An evaluation of preemployment drug testing

Drug analysis for control purposes in forensic toxicology, workplace testing, sports medicine and related areas

This MiniReview describes the present guidelines for drug testing in forensic toxicology, workplace testing and doping control of athletes. Such guidelines are established to secure the chain of custody, from sample collection through analysis with screening, confirmation methods and interpretation, to the final report of results. Specifications for good laboratory practice, facility maintenance and quality assurance programs are described. The advantages and limitation of immunological drug assays and the necessity of specific chromatographic confirmation methods are discussed. The importance of correct interpretation of positive test results is illustrated. The effect of drug testing on the prevalence of drug abuse, accident rates and effectivity at the workplace is discussed.

Preemployment drug screening at the Johns Hopkins Hospital, 1989 and 1991

During identical 2-month periods in 1989 and 1991, all applicants for employment at a major teaching hospital participated in preemployment drug screening. In 1989, before establishment of a formal preemployment testing program, screening was conducted without identifying information. Of 593 applicants screened, 64 (10.8%) were confirmed positive for one or more drugs. Marijuana metabolites were detected with the greatest frequency (35 samples, 55% of positive screens), followed by cocaine (36%), then opiates (28%). In 1991, after a formal preemployment testing program was in place, 365 applicants were screened, and 21 (5.8%) were confirmed positive. Opiates were most often detected (48% of positive screens), followed by cocaine (38%), then marijuana metabolites (28%). During both periods, positive urine screens were associated with ethnicity (non-White) and occupational category (blue-collar). Whereas in 1989 positive screens were associated with male gender, in 1991, females were more likely to test positive. The decline in prevalence following implementation of a screening program supports the notion that preemployment testing can serve as a deterrent for drug-using persons in applying for employment.

Drugs in the Workplace: Setting Harris Straight

Harris purports to set the record straight about drugs in the workplace. Instead, he perpetuates old myths and cynicism about the American workforce and gives us no reason to change our original thesis. That is, generally speaking, the American workforce is sober and its productivity is not affected to any great extent by alcohol and drugs. In our original article we made two points. First, we stated that no one has determined with any degree of certainty the magnitude of the so-called drug problem in the workplace. Even if accurate data were available, it would be difficult to determine whether a given level of use constitutes a significant problem. Second, we pointed out that even if drug use does, in fact, constitute a problem, there is little evidence to suggest that drug testing represents an effective solution. Harris offers no compelling evidence to reject those points.

Drugs in the Workplace: Setting the Record Straight

In a recent article in the Journal of Drug Issues (fall 1992), Crow and Hartman raised a number of questions concerning the magnitude of drug use in the workplace, the efficacy of drug-screening programs, and the use of employment testing in general. Although these authors raised some useful issues, they may have overstated their case. In the present article the author comments on the extent of the drug problem in the workplace and points out an additional, well-designed study that did conclude drug testing may be cost-effective. Similarly, recent federal civil rights laws may have less effect on drug-testing programs than suggested by Crow and Hartman. Finally, employment testing is far more valid and unbiased than suggested by Crow and Hartman.