On a global scale, emergency departments have been providing critical access to the health care system for many years, however, more recently visits to the emergency department has been an opportunity to identify patients with substance use disorders. Screening patients for illicit drugs and drug abuse has become increasingly more regular when a patient is admitted to the emergency department. Screening is vital to treat a patient with effective treatment. Nearly half of all emergency department visits in the US are categorized as relating to substance use disorders.
In a study completed at Ghent University Hospital in 2017 it was found that the most frequently reported drugs abused by emergency department patients are cannabis, cocaine, amphetamines, and opiates. It is important to screen patients in the emergency department if the patient is showing signs of confusion, deliriousness, unconsciousness, panic attacks, chest pain, difficulty breathing, vomiting, or seizures as these symptoms usually indicate drug intoxication or overdose.
Randox Toxicology’s Evidence MultiSTAT is a fully automated immunoanalyser that enables on-site simultaneous detection of up to 21 analytes from a single sample, making it ideal for an emergency department. It requires a small sample volume and generates results in 20 minutes. The process from sample entry to results can be completed in 3 simple steps, with minimum room for human error. The MultiSTAT is designed to analyse as quick, simple and reliable as possible.
|Barbiturates||Benzodiazepines I (Oxazepam)||Benzodiazepines II (Lorazepam)|
|Benzoylecgonine (Cocaine Metabolite)||Buprenorphine||Cannabinoids (THC)|
|Creatinine||Ethyl Glucuronide (EtG)||Fentanyl|
|Tricyclic Antidepressants (TCA)||UR-144/XLR-11||α-PVP (Flakka)|
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The World Heart Federation (WHF) is the acting global voice in leading the universal fight against cardiovascular disease (CVD). Part of the WHF mission is to ensure heart health equity for everyone. They believe everybody is entitled to cardiovascular health and well-being through health promotion, access to prevention, control and management of CVD 1.
World Heart Day falls on the 29th September where people make a promise to promote and implement healthier lifestyles to maintain a happy and healthy heart, reducing the potential risks of heart disease and stroke. CVD takes the lead being the number one cause of death world-wide 2 relating to all heart and circulatory diseases consisting of coronary heart disease, angina, heart attack, congenital heart disease, hypertension, stroke and vascular dementia 3.
According to the World Health Organisation2:
- An estimated 17.9 million people died from CVD in 2016, representing 31% of all global deaths. Of these deaths, 85% were due to heart attack and stroke.
- Out of the 17 million premature deaths (under the age of 70) due to noncommunicable diseases in 2015, 82% were in low- and middle-income countries, and 37% were caused by CVD.
- Most cardiovascular diseases can be prevented by addressing behavioural risk factors such as tobacco use, unhealthy diet and alcohol abuse.
Cytokines have a central role within the immune system; they are a category of signalling molecules that mediate and regulate immunity, inflammation and hematopoiesis 4. Cytokine and inflammatory mechanisms have major implications for the vascular system and can lead to CVD.
Cytokines exist in broad families that are structurally related but exhibit diverse function. The major classes of cytokines include: pro- and anti-inflammatory cytokines, cytokines of neutrophil and eosinophil recruitment and activation, cytokines derived from T-helper (Th) and T-regulatory (Tregs) cells, and cytokines of T-cell recruitment and growth factors. 5
Randox offers a comprehensive menu of 26 cytokine, cytokine receptors and growth factors over four multi-analyte arrays. Each cytokine assay is performed on biochip array technology with spatially discrete test regions containing antibodies specific to each of the analytes. The combination of highly specific antibodies and advanced chemistries enables up to 12 cytokines and growth factors to be detected simultaneously in a single sample.
Cytokine Array I Cytokine Array III
- Epidermal Growth Factor (EGF) – Granulocyte Macrophage Colony Stimulating
- Interferon-y – Interleukin-5
- Interleukin-1a – Interleukin-15
- Interleukin-1b – Macrophage Inflammatory Protein-1a
- Monocyte Chemotactic Protein-1
- Tumour Necrosis Factor-a
- Vascular Endothelial Growth Factor
Cytokine Array IV Cytokine Array V
- Matrix Metalloproteinase-9 – Interleukin-3
- Soluble IL-2 Receptor a – Interleukin-7
- Soluble IL-6 Receptor – Interleukin-13
- Soluble Tumour Necrosis Factor Receptor I – Interleukin-12 p70
- Soluble Tumour Necrosis Factor Receptor II – Interleukin-23
Key Benefits of Randox Cytokine Arrays:
- Multiplex testing from a single sample.
- Suitable for human serum and plasma samples.
- Small sample volume required.
- Excellent analytical performance.
- Fast throughput.
- Applicable to fully automated and semi-automated Evidence analysers.
Randox manufacture the majority of assay raw materials in-house and can therefore take a more tailored approach, by adapting assays to the needs of your research project to best fit your individual requirements.
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In the past year, Scotland’s drug related deaths have increased dramatically by 27%.
This almost levels the fatality rate per capita with the US. The latest figures showed the majority of fatalities was from the over 35 age group, known as the “Trainspotting generation.”
Westminster currently hold the power on the Misuse of Drugs Act, which Scotland believes should be relaxed as a method of controlling the issue in the country. One of Scotland’s most senior police officers has described the Misuse of Drugs Act as a relic that was “ripe for reform.”
The chair of the Scottish government’s task force on drug deaths, Catriona Matheson believes that treatment challenges should be investigated alongside decriminalisation;
“I understand why decriminalisation grabs most attention, but legislation, criminal justice, healthcare and public attitudes are intertwined”.
There is also a significant increase in the number of fatalities amongst the under 35 age group. These deaths are heavily linked to poly-drug use, including the relatively newly available drug named “street benzodiazepines.”
The lead pharmacist for addiction services at the city’s health and social care partnership, Dr Carole Hunter, said;
“The major problem for Glasgow is heroin and illicit benzos like etizolam or street Valium, which have never been cheaper or more available.”
International trials have shown that medicinal heroin can be an effective treatment for a number of opioid users who do not respond to regular methods of treatment. Hunter proposes opening an enhanced drug treatment centre in Glasgow for this medicinal heroin to be administered under supervision.
Dave Liddell, chief executive of Scottish Drugs Forum stated;
“Neither decriminalisation nor one drug consumption room in Glasgow is going to impact substantially on the death rate. The key focus needs to be on improving our drug treatment and care services. We need to look at access to opioid replacement therapy. Only 40% of people with a drug problem in Scotland are currently in treatment, compared with far higher numbers in England and many countries in England.”
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Addressing Drugs and Alcohol in the Workplace
Within any business, companies seek to outline clear methods in which employees should act and behave whilst carrying out their roles. These rules are outlined in company workplace policies. Every business – no matter which industry it operates in – should have well-documented and comprehensive workplace policies and procedures in place.
According to the Employment Law Handbook, a workplace policy is a set of rules and principles that aims to provide guidance to managers and workers in how to behave in the workplace. They can be in place for numerous different issues – bullying, harassment, internet use, health and safety are just a few that can be implemented.
Health and Safety
As mentioned above, health and safety is an important aspect of any workplace policy. The health and well-being of the working community is of utmost importance for sustainable development. Specifically, a drug and alcohol policy is a key part of the overall health and safety policy within a company. Alcohol and drugs through their effects on health, safety, work performance and absenteeism can jeopardise productivity, deny businesses the leading edge and curtail competitiveness. Effectively implemented drug and alcohol policies will help employers in the legal duty to protect the health, safety and welfare of employees.
The need for a Drug and Alcohol Policy
Drugs and alcohol misuse can have dangerous consequences within the workplace. All organisations can benefit from an agreed policy that applies to all staff. There are wide range of statistics available to highlight the worrying impact that drugs and alcohol can have on individuals. In 2016, it was estimated that £7 billion was lost in productivity through unemployment and sickness. Furthermore, 10.8 million adults in England are drinking at levels that pose some risk to their health. A survey carried out by UK based Health and Safety Consultants Protecting.co.uk showed that; from 2,600 workers in office, factory, retail and the public sector, 85% admit to being drunk at work in the last year; not including the Christmas party. 28% of those surveyed admitted using drugs at work, including NPS (formerly legal highs) cannabis and other illegal substances.
From a legal point of view, employers have a duty of care under the Health and Safety at Work Act 1974 to ensure, as far as is reasonably practicable, the health, safety and welfare at work of employees. Also, under the Management of Health and Safety at Work Regulations 1999, to assess the risks to the health and safety of employees. If an employer knowingly allows an employee under the influence of drug misuse to continue working and his/her behaviour places the employee or others at risk, they may face prosecution.
Advantages of having policies in place
Having well-developed policies and procedures can provide a range of benefits to an organisation. An effectively implemented drug and alcohol policy will ensure a clear understanding within the workplace of the rules relating to drugs and alcohol. It will also provide a greater awareness in workplaces of the effects of drugs and alcohol an consequently early recognition. Furthermore, it ensures that the necessary structures and procedures are in place should a problem arise. An up to date policy will also provide assurance that key staff have been trained to understand the issues involved and have the necessary skills to deal with any problems should they arise.
How can Randox Testing Services help?
At Randox Testing Services we offer a comprehensive consultancy service to help employers create an effective substance misuse policy. By providing this service we offer practical advice, guidance and support in composing a substance misuse policy.
Our confidential policy review service provides assistance to employers with an existing substance misuse policy. With this service, we help to modify existing documents to ensure it is legally viable and can withstand challenge in court.
To read more about workplace polices and their importance within an organisation, click here.
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The prevalence of drug addiction and abuse across the globe has become a growing concern. It is currently estimated that 71 million people use drugs of abuse with around 166,000 direct deaths occurring from drug use in 2017.
The WHO (World Health Organisation) estimate that 11 million people inject drugs across the globe, of which 1.3 million are living with HIV, 5.5 million with hepatitis C, and 1 million with both HIV and hepatitis C. In addition to infectious disease, long term drug abuse increases the risk of several cancers, cardiovascular effects, respiratory effects, gastrointestinal effects, kidney & liver damage and mental health issues.
The abuse of drugs is one of the most pressing issues in the USA and other countries globally. Drug abuse not only affects the individual, but can also have far-reaching consequences that affect family, employment, personal health, health care systems, local communities, and society as a whole.
Global Drug Abuse – The buzz that keeps on going!
> Misuse of illicit drugs affects society through secondary costs incurred such as crime, reduced productivity at work, and health care expenses.
> Substance abuse costs the US health care system about $11 billion, with overall costs reaching $193 billion.
> Substance abuse and addiction also affects other areas of life leading to broken families, destroyed careers, death due to negligence or accident, domestic violence, physical abuse and child abuse.
> Drug abuse and addiction changes the chemistry of your brain. The longer an individual abuses drugs, the more damage is caused, making it more difficult to return to ‘normal’ during drug rehabilitation.
> Treating and tackling drug addiction is a challenge. As drug treatment and health services continue to fall short, there is an increased need to continuously adapt drug detection and analysis.
Randox laboratories are at the forefront, aiding the fight against drugs of abuse with a comprehensive range of 10 drugs of abuse assays including several stimulants, sedatives and opioids available to run on Randox’s very own clinical chemistry analysers, the RX series. To find out now how Randox is helping to tackle the ongoing prevalence of drugs of abuse click here or buy directly from the Randox Online Store.
About Randox Laboratories
As a world leader in the in-vitro diagnostic industry with over 35 years’ experience, Randox is leading the charge in moving from a one-size-fits-all approach towards decisions, practices and products tailored to the needs of the individual. This innovative approach to diagnostics has facilitated the development of revolutionary products designed specifically to enhance a patients’ quality of life.
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Therapeutic Drugs Monitoring
Dehydration: Do you know the signs?
Dry mouth with thick saliva, headaches, feeling sleepy or irritable, weakness, dizziness made worse when you are standing… sounds like a hangover, right? These are actually all symptoms of early to mild dehydration.
While not a hangover, this can happen from drinking alcohol as it suppresses your production of a hormone called vasopressin. This hormone would normally tell your kidneys to reabsorb water rather than passing it along to your bladder – which explains the ten trips to the bathroom on a night out – and also makes your hangover worse the next day. Below are a list of dehydration signs to look out for:
Early or mild dehydration include:
- Flushed face
- Extreme thirst or unable to drink
- Dry, warm skin
- Can’t pass urine or reduced amounts, dark yellow colour
- Dizziness, made worse when you are standing
- Feeling Weak
- Cramping in the arms and legs
- Sleepy or irritable
- Dry mouth with thick saliva
Moderate to severe dehydration include:
- Heart failure
- Low blood pressure
- Sunken dry eyes
- Fast but weak pulse
- Severe muscle contractions in the arms, legs or back
- Bloated stomach
- Skin loses its firmness and looks wrinkled
- Rapid and deep breathing – faster than normal
- Lack of elasticity of the skin
Are you at risk?
While anyone can become dehydrated, there are certain groups that are particularly at risk such as infants, older people, diabetics and athletes. But what can you do to prevent dehydration? Drink plenty of fluids. Water is the best fluid to drink when dehydrated but also having a non-fizzy, low sugar sports drink will help to replace electrolytes that have been lost. These are minerals the body needs such as chloride, calcium, magnesium, sodium and potassium. Long term dehydration can have serious effects on your health.
Randox Health: What We Do
Randox Health packages go beyond a health check. We have the world’s most comprehensive full-body health programmes available on the market today, thanks to Randox Biochips which enable hundreds of individual tests to be carried out from one sample and giving you truly unrivalled knowledge about your health and wellbeing both now and in the future. Our goal is to help you extend your life. Your health matters to us and, above all, we are committed to improving healthcare worldwide by identifying and preventing illness at the earliest possible stage.
How we can help you?
Identifying the very first signs and risks of disease can help prevent health problems that may be on the horizon. Randox Health aim to do this before the appearance of unpleasant symptoms or illness. Prevention is always better than cure. Long-term mild dehydration may have caused damage to your health and our packages tests for up to 350 different biomarkers. Read about our packages here, or contact a member of our team for more information!
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Our Randox Health programmes
Scotland is set to introduce a new “zero tolerance” policy to those caught driving under the influence of drugs.
Ministers in Scotland want to make it easier for police officers to target people driving with illegal drugs in their bloodstream. The policy will supersede the current need to prove that someone was driving in an impaired manner as a result of drug consumption. The law in Scotland currently states that it is illegal to drive if impaired by drugs, be it prescription or illegal drugs.
Justice Secretary Humza Yousaf said;
“The introduction of drug driving limits will strengthen the power of Scotland’s police and prosecutors to tackle the minority of drivers who irresponsibly put themselves and other road-users at risk. Drug driving is completely unacceptable, and we will continue to use all of the tools at our disposal to prevent the avoidable deaths and damage caused by those who drive under the influence of drugs. Together with our stringent drink-driving limits, these new laws will ensure that Scotland have the UK’s most robust laws against impaired and unsafe driving.”
Under the new plan, eight of the most commonly abuse illegal drugs – including heroin, ketamine and ecstasy – will have limits set very close to zero to rule out claims of accidental exposure. A further eight drugs, which can have medicinal purposes – such as diazepam and methadone – will have higher limits based on their ability to impair drivers. These proposals would mean just having drugs in your system that breach the limits, this is sufficient evidence to prosecute.
Utilising our Biochip Array Technology, the Evidence MultiSTAT From Randox Toxicology has screening panels which cover a broad range of classical, prescription and common DUID drugs of abuse.
Recent studies have found harmful water and food contamination throughout China due to the country’s large use of antibiotics.
In June 2006 an infant receiving treatment for a fungal infection and pneumonia in Guangzhou City was found to be infected with a kind of super bacteria resistant to seven types of antibiotics. The Epoch Times reported that Dr. Song Yanyan, who was involved in the treatment, told Chinese media Sina that nowadays many newborn babies are found to be carrying super bacteria. In antibiotic susceptibility tests, 70% of newborns were found to show resistance to one or more antibiotics, a huge increase when compared with previous figures.
Epoch times reported that; Dr Ying – lead researcher of antibiotics at the Guangzhou Institute of Geochemistry, led a research team all over China to investigate the scale of antibiotics consumption and discharge into the environment. They produced an “antibiotics pollution map” and the findings were that in 2013 alone, 162,000 tons of antibiotics were consumed in China—52% for veterinary treatment, and 48% for human treatment. The researchers mainly focused on 36 types of the most commonly detected antibiotics. The annual consumption of these antibiotics was more than 90,000 tons, of which 84% was given to livestock.
It was found that because of the large number of animals in pig and chicken farms, farmers have been adding a variety of antibiotics to the feed to reduce the chances of infectious diseases. Similarly, aquaculture farmers often add antibiotics when feeding fish, shrimp and crab. The export of these chicken, fish and seafood products from China pose health concerns for consumers because of their high antibiotic levels.
In order to help the industry, Randox Food Diagnostics developed the revolutionary multiplexing Biochip Array Technology, allowing the screening of up to 54 individual meat, seafood, feed or cereal samples for multiple drug residues, growth promoters and toxins on the Evidence Investigator analyser in under 2 hours and 30 minutes. This high throughput allows the user to save on time and consolidate costs in comparison to confirmatory laboratories.
For more information, contact us by email at email@example.com.
In early May 2019, over 550 state employees in Egypt were referred to the Egyptian public prosecution office after being forced to take a drug test under a new law.
The Ministry of Social Solidarity announced on May 5th that 15,877 state employees had recently been drug tested, and that 555 had been referred to the Administrative Prosecution Authority (APA) for testing positive for illegal drugs.
The sudden crackdown on drug users follows the government in Egypt approving a bill in March that authorised the required drug testing of all state employees from ministerial to the local level. Alongside members of the civil service, employees working for public transportation, hospitals, and other state-run institutions must also be drug tested. Anyone who refuses to be drug tested will have their employment terminated.
The new law was brought in with explicit support from Prime Minister Moustafa Madbouli, following a deadly train crash in Cairo after which the train driver tested positive for drug use.
Egyptian law does not specify the punishment for someone who tests positive for drug use, but the director of Egypt’s Fund for Drug Control and Treatment – Amr Osman – has warned that any state bus or rail drivers testing positive for drug use face imprisonment for at least two years, and a fine of 10,000 Egyptian pounds ($582).
University students and employees will also be subject to mandatory drug testing, the education minister has announced. In this case, people who test positive will be offered “treatment” and will be sacked or expelled from the university if they refuse to comply.
Randox Toxicology offer the Evidence MultiSTAT, a fully automated immunoanalyser that, utilising Biochip Array Technology (BAT), enables on-site simultaneous detection of up to 21 drugs of abuse from a single sample. The Evidence MultiSTAT requires only a small sample volume and can generate results in under 20 minutes. The process from sample entry to results is completed in only 3 simple steps, with minimal room for human error. The MultiSTAT is designed to make set-up and analysis as quick, simple and reliable as possible.
At Randox Testing Services, we are always trying to think of new ways to get the message across about the positive impact workplace drug & alcohol testing can have on an organisation. So, we decided to speak with one of our colleagues; Simon Tibbo, who is regularly engaging with companies about how to be proactive in minimising the risks of substance misuse.
Read below to find out what he had to say.
From your experience and knowledge, what industries are currently implementing testing programmes?
Apart from the finance industry, I’ve personally seen testing programmes within almost all business sectors, from the obvious, safety critical industries, Rail Track, Maritime, Construction, Logistics, all the way through to manufacturing firms, retail outlets, and even predominantly clerical companies. If a company has a workplace substance misuse policy and are looking to satisfactorily enforce the terms within, they will be engaged with a service provider, such as Randox, to properly support the policy.
What are, in your opinion, the barriers that companies face when trying to implement working drug & alcohol testing?
The introduction of a substance misuse policy to an already existing ‘company handbook’ can be a challenge, especially if the work-force has been established for some time. People don’t tend to like change, especially within the workplace. Unions can sometimes be unwelcoming to the idea of random testing and will often look to restrict the scope of testing or the policy itself. I’d say that each industry/company will likely meet its own barriers whilst developing and implementing a policy, and some may well be unique to the individual circumstances. Often, customers may implement an amnesty period prior to the commencement of a drug testing programme. This gives employees the opportunity to come forward and declare if they have a substance misuse issue which they can address together with their employer without sanctions.
Why has there been a delay in some companies developing workplace policies that directly relate to substance misuse?
There could be many reasons as to why a company hasn’t implemented a policy, but I’d expect somewhere near the top of that list would be either the assumption there isn’t a substance misuse issue within the business/industry, the worry that a substance misuse issue within the business/industry is highlighted by the introduction of a policy, and therefore creating more problems than its seen to be solving, or even that a company is simply unaware the solution is available and beneficial.
How important within a policy is it that a company clearly outlines what is expected of an employee, and the consequences of substance misuse?
Very! A policy needs to be clear and concise in its structure and procedures. If you aren’t explaining the terms or the consequences you could potentially end up with a problematic HR process and unresolvable tribunal cases. If an employee has sight of a straightforward policy they will know what to expect if the terms are breached, not to mention enforcing it should be equally as straightforward. It is also important to state why the policy is in place – i.e. to protect the workforce, the public and the company reputation.
Is it important to state cut-offs in substance misuse policies?
For alcohol, yes, most certainly. For drugs, not so much. An alcohol test with a home office approved breathalyser will provide an evidential result, which can be directly related to a ‘site cut-off’ (in the same manner as the existence of a road legal limit). Workplace drug testing should adhere to specific guidelines set-out by the EWDTS (European Workplace Drug Testing Society) in not just it’s procedures, but also its expected substance cut-offs. The cut-offs differ between substances so it’s not quite as straightforward. My suggestion would always be, if you feel it necessary to include drug cut-off information, refer to the EWDTS guidelines, they’re available to download on the EWDTS website if anyone needs sight, but ensure your provider is working to them and don’t go into full details, it’ll serve only to add unnecessary bulk to what should ideally be a streamlined policy.
How effective has workplace testing been in helping companies reduce the risk of drug & alcohol use?
From personal experience I can tell you, I’ve seen companies implement a policy/testing practice due to an awareness of substance misuse, only to reduce the volume of testing over time as the approach has proved successful in reducing or eradicating the specific problem. I’d say that’s a testament to implementing a random testing practice, it sends a sensible message in a fair and balanced manner, which ultimately gets results. If it’s done right, it’s going to be beneficial, even if it’s not particularly well received at its inception. Other examples where testing volume has been scaled back have led to an increase in the rates of positives demonstrating that an active testing programme is a deterrent to substance misuse.
Going forward, what industries do you see adopting a more proactive approach in use of substance misuse testing?
Likely most industries, every company has a duty of care to staff, contractors, visitors and/or the public. There will always be industries that don’t agree, don’t want to uncover issues or don’t believe they exist, but it’s the people that matter and the more that’s done to promote safety, welfare and overall good practice, the more industries will settle to the idea.
About Randox Testing Services
Randox Testing Services offer a wide range of products and services for the testing of illicit substances. We can craft customised packages to suit the needs of our customers, no matter what the industry.
Our expertise and experience working within this industry allow us to provide a range of testing solutions that will impact the risk of substance use in the workplace. With an extensive collection network and quality products, we can meet the needs of your business.
To find out more, contact us:
Phone: +44 (0) 28 9442 2413
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