Drugs and Alcohol Policy and Procedures for XAVIER UNIVERSITY SCHOOL OF MEDICINE
Purpose
The purpose of this policy is to establish procedures to support a safe, healthy and productive work environment for all XUSOM students, free from the effects of substance abuse. The reasons for this are:
The use of controlled substances is against the law [Landsverordening verdovende middelen (AB 1990 no. GT7)].
The use of controlled substances and the misuse of alcohol increases the risk of accidents, jeopardizes the safe learning environment, and causes harm to an individual’s health and personal life
The abuse of alcohol and controlled substances impairs the Student’s judgment, resulting in increased safety risks, injuries and faulty decision-making.
The abuse of these substances also imposes an integrity risk on the student.
Scope
This policy applies to all XUSOM students.
For the execution of this policy XUSOM has contracted Medwork Caribbean N.V. and/or Laboratorio Familiar.
For the purpose of these procedures “Donor” or “Student” shall be considered any of the persons as described under 2 (a) here above.
For the purpose of these procedures a Donor’s sample of saliva, urine, blood or hair will be referred to as “Specimen”.
Students may be subject to testing throughout the year at any time XUSOM’s Administrators deems it necessary.
A controlled substance can be defined as any substance of which the use or possession is prohibited pursuant to the Landsverordening verdovende middelen (AB 1990 no. GT7).
Evidence of the presence of a controlled substance will be determined by analysis of the Donor’s sample of saliva, urine, blood or hair, and confirmed by gas chromatography / mass spectrometry by the designated laboratory
Evidence of the presence of alcohol will be from a breath test and/or analysis of the Donor’s urine and/or saliva and/or confirmation by a blood analysis.
The Student shall, when drugs are prescribed by a medical professional, inquire at the prescribing professional whether the drug prescribed has any side effects which may impair the Student’s physical and mental abilities. If the answer from the medical professional is affirmative, the Student shall obtain a written statement from the medical professional indicating any restrictions and their duration. For privacy reasons, the statement does not have to contain the name or type of medication used. However the Student will give the MRO permission to contact the prescribing professional and gain necessary information. The Student shall present the statement to the Dean of Basic Sciences and it will be forwarded to the Dean of Student Affairs.
Types of testing
XUSOM may execute the following 5 types of testing:
Pre admission testing
XUSOM may include a testing before the admission or as part of the admission process. The pre-admission testing is part of the medical examination prior to admission. Pre admission testing will include controlled substances only.
Post-accident testing
This testing may be performed on a Donor involved in an accident. The Donor at hand shall not consume a controlled substance or alcohol after the accident, unless 8 hours have expired, the Donor has been, or has determined that the Donor’s performance could not have contributed to the accident, whichever comes first. Post-accident testing may include both controlled substance and alcohol use.
Random testing
Students may be subject to testing at any time on a random basis. Upon being notified of selection the student must follow the applicable instructions and immediately proceed to the testing facility. Random testing will be spread reasonably throughout the year. Donors are selected at random by a software application which uses the Student Numbers. Random testing may include controlled substance and alcohol use.
Reasonable suspicion / Reasonable cause testing
A Student may be required to submit to a testing upon reasonable suspicion. Reasonable suspicion means that the actions, appearance or conduct of the Student are indicative of the use and/or presence in the Student’s body of a controlled substance or alcohol. Reasonable suspicion is based on specific, contemporaneous, observations concerning the appearance, behavior, speech or body odors of the Student.
Integral testing
As often as XUSOM’s management deems necessary, all Students will be tested, integral testing may include controlled substance and alcohol use.
TESTING PROCEDURES
General
All testing will be conducted by a Medical Review Officer (the MRO) or a Sample Collector (the SC) designated by Medwork/Laboratorio Familiar and, in the event the testing by the MRO/SC turns out to be positive, by the Laboratory, unless indicated otherwise by XUSOM at the time of testing.
The testing will be executed under strict privacy, confidentiality and accuracy standards. Donors will be tested only for alcohol and controlled substances (e.g. Marijuana, Cocaine, Opiates, Amphetamines and Phencyclidine (PCP). The testing will not disclose private medical facts about the Donor, such as pregnancy or disability. The MRO will only provide XUSOM with a positive or negative test result (for drugs and/or alcohol)
Controlled substance
The following materials will be used to perform the test:
- Specimen containers
- Test kit with relevant accessories
- Material for sealing of containers
- Name and numerical list of those to be tested
- Release form for use of prescription medication and consent to being tested and approval for Disclosing outcome of test to XUSOM (Exhibit 1 hereto).
The Students to be tested are called in as scheduled and instructed to be present at the designated testing facility with a prior notice of one hour. In the event of a post-accident testing the Student will be called in immediately after the accident. When the Donor arrives he/she will be informed of the reasons for the testing and the testing procedures that will be followed.
The Donor shall bring proper identification when presenting him or herself at the testing facility.
Prior to the testing the Donor will sign the top part of Exhibit 1 hereto, stating whether or not he/she is using prescription medication that could influence the outcome of the test to be performed.
The MRO/SC will inform the Donor which test will be performed (e.g. urine, saliva or any other test).
Donor will be asked to confirm that the numbers on the labels to be used to seal the containers are identical to the number noted on Exhibit 1. Donor will be asked to sign both labels for confirmation.
The Donor is not allowed to take purses, bags or containers with him/her into the collection site and will be requested to empty his/her pockets. The MRO/SC will take any other reasonable measures as he/she deems necessary to prevent adulterating or tampering of the specimen.
Donor will be requested to wash his/her hands under observation. Donor will select the containers and test kits to be used for the testing.
The Donor will be invited to enter the appointed collection site at the designated testing facility. A collection site may include a single-toilet room. The door to the toilet will be left slightly ajar, allowing the MRO/SC to supervise the adequate obtaining of a urine specimen from the Donor.
Immediately after having obtained the urine specimen the Donor will hand the specimen (container 1) over to the MRO/SC. MRO/SC will pour part of the contents of Container 1 into a second container (Container 2) and will seal this second container with one of the numbered labels.
If applicable the MRO/SC will read and record the temperature of provided specimen within four (4) minutes of collection and will look for evidence of tampering or adulterating.
MRO/SC will collect some urine from Container 1 and apply this to the test kits that Donor has selected. After having performed the tests MRO/SC will seal Container 1 with the second numbered label.
Donor is asked to read and sign the bottom part of Exhibit 1 hereto, to confirm that procedures were executed correctly, that Donor did not tamper or adulterate the specimen and that Donor consents to MRO of informing the HRM unit of the outcome of the test performed. After this the Donor is allowed to leave the testing facility.
At no time during the entire procedure is Donor allowed to leave the testing facility without permission of MRO/SC to do so.
If tampering or adulterating of the specimen is suspected or if the temperature of the specimen is outside of the acceptable range, the MRO/SC will immediately request of the Donor to provide a new specimen. A second suspected tampered specimen will be considered a refusal to test.
The MRO/SC can require collection under direct observation (“monitored collection”) whereas the Donor must allow the MRO/SC to establish that the urine flows from the body into the collection container.
If a Donor is not able to produce a urine specimen, he/she may drink water and wait until he/she is able to provide the urine specimen. Donor will remain in waiting area under observation and is at no time allowed to leave the testing facility. If Donor leaves the facility without having provided the MRO/SC with a urine specimen, this will be considered a refusal to test and MRO will inform HRM unit that Donor has failed to provide a urine sample
Alcohol testing
Evidence of alcohol can be determined by breath, urine, saliva and blood analysis. The laboratory technician may conduct a breath, saliva or urine test.
For alcohol testing Article 4.1 (a), (b), Article 4.2 (b), (c), (e), (o) apply.
If a test kit for urine is used, Article 4.2 (a), (d), (g), (h), (i), (j), (l), (n),(o), (p), (q) apply in the understanding that a second suspected urine tampered specimen will be immediately followed by a saliva and/or blood test.
If a test kit for saliva is used, the specimen shall be given in the presence of the MRO/SC and a witness.
If a breath analyzer is used for detection of alcohol, the Donor shall exhale into the breath analyzer in the presence of the MRO/SC and a witness.
Immediately after the specimen is obtained by the MRO/SC, he/she will proceed with the actual testing in the presence of the witness.
Refusal to test
The following behaviors by the Donor constitute a refusal:
- Refusal to appear for testing.
- Failure to remain at the testing site until the testing process is complete.
- Failure to provide urine, saliva, blood and/or any other specimen and/or failure to take a breath and/or any other alcohol test.
- In case of Monitored Collection, refusal to allow the direct observation.
- Refusal to sign the forms that are part of testing procedures. (f) Failure to take a second test as instructed.
- Otherwise fail to cooperate in the testing process.
- Perform any actions which prevent the completion of the test.
- A test reported by the MRO as a verified adulterated or substituted specimen
- Inability to provide sufficient quantities of urine to be tested without a valid medical explanation.
- Tampering with, attempting to adulterate or substitution of the specimen, or interference with the collection procedure.
- Not reporting to the testing facility in the time allotted.
RESULTS
General
The first result of a test will be read by the MRO/SC and confirmed by the MRO. The MRO, based on the result, will certify the first result as positive or negative. If the first result is negative, the specimen will be disposed of as well as the specimen containers and test kits used for the testing. Notwithstanding the previous XUSOM may decide, at its sole discretion, to send the specimen to the Laboratory if the first result is negative.
Controlled substances
If the first result is negative and Article 4.2 (p) does not apply, the specimen will be disposed of immediately. If the test kit used for the testing signals a positive outcome, the first test result is considered positive.
In case of a positive first test result, the specimen will be sent to the Laboratory for Gas Chromatography - Mass Spectrometry (GC-MS) confirmation, or perform any other relevant tests for further verification and confirmation.
The specimen in Container 2 will be kept for contra expertise.
In case of a positive first result for controlled substances, the Donor has the possibility to request a re-test (contra expertise) on the provided specimen, kept in Container 2, within two weeks after the first testing by the MRO/SC was executed, at his/her own expense. The laboratory engaged to perform the re-test must be approved by XUSOM.
Upon written request within seven (7) days after being notified of a positive test, confirmed by the Laboratory, the Donor may obtain copies of any records pertaining to his or her test.
If the first test result was positive, but could not be confirmed by the Laboratory, the specimen will be disposed of immediately after the Laboratory has notified XUSOM of the negative final result.
If the Laboratory has confirmed the positive test result, the specimen will be disposed of sixty (60) days after the Donor has been notified of the confirmation by the Laboratory of his/her positive test.
Alcohol
Article 6.A applies
A result will be considered positive if a Donor’s alcohol concentration is greater than 0.02%w/v (20g/dl weight/volume ration.
If the first test result is positive for alcohol, the Donor will be requested by the MRO to immediately submit him/herself to a collection of a specimen of his/her blood or any other required specimen to be performed by the MRO or other designated physician. The specimen will be sent to the Laboratory for GC-MS verification or any other relevant test method to confirm the test result.
Positive results
For the purpose of this XUSOM policy and procedures a refusal to test will be considered a positive test result.
Students presenting to Xavier Faculty or Administration acknowledging a dependency on drugs and/or alcohol are allowed to withdraw from the academic curriculum without penalty. They are referred to the private Rehabilitation Program of their choice at their expense. The school is to be advised as to the name of the Program, its location, the medical director and the projected length of stay. Periodic updates as to progress are to be forwarded to the Dean of Student Affairs.
Upon completion of the Program and at the recommendation of the Medical Director, the student may resume the academic curriculum but must submit to random chemical testing by the Dean of Student Affairs. Positive screens will result in expulsion from the school.
Students found to have used either of the substances to excess are subject to the disciplinary actions as stated in the Student Handbook under those headings.
Undisclosed drug / alcohol use offense or suspension/expulsion from any institutions prior to admission will be automatic dismissal from XUSOM, Aruba. If a student has gone through counselling or rehabilitation, student must inform and submit necessary documents prior to admissions.
Policies for preparing for and for dealing with emergencies or diseases.
The school’s policies to deal with emergencies and infectious diseases, are summarized below:
First aid and Emergency treatment: First aid will be provided to students, faculty, staff and visitors. At least 2 faculty are available all the time, who are trained in cardio-pulmonary resuscitation and first aid by the competent authorities like American heart association or American Red cross.
Faculty are trained of the appropriate procedures to handle emergencies such as asthma attacks and epileptic seizures.
Faculty, staff and students are also provided with hospital, police contact information in case of emergencies as indicated below:
Fire department, Ambulance and Police: 911
Hospital toll free: 587-4300
XUSOM telephone number: 588-7766
The school building has first aid kits, defibrillator kit, epinephrine auto injector and asthma inhalers at various places to be used for the appropriate medical emergencies.
In case students suspect an infectious disease, they inform the dean of the student affairs and then he will inform the dean of the institution. The dean will then notify the same to the local health bodies.
The school has a dedicated quarantine room to isolate the suspected or a confirmed case of infectious disease before handing over to the respective health authorities.
School has a trained microbiologist and an epidemiologist service all the time, to train the faculty, staff and students about the appropriate precautions to be followed during an outbreak of an infectious disease.
During Major Natural disasters like a Hurricane or flood, all the academic activities will be suspended. The school has a dedicated vehicle to transfer all the students and the faculty to a secure location and provide them with necessary medicine, food and water till the situation comes under control.