drugs of abuse

sensitive laboratory results

Now that marijuana is legal in many states, as well as in Washington D.C., some underwriting departments have asked us to update their sensitive test results to allow for positive THC. Several clients indicated that waiting for sensitive test results can cause a delay in their underwriting process. By reducing your number of sensitive tests, some of these delays are eliminated and underwriters can make faster decisions. This is a simple change that is requested through our team and may include other tests as well.

To walk you through this process, one of our Regional Account Managers, Rebecca Shady, answers some frequently asked questions.

Q. What results can be changed from sensitive to non-sensitive?
A. There are now 17 laboratory tests that can be categorized as non-sensitive. They include:   

Cocaine, codeine, fentanyl, hydrocodone, hydromorphone, morphine, norfentanyl, methamphetamine, marijuana, amphetamine, barbiturates, benzodiazepines, methadone, oxymorphone, oxycodone, phencyclidine, 6-monoacetylmorphine Each test is individually-based and a carrier can customize which ones should be identified as sensitive versus non-sensitive. Please note, a sensitive test must be reported as sensitive on both the raw data feed and on the text report.

Q. Am I able to customize my sensitive results by state?
A. At this time, we only have the ability to classify a result as sensitive or non-sensitive. We are unable to discern categorizations by state.

Q. What happens when a result is changed from sensitive to non-sensitive?
A. Once our team makes the change, all positives for that test will be received through your normal results feed. For example, if you want to start receiving THC as a non-sensitive, then a positive THC screen would appear with all other laboratory test results.

Q. I’ve determined that we currently have some results marked as sensitive, but I would like to accept them as non-sensitive. How do I make this request?
A. If you would like to update your requirements on what you identify as sensitive, please work with your Regional Account Manager (RAM). If you do not know who your RAM is or you do not have one, you may email our team at CSG.RAMS@QuestDiagnostics.com and one of our team members will contact you regarding your request.

Q. Can HIV be reported as non-sensitive?
A. At this time, any and all positive HIV results must still be reported as a sensitive test result.

Q. Will the process change for those tests that I want to keep as sensitive?
A. No. For any test that is currently identified as sensitive, you will continue to receive those results the same way as you do today.

We hope this helps answer any questions you may have regarding sensitive test results. If you have additional questions, please contact your Strategic Account Executive or Regional Account Manager.


*Professional Services fees may apply for complex or custom product and system integrations

cigarette and marijuana smoking

Smoking raises red flags for insurers across the board – applicants are usually rated if they produce a positive cotinine test. Further, tobacco use can lead to the potential onset of additional health risks, such as cancer, heart disease, stroke, diabetes and/or lung diseases. Aside from these health concerns, studies show a correlation of tobacco use and marijuana use. Statistics also reveal an increased risk of positivity for other drugs of abuse.

The likelihood of a tobacco user testing positive for marijuana

Our data scientist, Brian Lanzrath, extracted a sample of ExamOne applicant data to identify what, if any, correlation exists between the use of tobacco and marijuana. From 2017-2018, nearly 6.6% of ExamOne life insurance applicants tested positive for cotinine. You can see the states with the highest cotinine positivity rates on this map with Ohio, Kentucky, Indiana, Arkansas and Mississippi being among the five highest. Within each of those states, the positivity of those who tested positive for both THC and cotinine is as follows:

cotinine positivity by state

 

 

 

 

 

 

Overall, tobacco users are nearly 5 times as likely to test positive for THC as non-tobacco users.

Study finds tobacco users 25x more likely to test positive for PCP

Brian also discovered tobacco users were 5x more likely than non-tobacco users to test positive for methadone, PCP and cocaine. Further, marijuana users were nearly 25x more likely than non-marijuana users to test positive for PCP. They were also 15x more likely to test positive for cocaine and 10x more likely to test positive for methamphetamines. As the opioid epidemic continues to spread, it’s important for insurers to be diligent in their testing requirements. Laboratory expert, Betsy Sears, says as a result of the compelling data, there is a growing interest among carriers in using cotinine as a reflex for drug/expanded opioid screens.

Underwriting with precision

It’s important to understand that a positive cotinine test could mean more for insurers. Not only could it mean the applicant is at high risk for multiple health conditions, there is an increased risk the applicant could be misusing other substances that increase mortality. Navigate through the smoke by ensuring you are receiving a complete profile of your applicants.

To review your parameters, discuss reflex testing or to complete an analysis on your applicants, please contact us.

Ask the Expert: Drug trends in America

October 3, 2018 Ask The Experts

During one of our summer webinars, Betsy Sears, Executive Vice President, Laboratory Strategy and Sales, and Dr. Barry Sample, Quest Diagnostics Senior Director, Science and Technology, examined two of America’s populations for drug positivity rates by various drug classes. This included a workforce population and ExamOne life insurance applicants. Understanding the drug trends and positivity […]

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The rise in workforce drug positivity may be a concern among the life insurance population

June 22, 2018 Carriers

2018 Quest Diagnostics Drug Testing Index™ The 2018 Quest Diagnostics Drug Testing Index™ (DTI) has been released and workforce drug positivity remained at the highest rate we’ve seen in a decade. The positivity rate held steady at 4.2 percent which was the same in 2016. One of the biggest shifts in drug positivity was seen […]

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Top 4 blog posts from 2017

February 8, 2018 Uncategorized

Here’s a look back on our top four blog posts of 2017. As our industry continues to evolve, will these be the same topics top of mind this year, or will there be totally new trends for 2018? Follow our blog as we discover and address them this year. We are excited to learn more […]

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Illicit drug use in the US is at the highest rate in a decade

June 26, 2017 Carriers

Quest Diagnostics released its annual Drug Testing IndexTM in May.(1,2)  It revealed that the American workforce had the highest positivity rate for illicit drugs in the past 12 years. Cocaine continued its upward trend for the fourth consecutive year. Marijuana positivity increased dramatically with notable increases in Colorado and Washington, both states that have legalized […]

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Prescription Drug Misuse In America

July 22, 2014 Carriers

The abuse of prescription painkillers and narcotics has grown into a bonafide public health crisis, affecting virtually every state, city and small town in the United States.[1] Nearly half of the roughly 40,000 drug overdose deaths in 2010 involved pain medications, such as hydrocodone and oxycodone.[2] Approximately 2.1 million people are dependent upon or abusing […]

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