Testing Under the Influence

Rarely are California's doctors, unions and the Republican Party on the same page -- but this year, Proposition 46, which would mandate drug testing for doctors, is making some strange bedfellows.
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Workplace drug testing isn't effective. So why do we do it?

Rarely are California's doctors, unions and the Republican Party on the same page -- but this year, Proposition 46, which would mandate drug testing for doctors, is making some strange bedfellows. Doctors are fighting back against what they see as an intrusive and useless practice, but they would hardly be the first group to be subjected to drug testing as a condition of employment.

Today over 60 percent of American employers insist on testing their workers. But there are many drawbacks to indiscriminate testing, including its questionable efficacy, the loss of privacy, loss of employment and more. It's past time we as Americans reexamine our commitment to suspicion-less drug testing in the workplace.

Ironically, workplace drug testing is largely the product of legislation initiated during the Reagan years. In 1986, as part of the War on Drugs, the administration issued an Executive Order requiring that federal agencies and employers with federal contracts begin testing their employees. Their position was codified with The Omnibus Transportation Employee Testing Act of 1991. Private companies across the country began to follow suit, and since then workplace drug testing has grown into a billion dollar industry.

As the industry grew and everyone from lab technicians to substance abuse counselors to specimen collectors benefitted, the assumptions behind it became more and more entrenched (and with federal legislation on the books, few were willing to look at it critically). On its face, the argument seems logical: Drug testing will improve safety in America's workplaces by discouraging people to use. But whether or not drug testing actually makes us safer is very much up for debate -- and in fact, there is no real evidence that drug testing workers improves safety at all.

This is for two main reasons. First, the vast majority of workplace drug tests are performed through urine analysis, because urine tests are the only method approved for federally-mandated testing. The problem with urine analysis, as opposed to blood testing, is that it registers residual metabolites present in people's systems. That means they can't tell the difference between someone who smoked marijuana over the weekend and someone who is high at work. So while a positive test might cause someone to lose their job and damage their reputation, it won't necessarily make anyone safer. Because urine analysis cannot show a correlation between positive results and impairment, there is thus no correlation between testing and safety.

Second, companies rarely test for legal substances like alcohol or high concentrations of prescription drugs. The "Federal 5," or the five substances most commonly tested for, are amphetamines, cocaine, marijuana, opiates and phencyclidine (PCP). But studies show that alcohol is far more widely abused than cocaine and other drugs, and there is a greater correlation between alcohol and workplace accidents than exists with drug use.

So if it doesn't work, why do we do it?

The argument is an emotional one -- not a data-driven one. The fact is that there is not enough compelling evidence that it works to justify the expense. One billion dollars a year is a lot of money that could be invested in programs that have been proven to make people safer, like education, treatment and improved training.

It's also important to note that because many tests are performed pre-employment, there are no regulations covering them. Virtually all of them are simple screens that are not confirmed by a different methodology, and thus are not forensically defensible. That means that thousands of people each year may be denied employment because of shoddy testing.

Also, this is America. I think we can all agree that urine is an inherently private matter, and that being required to strip, urinate and then hand your urine over to your boss falls outside the traditional requirements for employment. To underline that point, I'd like to invoke the words of someone I never before imagined I would quote.

In 1989, Supreme Court Justice Antonin Scalia made the point that "The impairment of individual liberties cannot be the means of making a point... symbolism, even symbolism for so worthy as cause as the abolition of unlawful drugs, cannot validate an otherwise unreasonable search."

Strange bedfellows indeed.

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