Alcohol and drug abuse in the workplace are an increasing concern. (Well, drug abuse is. Alcohol abuse gets a nod and a wink.) Drug abuse, especially opioid abuse, is increasing rapidly, and so are overdose deaths due to addicts switching from relatively safe (if addictive) prescription painkillers to heroin or even more powerful prescription opioids such as fentanyl.
Drug abuse treatment is difficult and expensive, and besides many people (especially in government) are less interested in treating addicts than punishing them for their moral failings. To that end, workplace drug testing is a big business and becoming bigger every year.
In the United Kingdom, alcohol and drug abuse cost an estimated £36bn a year. That has driven UK drug testing market revenue to as much as £167m and may be £231m by 2019, mainly due to its popularity and accuracy for family law, workplaces, and law enforcement.
The UK may have the highest number of addicts per capita in the EU – its reputation, deserved or not, is as the Addiction Capital of Europe – but it is a tiny share of the overall global drug testing market of £3.8bn – predicted to rise to about £6bn by 2022.
(More than half of all drug testing is in North America. In some parts of the United States, some businesses are having a difficult time finding new employees who can pass a drug test, or are even willing to try.)
With that much money at stake, drug testing companies have an incentive to tout the value of their services. There’s some disagreement as to how relevant substance abuse testing in the workplace is to productivity, safety, employee attraction and retention, however.
Tests Don’t Always Include Opioids, Alcohol
For one thing, the tests don’t always check for the prescription opioids. A 2017 National Safety Council study found that of the 57% of companies that conduct employee drug testing, only 59% check for synthetic or semi-synthetic opioids. A test for natural opiates, such as heroin may not detect them.)
It’s not that employers aren’t testing for enough drugs, but that a company’s drug test established decades ago, may be testing for the wrong drugs, drugs that are not used any longer, such as Quaaludes.
On the other hand, they almost never test for alcohol, which is abused more than cannabis and opioids combined.
A new US Department of Transportation rule will for the first time require that the semisynthetic opioids – buprenorphine (Suboxone), oxycodone (OxyContin, Percocet), hydrocodone (Vicodin), hydromorphone (Dilaudid) and oxymorphone (Numorphan) – that are the most visible symbols of the opioid epidemic will be included in the screen. Notably missing is fentanyl, the drug contributing to many, maybe most, recent opioid overdoses.
A Cannabis Conundrum
If the tests don’t look for alcohol or opioids, the main drug they will find is cannabis.
Even in states where it is legal, companies can decline to hire cannabis users. Those that do risk missing out on a significant part of the populace, however. Law enforcement frequently disqualifies applicants who have used within the past two years. A third of college students polled admitted to using cannabis in the previous year.
A problem is that unlike alcohol and opioids, cannabis remains detectable in the body much longer than its intoxicating effects. A weekend imbiber who may be stone cold sober during the work week can be punished by a random drug test that hasn’t negatively impacted his work performance.
Reasons for Drug Testing
Despite the ills associated with substance abuse and addiction, the same can be said for alcohol, opioids, heroin and other drugs. If it doesn’t affect their work performance, some argue that it isn’t the employer’s business. A stimulant such as cocaine or Adderall can even improve performance, at least in the short term, though it has long-term health and behavioural effects.
The incident that arguably launched the drug testing mania – a twin-engine plane crashing into the deck of the USS Nimitz in 1981 – did detect marijuana use by some crew members, but the crash was attributed to the use of cold medicine by the pilot.
It’s understandable that a company wouldn’t want to trust a drug user with operating heavy equipment, such as an aeroplane, but such tests are sometimes required when there is considerably less risk of injury.
A Slate.com writer reported that a research editor friend was required by her employer to take a urine test.
One statistical benefit of workplace drug testing, even in Europe, is that once it is introduced, the rates of drug abuse detected usually decline. Whether this is due to fear of getting caught and losing their jobs, drug rehab treatment through work or just that people who use drugs stop applying for jobs in companies that test for drugs is not known.
The Impairment Test Alternative
A better test might be one that measures impairment for whatever reason, not an arbitrary percentage of intoxicant in the urine, blood or spit. If workers don’t show up looking clean and groomed, can’t stay focused, and do the work, it shouldn’t matter if it’s because of drugs or some other cause. They need help, need to improve or get out.
Impairment tests measure cognitive ability, such as hand-to-eye coordination and reaction time, plus eye movements and agility. That’s a better indicator of work fitness than drug testing.
Alcohol and Drug Rehab Treatment
Employers providing help for alcohol and drug abuse is not just compassionate, not just recognising that addiction is in many ways a disease, but a necessity as the workforce grows tighter and substance abuse rates get higher. Keeping qualified, experienced and trained employees is vital.
Major insurers now offer substance abuse treatment coverage, are in fact required to offer it by the terms of the Affordable Care Act also known as ObamaCare. Workers who have employer-provided healthcare through Aetna – which CVS Pharmacy is attempting to buy – have access to an Aetna rehab provider network. Those insured by United Healthcare and Blue Care Network can avail themselves of the medication-assisted treatment Probuphine, an implant delivering a steady dose of buprenorphine to opioid addicts to control cravings and withdrawal symptoms.
Privacy Vs. Safety
The reasons why Europe has less drug testing than the US may in part be due to worker privacy rights. In Belgium and Finland, for example, employees can’t even choose to give up such rights, and Europeans, in general, have greater protections than in the US. Canada, too, has more worker protections. Random drug testing is not permitted. Drug testing is allowed only for reasonable suspicion.
In the US, the National Safety Council argues that drug testing should be done before employment, at random times during employment, and following any workplace place “incident” that could be caused or aggravated by substance abuse. This seems motivated at least as much to protect employers from liability and litigation as their workers’ health or even productivity.
The costs associated with drug testing are increasing in Europe as well as the US. No one can say categorically that the cost is worth the benefit, except to the companies providing the drug testing services.
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