Work-Place Alcohol and

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Work-Place Alcohol and Other Drug Testing Dr.
Cameron Wild Associate Professor University of
Alberta Addiction and Mental Health Research
Laboratory Centre for Health Promotion Studies,
and Department of Public Health Sciences
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• Work-Place Alcohol and
• Other Drug Testing
• History and context of the issue
• Technologies for drug testing
• Evidence underpinning drug testing
• Prevalence of drug use and industrial accidents
• Alcohol and other drug use in Alberta
• National workplace drug policy survey
  Preliminary results
• Unintended negative effects of drug testing

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• 1. History and context of the issue
• In 1986, an Executive Order was signed promoting
  the establishment of a drug-free federal
  workplace in the USA
• A policy was adopted to implement random drug
  testing in aviation, rail, mass transit,
  trucking, and pipeline occupations
• A 1993 survey reported that 85 of large US firms
  had instituted testing programs for illicit drug
  use
• Alcohol testing in US workplaces is much less
  common

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• 1. History and context of the issue
• In Canada, random drug testing in workplaces is
  generally occurs much less often
• However, following the US lead, testing for
  illicit substance use is much more prevalent than
  alcohol testing
• Recent court cases (TD Bank, Imperial Oil) in
  Canadian worksites have challenged the practice
  of random drug testing

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• 1. History and context of the issue
• Why do firms engage in alcohol and other drug
  testing?
• Reason 1. Workplace safety. Policy statements
  from Canada, Australia, Netherlands, France,
  Sweden reveal either explicitly or implicitly
  that workplace safety is the most frequently
  offered justification for workplace drug testing
  programs. This rationale relies on economic
  costs and cost-saving arguments.
• Reason 2. Identifying employees engaging in
  illegal behaviour. This rationale likely
  accounts for the imbalance of existing testing
  programs toward detection of illicit drug use,
  rather than alcohol use.

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• 1. History and context of the issue
• Why do firms engage in alcohol and other drug
  testing?
• Reason 3. Corporate symbolism. Many firms
  believe that it is simply good public relations
  to promote drug free workplaces.

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• 1. History and context of the issue
• Why do firms engage in alcohol and other drug
  testing?
• All 3 reasons raise important questions What is
  the scientific evidence for or against alcohol
  and other drug testing? Do they actually improve
  workplace safety? Do they effectively identify
  employees engaging in illegal activities? What
  are the impacts of symbolic policies toward
  employees?

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• 2. Technologies for drug testing
• Alcohol testing administration of a breathalyser
  to employees to determine Blood Alcohol Content
  (BAC)
• Other drug testing obtaining a urine sample from
  employees, which is then analyzed in a laboratory
  for the presence of drug metabolites
• These tests can be implemented in different ways
  random testing, testing in situations of probable
  cause, and pre-employment drug tests

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2. Technologies for drug testing
Drug effects and intoxication need to be
understood from a dose-response perspective
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2. Technologies for drug testing
Techniques for detection depend on drug
elimination Elimination time varies across
different drug classes
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• 2. Technologies for drug testing
• Alcohol testing breathalyser test results can
  detect level of alcohol in the blood. Can be
  administered in the workplace and results can be
  obtained almost immediately
• Other drug testing obtaining a urine sample can
  only determine whether drug metabolites are
  present in the body. Urine tests therefore
  cannot be used to determine when or how much of a
  drug was taken.
• Detection periods (time between ingestion of a
  drug and a positive test) vary across drugs.
  Morphine can be detected for a couple of days,
  cannabis for several weeks

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• 3. Evidence underpinning drug testing
• Laboratory evidence
• Over 50 years of laboratory evidence shows that
  psychomotor abilities deteriorate considerably
  with ingestion of alcohol
• For other drugs, some produce large performance
  deficits others produce minor or no changes
• Examples benzodiazepines (e.g., valium) reduce
  psychomotor performance opiates do not affect
  human performance at low moderate doses
  stimulants (amphetamines, cocaine) do not
  undermine performance mixed evidence for
  cannabis
• Pharmacological properties and effects on human
  performance varies considerably across drugs

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• 3. Evidence underpinning drug testing
• Epidemiological evidence
• Useful for determining whether alcohol/other drug
  use causes workplace accidents
• Alcohol most studies of BACs among injured
  workers are methodologically weak (no control
  groups) and are too few to conclude that drinking
  is a major factor for work injuries/accidents
• Alcohol alcohol involvement in work injuries is
  small, estimated to be between 3-4 in one review
  and 4-11 in another review
• Extremely reliable dose-response relationship
  between BAC and traffic collisions. Relative
  risk of collision with a BAC of .08 mg is about
  2 and rises to between 12 and 100 at .16 mg

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• 3. Evidence underpinning drug testing
• Epidemiological evidence
• Other drug use existing evidence is sparse and
  inconclusive with respect to a causal link
  between other drug use and workplace accidents
• For studies in this area, it is generally unknown
  whether any individuals involved in job accidents
  were actually under the influence of other drugs
  at the time of accident
• A 1991 study in Alberta toxicology reports from
  459 deaths from work injuries found that 8.5
  tested positive for cannabinoid metabolites, 6.7
  tested positive for other nonprescription drug
  metabolites

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• 4. Prevalence of drug use and industrial
  accidents
• Survey research
• Alcohol use by far the most used drug (80 of
  the population in most industrialized countries)
• Other drug use much less prevalent (in order
  benzodiazepams, cannabis, amphetamine, cocaine)
• If few people use other drugs, and fewer still
  use drugs on the job, then the proportion of job
  accidents caused by other drug use is probably
  low
• Less than 10 of respondents who use other drugs
  also report using at the workplace at least once
• Newcomb Little justificationfor the widespread
  concern if not hysteria regarding drug abuse at
  work

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• 4. Prevalence of drug use and industrial
  accidents
• Keeping things in perspective
• Workplace accidents/injuries are caused by a wide
  range of factors poorly maintained equipment,
  inadequate training/supervision, sleep problems
  (possibly the most important lifestyle
  contributor to industrial accidents)
• Given the relatively small contribution of
  alcohol/other drug use to work injuries, the most
  effective programs should target a broad range of
  factors in addition to alcohol/drug use

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5. Alcohol and other drug use in Alberta

• Use among Alberta Adults
• Current drinkers 79.3 AB, 74.1 CAN
• (National Population Health Survey, 1998/1999)
• Litres alcohol/person 8.7L AB, 7.7L CAN
• (Statistics Canada, year ending March, 2002)
• Sales per capita 111.6L AB, 104.2 L CAN
• (Statistics Canada, year ending March, 2002)
• Heavy drinkers 22.5 AB, 20.1 CAN
• (5 drinks on 1 occasion, 12 times/year
  Canadian Community Health Survey, 2000/2001)
• Alcohol dependent 3.5 AB, 2.6 CAN
• (Canadian Community Health Survey, Mental Health
  and Well-being, 2002)

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• 5. Alcohol and other drug use in Alberta
• Alberta Alcohol Survey
• Population survey of over 10,000 Alberta adults
  18 years of age
• Designed to describe prevalence of alcohol
  problems across the province
• Alberta Addiction Survey
• Population survey of over 3500 Alberta adults 18
  years of age
• Designed to describe prevalence of other drug use

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5. Alcohol and other drug use in Alberta

• Use Edmonton Adults
• Current drinkers 81.0
• Problem drinkers 14.7
• Men more likely to
• -be problem drinkers
• -be alcohol dependent
• -believe they cannot cut
• down without help
• -be willing to cut down
• -seek treatment
• Women more likely to
• -abstain
• -have interest in self-help

Source Alberta Alcohol Survey (2002)
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5. Alcohol and other drug use in
Alberta Alberta-wide data on problem drinking
Source Alberta Alcohol Survey (2002)
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5. Alcohol and other drug use in
Alberta Self-reported use of other drugs in
previous 12 months
Source Alberta Addiction Survey (2002)
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5. Alcohol and other drug use in Alberta

• Alcohol continues to be the most-used drug
  across the Province
• (80 of adults surveyed)
• Of those who drank alcohol in the previous
  year, about 15 can be
• classified problem drinkers (more likely
  to be young, male, low
• levels of education)
• Of those who drink alcohol, 4 or less
  exhibit clinical symptoms
• of alcohol dependence
• Cannabis use is reported by about 14 of
  Alberta adults (i.e., used
• once or more in previous 12 months)
• Nonmedical use of painkillers, sedatives
  next most popular drug
• of use

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6. National workplace drug policy survey
Proportion of firms with 100 employees reporting
EAP programs (preliminary sample of 476 companies)
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6. National workplace drug policy survey
Proportion of firms with 100 employees reporting
health promotion programs (preliminary sample of
476 companies)
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6. National workplace drug policy survey
Proportion of firms with 100 employees reporting
worksite alcohol/drug screening (preliminary
sample of 476 companies)
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• 7. Unintended negative effects of drug testing
• Crant Bateman (1990) gave descriptions of a
  potential employer to respondents and manipulated
  drug testing (present or absent) and need for
  drug testing (high or low). Results were that
  people had more positive attitudes and intentions
  toward companies that did not have drug testing
  programs and toward companies that did not need a
  testing program
• Konovsky Cropanzano (1991) reported that
  perceived fairness of drug testing procedures
  predicted trust in management, job satisfaction,
  commitment to the organization, turnover
  intentions

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• Summary
• Current alcohol and other drug detection
  technologies are not uniformly effective in
  determining whether workers are intoxicated on
  the job
• Alcohol use by far the most likely problem in
  relation to worksite safety
• Remember that best evidence to date indicates
  that alcohol and other drug use accounts for a
  small proportion of worksite injuries. Other
  factors, such as sleep deprivation, need to be
  addressed in comprehensive employee programs

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• Summary
• Larger Western Canadian companies may have more
  employee programs, including drug testing
  programs, compared to other areas of Canada
• Remember that evidence suggests that employee
  loyalty, intentions to leave, etc. are strongly
  affected by how employees perceive implementation
  of drug testing policies
• Be honest about whether the goals of implementing
  a worksite drug testing program are to serve
  safety, criminal, or symbolic purposes