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A critical assessment of the impact of drug testing programs on the American workplace - Executive summary

 by Alexander DeLuca, 10/19/2002  
Term Paper, Human Resources Management in Health Care Institutions, Professor O'Connor, Executive Masters of Public Health program, Mailman School of Public Health, Columbia University, New York City

[Executive summary - browser version] [Full text - browser version]  [Full text - print version]  

Is it not economically unjustifiable and morally irresponsible to promote the often indiscriminant use of an intrusive, stigmatizing, very expensive and arguably unconstitutional drug-testing technology whose efficacy has never been demonstrated?  

Origins of drug testing.
In 1986, Reagan made the concept of a “drug free workplace” a national policy goal and mandated every federal agency establish a program of urine drug testing for employees working in “sensitive positions.” In that year, 21% of companies had testing programs; a decade later 81% did and 13% of workers had had a mandatory test.

What is the problem for which drug testing is the solution?
There is no evidence that drug testing can make the workplace a safer and more prosperous environment nor is there any credible evidence that drug testing has any appreciable impact on rates of problematic substance misuse. Rather, the value of drug testing programs is symbolic. Workplace drug testing is a proxy for ‘doing something about the drug problem.’ It stands in lieu of a rational, planned managerial response to the real problems. Having a drug-testing program makes a public statement that the employer is ‘tough on drugs.’

Claims of drug testing proponents: Productivity.
A study by the Research Triangle Institute estimated that drug users cost business $33 billion in “lost productivity.” To get that number they compared the income of households with a daily marijuana (MJ) use to those without, took the difference and multiplied it by the number of MJ users in the work force. One can only comment that a statistic labeled “lost productivity” that is not based on analysis of any actual productivity data is meaningless.

Claim: Drug users cause workplace accidents.
The claim that drug users cause workplace accidents has been conclusively shown to be false. There is no association between drug use, past or present, and accidents.

Claim: Drug users use more medical benefits.
Research on the claim that drug users consume more than their share of medical benefits is equivocal. Some studies do support this claim, others show drug users costing companies less in medical benefits.

Claim: Drug users are associated with increased employee turnover.
The claim that drug users quit or are fired at a higher rate may have some merit. Workers drinking to intoxication or using drugs weekly were more likely to get fired or resign but only a very small proportion of workers fall into this category of use and they are identifiable without the use of drug testing.

Claim: The historical decrease in test positivity rates proves drug testing is effective.
This appears to be true if you only examine drug use rates since 1986 when wide-scale testing was started. However the marked trend of decreasing drug usage began a decade earlier. To claim drug testing caused the decline is, ahh, disingenuous to say the least.

What can drug testing accomplish?
Drug tests cannot detect impairment, shed no light on the intensity or chronicity of use and are entirely useless in distinguishing non-problematic recreational use from use which leads to medical, behavioral or social consequences. A urine drug test administered to workers on arrival at the workplace would more likely be positive in a person who had smoked marijuana three days earlier than it would a person who snorted cocaine in the parking lot and then walked in the door. And alcohol, a substance that is far more widely abused than are illicit drugs, is completely ignored.

Drug testing is expensive.
In 1990 the federal government spent approximately 11.7 million dollars to test workers in some 38 federal agencies. Of 29,000 tests administered, only 153 were positive or about 0.5 percent. The cost per positive drug test to the taxpayer is therefore about $77,000. But because drug testing can only detect past drug use, not drug abuse or drug impairment, the real cost is even higher.

Drug testing is unconstitutional.
The Fourth Amendment requires the government to obtain a warrant supported by probable cause to search a person, the only exception being when the government has demonstrated to the satisfaction of the Court that it has a special need for a search, such as protecting public safety. The crux of the constitutional problem with suspicion-less drug testing: you cannot claim a special interest in everyone.

Why don’t we just declare victory and go home?
Drug (including alcohol) use is not equivalent with drug abuse. By definition, drug abuse is drug use that causes problems or harm to self or others. Frequent, immoderate drug and alcohol abuse does indeed cause problems in the workplace, but this group is underrepresented in the work force and represents a very small minority.  There is no “drug problem” in the workplace that a mass-screening program like suspicion-less drug testing could possibly impact.

There is an alternative…
Suspicion-less drug testing is the antithesis of everything the human relations movement in labor management stands for. It is a paternalistic and degrading technology that establishes a de-facto adversarial relationship between employers and employees in companies that practice it. We have seen that drug testing targets a group of employees, casual marijuana users, which are particularly unlikely to be a source of workplace problems and that it is utterly ineffective in detecting acute or chronic hard drug use or any degree of alcohol abuse. It may be an effective symbol that an employer is “tough on drugs” but it is morally wrong to trash the individual liberties of the many, and cause harm to innocents, in order that the few be punished in pursuit of making a symbolic point. 



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Alexander DeLuca, M.D., FASAM.

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Originally posted:  2002-10-15

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