Orange County Voices : COMMENTARY : Humane, Comprehensive Approach Is Best for Drug Testing : Substance use and abuse by police is of particular concern. The issue is how to test well and work appropriately with results.

Urine testing for drugs of abuse in the workplace is becoming widespread in American society.

Federal legislation mandates drug testing for federal employees and for most businesses contracting with the federal government. Drug testing programs pursued by the U.S. military have been a highly successful aspect of drastic improvements in the previously serious drug abuse problem in the armed forces.

Illegal substance use is of great concern in general in U.S. society, but it is of particular importance in individuals employed in certain key occupations, such as air traffic controllers, pilots, physicians, professional athletes, tractor-trailer drivers, railroad engineers, elected officials and law enforcement officers.

Substance use and abuse by police is of particular concern for many reasons. These include:

* Direct deleterious effects of drugs on intellectual and motor functioning.

* Toxic effects such as disorientation, paranoid rages and provocation of others.

* Law enforcement personnel being put into an alliance with drug pushers and importers.

* Compromises in the collection and use of evidence (by diversion to self-use).

* Destruction of the utility of police officers as role models for abstinence by youth.

* A diminishment of society’s confidence in helpful behaviors on the part of law enforcement. (If police officers say yes to drugs, how can they teach kids to say no?)

The most commonly accepted tests for drug abuse are those that take place before employment and those for probable cause, such as when an accident or error was probably caused or contributed to by substance use. Much more controversial is the routine testing of all individuals, particularly when it is random.

Random testing is less accepted because of the high cost of repeated testing of all workers, violation of individual rights to privacy and unresolved legal issues. Another problem with drug testing is that it does not evaluate any aspect of problem drinking (except for concomitant drug use).

Drug testing is also challenged on its reliability in regard to faking good results as well as false positives. The answers to these difficult questions are being provided in professional journals.

To summarize a few basic facts about testing accuracy: Laboratories, particularly those certified by the National Institute on Drug Abuse, are extremely accurate. The institute prescribes that initial screening be done by immunoassay, for the five major illicit drugs: amphetamines, cocaine, marijuana, opiates and phencyclidine (PCP). All positive results would then be confirmed by more accurate gas chromatography-mass spectrometry (GC-MS).

The use of a confirmatory test helps eliminate false positives as a result of lab error. GC-MS also differentiates such chemically related drugs as cold capsules or nasal sprays containing phenylpropanolamine or ephedrine from amphetamines, as well as poppy seed use from heroin.

A serious concern is the concealment of drug use. The most common methods of doing this are substituting the urine of a drug-free person or contaminating the urine with adulterants. The usual way to deal with this problem is to observe the voiding of all urine specimens. This is an embarrassing and expensive procedure. Substances can also be taken internally that will negate some tests. This can be countered by knowledgeable labs that test for all adulterants. However, this would greatly raise testing costs.

Labs can test for every potential drug of abuse, but each additional test can be expensive. We should not test for drugs unless there is a high probability of their presence.

There is an answer to this apparently unsolvable problem. The issue of drug testing should not be an adversarial one for any group.

Drug testing can help troubled individuals within the police force, as well as contributing to the good of law enforcement and society in general. How? Look again at the three major testing situations:

* Pre-employment testing: Every company including a police department should have the right to decide what, if any, level of illegal drug use is acceptable in the individuals they hire. For police officers, that level should be zero.

* Probable cause: Every institution should have the right to understand fully the cause of serious incidents, accidents and injuries, including the possible role of drugs of abuse. This should take place only with fair safeguards that protect the rights of society as well as those of the individual. Alcohol intake that leads to the same problems should be considered similarly.

* Random testing: More discretion is required. I favor random testing only if the tests are first evaluated confidentially by a physician fully trained in the issues of chemical dependency and drug testing of law enforcement officers. This physician (termed a medical review officer) should be able to assess the extent of the problem and refer the officer for appropriate treatment when necessary. In this case, the police department would need the capacity to provide appropriate and affordable individualized treatment.

Well-staffed employee assistance programs are also helpful. Any individual who tests positively for drugs of abuse once should then have random screenings at greater frequency. A second positive should result in more intensive treatment, a third in a leave of absence until there is evidence that the problem is resolved and a fourth in dismissal.

Thus, the issue is not to test or not to test, but how to test well and work appropriately with the results. Society would do well to divert some portion of the billions of dollars being spent on preventing importation and manufacture of illicit drugs to adequate detection, handling and treatment of drug abuse by police officers.

DR