Drug and Alcohol Testing in the Workplace: A Review of Current Testing Techniques

Abstract

Abstract Drug and alcohol abuse continues to be a problem in the workplace and a major public health concern. The cost of drug abuse to the industry runs into billions of dollars and its close association with HIV transmission makes it even more important. Several studies have confirmed that majority of drug users are either employed or potential employees. The prevalence of substance abuse is also rising steadily. Many employers therefore now have drug and alcohol policies, which are enforced to varying degrees. The indications for testing and the drugs tested for, also vary from one company to the other, and so does the testing process. Several user-friendly drug-testing (screening) kits have also appeared in the market for on-site drug testing on subjects' urine, oral fluids or hair. Cut-off points are also changing. This paper provides a general overview of drug and alcohol programs in the workplace and discusses our 8-year experience between 1993 and 20011,2. Introduction The abuse of drugs and alcohol is widespread, and along with its related crimes, permeate every corner of our society. It afflicts urban and rural areas, the rich and the poor, educated and uneducated, the workplace and the sports arena. Broadly defined, drug abuse covers any activity involving illegal drugs, chronic or improper use of alcohol, and misuse of over-the counter drugs and prescription medication. Although any drug may be abused, whether legal, over-the-counter, prescription or illegal, the ones most commonly abused are those that are capable of altering mood, behaviour, perception or mental functioning. Unfortunately, the abuse of such mind-altering drugs often leads to drug dependence, a state in which the individual loses control over the use of the substance in question and even after realizing the negative effects, still has an increased need to use it. He is also unable to stop it despite attempts to cut down or quit. The final stage of the continuum is that of addiction in which the individual becomes physically and psychologically reliant on the use of that substance and frequently engages in self-destructive and criminal activities to sustain the habit. Also, whether directly or indirectly, drug abuse is now a major vector for the transmission of many infectious diseases including HIV / AIDS, Hepatitis B and C, and tuberculosis. Of all the substances commonly abused, alcohol, marijuana and cocaine are the most troublesome in the workplace today. The common reasons for abusing drugs are shown on Appendix 1. The magnitude of the drug abuse problem Drug abuse statistics from US present staggering figures:Seventy five percent of drug users in America today are employed;Alcoholism alone causes over 500 million LWDs per year;Between 1982 and 1990, about 211,000 people died in alcohol-related highway crashes (an average of 1 alcohol related death every 22 minutes)In 1999, 14.8 million Americans 12 yr. and older (6.7% of that population) were current illicit drug users, and 3.6 million people were dependent on drugs.Alcohol was more commonly abused by young people and in 1999, there were 10.4 million underage current drinkers;11.2 million aged 12 years and older were current marijuana users in 1999, which showed an increasing trend since 1997.3,4 methylenedioxyamphetamine (MDMA, Ecstasy), a synthetic psychoactive drug with stimulant and hallucinogenic properties is increasingly being used by youths.There were 934,000 new cocaine users and 149,000 new users of Heroin in 1998554,000 emergency drug episodes were recorded in 1999, mostly from cocaine, alcohol, and drug combinations,15,973 drug-induced deaths occurred in 1999, primarily from drug consumption, overdoses etc.