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Forensic Drug Abuse Advisor Vo. 7 (1) January 1995, p.6

Subcommittees of the National Research Council and the Institute of Medicine have completed a study assessing the extent of drug use in the workplace, and the impact of drug abuse on job performance. Drug testers may be a little upset by some of its conclusions, since the study raises important questions about the scientific rationale for workplace drug testing.

Workplace drug testing is a very big business. The study group estimates that the United States is spending at least 1.2 billion dollars per year on drug testing (24 million tests per year at an estimated total cost of $50 each), not counting any money spent on time lost from work attributable to the testing process. Statistical evidence from a variety of sources suggest that, except for alcohol, drug use in the workplace has been steadily decreasing for the last 15 years (the percentage of heavy drinkers in the population appears to be unchanged). In 1990, the overall rate for workers admitting to having used an illicit drug some time during the preceding month was 7%. However, today in some areas, such as the air transport and nuclear industry, the rate is well below 1%.

No study has ever demonstrated that this decrease is due to the work testing program, nor has it been demonstrated with any certainty that, in commonly used doses, any of the widely abused drugs significantly impacts on job performance. There is, however, good evidence that drug users are more likely to be absent from work, and there is also good evidence that alcohol abuse is associated with increased occupational injuries.

The committee felt that much of the data reviewed for its report was flawed, or at least of dubious statistical power, and they concluded that "the preventive effects of drug-testing programs have never been adequately demonstrated." As Craig Zwerling pointed out in a recent issue of JAMA, Journal of the American Medical Association (272 [18] 1467-1468), the conclusion reached by the study group was the same as that reached in a 1992 study, namely that there was "almost no credible warrant of effectiveness."

Zwerling also went on to note that "a large industry of drug testers has arisen with a financial stake in expanding the market for workplace drug tests. The industry includes the companies that manufacture the equipment and chemicals used in drug testing, the laboratories that carry out the test, the companies that collect the urine specimens, the medical review officers (MRO's) who review the test results, and the consultants who advise companies on drug testing."

The study was sponsored by NIDA (National Institute on Drug Abuse) and the results have been published in book form by the National Academy Press. The full title is "Under the Influence? Drugs and the American Work Force," Normand, J, Lempert, R, and O'Brien, C eds. (Committee on Drug Use in the Workplace, National Research Council / Institute of Medicine). 321 pp $39.95, ISBN 0-309-04885-0

COMMENT: This book should be required reading. Somebody has to do the studies to prove that the whole process works. But who is going to put up the money to do the studies? NIDA has just as big a vested interest in maintaining the status quo as the drug testing companies, and the reagent manufacturers. In fact, it may be too late to ever do the studies that would justify the money and effort being spent on these programs.

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