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The only methodology for
drug testing approved by the U.S. Department of Health and Human
Services is urinalysis.
Urinalysis involves screening
urine for the presence of drug metabolites in a relatively simple
and inexpensive procedure. Samples with positive results are then
subjected to a highly accurate but more expensive confirmation procedure
known as gas chromatography/mass spectrometry (GC/MS). No adverse
personnel action should ever be taken before completing the two-step
procedure.
Most employers look for a
vendor to handle drug testing requirements. In determining how to
go about drug testing and what facility to use, consider the following:
• The laboratory should
provide guidance in the development of collection procedures to
assure that samples are properly ob- tained and not falsified;
• The vendor should
provide all materials for collecting samples as well as specific
written instructions for doing so. These may include containers,
chain-of-custody and report forms, evidence tape, prepaid tamper-proof
mailers and labels. The contract price should include these items
as well as courier service. Separate financial arrangements may
be needed if a urine collection vendor is required in addition
to the laboratory services. If a separate collection vendor is
used it should be a facility that specializes in specimen collection
for the purpose of workplace drug testing.
• Containers should
not contain preservatives that might alter the drugs or metabolites
being sought. Containers should also include a built-in temperature
strip that is capable of measuring the temperature of the urine
sample. This is useful in detecting sample substitutions or other
attempts at cheating the test.
• The laboratory and
its personnel must comply with state licensing and certification
requirements.
• A clear, up-to-date
laboratory methods procedure manual must be included. Most reputable
laboratories follow the procedural guidelines approved by the
U.S. Department of Health and Human Services.
• Tests must be performed
only by technicians trained and experienced in the specific drug
test procedures.
• The laboratory must
furnish an analytical plan to assure that a positive test is followed
by a GC/MS confirmatory test and that no results are transmitted
to the company based solely on a screening result. In other words,
all positives should automatically be submitted for GC/MS confirmation
and quantitation.
• The limits of sensitivity
and specificity for each test procedure should be defined. Most
employers, including non-regulated employers, follow the cutoff
levels established by the testing program of the U.S. Department
of Transportation. Any change from the laboratory’s normal
thresholds for detection should be agreed upon in writing.
• The technical and
administrative procedures used should differentiate legitimate
therapeutic drug use from illicit drug use. In other words, legal
medications used by the employee for legitimate medical reasons
should be ruled out before a positive is declared. Many employers
use the services of a physician known as a Medical Review Officer
(MRO) to determine whether legal medications are involved. Employers
regulated by the Department of Transportation are required to
use an MRO.
• The laboratory should
be able to identify any of the normally abused illegal drugs or
their metabolites and to offer several “panels” or combination
of tests as a cost- effective option to general testing.
• Once the specimen
has arrived at the laboratory via approved courier, a confirmed
written test result should be delivered within two to three days.
Employer actions should never be based upon a verbal test result.
Procedures should be established to maintain confidentiality both
at the laboratory and in the company, and refrigerated storage
of positive samples should be offered by the laboratory.
• Expert testimony
in the form of written records and personal appearances concerning
results, methodology and opinions should be available with timely
notification.
• Laboratory personnel,
technical and managerial, should be subject to a program of drug
testing.
In conducting drug testing,
employers must balance legal liabilities due to lawsuits (brought
by unhired applicants and employees who refuse to take the test
or who are discharged or disciplined for positive test results)
against the well-being of customers, clients, fellow employees,
and members of the general public who may be injured or affected
by a drug-using employee. Settlements in the former category are
usually in the low thousands of dollars, while those in the latter
are often in the millions.
Courts are holding more and
more companies responsible for mistakes made by poorly trained personnel
operating without well-conceived guidelines. As courts have declared,
there is enormous liability when a company does nothing or does
the wrong thing in the face of the clear evidence of drug and/or
alcohol abuse throughout the workplaces of our country.
Many states have drug testing
laws that determine what an employer can and cannot do. It is important
that employers determine what laws, if any, exist in the states
where they conduct business to ensure that the testing rules and
procedures established are in compliance with state regulations.
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