Drug Testing

(drug testing vs impairment testing) "Few employers have used impairment testing, and information concerning that experience is very limited and extremely difficult to obtain. The available information, however, indicates that impairment testing is not just a better answer on paper, but in practice as well. Employers who have used impairment testing consistently found that it reduced accidents and was accepted by employees. Moreover, these employers consistently found that it was superior to urine testing in achieving both of these objectives."

(drug testing - workplace procedures and cutoff levels) "Workplace drug testing programs for marijuana in the U.S. generally observe the following procedures: a urine sample is collected – either announced or random – and screened for THC metabolites using an immunoassay test. Such immunoassays can be performed rapidly and at low cost, yet they are not highly specific for THCCOOH, the main metabolite of THC. If screening test results indicate the presence of THCCOOH above a specified "cutoff" level (most commonly used is 50 nanograms/milliliter (ng/mL) or parts per billion (ppb), the sample is "confirmed" by the more specific GC/MS (gas chromatography/mass spectroscopy) method. If GC/MS detects THCCOOH at levels above the confirmation cutoff, usually 15 ppb, a urine sample is considered "confirmed positive". Some employers and law enforcement agencies in the U.S. use a lower screening cutoff of 20 ppb and confirmation cutoff of 10 ppb. Very few drug-testing programs rely only on the outcome of a screening test and do not demand confirmation testing by GC/MS."

(drug testing - psychological tests) "There is no psychological test that can reliably screen for substance abuse. The MAC-R Index on the Minnesota Multiphasic Personality Inventory 2 (MMPI-2) detects only addiction potential, not current use. If someone has been addicted in the past but is currently living a sober lifestyle, that person is still likely to test positive for addiction potential as this is more a personality style instead of a measure of current status (Friedman, Lewak, Nichols, & Webb, 2001). The idea behind the Substance Abuse Subtle Screening Inventory (SASSI) (Miller, 1994) is a good one. Essentially, it is an attempt to identify substance abuse through a self-report of symptoms that are associated with substance abuse without directly asking the central question. The Michigan Alcohol Screening Test (MAST) (Selzer, 197 1) is considerably less subtle, asking questions more directly. NCS also has an Alcohol Use Inventory (Horn, Wanberg, & Foster, 1987) that it markets."

(drug testing - hemp foods) "The results of this study indicate that even extended ingestion of currently available hemp foods is not likely to produce urine samples which exceed the 50 ppb cutoff in the immunoassay screening test. The occurrence of screening positives at the 20 ppb cutoff is conceivable. However, their confirmation by GC/MS at the 10 or 15 ppb cutoff is highly unlikely."

Drug Testing - Data

(2011 - drug testing - most detected drugs) "American workers continue to use prescription opiates at relatively high levels according to Drug Testing Index™ (DTI) ... Hydrocodone and oxycodones remain the most detected prescription opiates in the U.S. general workforce, with 1.3% and 1.1% positivity rates, respectively, in the first half of 2011. Compared to 2005 levels, oxycodones are 96% higher (0.56% vs. 1.1%) and hydrocodone 47% higher (0.88% vs. 1.3%) in positive prevalence.

"According to Drug Testing Index data from urine drug tests, only marijuana, at 2.0% in the first half of 2011, holds a positivity rate higher than hydrocodone (1.3%) and oxycodones (1.1%)."

(2011 - drug testing - detection from random or post-accident testing) "Random drug testing and post-accident testing detected dramatically more positives for prescription opiates than preemployment drug testing from January 2011 through June 2011 in the U.S. general workforce. Pre-employment screening revealed a 0.85% positivity rate for hydrocodone and a 0.65% positivity rate for oxycodones. However, random drug test positivity was nearly double, at 1.6% and 1.2%, respectively. Post-accident testing for hydrocodone and oxycodones continue to reveal dramatically higher rates of positivity at 3.7% and 1.8%, respectively."

(2008 - drug testing - reporting disincentives) "Occupational safety and health stakeholders we interviewed and occupational health practitioners we surveyed told us that primary factors affecting the accuracy of injury and illness data include disincentives that affect workers’ decisions to report work-related injuries and illnesses and employers’ decisions to record them. ... Workers’ fear of disciplinary actions may be compounded by policies at some worksites that require workers to undergo mandatory drug testing following incidents resulting in reported injuries or illnesses, regardless of any evidence of drug use. Several labor representatives described mandatory drug testing policies as a disincentive that affects workers’ decisions to report injuries and illnesses, and 67 percent of health practitioners reported they were aware of this practice at the worksites where they treated workers in 2008."

(2008 - drug testing - arrestees) "Illegal drugs are widely used among the arrestee population. Two thirds of all arrestees tested positive for at least one substance in their system at the time of arrest and 15 percent or more in all sites test positive for more than one substance. The most common substances in all but three sites are marijuana, cocaine, opiates and methamphetamine."

(2006 - positive drug test results) "The 2006 Drug Testing Index showed that positivity for amphetamines (positive test results for amphetamine and methamphetamine as a percent of all tests for the substance) declined 20 percent to hit to a new low level among federally mandated, safety-sensitive workers – 0.28 percent, down from 0.35 percent in 2005. Among the general workforce, positivity for amphetamines declined 12.5 percent – from 0.48 percent in 2005 to 0.42 percent in 2006. In addition, the number of positive tests for marijuana, as a percent of the total number of tests for the drug, was down 6.3 percent among the U.S. general workforce compared to 2005 – to 2.38 percent from 2.54 percent. The 2006 Drug Testing Index summarizes the results of more than nine million workplace drug tests performed by Quest Diagnostics between January and December 2006.

"Overall, the testing data indicated that drug use by employees and applicants fell to the lowest level since Quest Diagnostics began publishing the Drug Testing Index in 1988. Of all urine workplace drug tests performed by Quest Diagnostics during 2006 for the combined U.S. workforce, 3.8 percent had positive results, compared to 4.1 percent in 2005 and 13.6 percent in 1988."

(2004 - companies that drug test) The American Management Association has conducted surveys of workplace surveillance and medical testing. In 1991, drug testing of some kind was conducted by 63% of companies surveyed, growing to 81% in 1996, falling to 66% in 2000 and then to 62% in 2004. Drug testing of new hires was conducted by 48% of companies in 1991, growing to 68% in 1996, falling to 61% in 2000 and then to 54.5% in 2004. Drug testing of current employees was conducted by 52% of companies surveyed in 1991, rising to 70% in 1996, falling to 47% in 2000 and then to 44.3% in 2004.

(2003 - drug testing of sheriffs) "Nearly all officers were employed by a sheriff’s office that used criminal record checks (99%), personal interviews (98%), background investigations (98%), and driving record checks (95%) (figure 4). More than 4 in 5 officers were employed by an office that used medical exams (87%), and drug tests (85%). More than two-thirds were employed by one using psychological evaluations (72%) and credit checks (69%). More than half of officers worked in sheriffs' offices using written aptitude tests (58%) and physical agility tests (54%)."

(2000 - companies that drug test) The American Management Association in its 2000 survey on workplace surveillance and medical testing found the following percentages of companies which conduct drug tests:

(1990 - companies that drug test) The Bureau of Labor Statistics noted a high turnover in drug testing plans after a large survey of 145,000 businesses. It found that "overall about 1 of 3 establishments that reported having a drug testing program in 1988 said they did not have one in 1990." Further, "46 percent of the small businesses that reported having a drug-testing program in 1988 did not have one 2 years later."

Drug Testing - Law and Policy

(law) "The federal government does not impose rules regulating or prohibiting testing in the private sector and instead gives direct governance to specific agencies for employees under their jurisdictions and to the states. Two federal departments (Department of Transportation and Department of Defense) require random drug testing for contractors and employees holding certain jobs and in certain circumstances (e.g., after an accident). In addition, there is a federal law (the Omnibus Transportation Employee Testing Act, Pub. L. No. 102-143) that requires testing for specific types of transit operators. For private industries, state laws cover drug testing for both job applicants and employees. The details of laws across states vary: Random testing may be explicitly prohibited but may also be required for certain jobs, such as school-bus drivers. Some states also have conditions detailing the confidentiality afforded to test results or the policies and procedures for conducting such tests (ACLU, 2000)."

(drug testing - alcohol) "Although most laws concerning drug testing are at the state level, federal law must be considered when employers do test for ethanol (i.e., alcohol). The Americans with Disabilities Act (ADA) (Pub. L. No. 101-336) protects individuals with disabilities from discrimination in the workplace. Individuals with current alcohol-induced impairments and past alcohol problems are covered under the ADA. Thus, applicants cannot be tested or questioned about alcohol-use disorders until after a job offer has been made, and, even then, the law restricts when and under what conditions employees can be tested for alcohol use and other alcohol-use disorders. Moreover, employment decisions, particularly negative ones, cannot be based on these test results unless the employer can establish impairment caused by alcohol use (Hartwell, Steele, and Rodman, 1998). On the other hand, use of illegal drugs and of prescribed drugs used illegally and the drug-use disorders associated with such use are not covered under the ADA."

(law - pregnancy and drug testing) "Ferguson v. City of Charleston (2001) is an important case in the family law domain because MUSC’s [Medical University of South Carolina] policy of testing pregnant women for illegal drugs raises issues at the intersection of public health and constitutional law. The public-health aspects concern the very real and significant risks to maternal, fetal, and societal well-being of drug use during pregnancy; in addition, the policy raises constitutional questions about what constitutes a reasonable search and seizure and women’ s privacy right to reproductive autonomy. Ultimately, the case addresses how best to strike the sometimes competing interests between mothers and their unborn children.

"Although the policy was discontinued before the Supreme Court’s ruling and the Court held the policy to be unconstitutional, all the components of the decision—majority, concurring, and dissenting opinions—point to ways in which a similar policy could be designed so as to avoid the constitutional pitfalls encountered by the policy in Ferguson (2001). The petitioners won, but their victory is likely to be short lived. Recent developments in a number of states, combined with ongoing public concern about drug abuse, especially by pregnant women, suggest that despite Ferguson’s outcome, pregnant women should not feel too secure from state intervention when receiving prenatal care. Such interventions are likely to have significant consequences for pregnant women’s legal rights, as well as for their health, their fetuses’ health, and their behavior during pregnancy."

Drug Testing - Research

(drug testing and productivity) In a study of high tech industries, researchers found that "drug testing programs do not succeed in improving productivity. Surprisingly, companies adopting drug testing programs are found to exhibit lower levels of productivity than their counterparts that do not... Both pre-employment and random testing of workers are found to be associated with lower levels of productivity."

(drug testing and management processes) "While the inquiry team could see a role for employee drug testing within safety-critical areas (although even here they were far from convinced that such drug testing was effective), there was deep scepticism as to the value of such testing more broadly. Indeed, the inquiry team noted that ‘For the most part, it is unclear that anything can be achieved through drug and alcohol testing that could not be done better through other managerial and supervisory processes’"

Drug Testing - Students

(2005 - student drug testing goals) "One approach to address student substance use is school-based mandatory-random student drug testing (MRSDT). Under MRSDT, students and their parents sign consent forms agreeing to the students’ random drug testing as a condition of participation in athletics and other school-sponsored competitive extracurricular activities. The programs are designed to supplement existing school-based substance use prevention strategies and have the twin goals of (1) identifying students with substance use problems for referral to appropriate counseling or treatment services and (2) deterring substance use among all students. Recent national estimates indicate that 14 percent of U.S. public school districts conducted random drug testing in at least one of their high schools during the 2004–2005 school year (Ringwalt et al. 2008), and since 2003, the U.S. Department of Education’s Office of Safe and Drug-Free Schools (OSDFS) has operated a grant program to support MRSDT programs in schools."

(drug testing evaluation) "To help assess the effects of school-based random drug testing programs, the U.S. Department of Education’s Institute of Education Sciences (IES) contracted with RMC Research Corporation and Mathematica Policy Research to conduct an experimental evaluation of the MRSDT [mandatory-random student drug testing] programs in 36 high schools within seven districts that received OSDFS [Office of Safe and Drug-Free Schools] grants in 2006.

"The study’s key findings indicate that:

"1. Consistent with the goals of the program, students subject to MRSDT reported less substance use than comparable students in high schools without MRSDT. Specifically, student-reported past-30-day use of substances tested under their districts’ MRSDT policies was lower in schools implementing MRSDT than in schools without such policies. A similar, though not statistically significant, pattern was observed on other student-reported substance use measures.

"2. However, the MRSDT program had no “spillover effects” on the substance use reported by students who were not subject to testing and had no effect on any group of students’ reported intentions to use substances in the future.

"3. Contrary to concerns raised about the possible unintentional negative consequences of random drug testing, the MRSDT program had no effect on the proportion of students participating in activities subject to drug testing or on students’ attitudes toward school and perceived consequences of substance use.

"4. There was some evidence that impacts of the MRSDT program were related to the ways in which the programs were implemented. Both testing for a larger number of substances and testing for alcohol and tobacco were significantly correlated with lower substance use in the treatment schools relative to the control schools. However, it was not possible to distinguish between these two factors due to the fact that districts that tested for a larger number of substances were also those districts that tested for alcohol or tobacco. Impacts were not significantly related to other implementation characteristics examined."

(drug testing and student drug use) "The deterrent effect of drug and alcohol testing was present for the index of past year illicit drug use and combined drug and alcohol use, each at two follow-up time points. If DAT were to have an impact, the expected deterrent effect likely would be that the policy would alter recent (e.g., past month) use of drugs or drugs and alcohol, since student-athletes were under the threat of testing during that time period, but not during the summer months. However, no differences were noted at any of the four follow-up time points for past month indices of use of drugs or use of drugs and alcohol. With 16 opportunities overall to demonstrate a substance-use deterrent effect during 2 years and four follow-up assessments (Table 3), only four effects were significant. The significant effects for past year drug use and alcohol and drug use were not independent, as both scales included drug use."

(drug testing and student drug use) "No DAT [Drug and Alcohol Testing] deterrent effects were evident for past month use during any of four follow-up periods. Prior-year drug use was reduced in two of four follow-up self-reports, and a combination of drug and alcohol use was reduced at two assessments as well. Overall, drug testing was accompanied by an increase in some risk factors for future substance use. More research is needed before DAT is considered an effective deterrent for school-based athletes."

(drug testing and student drug use) According to the National Center on Addiction and Substance Abuse at Columbia University, "Drug testing of students is more prevalent in schools where drugs are used, kept or sold than in schools that are drug free. While only 23 percent of drug-free schools drug test students, 38 percent of non-drug-free schools conduct some type of drug testing.

"Drug testing is not associated with either significantly lower risk scores or lower estimates of student body drug use. The average risk score of teens attending a school that is not drug free but has drug testing is 1.69; the average risk score of students at non-drug-free schools without drug testing is 1.50. The estimate of students using illegal drugs averages 40 percent for non-drug-free schools with testing and 34 percent at non-drug-free schools without testing."

(drug testing and student drug use) "Drug testing of any kind, including for cause or suspicion, was not a significant predictor of marijuana use. These results remained for all samples, even after controlling for student demographic characteristics."

(drug testing and student drug use) Researchers on a grant from NIDA found that school drug testing has no impact on student drug use. According to the researchers,

"Does drug testing prevent or inhibit student drug use? Members of the Supreme Court appear to believe it does. However, among the eighth-, 10th-, and 12-grade students surveyed in this study, school drug testing was not associated with either the prevalence or the frequency of student marijuana use, or of other illicit drug use. Nor was drug testing of athletes associated with lower-than-average marijuana and other illicit drug use by high school male athletes. Even among those who identified themselves as fairly experienced marijuana users, drug testing also was not associated with either the prevalence or the frequency of marijuana or other illicit drug use."

(drug testing and student drug use) "In the HLM (Hierarchical Linear Modeling) analyses for students in grades eight, 10, and 12, drug testing (of any kind) was not a significant predictor of student marijuana use in the past 12 months. Neither was drug testing for cause or suspicion."

(drug testing and student drug use) "Drug testing of athletes was not a significant predictor of marijuana use by male athletes in high school."

(drug testing and student drug use) "Similar to results for marijuana use, drug testing of any kind and drug testing for cause and suspicion were not significant predictors for use of other illicit drugs among students in grades eight, 10, and 12. Within the high school subsamples, use of illicit drugs among high school male athletes and current marijuana users was not significantly different based on drug testing at the school. Even after controlling for student demographic characteristics, drug testing was not a significant predictor for other illicit drug use in any of the samples."