When Will Testing and Treatment Meet?

By Enos, Gary A. | Behavioral Healthcare Executive, June 2009 | Go to article overview

When Will Testing and Treatment Meet?


Enos, Gary A., Behavioral Healthcare Executive


In this troubled economy, many people unfortunately are turning to alcohol and/ or drugs for temporary relief from multiple problems. Yet as use and addiction tighten their grip, many thankfully also are seeking out treatment providers for help. One tool at clinicians' disposal for assisting clients and enhancing treatment's potential for success is drug testing. This special section presents some perspectives on this important topic.

William Judge regrets the quiet passing of the 20-year anniversary of what he considers a seminal moment in the nation's effort to eradicate problem drug use. In September 2006, the 20th anniversary of President Ronald Reagan's executive order establishing the goal of creating a drug-free federal workplace largely escaped the addiction community's notice.

Judge, an Illinois attorney and expert on drug testing trends and technologies, believes society has largely missed an opportunity to link testing with employee assistance and counseling, which he cites as the primary intent of President Reagan's executive order. Addiction treatment professionals have never truly embraced testing as an integral part of their work, he says, and employers in turn have seen testing more as a tool to weed out employees with problems rather than a vehicle for building a stronger workforce with their existing talent.

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"We do 40 million tests a year, and there are 2 million positives, but these individuals are not getting the help they need," says Judge. "This is an untapped market for clinicians."

In some respects, clinical professionals have largely straddled the fence on the testing issue as testing proponents and civil libertarians continue to argue over legal and policy issues surrounding testing. While most residential treatment programs require clients to submit to drug testing during treatment, and while testing has become a more pivotal element of aftercare, many professionals still don't see testing as having a major role in their work, Judge believes. "Perhaps they feel they're so good at what they do that testing is not needed," he says.

Still a young field

Although many private workplaces had incorporated drug testing programs prior to President Reagan's 1986 executive order, Judge believes the 1986 milestone took the issue of testing to a new level, giving people reason to believe that testing could be a viable industry.

The next significant moment in workplace testing's history occurred with the U.S. Department of Transportation's 1989 issuance of workplace testing regulations for the transportation industries under its jurisdiction, Judge says. The original rules encompassed interstate transportation only and were limited to testing for illegal drugs, but were amended in the 1990s to include intrastate services and alcohol testing, he says.

Also during this period, as more federal agencies formally instituted regulations for workplace testing, the appropriateness of testing was being evaluated in the federal courts. Judge says the U.S. Supreme Court issued its first testing-related decision in 1989. Early court decisions upheld the Federal Railroad Administration's testing program and validated the random testing of customs officials, who carry firearms, Judge says.

"Literally every federal agency's rules were challenged in the courts," Judge says, with the judicial system having to weigh privacy interests against the government's interest in bringing about a drug-free workplace. The vast majority of decisions were issued in favor of the regulating agencies, and soon this created a momentum for more employers in safety-sensitive industries to look at testing, Judge says.

But while more employers started mandating testing, very few were facilitating treatment or other outreach for workers who tested positive, and this remains a problem to a great degree today, according to Judge. …

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