Harrison, Lana D.,
Michael Backenheimer and James A. Inciardi (1995), Cannabis use in the
United States: Implications for policy. In: Peter Cohen & Arjan Sas
(Eds) (1996), Cannabisbeleid in Duitsland, Frankrijk en de Verenigde
Staten. Amsterdam, Centrum voor Drugsonderzoek, Universiteit van Amsterdam.
© Copyright 1995, 1996 Centrum voor Drugsonderzoek, Universiteit van Amsterdam. All rights reserved.
Lana D. Harrison, Michael Backenheimer and James A. Inciardi
Employee absenteeism, accidents and theft in the workplace are three of the most serious problems facing employers. Drug abuse and alcoholism are thought to be major contributors to these problems. The 1991 Household Survey reported that, for the year 1991, some 68% of illicit drug users were gainfully employed. In 1986 the President issued an Executive Order that all Federal Agencies shall be drug-free. The Drug-Free Workplace Act was passed by the Congress in 1988. It mandates that Federal grantees and Federal contractors (with a value of $25,000 or more) shall, following proscribed guidelines, seek to establish a drug-free workplace. Of note is the fact that the Act does not require drug testing of employees. However, under specific circumstances, drug testing may be required by Federal, State or local regulations. The Center for Substance Abuse Prevention (CSAP) of the Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that more than $100 billion in workplace losses can be attributed to accidents, lost productivity and related problems of alcohol and substance abuse.
Concerned with the economic costs of substance use, many employers, following the lead of the military and the Federal establishment, have instituted drug testing. The majority of workplace drug testing is pre-employment drug testing, conducted prior to hiring. There are several drug screens available. The urine screen allows detection of drugs but can only determine that a subject has used a given substance in the recent past. It is not accurate enough to determine impairment or whether the subject was under the influence of a given substance at the time of the test. Thus recreational or very occasional drug users could be detected, even though they don't use 'on the job.' Urine screens are not used for detecting alcohol. Although valid for alcohol, since alcohol is quickly excreted from the body, the urine screens are not positive for very long after ingestion. Blood tests are considered (and are indeed) far more invasive than urine screens. Importantly, however, blood tests measure the amount of alcohol (and other tested drugs) present at the time of the test and, using established standards, can be used in formal proceedings to give evidence as to whether or not the subject was 'under the influence.' Currently, blood tests are primarily reserved for alcohol related issues. Saliva and hair tests may soon enter the work place as less intrusive ways of detecting substance use. The validity and reliability of these methods has not as yet been established to a degree sufficient to allow their regular use in the workplace. For alcohol (but not other drugs) detection, the use of a breath-alcohol procedure is becoming standard practice. It can determine blood alcohol level, providing an assessment of current impairment.
Also of note is a decision by the Food and Drug Administration (FDA) to allow the marketing of a sweat patch as a method in drug testing. The patch is worn for one to two weeks and absorbs sweat that is tested for the presence of illegal drugs. Approved initially only for use in the criminal justice field (i.e. the testing of parolees or people on probation), it is nevertheless likely the manufacturers of the patch will push for its use in drug treatment facilities and for workplace testing.
The urine screen is the most common drug detection method employed by industry as on a cost/benefit basis they are thought to be inexpensive, valid and reliable. Urine screen costs range from $10 to $35 for an initial screen, and $25 to $75 for a confirmatory retest. The price variation is largely a function of the number of drugs being tested for plus the volume of tests conducted. Pre-employment drug screening is now a fact of life in many facets of the economic world. A majority of the Fortune 500 companies employ drug urine screens in one form or another. Most commonly, drug testing occurs prior to employment, when reasonable cause exists (signs of use or unsafe or unsatisfactory work performance), randomly, after accidents and after treatment for substance use.
Drug screens potentially hold significant negative consequences for marijuana users who are subjected to screening. Because marijuana is stored in the 'fatty' tissues for significant lengths of time after ingestion, marijuana users are at high risk of detection with respect to urine screens. In 1990 it was estimated that nearly 90% of positive urine (EMIT) screens were for marijuana (Blum, 1990). This has changed dramatically over the past 5 to 6 years. Today, positive screens for marijuana constitute about 50% of all positive workplace drug tests with the remainder being 45% cocaine and 5% 'other' (Walsh, 1995). One study done in the time frame October 1990 through March 1992 analyzed results from almost 2 million urine screens (Normand et al., 1994). Positive results were found in nearly 70,000 of the tests, close to 4%. About 35,000 of the positives, 50% of all positives and 2% of all tests, were positive for marijuana. Cocaine was a distant second with 1% of all tests showing positive. Data from the Household Survey indicate that among full-time employed males, the use of marijuana, heavy alcohol, cocaine and/or any illicit drug varied inversely with income level. This finding was particularly true for young males in the 18-25 year age group (Normand et al., 1994). Recently (1995) a well-known college football player who tested positive for marijuana on several occasions is estimated, upon turning professional, to have lost several million dollars because some teams were unwilling to draft him and 'take the chance.' Originally projected to be among the first 5 players drafted, he was drafted twelfth; the loss of ranking costing millions not only in salary but also in possible endorsements and personal appearances.
A hallmark study of pre-employment drug screening found it makes good economic sense to drug test potential employees. Under totally 'blind' conditions it was found that those who tested positive for marijuana were involved in more accidents, reported more injuries, and missed more work. This study of 4797 applicants who were subsequently employed by the U.S. Postal service, were followed for just over a year. About 7.8% of the applicants tested positive for cannabis. Twenty-six percent of the marijuana users were involved in industrial accidents compared to 19.2% of those who tested negative for all drugs. Eighteen percent of marijuana users suffered injuries compared to 11.7% of those with a negative drug test, and the average absence rate for marijuana users was 7.1 compared to 4.0 for non marijuana users (Zwerling et al., 1990). The study has been criticized for failing to control for the effects of alcohol use on the association between preemployment drug screening results and employment outcomes. It is highly likely that the employment outcomes were confounded by alcohol use.
Data from the SmithKline Beecham Drug Testing Laboratory show that 18% of workplace drug tests were positive in 1987. This percentage has more or less steadily declined to 7.8% in 1994. This is a 57% decline in the percentage of workers showing positive tests in the time span 1987-1994 (CSAP, 1995). In 1993, 3.4% of the drug tests were positive for marijuana.
As the result of drug testing on the job, workers face treatment programs, reprimand, dismissal, and lack of promotion opportunities, should they test positive for marijuana or any other substance. In several areas of popular domain, professional sports being one example, several 'name' players have had their careers cut short by positive testing. With marijuana being fat soluble and staying in the body for significant periods of time and with screening techniques becoming ever more sensitive, the risk of testing positive in the workplace is perhaps just as real (or more real) than the risk of being arrested for marijuana possession. The urine test cannot distinguish between drug use in the workplace and drug use in the workforce. Since a urine test cannot distinguish time of use, workers are penalized for drug use, regardless of the location and timing of use.
Testing for illegal substances is the rule in law enforcement agencies throughout the nation. In 1990, a majority of State police agencies and local police agencies serving populations of 25,000 or more had mandatory testing for illegal substances for all applicants seeking sworn positions within their departments. Moreover, about 3% of local sworn law officers worked for departments having mandatory drug testing for regular field officers and 17% worked for departments having a random selection drug testing program for sworn officers. In about two-thirds of local police and sheriffs' departments and in about three-quarters of State police departments, nonprobationary officers could be terminated after one positive test. Almost all departments had a policy demanding dismissal for two positive tests (BJS, 1992, p. 6).
Drug testing has become an industry unto themselves. In 1984 it is estimated that over 4 million workers were subjected to urine screens (Slaughter, 1988, p. 464). The current estimate is about 60 million workplace drug tests are performed annually (Walsh, 1995). The Department of Transportation (DOT) has been doing drug testing on railroad and airline industry personnel for about the past 7 years. They alone conduct on the order of 200,000-300,000 drug tests per year. Of the 60 million workplace drug tests that are conducted annually, only 50% (30 million) are carried out by laboratories certified by NIDA. The remaining 30 million are conducted by non-certified laboratories or involve the use of various drug detection kits. This thriving industry is estimated to be of the magnitude of $75 billion per year. It has been growing steadily as evidenced by the fact that in 1987, 22% of U.S. companies did at least some employee testing. By 1992, this percentage had increased to 63% (Staimer, 1995).
The conclusion from the available research is that marijuana users have higher absteeism rates, injuries, accidents, and job turnover. With special reference to marijuana, however, it must be noted that length of time since use becomes a critical variable that would seem to be overlooked by current testing methods. Because of its detectability for relatively long periods of time, it would appear that the recreational and occasional user of marijuana is at high risk with respect to being detected, yet the workplace makes no allowance for this. There also can be little question that drug testing of the workforce can be a positive tool in reducing the cost of substance use to industry. It must be remembered, however, that it is a highly profitable industry that has been growing rapidly in recent years.
BLUM, JEFFREY M., Transmittal of May 21, 1990 from Jeffrey M. Blum, Associate Professor of Law at the University of Buffalo School of Law to the Honorable John L. Elfvin, United States District Court, Western District of New York, Buffalo.
BUREAU OF JUSTICE STATISTICS. 1992. 'Almost 19,000 State and Local Law Enforcement Officers Fight Drugs Full Time,' National Update Vol. II:1.
CSAP. 1995. 'Statistical Bulletin Drug Free for a New Century.' Rockville, MD: U.S. Department of Health and Human Services.
NORMAND, JACQUES, RICHARD O. LEMPERT, AND CHARLES P. O'BRIEN (EDS.) 1994. Under the Influence? Drugs and the American Work Force. Washington, D.C.: National Research Council/Institute of Medicine, National Academy Press, 1994.
SLAUGHTER, JAMES B. 1988 'Marijuana Prohibition in the United States: History and Analysis of a Failed Policy,' Columbia Journal of Law and Social Problems 21:4, pp. 417-475.
STAIMER, MARCIA. 1995. 'More Companies Test for Drugs.' USA Today, March 29, 1991.
WALSH, J. MICHAEL. 1995. Personal communication, The Walsh Group, Bethesda, MD., May 26, 1995.
ZWERLING, CRAIG, JAMES RYAN AND ENDEL JOHN ORAV. 1990. 'The Efficacy of Preemployment Drug Screening for Marijuana and Cocaine in Predicting Employment Outcome,' Journal of the American Medical Association 264(20), pp. 2639-2643.