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Drug Abuse Testing

Drug abuse affects the company as well as the employee. The key to any successful drug-free policy is first knowing the depth and breadth of the problem.

December 17, 2000
Related Topics: Substance Abuse
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There’s no doubt that a drug-free workplace is a safer workplace. Numerousstudies have demonstrated that the implementation of drug abuse testing resultsin a 50% decline in the number of accidents and injuries. Before implementing adrug-free workplace policy and program, it is essential you understand who usesdrugs, what these programs really detect, and the details of a drug testingprogram.

The scope of the problem
According to the Substance Abuse and Mental Health Services Administration (SAMHSA),in 1999, an estimated 6.5% of adults working full time were users of illegaldrugs. This is a decline from 1997 when 7.7% of the same group used illegaldrugs. In 1999, 8.6% of part time employed adults abused drugs. The same studyfound that 16.5% of unemployed Americans over age 18 used illegal drugs. In 1999there were 9.4 million drug users working full time.

Drug use vs. impairment
The real goal of a drug abuse testing program is the determination ofimpairment -- is the employee unable to safely perform the tasks of his/her job?Unfortunately, studies have shown that there’s little correlation between druglevels in the urine and impairment.

There are many factors that may result in impairment: inadequate sleep,non-work related mental stress or worries, work-related stress, distractions atthe workplace, etc. Many over-the-counter antihistamines, sleeping pills, andother drugs may cause significant drowsiness. These are never tested for in drugabuse tests.

Lacking a better way to determine an individual’s impairment, the testingof urine for the presence of certain drugs or their metabolites (breakdownproducts) has become the standard. Although other body fluids (saliva and blood)and body parts (hair and fingernails) can be used to determine the presence ofdrugs, urine remains the "gold standard" for abuse testing programs.

What to test for
The five most commonly tested for drugs are amphetamines, cocaine, marijuana,opiates, and phencyclidine. This panel is often referred to as the"DOT-5" (Department of Transportation) or the "NIDA-5"(National Institute of Drug Abuse). These five drugs are the drugs that must betested for under federal Department of Transportation regulations. Most"non-regulated" companies test for the same set of drugs.

There are some areas of employment, particularly hospitals, nursing homes andother patient care settings, that use an expanded panel which includes drugsmore commonly abused by healthcare workers.

Drug use vs. drug abuse
You may have noticed that I refer to "drug abuse testing" and notjust "drug testing." That’s because what we are really testing foris the illegal or illicit use of drugs and not their legitimate use.

For some substances, such as phencyclidine, any use is synonymous with drugabuse since there are no legitimate medical uses for this drug. Other drugs,such as opiates, amphetamines, and, rarely, cocaine and marijuana do haveacceptable and legitimate medical uses. The presence of any of these drugs inthe urine doesn’t necessarily indicate either abuse or a problem. That’swhere the Medical Review Officer (MRO) is crucial.

Why not test for more drugs
Many an employer’s first reaction after deciding to implement a drug-abusetesting program is to test for any drug that can be abused. There are a numberof problems with this approach.

First, the cost goes up for each additional drug added to the test. The drugsin the DOT-5 panel are those that are most commonly abused. This panel is widelyaccepted by both federally regulated and non-regulated employers as the standardpanel.

Second, the testing process is standardized for the DOT-5 drugs. Wheneveradditional drugs are added to the panel, there’s additional room for errorsand problems.

Third, if additional drugs are added to the testing panel there’s a greaterchance of a positive result which, upon investigation, turns out to belegitimate and not abuse. This adds time to the verification process and delaysin getting an employee on the payroll.

Recent Articles by Richard Sagall, M.D.

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