diagnostics performs specimen validity testing on every oral fluid specimen, yielding the added assurance that the specimen is appropriate for testing.

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4. Reduces Collection Fees and Downtime

•  Collecting onsite eliminates the fees associated with urine and hair testing collections

•  Not having to travel to a collection site reduces lost productivity

•  Simple and fast to collect

•  We provide complimentary oral fluid collector training on our website http://questdiagnostics.com/home/companies/employer/drug-screening/knowledge-center/online-training/specimen-collections.html

Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers

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5. Enables Remote Collections

•  No access to a collection site? No problem!

•  Flexibility of being able to test anytime, anywhere

•  Remote geographies

•  Off-hours collections

•  Well-suited for retail, grocery, staffing and construction workers

Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers

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6. Simplest Sample Type to Provide

•  Easy on donors when compared with urine or hair

•  Less invasive collection leads to reduced donor anxiety and enhanced donor dignity

•  No shy bladder issues

•  No taste on the collector pad

•  4 out of 5 collections are completed in five minutes or less

Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers

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7. Assurance of Valid Sample Collections

•  Indicator window reduces repeat collections - the leading cause of employer dissatisfaction

•  Built-in indicator window turns blue when 1 mL of oral fluid has been collected, reducing the likelihood of the sample being rejected as “quantity not sufficient” and thereby eliminating the time and expense associated with a second collection

•  Sample adequacy indicator likely required on oral fluid collection devices

– Minimum volume collected

– Dilution assurance through known quantity collected

•  Cutoffs expressed as original (“neat”) oral fluid

– Standardization across various devices

•  Oral-Eze currently meets these requirements

Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers

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8. Lab-based Test Helps to Ensure Quality

•  Screening and confirmation performed at a certified laboratory provides the assurance of quality, consistency and results dependability

•  Our oral fluid testing is performed at our Lenexa, Kansas laboratory

•  This centralized laboratory and the logistics that support our specimen transportation provides excellent test result turnaround time

•  Negative results are typically reported within 24 hours

•  Positive results typically report in 36-96 hours

Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers

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Oral Fluid THC Concentrations

•  Data from nearly 30,000 Oral-Eze Oral Fluid THC Confirmations

•  Lab-based (Oral-Eze) cutoff = 1.5 ng/mL

•  >50% <15 ng/mL

•  >75% <40 ng/mL

•  POCT cutoff = 40-50 ng/mL

•  Lab-based testing makes a difference! or less

Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers

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9. Test for Common Drugs of Abuse

Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers

•  Amphetamines

•  Methamphetamines (including MDMA and its metabolite)

•  Opiates (Codeine, Morphine, Hydrocodone, Hydromorphone, 6-monoacetylmorphine)

•  Cocaine (metabolite)

•  Marijuana (THC)

•  Phencyclidine (PCP)

•  Working to add additional drugs to the Oral-Eze panel

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Oral-Eze Cutoffs (expressed as “neat” oral fluid)

Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers

Quest Diagnostics

Positivity Rates by Drug Category Oral Fluid Drug Tests - For U.S. General Workforce, as a Percentage of All Such Tests

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Source: 03/13 Quest Diagnostics Drug Testing Index™

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10. Widely Accepted Testing Modality

•  Widely accepted testing modality – we performed nearly 700,000 oral fluid drug screens from hundreds of clients in 2012

•  Stand behind the accuracy and reliability of our test results

•  Assurance that lab-based oral fluid testing with Oral-Eze will yield dependable results, helping to create a drug-free workplace

Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers

Quest Diagnostics

Summary

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Recap of Benefits

1.  Detects recent drug use

2.  Excellent drug detection

3.  Difficult test to cheat

4.  Reduces collection fees and downtime

5.  Enables remote collections

6.  Simplest sample type to provide

7.  Assurance of valid sample collections

8.  Lab-based test helps to ensure quality

9.  Test for common drugs

10. Widely accepted testing modality

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Questions

R. H. Barry Sample, Ph.D., D-FTCB Director of Science and Technology barry.x.sample@QuestDiagnostics.com

QuestDiagnostics.com/Oral-Eze

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Aaron Atkinson, MBA Product Manager aaron.j.atkinson@QuestDiagnostics.com

Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers

Quest Diagnostics

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