Drug abuse is a major
problem in North America. Â US government
studies indicate that approximately 8% of all adult males, and 4% of all adult
females will suffer from a period of drug abuse or dependence in their lifetimes. Â The most common problem drugs are marijuana
(THC), pain-killing opiates (such as heroin, as well as prescribed medications,
such as morphine or Demerol), stimulants, such as cocaine (and crack),
amphetamine and methamphetamine, and, in more recent years, "club
drugs" such as Ecstasy. Â Of these
drugs marijuana is most commonly used, with more than half the adult population
reporting one or more episodes of use, but cocaine and opiates are the drugs
most commonly associated with accident, illnesses, and major criminal acts,
such as larceny.
The impact of drug abuse on
businesses has been the subject of considerable debate. The US National
Institute of Drug Abuse and their private Institute for a Drug Free Workplace,
both cite studies indicating increased absenteeism and illness among illicit
drug users, as compared to their non-using peers, as well as problems of theft
and violence. Drug testing proponents claim drug abuse costs US industry more
than seventeen billion dollars per year. Critics of the "war on
drugs," most prominently represented by the American Civil Liberties Union
and The Open Society Fund of George Soros, have questioned this data, asserting
that drug detection is, in fact, mostly marijuana detection, that routine
testing is an unnecessary invasion of privacy, that the economic costs of
employee drug abuse has been exaggerated, and that comparisons of companies
that drug test to those that do not indicate no difference in losses due to
employee theft, illness or accidents. Despite differences of opinion, there is
general agreement that cocaine, opiate and methamphetamine users can present
serious workplace problem, including a higher risk of accidents, as well as
incidents of theft, absenteeism, and even violence. Even one drug-abusing
employee can cause enormous damage, but anti-drug test advocates claim few
"hard drug" users are present in the workforce.
Arguments over the value and
appropriateness of drug testing have focused on urine testing, which is used by
about 90% of those companies with a drug-testing program. However, new
modalities, including hair, saliva and electronic testing, offer the
opportunity to address many of the concerns expressed by anti-test groups,
while accomplishing to goal of assuring a safe, sober and healthy workforce. Â This article will focus on the employer''s
choices in drug test modality, and the strengths and weaknesses of each
approach to testing.
Urine testing has dominated the test process for the last thirty years: it is
relatively inexpensive, well established, easily implemented in most work
settings, and available in both instant on-site and lab based formats. However,
urine testing is often perceived as messy, intrusive, and overly sensitive to
"recreational" marijuana use. In fact, urine testing can detect
marijuana up to six weeks after cessation of use among heavy users, although
use by the "recreational Saturday night user" can be detected for
only three or four days. Finally, even a cursory examination of the Internet
will indicate the myriad, astoundingly creative, and often effective methods
available to those who seek to defeat urine drug detection. Despite these
drawbacks, urine testing remains an effective method for deterring employee
drug use, and remains the testing method most often chosen for pre-employment
drug abuse detection. Â Both on-site and
lab based testing are inexpensive and easily implemented.
Hair, saliva, and electronic testing offer
many of the benefits of urine testing, without the invasive, undignified
quality of a "pee test," without what many consider "over-detection"
of marijuana, and without the many, easy ways sophisticated users have
available to defeat urine tests. The new modalities are not only effective, but
cost competitive with urine testing.
Hair
testing is an extremely clean option, involving cutting approximately 120
strands of hair from the back of the head and sending the hair sample to a lab
for testing. Results are usually available within two to three days after the
lab receives the sample. Hair tests, which detect illicit drug use over the
past ninety days, will reveal regular
marijuana use, but the one-time marijuana user will typically go undetected.
Hair testing is extremely difficult to defeat without massively damaging hair,
and if head hair is unavailable or appears damaged, body hair can be used
instead. Hair testing is marginally more expensive than urine testing, but is
far more effective in identifying users of dangerous drugs, such as heroin,
cocaine and methamphetamine. A pre-employment hair-testing program is extremely
easy for the employer to establish. However, hair testing is less often used
for random testing of current employees, and is unsuitable as a for-cause or
post-accident test.
Saliva testing has been touted as a "fitness for duty" test, as its window
of detection begins as soon as a drug is ingested. Saliva tests will reveal
only current or very recent (within
the past twelve hours) marijuana use, but will detect use of cocaine, opiates,
methamphetamine and Ecstasy over the past two to three days (urine will detect these
drugs for three or four days after use). Saliva is typically experienced as
cleaner and less intrusive than urine, and there are currently no known methods
for defeating saliva testing. Saliva testing is useful for pre-employment,
random, post-accident and for-cause testing. Both lab-based and on-site systems
are available; the on-site system offers results ten minutes after taking the
saliva sample. Saliva tests compare favorably in price to urine testing.
Electronic testing focuses on "fitness for duty," and allows employers to screen
for fatigue, drug and alcohol intoxication, medication effects, stress and
illness. The new electronic testing methodology has been used primarily in high
stress, safety conscious occupations, such as mining and aviation. The
electronic system is based upon development of an individual profile for each
employee, which is then used as a benchmark to measure significant deviation
from that norm; such deviations reflect the effects of fatigue, intoxication,
medication and illness, and can allow an employer to remove a questionable
employee from duty until the problem is diagnosed and resolved. Electronic
testing is entirely focused on current status, and detects drug or alcohol use
(and other problems) only when there is a current impairment in
performance. Â Electronic testing is
entirely clean and does not intrude on the personal life of employees. The
electronic system cannot be "gamed" or defeated. If properly
introduced, employees readily accept electronic testing. Electronic testing is
the fastest and least expensive testing mythology for employers who are
interested in large scale testing of current employees, especially where safety
considerations are paramount. Since it depends on developing an individual
profile for each employee, it is not suitable for pre-employment testing, but
it can be used for random, for-cause and post-accident testing.
In deciding on the
appropriate drug-test modality, some of the questions employers should ask
themselves are:
           What is the goal of the testing program?
           How serious a problem in drug use among job applications
or current employees?
How
serious does the firm regard occasional marijuana use among applications? Among
current employees?
What
policies are in place to identify and help drug-abusing employees?
What
policies are in place for post-accident and for cause testing?
Given
the strengths and weaknesses of urine, saliva, hair and electronic testing,
which is best for the needs of the company, consistent with company goals?
By:
Douglas Stellato Kabat, CSW and Joanna Stellato Kabat, CSW
Email: HlthProd[at]aol.com