Calling mandatory urine drug screening "chemical McCarthyism," the editor of the Journal of the American Medical Assn. has delivered a blistering attack on the misuse of the increasingly popular tests to screen for evidence of illegal drug use.
In a strongly worded editorial published in the journal today, Dr. George D. Lundberg said such tests can often produce unreliable results and may infringe on civil liberties.
Conceding that "urine drug screening technology has improved immensely" in the last decade, Lundberg said even the "very best" laboratories continue to make "distressingly large numbers" of errors when testing for evidence of drug use.
He cited recent surveys that found the ability of laboratories to accurately detect drugs ranged from 75% to 95% for some substances and from 30% to 60% for others.
'Hypocrisy' of Screening
The influential journal editor also criticized the "hypocrisy" of screening for illegal drug use while ignoring "the most commonly lethal drugs (ethyl alcohol and tobacco)."
Lundberg's comments are more strident in tone than most editorials published in the Chicago-based medical journal, which has a circulation of about 600,000. They add a strong voice in the controversy over drug testing, all the more because of the physician's experiences in researching drug abuse while a member of the department of pathology at the USC Medical Center in the early 1970s.
Advocates of urine drug screening for employees say such tests will improve work performance, decrease job-related accidents and absenteeism and decrease the use of illegal drugs in general. Such screening is also being used by many employers, including some government agencies, as part of preemployment hiring process and when drug use by an employee is suspected.
The greatest controversy has surrounded the random, unannounced urine testing, which so far is the least prevalent form of drug screening. Lundberg's comments were targeted at such mandatory screening, although some of his comments apply to urine drug tests in general.
If every employee in the United States work force were tested once a year, it would cost "$8 (billion) to $10 billion," he said.
"This is terrific for the laboratory industry and all the attorneys who will argue these cases . . . but should we spend that kind of money?" he wrote. "In fact, we have not found one proper cost-benefit analysis of this process" in the medical literature.
Lundberg said compulsory random drug screening should be done only after it is ratified by "an informed electorate, probably through state-by-state referenda. Such a national application would probably necessitate an amendment to the U.S. Constitution. The issue is that important."
Lundberg applauded the rising tide of popular opinion against drug abuse but cautioned that there is "no way to get rid of psychoactive drugs in a free society."
In his editorial, Lundberg reprinted a letter on the same topic that he had written to the New England Journal of Medicine in 1972. In that letter, he said, "An era of chemical McCarthyism is at hand, and guilty until proven innocent is the new slogan."