Magazine article Risk Management

Comprehensive Screening Ensures Drug Test Accuracy

Magazine article Risk Management

Comprehensive Screening Ensures Drug Test Accuracy

Article excerpt

Comprehensive Screening Ensures Drug Test Accuracy

The impact of drug abuse on the workplace, and on a larger scale, on our society is difficult to comprehend. Drug usage and sales have pervaded into the middle- and upper-class neighborhoods, crack houses abound and drugs are sold openly on street corners in many major cities. In 1985, the National Institute on Drug Abuse (NIDA) estimated there were 20 million cannabis users, 5 million cocaine users, 3 million stimulant or sedative users and over 100 million alcohol users.

Since this survey, cocaine in the form of crack has had a traumatic impact. Cocaine related deaths in 1982 were less than 200, but in 1986 they had increased to over 600. A parallel increase exists in the number of emergency room visits related to cocaine. Even more significant, it is estimated that 25 percent of all cases of AIDS are related to intravenous drug abuse, and approximately 70 percent of perinatal cases of AIDS are linked to I.V. drug use. The cost to society, already in the billions of dollars, continues to escalate in lost profits to industry and increased medical costs for drug related maladies.

Statistics show that the workplace is affected in many ways. Employees with substance abuse problems are estimated to have an absentee rate from four to eight times greater than that of the unaffected population and are at two to three times the risk of being involved in an industrial accident. Increased sick leave, grievance procedures related to job loss or injury and decreased productivity add to losses estimated at over $100 billion annually.

To combat the problem of substance abuse within the workplace, employers are turning to substance abuse testing and employee assistance programs to curb the amount of drug use within their respective employee pools. Companies have many testing options, but primarily use pre-employment testing. Also being utilized are routine monitoring programs performed at an annual physical and random testing. Random testing is generally confined to situations in which an overriding consideration of either security or public trust is at stake.

The most common reasons cited for instituting a substance abuse policy are safety for the worker or fellow worker, health concerns, decreased productivity, security and public trust. Security is generally relegated to industries that serve the public and face the possibility of an accident with devastating affects on the population--like the nuclear power industry. Public trust is generally cited in industries affiliated with transportation (airlines, rail and bus lines) which rely on the general public's utilization for profits.

On the other end of the spectrum are employee concerns. An employee expects a policy to be fair, to provide accurate and reliable results, confidentiality at all times and due process when a positive result is reached. Upon finding a positive result, employees are also concerned that an employee assistant program be provided for rehabilitation, rather than just termination.

The analytical methods currently in use for the detection of abused substances are well researched and numerous articles have been written concerning each technique. An initial screen which tests for the presence of abused substances is performed on urine samples to separate the drug users from the non-drug users. This procedure is followed by a confirmatory test based on a methodology independent from that of the initial screen test. The most widely used methodologies for screening for abused substances include enzyme mediated immunotransmittance, radioimmunoassay and fluorescent polarization immunoassay. These methods are able to detect major classes of drugs, the parent drug or major metabolites of a drug. While they offer excellent sensitivity, these methods are capable of producing false positive results. Therefore, it is mandatory that all initial positive screen results be confirmed by an independent second methodology. …

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