Workplace drug testing: Evidence and issues

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Workplace drug testingEvidence and issues
Ken Pidd National Centre for Education Training
on Addiction (NCETA)

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1. Alcohol, drugs the workplace putting it into a
   safety context
2. Workplace drug testing as a response to safety
   risk

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Workforce workplace use

• Workforce use
• Overall use
• Impact on workplace safety indirect dependent
  on other factors (fatigue, hangover, health
  outcomes, addiction)
• Workplace use
• Use at work/work under the influence
• Impact on workplace safety directly associated
  with use (intoxication/impairment)

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• Alcohol, drugs the workplace
• putting it into a safety context

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Workforce alcohol use by industry
drinking weekly (or more often) at risk levels
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Workforce drug use by industry
of workers using drugs (last 12 months)
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Construction workforce use in context
YES
YES
Drug use
Risky alcohol use
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Construction workforce use in context
Risky alcohol use
Drug use
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Workplace use
Alcohol use at work
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Workplace use
Drug use at work
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Construction workplace use in context
Work under the influence
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Construction workplace use in context
Work under the influence
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Alcohol drug related accidents

• Up to 15 of all workplace injuries/accidents may
  be related to alcohol or drug use
• At least 85 of injuries are not
• Other factors associated with workplace injuries
• Unsafe work conditions
• Fatigue
• Unsafe equipment
• Poor/no training

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2. Workplace drug testing as a response to
safety risk
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Types of workplace tests

• Breath analysis (use increasing)
• Urinalysis (most common)
• Saliva (growing popularity potential)

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Breath Testing

• Advantages
• Onsite test that can reliably indicate alcohol
  intoxication/impairment
• Non-intrusive
• Wide acceptance

• Disadvantages
• Can only detect alcohol use
• Requires constant calibration (can be affected by
  paint solvents)
• Cannot detect hangover effects

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Urinalysis

• Advantages
• In-expensive (test)
• Fully developed methodology
• Fewer sample storage issues

• Disadvantages
• Collection can be expensive time consuming
• Cannot detect impairment/intoxication
• Cannot detect hangover effects
• Long window of detection (cannabis)ay miss

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Saliva testing

• Advantages
• Relatively non-intrusive
• Can detect recent use
• Difficult to adulterate sample

• Disadvantages
• Can be difficult to collect sufficient fluid
• Low reliability (cannabis)
• Cannot detect intoxication/impairment
• Cannot detect hangover effects
• Sample can deteriorate at room temp

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Methods of testing

• On-site screen (initial test)
• Laboratory analysis (confirmation of positives)

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On-site drug screening

• Advantages
• Relatively inexpensive (compared to lab testing)
• Quick cost effective initial screen
• Easy to administer
• Disadvantages
• Cannot distinguish between prescribed drug use
  illicit drug use
• On-site tests have a much lower level of accuracy
  reliability than lab testing
• Subject to user error

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Laboratory drug analysis

• Advantages
• Much more reliable accurate than on-site tests
• Can detect a much wider range of drugs
• Can detect both the level of drug/drug metabolite
  present
• but test itself cannot determine
  intoxication/impairment, amount use or pattern of
  use

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Laboratory drug analysis

• Disadvantages
• Can be expensive time consuming
• Cannot distinguish between legitimate
  prescription drug use and illegitimate use
  without donors medical background
• As with on-site tests, some prescribed drugs/food
  stuffs can produce false positives
• As with on-site tests, subject to human error

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Testing programs
Pre-employment Post accident/incident Random Fo
r cause
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Pre-employment

• Advantages
• Cost effective method of screening out drug users
• Disadvantages
• Can deter skilled capable workers from applying
• Can screen in some drug users screen out some
  non-drug users
• Limited efficacy
• Rationale based on false assumptions

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Post accident/incident

• Advantages
• Allows collection of statistics on potential
  drug-related incidents
• Disadvantages
• Limited evidence of causal role
• May lead to under reporting of minor accidents
  near misses
• May lead to delay in treatment seeking
• Potential to jeopardise no fault workers
  compensation schemes

(accident/near miss)
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Random

• Advantages
• Possibly most effective method of deterring use
• Disadvantages
• Receives least support from employees
• Most open to employer abuse
• Fosters culture of mistrust

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For cause

• Advantages
• Only applied to individuals suspected of drug
  use/impairment
• Disadvantages
• Can be used to victimise employee
• Subjective application

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The efficacy of testing

• Deterrence effect?
• Reduces prevalence of injuries/accidents?
• Improves safety?
• Cost effective?

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Main problems with workplace testing

• A test can only determine past drug use

• It cannot determine
• the degree of impairment/intoxication
• except alcohol breath analysis
• the amount used or the time of use
• how it was administered
• If the person is a chronic/casual user or an
  addict
• If the drug was prescribed

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• Testing may mask the true extent of risk
• Underreporting of accidents near misses
• Avoidance
• Change in pattern of use, masking agents, sample
  substitution
• Testing may contribute to the risk
• Displacement to more dangerous - but less
  detectable - drug use (ice/speed, synthetics)

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Australian standards

• AS 4760 2006
• Procedures for specimen collection the
  detection quantitation of drugs in oral fluid
• AS/NZS 4308 2001
• Procedures for the collection, detection
  quantitation of drugs of abuse in urine
• Problems
• Voluntary
• Mainly apply to laboratory, not on-site testing

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Other issues

• Lack of industry regulation
• Lack of relevant legislation
• Limited understanding of testing
• May divert resources away from more effective
  strategies
• Focus on individual worker
• Employer control/intrusion

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Thank you
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• Consultancy Advice on
• Workplace AOD policies
• Workplace AOD intervention strategies
• Tailored employee awareness education sessions
• Tailored supervisor OHS staff training programs
• Evaluation of education, training intervention
  strategies

www.nceta.flinders.edu.au