Policy Statement: Alcohol and Other Drug Testing - National Council on Alcoholism and Drug Dependence

The National Council on Alcoholism and Drug Dependence

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Policy Statement:

Alcohol and Other Drug Testing

Summary of the Issue

Historically, drug testing was most widely used in the treatment environment, to monitor compliance with the treatment regimen or to undermine the denial of the new client about his or her drug problems. Now, many employers have instituted drug testing in the workplace, much of it facilitated by the leadership of the federal government as a major focus of its "war on drugs." Employers contend testing is necessary to control employee drug abuse and its deleterious effects on workplace productivity, safety, and security. Forms of testing include pre-employment, post-accident, for cause and random. Employers are more likely to conduct drug tests on job applicants than current employees; and, job applicants are more likely to test positive than current employees. There are also differences in the drugs which are tested for, although generally, outside the transportation industry, testing for alcohol is rare. Reliability and accuracy of testing and laboratory procedures has improved significantly over the last five years, although concerns remain about the impact of false positives and of testing procedures which reveal the presence of medically prescribed drugs.

Many questions have been raised about the efficacy of drug testing in the workplace including issues of cost-effectiveness, civil liberty concerns, accuracy of results, the exclusion of alcohol from most testing programs as well as concerns about the role of employee assistance programs and treatment opportunities in the context of drug testing programs. Critics have argued that urine screening constitutes a serious invasion of privacy and is a tool limited in its ability to measure actual job impairment.

Since the early 1970s, the National Council on Alcoholism and Drug Dependence, Inc. (NCADD) has served as a national voice for the development of comprehensive therapeutic programs to address alcohol and other drug problems in the workplace. NCADD worked in close partnership with leading business and labor leaders to facilitate interventions for alcoholism in the workplace. As an historical leader in the development of occupational alcoholism programs, now called employee assistance programs, NCADD supports a comprehensive and therapeutic approach to alcohol and other drug problems at the workplace. While alcohol and other drug testing may have an important but limited role in identifying employees suffering from alcoholism and other drug addictions, such testing must be integrated into comprehensive employee assistance programs. EAPs which offer confidential identification and referral services and employer-sponsored health insurance coverage for a continuum of alcoholism and drug treatment services hold the greatest promise for a safe and productive workplace and workforce.

Background

In March 1986, the President's Commission on Organized Crime suggested that drug testing in the workplace, private and public, would deter workers from using illegal drugs, and therefore, reduce the demand. Executive Order 12564, issued Sept. 15, 1986, called for each executive branch agency to establish random drug testing for employees in sensitive positions. Regulations from the U.S. Department of Transportation, Department of Energy, Department of Defense and Nuclear Regulatory Commission extended mandatory testing into regulated businesses in the private sector beginning in 1988. The Drug-Free Workplace Act of 1988 required many federal grantees and contractors to provide drug-free workplaces and the National Drug Control Strategy provides a clear mandate for private sector employers to develop drug-free workplace programs. Neither the Drug-Free Workplace Act nor the National Drug Control Strategy address alcohol use or alcohol-related impairment at the worksite.

In 1988, mandatory guidelines were promulgated for federal workplace drug testing programs and the National Institute on Drug Abuse published a manual for medical review officers. The medical review officer was defined as a licensed physician with knowledge of substance abuse disorders with appropriate medical training to interpret and evaluate positive test results. These developments coupled with NIDA certification of drug testing laboratories did much to alleviate concern about quality assurance and quality control in regard to the accuracy of drug testing practices.

The American Management Association (AMA) has surveyed member organizations each year since 1987 on the prevalence of workplace drug testing. The number of responding companies performing tests has increased from 22 percent in 1987 to 63 percent in 1991. Companies conducting periodic and random tests grew by 97 percent during 1990. From 1987 to 1991, firms reporting that they test only for cause decreased from 85 percent in 1987 to 61 percent in 1991--indicating a substantial increase in companies performing other forms of testing, due in large part to extensive testing requirements imposed on federally regulated companies.

In December 1991, the Intermodal Surface Transportation Act was enacted and signed into law. This law, Public Law 102-240, contains a provision requiring random alcohol testing for transportation workers.

A widely publicized fatal subway crash in New York City apparently caused by an alcohol-impaired motorman who had consistently tested negative for illegal drugs again raised the issue of the effectiveness of illegal drug testing in ensuring a safe workplace. In the wake of the accident, proposals for change ranged from the adoption of random alcohol testing to calls for the implementation of performance testing and the rapid expansion of supervisory training and employee assistance programs.

Despite the adoption of some forms of drug testing throughout large sectors of the business community, controversy on this subject remains. The notable absence of alcohol education and/or testing in most workplaces and the inadequacy of illegal drug testing to measure current impairment remain difficult issues.

Policy Recommendations

Workplace Activities and Policies to Achieve an Alcohol and Other Drug-Free Workplace

NCADD supports the development of employee assistance programs as the primary focal point for education, training and intervention activities aimed at reducing alcohol and other drug problems in the workforce.

All employers should have clear written policies concerning the use of alcohol and other drugs at the worksite. Such policies should include the consequences of alcohol and other drug impairment on the job as well as internal and community-based resources for employees and their families who may be suffering from alcoholism and other drug dependence.

Employers should support the creation of a workplace environment which encourages and facilitates self-referrals through alcohol and other drug education and strong employee assistance programs. Policies should encourage individuals to come forward for help without fear of reprisals and with assurances of confidentiality.

All sectors of the business community need to address prevention and education activities regarding high-risk alcohol use and alcoholism and examine the limitations of current policies which address only illicit drug use.

All personnel should be educated and trained regarding the health and safety risks associated with alcohol use. Supervisors should be trained to identify workers who may be suffering from alcohol or other drug problems. Training and educational sessions should be accompanied by the distribution of a list of resources available through the workplace and through the community for treatment and for self-help groups like Alcoholics Anonymous, Narcotics Anonymous and Al-Anon.

Employees displaying indicators of problem drinking or drug use should be referred to an employee assistance professional where further assessment and referral can be made in a confidential, non-threatening setting.

Alcohol and Other Drug Testing

NCADD acknowledges the widespread use of urine testing for illegal drugs as a component of drug-free workplace programs. NCADD opposes the use of workplace urine testing programs as a substitute for comprehensive employee assistance programs. NCADD questions the efficacy of all drug-free workplace programs, including those which utilize urine testing for illegal drugs, which deny and do not address alcohol as the drug of choice of employed workers.

NCADD acknowledges the potential value in alcohol and drug testing of particular employees when there is reasonable suspicion that the employee is under the influence of drugs or alcohol, or has suffered or caused a personal injury or caused a work-related accident.

NCADD supports the development of the following policies and procedures as critical components of any alcohol and/or drug testing program in the workplace:

Employers must develop a written alcohol/drug testing policy which must contain specific information including who may be tested, the substances for which employees may be tested, the circumstances of testing, and the individual's rights under the policy and the law.

Employers must provide extensive notice of their testing policy.

Employers must use a licensed testing laboratory.

Actual process of collection must be regulated to ensure accuracy, privacy and dignity.

Employers must insure the security of all bodily fluids tested for alcohol or other drugs.

All positive screening tests must be confirmed by a second more accurate test.

Any body fluid testing must be ordered and supervised by a licensed health care professional.

Test results must be confidential and employees must be given access to all information concerning their test results.

Employers should establish notice provisions, grant the individual a chance to explain a positive alcohol/drug test, and provide appropriate time and health insurance coverage for treatment as with any other illness.

Employers should be prohibited from terminating employees following the first confirmed positive test, (solely on the basis of the test) until the employee has the opportunity to participate in a rehabilitation program after an appropriate evaluation for an addictive disorder.

Employers who require pre-applicant drug testing should administer drug tests only after a conditional offer of employment has been made. Applicants rejected on the basis of a positive drug test should be fully informed of the results of their tests and offered resources for alcohol and other drug services in the community. Individuals denied employment after a positive drug test should be given the opportunity to reapply and to offer evidence that they are drug-free.

Federal Policy Recommendations

The Drug-Free Workplace Act of 1988 should be amended to include alcohol use and alcoholism in the education and training portions of the Act.

Congress and the Administration should continue to create incentives, through legislation and administrative action, for employers, especially small businesses, to implement employee assistance programs at the worksite.

Congress should ensure that any universal health insurance reform legislation which is enacted contains explicit and comprehensive coverage for alcoholism and other drug addictions treatment.

Congress and the Administration should support the development of demonstration programs which utilize performance testing for workers in safety sensitive positions as an alternative to urine testing programs.

Approved by the Delegate Assembly (October 21, 1993) and adopted by the Board of Directors of the National Council on Alcoholism and Drug Dependence, Inc., (October 23, 1993).

National Council on Alcoholism and Drug Dependence, Inc.

244 East 58th Street, 4th Floor, New York, NY 10022
phone: 212/269-7797 fax: 212/269-7510
email: national@ncadd.org http://www.ncadd.org
HOPE LINE: 800/NCA-CALL (24-hour Affiliate referral)