Dilemmas in Employment Drug Testing

Dilemmas of Drug Testing: The Significance of Testing Modalities
(Urine, Hair, Saliva and Electronic Measurement) in Employee Drug Testing

By Douglas Stellato Kabat, CSW and Joanna Stellato Kabat, CSW

Drug abuse is a major problem in North America.  US government studies indicate that approximately 8% of all adult males, and 4% of all adult females will suffer from a period of drug abuse or dependence in their lifetimes.  The most common problem drugs are marijuana (THC), pain-killing opiates (such as heroin, as well as prescribed medications, such as morphine or Demerol), stimulants, such as cocaine (and crack), amphetamine and methamphetamine, and, in more recent years, "club drugs" such as Ecstasy.  Of these drugs marijuana is most commonly used, with more than half the adult population reporting one or more episodes of use, but cocaine and opiates are the drugs most commonly associated with accident, illnesses, and major criminal acts, such as larceny.

The impact of drug abuse on businesses has been the subject of considerable debate. The US National Institute of Drug Abuse and ther private Institute for a Drug Free Workplace, both cite studies indicating increased absenteeism and illness among illicit drug users, as compared to their non-using peers, as well as problems of theft and violence. Drug testing proponents claim drug abuse costs US industry more than seventeen billion dollars per year. Critics of the "war on drugs," most prominently represented by the American Civil Liberties Union and The Open Society Fund of George Soros, have questioned this data, asserting that drug detection is, in fact, mostly marijuana detection, that routine testing is an unnecessary invasion of privacy, that the economic costs of employee drug abuse has been exaggerated, and that comparisons of companies that drug test to those that do not indicate no difference in losses due to employee theft, illness or accidents. Despite differences of opinion, there is general agreement that cocaine, opiate and methamphetamine users can present serious workplace problem, including a higher risk of accidents, as well as incidents of theft, absenteeism, and even violence. Even one drug-abusing employee can cause enormous damage, but anti-drug test advocates claim few "hard drug" users are present in the workforce.

Arguments over the value and appropriateness of drug testing have focused on urine testing, which is used by about 90% of those companies with a drug-testing program. However, new modalities, including hair, saliva and electronic testing, offer the opportunity to address many of the concerns expressed by anti-test groups, while accomplishing to goal of assuring a safe, sober and healthy workforce.  This article will focus on the employer's choices in drug test modality, and the strengths and weaknesses of each approach to testing. Subsequent articles will focus on problems associated with marijuana and Ecstasy detection, issues of test reliability and accuracy, and policy development and implementation.

Urine testing has dominated the test process for the last thirty years: it is relatively inexpensive, well established, easily implemented in most work settings, and available in both instant on-site and lab based formats. However, urine testing is often perceived as messy, intrusive, and overly sensitive to "recreational" marijuana use. In fact, urine testing can detect marijuana up to six weeks after cessation of use among heavy users, although use by the "recreational Saturday night user" can be detected for only three or four days. Finally, even a cursory examination of the Internet will indicate the myriad, astoundingly creative, and often effective methods available to those who seek to defeat urine drug detection. Despite these drawbacks, urine testing remains an effective method for deterring employee drug use, and remains the testing method most often chosen for pre-employment drug abuse detection.  Both on-site and lab based testing are inexpensive and easily implemented.

Hair, saliva, and electronic testing offer many of the benefits of urine testing, without the invasive, undignified quality of a "pee test," without what many consider "over-detection" of marijuana, and without the many, easy ways sophisticated users have available to defeat urine tests. The new modalities are not only effective, but cost competitive with urine testing

Hair testing is an extremely clean option, involving cutting approximately 120 strands of hair from the back of the head and sending the hair sample to a lab for testing. Results are usually available within two to three days after the lab receives the sample. Hair tests, which detect illicit drug use over the past ninety days, will reveal regular marijuana use, but the one-time marijuana user will typically go undetected. Hair testing is extremely difficult to defeat without massively damaging hair, and if head hair is unavailable or appears damaged, body hair can be used instead. Hair testing is marginally more expensive than urine testing, but is far more effective in identifying users of dangerous drugs, such as heroin, cocaine and methamphetamine. A pre-employment hair-testing program is extremely easy for the employer to establish. However, hair testing is less often used for random testing of current employees, and is unsuitable as a for-cause or post-accident test.

Saliva testing has been touted as a "fitness for duty" test, as its window of detection begins as soon as a drug is ingested. Saliva tests will reveal only current or very recent (within the past twelve hours) marijuana use, but will detect use of cocaine, opiates, methamphetamine and Ecstasy over the past two to three days (urine will detect these drugs for three or four days after use). Saliva is typically experienced as cleaner and less intrusive than urine, and there are currently no known methods for defeating saliva testing. Saliva testing is useful for pre-employment, random, post-accident and for-cause testing. Both lab-based and on-site systems are available; the on-site system offers results ten minutes after taking the saliva sample. Saliva tests compare favorably in price to urine testing.

Electronic testing focuses on "fitness for duty," and allows employers to screen for fatigue, drug and alcohol intoxication, medication effects, stress and illness. The new electronic testing methodology has been used primarily in high stress, safety conscious occupations, such as mining and aviation. The electronic system is based upon development of an individual profile for each employee, which is then used as a benchmark to measure significant deviation from that norm; such deviations reflect the effects of fatigue, intoxication, medication and illness, and can allow an employer to remove a questionable employee from duty until the problem is diagnosed and resolved. Electronic testing is entirely focused on current status, and detects drug or alcohol use (and other problems) only when there is a current impairment in performance.  Electronic testing is entirely clean and does not intrude on the personal life of employees. The electronic system cannot be "gamed" or defeated. If properly introduced, employees readily accept electronic testing. Electronic testing is the fastest and least expensive testing mythology for employers who are interested in large scale testing of current employees, especially where safety considerations are paramount. Since it depends on developing an individual profile for each employee, it is not suitable for pre-employment testing, but it can be used for random, for-cause and post-accident testing.

In deciding on the appropriate drug-test modality, some of the questions employers should ask themselves are:

What is the goal of the testing program?

How serious a problem in drug use among job applications or current employees?

How serious does the firm regard occasional marijuana use among applications? Among current employees?

How serious does the firm regard occasional marijuana use among applications? Among current employees?

What policies are in place for post-accident and for cause testing?

Given the strengths and weaknesses of urine, saliva, hair and electronic testing, which is best for the needs of the company, consistent with company goals?