Drug Testing in the Workplace Work-Place Alcohol and Other Drug Testing Dr. Cameron Wild Associate Professor University of Alberta Addiction and Mental.

Drug Testing in the Workplace

Work-Place Alcohol and Other Drug Testing

Dr. Cameron Wild

Associate ProfessorUniversity of Alberta

Addiction and Mental Health Research LaboratoryCentre for Health Promotion Studies, and

Department of Public Health Sciences

Drug Testing in the Workplace

Work-Place Alcohol and Other Drug Testing

1. History and context of the issue2. Technologies for drug testing3. Evidence underpinning drug testing4. Prevalence of drug use and industrial

accidents 5. Alcohol and other drug use in Alberta6. National workplace drug policy survey:

Preliminary results7. Unintended negative effects of drug testing

Drug Testing in the Workplace

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

Drug Testing in the Workplace

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

Drug Testing in the Workplace

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.

Drug Testing in the Workplace

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”.

Drug Testing in the Workplace

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?

Drug Testing in the Workplace

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

Drug Testing in the Workplace

2. Technologies for drug testing

Typical Dose-Response Curve

Dose

Drug effects and intoxication need to be understood from a dose-response perspective

Drug Testing in the Workplace

2. Technologies for drug testing

Techniques for detection depend on drug elimination – Elimination time varies across different drug classes

Half-time Systemic Drug Elimination

0

20

4060

80

100

120

t0 t1 t2 t3 t4 t5 t6 t7

Half-time

Per

cen

t

Drug Testing in the Workplace

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

Drug Testing in the Workplace

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

Drug Testing in the Workplace

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%

Drug Testing in the Workplace

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

Drug Testing in the Workplace

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 justification…for the widespread concern if not hysteria regarding drug abuse” at work

Drug Testing in the Workplace

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

Drug Testing in the Workplace

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)

Drug Testing in the Workplace

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

Drug Testing in the Workplace

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

Alcohol use among adults residing in the Capital Health Authority

0

50

100

150

200

250

300

350

Current Drinker Abstainer

Co

un

t

18-24

25-34

35-44

45-54

55-64

65+

Source: Alberta Alcohol Survey (2002)

Drug Testing in the Workplace

5. Alcohol and other drug use in Alberta

Alberta-wide data on problem drinking

Problem Drinking:

Age x Education Interaction

Age

65+55-6445-5435-4425-3418-24

Pe

rce

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ge

of P

rob

lem

Dri

nke

rs

50

40

30

20

10

0

Education

Lacking high school

High school diploma

Post-secondary

Source: Alberta Alcohol Survey (2002)

Drug Testing in the Workplace

5. Alcohol and other drug use in AlbertaSelf-reported use of other drugs in previous 12 months

SEDATIVES

TRANQUILIZERS

AMPHETAMINES

PAINKILLERS

INHALANTS

MARIJUANA

COCAINE

HALLUCINOGENS

HEROIN

PERCENT

1614121086420

2

2

14

6

2

4

Source: Alberta Addiction Survey (2002)

Drug Testing in the Workplace

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

Drug Testing in the Workplace

6. National workplace drug policy survey

55 60 65 70 75

National

Westernprovinces

Ontario

Easternprovinces

Proportion of Companies

Proportion of firms with 100+ employees reporting EAP programs (preliminary sample of 476 companies)

Drug Testing in the Workplace

6. National workplace drug policy survey

0 20 40 60 80

National

Westernprovinces

Ontario

Easternprovinces

Proportion of Companies

Proportion of firms with 100+ employees reporting health promotion programs (preliminary sample of 476 companies)

Drug Testing in the Workplace

6. National workplace drug policy survey

0 5 10 15 20 25

National

Westernprovinces

Ontario

Easternprovinces

Proportion of Companies

Proportion of firms with 100+ employees reporting worksite alcohol/drug screening (preliminary sample of 476 companies)

Drug Testing in the Workplace

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

Drug Testing in the Workplace

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

Drug Testing in the Workplace

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