Worksite Drug Testing

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Because of the growing use of illicit drugs and the abuse of prescription drugs and alcohol in modern society, an extensive program of worksite drug testing has developed. Workers who abuse drugs are much more likely to injure themselves and put fellow workers at risk, and many companies now require preemployment drug screening as a tool to keep those who have been abusing drugs out of the workplace. Drug testing can be done for the use of illegal drugs, for the abuse of legal drugs for which a person does not have an appropriate medical need and prescription, or for abuse of alcohol.

Not only has the number of companies that use drug screening risen dramatically over the years, but organizations such as the United States Armed Forces also have regularly implemented intake drug testing. Many legal protections guarantee employment in spite of having evidence of illness, but drug abuse is not covered in the same way, and employment may be legally denied for failure to pass a drug test.

In addition to preemployment drug testing, many corporations employ repetitive drug testing; and in some work settings, such as in the transportation area, random drug testing may be carried out for all workers engaged in certain activities. Also, when there is an accident in transportation, or in many other work settings, an immediate post-accident drug test is often done. In such instances, the results can lead to disciplinary or legal action.

Drug testing and evaluation must follow strict legal guidelines. Specially designated medical officials, called Medical Review Officers (MRP), review results and simply report that an individual has either passed or failed a drug screen; they are barred from revealing to anyone, including the police, which substance or substances were detected. Drug testing generally utilizes urine samples. However, blood tests and hair analysis may also be used. Workers have legal rights with regard to the taking of urine specimens, and these are safeguarded by elaborate collection and handling procedures. All personnel involved must conform to rigid guidelines, with a proper "chain-of-custody" being followed. This means that specimens must be obtained under close supervision, including visual inspection and temperature measurement, and put into sealed containers with the person from whom the specimen has been taken signing for it. Each person handling the specimen must sign for it along the way.

Substance abuse is characterized by either the use of illegal drugs, or the used of prescription drugs for which one has no prescription. Initial screening tests, which are relatively insensitive, must be further validated by the use of more specific and accurate test measurements. Such secondary testing must be carried out to verify, or disprove, the findings of the relatively insensitive screening tests most commonly used.

Arthur L. Frank

(see also: Alcohol Use and Abuse; Occupational Safety and Health; Substance Abuse, Definition of )


Olden, K. (1997). "Substance Abuse and Employee Assistance Programs." In Occupational and Environmental Medicine, 2nd edition, ed. J. LaDou. Stamford, CT: Appleton and Lange.

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Worksite Drug Testing

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