When and How to Drug Test for Drugs at Work
Workplace drug tests continue to be a hot-button topic. Do they work? Are they legal? Do companies have a moral obligation to conduct them? Opinions abound. But instead of focusing on opinions, let’s look at two undeniable facts.
Fact #1: There is a rise in failed drug tests.
Quest Diagnostics reported a 34.5 percent uptick in failed drug tests in the transportation and warehousing sectors. This increase took place between 2015 and 2018. Other industries that saw a rise in failed drug tests include wholesale (20 percent) and construction (13 percent).1
It’s no coincidence that the industries highlighted have their share of safety-sensitive jobs, which follow strict drug testing guidelines; however, drugs or alcohol can impair the performance of any employee regardless of industry or job type. Working under the influence of illicit substances can place the employee, co-workers, and even the general public at risk, and that risk can have costly consequences.
Fact #2: Substance abuse in the workplace costs companies and their workforces.
According to the National Institute on Drug Abuse (NIDA), substance abuse costs companies roughly $740 billion annually in lost workplace productivity, health care expenses, and crime-related expenses.2 Employees with substance abuse issues are statistically more likely to be involved in workplace accidents or worse. In fact, the inappropriate use of drugs or alcohol has been responsible for a surge in workplace deaths. The latest report from the Bureau of Labor Statistics (BLS) indicates that accidental overdoses from nonmedical use of drugs or alcohol while at work increased by 12 percent from 2017 to 2018, and the number of workplace fatalities has increased annually for the past six years.3
While the financial impact of substance abuse at work can be devastating, let’s not overlook the emotional and psychological ramifications. Employee morale can take a hit when an employee gets injured on the job. One can only imagine the psyche of a workforce following a workplace fatality, especially if the cause of death was even remotely tied to the use of drugs or alcohol. Whether an employee suffers from alcohol abuse or prescription opioid addiction, any consequent workplace injury or fatality can have short- and long-term effects that go far beyond a company’s bottom line.
A workplace drug testing program cannot guarantee a company will have a drug-free environment; however, not having an in-depth program in place can leave a company – and its workforce – at greater risk.
Workplace drug testing benefits
Before looking at some of the benefits of drug testing at work, let’s address the misconception that workplace drug testing is more about invading an individual’s rights or privacy – policing rather than protecting.
“Workplace drug testing is not a law-enforcement program,” said Michael Berneking, MD, a medical review officer at Concentra®. “It is simply designed to deter substance abuse.”
Dr. Berneking goes on to explain how, through deterrence, an employer can reap secondary benefits, such as reducing workplace injuries and related health care costs and reducing absenteeism and lost productivity.
Even from the perspective of workplace hiring, by screening applicants for illicit substances, employers can help to reduce the risks associated with workplace substance abuse. Job applicants who abuse drugs and/or alcohol may reconsider applying altogether. Many employers require new-hires to pass a drug screening as a condition for accepting a job offer. This type of drug screening is commonly known as a pre-employment drug test.
Six drug testing scenarios
There are numerous reasons to screen employees for drug and alcohol abuse. Many employers conduct drug tests for work to help maintain a safe workplace, while some companies must conduct them for federal and/or state regulatory compliance. There are six common scenarios for drug testing employees. Pre-employment testing has already been mentioned. Here is some basic information on five other scenarios for drug testing at work.
Reasonable Suspicion/Cause: If an employee’s appearance, behavior, speech, smell, etc., causes an employer to suspect drug or alcohol abuse, that employee may be subject to this drug screening.
Random Testing: Random tests help encourage employees to remain drug and alcohol-free throughout their employment. The tests must use a random selection process where every employee has the same chance of being selected for screening. Some tests even include small windows of time to complete the drug test.
Post-accident Testing: If a workplace accident is possibly the result of drug or alcohol abuse, the employer can require a drug screen. Employers should keep in mind that, per Occupational Safety and Health Administration (OSHA) post-accident drug testing provisions, drug testing can only be required if there is reasonable suspicion that the use of an illicit substance was a factor. For employees regulated by various federal agencies including DOT, there are specific regulations detailing when post-accident testing is required.
Return-to-duty Testing: A return-to-duty (RTD) test is conducted with employees who test positive for illicit substances or violate a company’s substance abuse policy. These employees must pass a drug test before returning to work in their assigned role. RTD testing guidelines vary for regulated and non-regulated workforces.
Follow-up Testing: An employee may be tested periodically upon completing the RTD process. This drug test may be administered in addition to random testing on an unannounced basis at least six times in the first 12 months following an RTD drug test.
Common drug test specimen types
When an employer elects to conduct drug testing, a decision has to be made about how testing will be conducted – specifically, how will drug test specimens be collected. The four most common sample types – urine, blood, saliva, and hair – may differ by detection time, ease of collection, and cost. There’s an ongoing debate over which testing method is best. Each specimen type has its pros and cons. Here are some basic facts about each one.
Urine Drug Testing
Urine samples are relatively simple to collect and noninvasive for the employee. They are usually the least expensive of the drug test methods, are effective at detecting recent drug use, and many regulated tests require urine testing. However, while urine samples can detect the presence of illegal drugs, they can’t determine impairment.
Blood Drug Testing
Blood samples are more expensive and more invasive than other drug test samples. They are very accurate and can provide a level of the drug in the bloodstream. Because they are invasive and have longer processing times, blood samples are more likely to be used in medical settings and for legal investigations, instead of routine employment-related drug testing.
Saliva Drug Testing
Saliva samples are typically more expensive than urine samples and are also relatively noninvasive. Saliva is becoming a more popular drug test sample because it’s easy to collect and it’s the best for detecting recent use, but it requires a more extensive lab process to ensure accuracy.
Hair Drug Testing
Hair samples are the best choice for detecting long-term drug use, but they do not usually detect use within the past week making them a poor choice for post-accident or reasonable suspicion testing. Hair testing is a little more expensive and requires a specified amount of hair, so this can be difficult when testing people with short or no hair.
Employers have several factors to consider when choosing a specimen type, such as the desired window of detection, testing cost, and even state and federal drug testing laws that could determine which specimen type to use.
Understanding drug testing rules
Knowing when and how to conduct drug tests at work is essential to fostering a drug-free workplace culture. It’s also important from a compliance standpoint. The many regulations surrounding drug testing make it a legal minefield, and navigating it can be challenging.
“Drug testing is a very complicated issue, and it is affected by not only federal law, but state and local statutes as well,” Dr. Berneking explained.
Whether a company operates under federal guidelines or in the private sector, it has a right to conduct drug screenings for safety and health reasons. As a matter of best practices, employers should have a firm understanding of all applicable drug testing regulations; therefore, a company’s drug testing policy should be vetted by the appropriate risk management and legal authorities. This helps to ensure an employer’s drug testing policy and procedures align with applicable local, state, and federal testing guidelines. It also protects both the company and its employees. Otherwise, a company could make costly mistakes, such as applying regulated drug testing requirements to non-regulated employees, and vice versa. Another common mistake involves companies that operate in multiple states but are not well versed in state-by-state drug testing guidelines.
“Your medical review officer may or may not be familiar with all the laws,” said Dr. Berneking. “They are required in the regulated world only to be familiar with federal regulations and the regulations of the states they work in.”
Larger companies may have a risk manager and/or legal counsel on staff, but many smaller businesses may lack the budget to afford these full-time staff members or the workforce size to justify them. On top of providing the clinical services required for workplace drug testing, an occupational medicine clinician can also serve in a consultative role, supporting the efforts of company risk managers or offering insight into how employers with no in-house risk-management team can maintain drug testing compliance.
Establishing a program for drug tests at work
Why does workplace drug testing matter? As statistics show, the effects of substance abuse are costly to employers. Many employers question whether substance abuse is a real issue for them, but when the National Council on Alcoholism and Drug Dependence (NCADD) reports that more than 70 percent of those who abuse drugs are employed, it’s hard not to view it as a widespread workplace issue.
The steps required to establish a drug testing program often vary by the employer, as employers have different drug testing needs and requirements based on their industry and any applicable government regulations. But once a written, detailed policy has been established, it should be distributed to the entire workforce.
Training your workforce on company drug testing standards is also a necessity – especially for managers or supervisors. Training should include explaining the different aspects of your drug testing program, such as:
- Protocols for executing the drug testing policy
- Policy rules and expectations
- Testing guidelines
- Consequences of violating the drug policy
Now that you know some of the essentials to workplace drug testing, it’s time to establish, or re-establish, your drug testing program. Concentra can help. Along with expertise and experience, we offer comprehensive workplace drug testing services for employers of all sizes and industries.
- Workforce Drug Positivity Increases in More Than One-Third of U.S. Industry Sectors Examined, According to Quest Diagnostics Multi-Year Analysis. (2019, September 11). Retrieved February 10, 2020,
- Trends and Statistics, According to the National Institute on Drug Abuse. (2020, February 6). Retrieved February 10, 2020.
- National Census of Fatal Occupational Injuries in 2018, According to Bureau of Labor Statistics. (2019, December 17). Retrieved February 10, 2020.