More doctors and nurses have been trained to screen for substance use in the past few years than in the entire history of the field, according to Dr. Troy Jones, an assistant professor in the department of epidemiology, psychiatry, and public health at the University of Michigan. Jones spent 20 years as a pharmaceutical company clinical scientist and is now president and CEO of Ascend Testing Services, a diagnostics and drug testing firm based in Chicago.
Drug testing for physicians is still a small part of the business, says Jones. There are likely thousands of drug-related incidents each year that get doctors suspended or kicked out of the workforce. A drug screen is usually the end of the line for workers who have used prescription drugs improperly or illegally, but drug screens can also occur in situations that have nothing to do with drugs, like an ill employee failing a good first day on the job. And since these drug screens are performed for employers rather than patients, they don’t provide any information on the user’s drug use. Jones says drug tests can be biased. For instance, substances like marijuana have a different impact on people than prescription medications, so they should be screened for separately. The dangers of drug abuse are also different. For example, a car accident might increase the probability of drug abuse for a driver. It would also decrease the risk of some substance abuse because a driver could get thrown out of the driver’s seat and lose their ability to drive.
Basic Drug Screening
A drug screening provides information only on potential drug use, not on the probability of drug abuse or addiction. An employer doesn’t need a blood test to determine whether someone is in substance abuse recovery. An employer may simply ask if an employee is in an addiction recovery program or drug treatment. However, escalation to a 5 Panel drug screen might have some justifiable grounds.
The Drug Abusers Network, based in Kansas City, Missouri, says employers can get the most information by determining how much each employee is likely to be affected by drugs and treatment. Drug tolerance, the level of drug use that induces a negative effect on an employee, usually decreases over time. The information is typically gathered by conducting various tests on the employee to determine their physical and mental reaction to different doses. For example, taking a person on a 30-milligram dose of an opioid medication, like hydrocodone, would trigger a high response in most people, while taking the same dose in the face of a 30-milligram dose of methadone would trigger an almost negligible response.
What about Drug-Use Risk
But drug tolerance tests don’t tell much about risk. For an employee to receive substance abuse treatment or avoid being terminated or suspended due to drug use, the employee would have to have a serious amount of drug abuse. Employers should pay close attention to employees that are taking drugs with a relatively low risk of causing harm. Employers should also pay attention to the way employees handle and consume drugs.