Why drug testing might not protect your hospital

The costs are high. The risks are even higher.

Especially for a hospital or other health care facility, where controlled substances may be within reach every day.

The problem is employee drug use and on-the-job impairment. The solution? That’s where the debate begins.


Is pre-employment and random drug testing the answer?

In theory

Standard wisdom promotes pre-employment drug testing, often with random follow-up testing of current employees. This process, it has been argued, will reduce the incidence of drug use on the job, and help us in achieving the goal of a drug free workplace. This is turn will reduce the costs associated with drug use: absenteeism, poor job performance, critical job errors and turnover.


The problems

Unfortunately, some studies have called in question the usefulness of blanket preemployment drug testing, even in medical settings. In an article in the Journal of Occupational and Environmental Medicine, one study found little or no correlation between drug testing and reducing those costs. Further, they found that drug testing was frequently inequitably applied, inaccurate and often required further, expensive testing to rule out false positives.

Another article in Addiction Professional Journal reported in July of this year that while test positive rates are declining, actual on the job drug use is increasing. They attribute the discrepancy to both lack of controls and easy access to dilutants and other result-altering substances in local communities and online.


Why drug testing still might help

Others claim that the process of drug testing, while admittedly flawed, works as an effective deterrent to drug and alcohol use among job applicants and employees. The chance that they might be caught by a test, even if the test is imperfect, may stop some employees from using drugs if they want to get or keep a job.

For that purpose, on-the-spot drug testing may provide the highest level of accuracy and deterrent effect. It’s difficult to prepare for something you do not know is coming. Develop a clear drug free workplace policy, and make sure your employees are aware of the standards and penalties.

As you articulate your policy and its goals, keep in mind the rules governing drug testing in your state or province. Many states ban job site testing and almost all have mandatory notification requirements to notify employees of their rights during and after a workplace drug test.


Alternatives to drug testing

A Journal of Occupational Health Management article by Raphael H. Warshaw offered a different way to measure employee impairment, and effectively screen applicants. He suggests performance based assessment tools as a better tool. His sentiments were independently echoed in articles in Inc. Magazine and on several online HR journals.

Task, neurological and biometric performance tests can measure even small amounts of impairment, and cannot be fooled by dilutants, nor can anyone else take the test (a common problem with urine testing.). These tests get to the heart of what drug testing was supposed to do – evaluate whether applicant or employee “A” can safely and effectively perform the tasks needed for a given job. And since fatigue and stress can impair performance as much as drug or alcohol use, these tests actually provide a larger picture of employee abilities such as response time, dexterity and precision.

While performance tests may be less convenient – they need to be repeated regularly to pick up impairment due to substances or other stressors – they are extremely effective in detecting what drug testing initially promised – impairment of essential skills and judgment.