Testing For Drugs

Chances are drug-users are more likely to be late, file workers' claim, cause accidents -- and be employed in the construction industry

"We can't afford to lose any employees in this tight labor market even if they are substance abusers." -- vice president of $10 million construction company.

What this vice president didn't fully comprehend was that drug-users are only one-third as productive as nonabusers, three times likely to be late, almost four times more likely to be in a workplace accident and five times more likely to file a workers' compensation claim, according to a research from the National Institute on Drug Abuse.

And, what the owners of the company didn't realize was that their insurance would not pay a claim if it was drug-related and that shareholders could be personally liable for damages.

I recently consulted for a small company that suspected a few employees smoked marijuana. However, the concern became alarming when employees went into the office smelling like marijuana. This signaled several things: 1) the employees were smoking marijuana during working hours; 2) the employees were brazenly flaunting their habits because they knew the employer wouldn't do anything; and 3) the employees didn't realize the problems this would pose with customers and the company's reputation.

More alarming, however, was the fact that the company could go out of business with one drug-related fatality lawsuit. In other words, the drug-user causing the accident would lose a job while the owners of the company would lose their business.

Different Types of Programs

In order to understand drug testing itself, let's step back and look at the different types of substance abuse programs:

Pre-employment
Post-accident
Random

In general, pre-employment and post-accident drug testing are performed at most companies and serve to warn employees that the company is drug-free. However, most pre-employment and post-accident drug testing programs don't deter drug use. With pre-employment testing, users refrain from drugs during the job search so they can pass the test. Then, after accepting the new job, they often start using drugs again. Typically, if the person refrains from using drugs for three days or longer, they will pass a urine test.

Post-accident tests don't deter drug use because many small- to medium-sized companies forget to request a test after an accident or management can't determine when an accident is serious enough to require a test. As a result of their indecision, management simply doesn't test anyone.

Random tests, on the other hand, decrease and deter drug usage. One of the most critical elements of the program is its random nature -- in both who is selected and how often the tests are performed. That is, you might decide to test 25 percent of your employees once a quarter.

Computer-based, random-name-generated software keeps the process completely objective. Consequently, some employees might be tested several times in a row, or they may not be tested for a long period of time -- the nature of random testing. It is for this reason, however, that random testing both decreases and deters drug usage -- employees don't know when they'll be tested.

Urine Vs. Oral Testing

While urinalysis seems to be most common procedure, there are negative elements associated with it:

It takes too long depending on whether the employee is tested on site or is sent to another facility, each test can take anywhere from 15 minutes to an hour including the time to document the test, sign the consent forms, initial the container or urine, etc.

It's urine. Urinating into a container then handing it to the collection person can be humiliating.

It requires special facilities. For example, the collection bathroom can't have running water so the water to the sink must be securely turned off. Or the employee needs to take valuable time off the job to go to a collection site. In some cases, a bathroom-equipped van visits job sites. In any event, special facilities are required that consumes valuable time on behalf of the person administering the program and the person being tested.

It is poor use of staff in administering such a program.

Ironically, not all test subjects disapprove of urinalysis. Adulterating test samples has become an underground science as evidenced by scores of Internet Web sites (more than 40 sites at last count) advertising various methods and products designed specifically to help drug-users beat urine tests. Thus, despite the good intentions of the testing program, the people most in need of intervention often skip through the cracks and cheat their employers.

"Someone adulterating a test is much more likely to be a heavy drug-user," says Michael Peat, Ph.D., president of substance abuse testing for LabOne, Inc. "And now this person is deliberately tampering with the specimen."

Generally, there are three ways to adulterate urine samples -- 1) masking agents; 2) dilution; and 3) substitution. With masking agents, the person being tested can ingest certain chemicals and herbs to mask the effect of the drug. Dilution can be accomplished by drinking a lot of water before the test. And, substitution implies keeping urine in a temperature-controlled container on the person's body along with other means such as buying freeze-dried urine, etc.

As a result, companies may consider the benefits of oral fluid testing. Since it can be done anywhere and anytime and easily observed, oral fluid testing doesn't give an individual the chance to adulterate or substitute a urine sample. In addition, laboratory-based oral fluid tests have indeed shown comparable ability to detect drug use when compared to laboratory-based urine tests.

Another key difference is that oral fluid testing reflects recent drug use whereas other methods can only show that the drug was present in a test subject's body at some point in time. That is, traces of drugs can linger in urine samples for three or more days after use. For workplace accident investigations, that can cloud the picture of whether drug use was the probable cause.

Employers are most interested in detecting recent use -- the person who smokes marijuana, for example, before coming to work or during lunch and/or breaks. In all of these situations, oral fluid testing will be effective. Marijuana takes four to six hours to show up in urine. On the other hand, THC (found in marijuana) will show up immediately with the oral test, but it will only last 24 hours in the saliva.

In other words, if an employee smoked marijuana before coming to work and is tested at noon, the employee will show up and negative with a urine test, but positive with an oral test. (In general, the window of detection is roughly the same for cocaine, opiates, amphetamines and PCP.)

Implementing Oral Testing

Now that we've established the advantages of oral fluid testing, let's look at how easy it is to collect the sample. Basically, the kit comes packaged with a small swab that resembles a toothbrush without bristles, and a specimen vial to hold and protect the swab during shipping. The administrator opens the outer packaging so that the person being tested can remove the swab by its handle. The donor simply puts the swab between the lower cheek and gums for two minutes to collect the sample. The administrator opens the vial and gives it to the donor to insert the swab and snap off the handle for shipping. The donor then accepts the cap and seals the vial with tamper tape. Called the SWAB, SNAP and SEAL method, the entire test takes less than three minutes.

The kit is then sent via overnight courier to a certified laboratory for testing. Just as with traditional urine testing, samples go through an enzyme immunoassay (EIA) screen and, when screening results are positive, a gas chromatography/mass spectrometry (GC/MS) confirmation process. The lab posts negative test results within 24 hours, and can confirm positive results within 72 hours.

Oral fluid testing done in-house cost between $45-$55, (there is a discounted price for PHCC members). Downtime and delays, adulteration and dilution are virtually eliminated in this new process.

One final note regarding liability: Many companies erroneously think that by hiring a third-party administrator -- and this is usually the case with urine testing -- that the company is out of the liability loop. This is, if an employee sues someone for an incorrect urine test, they'll sue the third-party administrator. Wrong. The fact that a company approved the third-party administrator draws the company in to a lawsuit.

On the other hand, a self-administered test such as we've described with oral testing helps protect the company. In this case, the employee is the only person to touch the swab. In addition, the employee places a seal over the top of the swab container and initials the seal indication that the administrator did not touch the sample. In other words, the employee essentially signs off that no tampering took place and can only sue himself.

Drugs At Work

Research usually convinces companies to proceed with random testing. Take your pick from the following:

Employees diagnosed with drug or alcohol dependencies were up to 20 percent more likely to be injured on the job than those not abusing drugs or alcohol, according to the Pacific Institute.

Only 3 percent of small businesses have drug testing programs and only 12 percent have a formal policy, according to the U.S. Department of Labor's Bureau of Labor Statistics. In contrast, among larger companies, those with 250 or more employees - 46 percent test their workers and 74 percent have formal antidrug policies.

Almost three-quarters of the nation's 11.7 million drug-users are employed and as many as 23 percent of them use illegal drugs on the job, according to the National Institute on Drug Abuse. The cost to businesses of drug use is $75 billion-$100 billion in lost productivity, higher health care costs and workers' compensation costs. Also, drug-users have higher absentee and tardiness rates than non-abusers.

As if all these statistics aren't enough to convince a company of the need for a drug policy and testing, according to the National Institute on Drug Abuse's National Household Survey on Drug Abuse, conducted in 1991 the construction industry has the highest percentage of drug abusers:

Percentage of full-time employees, ages 18-34 using drugs by industry.

Construction 15.5%
Wholesale Trade 13.6%
Retail Trade 12.2%
Repair Services 11.3%
Transportation 9%
Finance 8.8%
Manufacturing 8.2%
Professional 6.5%

Source: National Institute on Drug Abuse

What To Expect

I've implemented substance abuse programs at companies that told me point blank that they didn't have a problem and I wouldn't find any "druggies" at their company. They made similar assertions that having a drug program would tell the employees that company management didn't trust them.

One such company that said it didn't have problem decided to implement a random substance abuse program. They anticipated a mildly negative reaction to the announcement of the program, but the response was much more than mild. During the next week, employees stormed into the office one-by-one and told management this program was against their constitutional rights. Some even admitted smoking marijuana, but said it was on the weekends and that management had no right to control their free time.

The company held a voluntary evening meeting of all its employees, and let an attorney make a presentation and answer any questions. Management thought perhaps 50 percent of its employee would attend; however, they all attended. The employees patiently listened to the presentation, but afterward the questions came one after another with heated debate.

The company tried to be compassionate about the program and delayed the implementation by six months to allow employees to eliminate drugs from their systems. The company also offered free rehab with no repercussions to anyone who volunteered, and offered re-employment to any employee who completed a rehab program after testing positive.

After the first round of tests, the company had no positives. This confirmed the original impression. However, these results are exactly what to expect at the start. That is, the employees want to keep their jobs and will be for careful for the first six months. After that, they typically start taking chances.

This is just what happened. In total, during the first year the company lost 20 percent of its workforce to marijuana and cocaine. Most of these people were the same ones who contested the program from the beginning. That was a staggering number, especially when it was compared to the national average of 10 percent.

However, the surprise was that sales did not decrease 20 percent with 20 percent fewer employees. Instead, sales attributed to the loss dipped 4 percent, thus fulfilling another prophesy -- drug-users are only one-third as productive as a drug-free employee.

The company didn't have any success stories regarding employees who entered rehab. Most dropped out during the process. In hindsight, the company should have eliminated the rehab provision from its policy. That is, if a person tests positive, he is now fired immediately. Although it seems compassionate to give an employee a chance, it also enables him to "take a chance" because he knows he won't be fired. Also, dealing with the rehab issue consumed far too much management time.

Strategically and financially, the company replaced the employees and has increase revenues. As an added benefit, it switched insurance carriers and saved approximately 20 percent of the premium partially due to the no-nonsense drug policy.

From a nonquantitative perspective, employees said they were glad the company implemented the program because they felt safer. Now they know the person working next to them is drug-free and probably won't contribute to an injury or death.

In turn, morale is higher. Not only do the employees feel safer, they know the company wouldn't tolerate drug-users.

Was it a headache? You bet. Would management do it again? Absolutely. The temporary dip in revenues was inconsequential to the increased morale among the employees, and it feels good to work in a drug-free environment.