Use and abuse

Safety professionals tasked with running an effective drug-free workplace program are facing new challenges to keep employees safe while avoiding liability issues.

Although alcohol abuse is the most common controlled substance found to contribute to workers suffering fatal injuries in the workplace, recent reports show prescription drug abuse has become a public health crisis, and more states have laws that make medical marijuana use legal.

Drug-free workplace programs are not required by OSHA, and no agency standards exist for these programs. According to its website on workplace substance abuse, OSHA “supports comprehensive drug-free workforce programs, especially within certain workplace environments, such as those involving safety-sensitive duties like operating machinery.” Drug-testing programs also need to take into consideration an employee’s right to privacy, OSHA cautions.

Alarming trends in drug use

In April, Director of the White House Office of National Drug Control Policy Gil Kerlikowske, Assistant Secretary for Health Howard Koh, Commissioner of Food and Drugs Margaret A. Hamburg, and Administrator for the Drug Enforcement Administration Michele M. Leonhart released an action plan responding to America’s prescription drug abuse crisis.

According to researchers from the Center for Behavioral Health Statistics and Quality at the Substance Abuse and Mental Health Services Administration, the rate of increased prescription drug use has become a public health issue and a concern to employers. Results of the 2009 National Survey on Drug Use and Health showed that of the estimated 19.3 million illicit drug users who were 18 or older at the time of the survey, 12.9 million (66.6 percent) were employed either full or part time.

The population entering the workforce – people 18 to 25 years old – are showing an increased rate of prescription drug use, said Peter Delany, director of the Center for Behavioral Health Statistics and Quality at SAMHSA. Non-medical use of prescription drugs among this age group increased to about 6.3 percent in 2009 from 5.5 percent in 2002, he said. More alarming is that the same age group is increasingly turning up in emergency departments because of drug abuse, he said. Overall, emergency department visits involving misuse or abuse of pharmaceuticals increased 98.4 percent between 2004 and 2009, according to a report from SAMHSA’s Drug Abuse Warning Network.

Cost to employers and employees

The reality is that prescription drug abuse has negative repercussions on all facets of a person’s life, Delany said. For example, people addicted to prescription drugs will not be attentive at work and, if they are going through mild withdrawal, they could be absent for days because of related health problems. Other possible consequences include injuries resulting from a motor vehicle crash on or off the job, Delany said.

According to the American Council for Drug Education in New York, employees who abuse drugs are 10 times more likely to miss work, 3.6 times more likely to be involved in on-the-job incidents (and 5 times more likely to injure themselves or another worker in the process) and 5 times more likely to file a workers’ compensation claim. They also are said to be 33 percent less productive and responsible for potentially tripling health care costs.

Drug testing trends

Barry Sample is director of science and technology at Quest Diagnostics Inc., a Madison, NJ-based provider of diagnostic testing, information and services. He said the Quest Diagnostics Drug Testing Index released in September 2010 shows that although positive drug tests for cocaine and methamphetamine are on the decline, an increasing number of American workers and job applicants tested positive for prescription opiates. Depending on the particular prescription opiate, post-incident drug-test results show much higher positive rates compared with pre-employment tests, Sample said.

For example, post-incident drug test results for hydrocodone detected opiates can show up to 4 times more often than pre-employment tests. These findings point to the possibility that prescription drugs played a role in an incident, he said.

Drug testing has evolved from employers waiting to receive the results of a pre-employment drug test before fully hiring a new employee. Today, it is not unusual to see a potential employee walk away from a job interview with strands of hair taken for hair follicle drug testing.

Workplaces can conduct both hair follicle and urine testing, receive instant feedback from oral fluid testing, and conduct random drug testing and return-to-duty drug testing. Tests easily can be administered by an employer, hiring manger or human resources professional, Sample said.

Issues arise, however, when drug testing policies do not spell out conditions for testing, which leaves the employer open to worker claims of discrimination or invasion of privacy.