There’s Peril in Drug Testing, Too : Numerous Chances for Error Make It a Poor Personnel Guide

Urine tests are so simple and straightforward, much better than truth serum or lie detectors. Regardless of the subject’s claims, in hours the facts are known. If the results indicate drug use, action can be taken: dismissal, suspension, or an insistance on treatment and a deadline for getting clean. Furthermore, tests are not very expensive. Thanks to entrepreneurs ready to meet the demand with machinery for testing large numbers of people, an examination can cost as little as $3 to $5.

Not only has an apparently ideal detection instrument been developed, these times favor vigorous methods to root out drug users. If we use the American drug epidemic that peaked around the turn of the century as a model for current trends, we appear to be entering the decline of our 25-year trial with drugs. This phase, however, may well last, as it did once before, a decade or more until the drug problem appears to be under satisfactory control.

The final chapter begins with the crystallization of a national consensus against drug use as a result of decades of growing familiarity with the negative effects of chemical ingestion. The efforts of those supporting drug legalization and promoting the alleged beneficial effects of drugs wane before this broad opposition. Societal institutions move into parallel opposition to dealers and users. Obstacles to crushing drug use are brushed aside as political leaders vie with one another in expressing their hatred of drugs. Drug testing in this charged atmosphere arrives as a kind of X-ray vision for locating drug abusers. Not to use it fully and widely would seem a dereliction of national duty.

Such a simple and zealous use of drug tests, however, can cause a great deal of harm. While the test itself is simple, it is only part of a complicated process. Whether education about the complexity of drug tests will catch up with the enthusiasm for testing is uncertain. It is difficult to be optimistic.

In what ways are drug tests more complicated than they at first appear? To begin with, unless the samples are provided under direct supervision, many “dirty” urines will be missed; drug users can be ingenious at nullifying a urine testing procedure, as any drug-abuse clinic will confirm. Then, the urine (or blood) sample should be protected as if it were evidencein a major criminal case. To be just, every step must be shown to be free from the possibility of error or malicious tampering. In other words, the sample must be protected from the possibility of error by the staff and/or the “patient” in order to maximize the validity of the procedure. And we still haven’t arrived at the testing laboratory.

Compared to other medical tests, urine tests seem fairly reliable. Still, no tests are infallible, and the dependability of a laboratory can vary over time. False positives can cause a lot of grief for the subject: How do you prove that the test was in error if the substance, say, cocaine, would normally be out of your body in 24 hours and the result comes back two days later? Retaking the test would prove nothing.

Back at the workplace the result ought to be accepted as one part of an overall drug program for workers. The danger is that a positive result may be received as if it were a definitive answer.

The ways in which a bureaucracy could manipulate such a highly charged bit of information could devastate an employee. Even total abstainers would discover that they are not immune to the vagaries of the testing process. Every step in the procedure, from how workers are randomly chosen to who had access to the sample, would be subject to close and fearful (or angry) scrutiny. An employer who thinks that the check-mark on a urine test report is a worker’s biography would have an extremely negative effect on morale.

In sum, drug-testing results are not a simple short-cut to locating workers who deserve to be fired or not hired. Single tests are appropriate as guides to further investigation or as a warning of possible problems, but the many paths to a positive test suggest that the message is not as clear as it may first appear. I have not even considered here the important question of privacy or the potential problems caused by a positive test from persons who receive controlled substances for the treatment of epilepsy, or methadone as part of a drug-treatment program.

In order to meet the issues raised by drug testing, reasonable employers must become involved in broader and more sophisticated programs rather than just contracting with a laboratory for the cheapest screening rates. Those with the responsibility for making the decisions should put themselves in the place of a person defending himself or herself against a positive test. Wisdom comes from looking at the bottle from both sides.