Industry And Workplace, Drug Use In (Encyclopedia of Drugs, Alcohol, and Addictive Behavior)
The 1991 NATIONAL HOUSEHOLD SURVEY ON DRUG ABUSE (NHSDA) indicated that roughly ten million employed Americans were "current users" of illegal drugs. Drug use by employees and workers has become an important issue for American business. In the 1990s, employers of all types (large and small businesses, nonprofit organizations, government) are attempting to contain the negative impact of illegal drug use on job performance, PRODUCTIVITY, safety, and health (Walsh & Gust, 1989).
Drug use "in the workplace" is perhaps a misnomer in that today's employer policies focus on drug use by the "worker," whether that use is at the work site or off the job. In the United States, drug abuse in the workplace was recognized as a serious problem in the early 1980s, and in the next decade a slow but progressive response by both labor and management yielded model programs and policies to deal with the issue. Typically, by 1993 most organizations had comprehensive programs that included the following basic components: a written policy; supervisory training; employee education; employee assistance resource; and DRUG TESTING.
With such a comprehensive approach, the workplace has proven to be one of the most effective venues for drug prevention, treatment, and rehabilitation efforts (Gust & Walsh, 1989; Gust et al., 1991). Figure 1 shows the NHSDA data for "current users" (those reporting use of an illegal drug within thirty days prior to the survey), with figures broken down by employment status. Many observers believe that comprehensive workplace-based programs that reach out not only to the workers but also to their spouses and their student children can have an impact on at least 80 percent of all current users.
These endeavors have not been undertaken without controversy, especially with regard to the use of employee "drug testing," but the controversy is perhaps the most interesting part of the story. The development, current status, and future of these policies and programs will be discussed in detail later in this article. The evolution of workplace-based antidrug programs provide insights into the way unique social problems create a need for and the eventual development of innovative public policy (for additional information, see Walsh & Yohay, 1987).
Workplace "antidrug" policies date back to the 1960s, particularly in the transportation and other safety-sensitive industries. These policies were not then very effective because detection methods were poor and the signs and symptoms of drug use are often subtle and difficult to identify. Not until 1980, when new technology became available that provided reliable, inexpensive detection methods for MARIJUANA and other commonly abused drugs, did workplace detection efforts begin to be effective. Interestingly, the "workplace" that triggered the birth of these antidrug initiatives was the U.S. military.
In 1971, President Richard M. Nixon, as commander in chief, changed the Uniform Code of Military Justice so that testing positive for an illicit drug was no longer a court-martial offense. He ordered the military to start a program of urine testing among U.S. troops in VIETNAM and to offer treatment to those who tested positive for drug use. This urine-testing program was then expanded to service personnel worldwide. In the mid-1970s, the
The remarketing and reintroduction of drug-testing technology in 1981 occurred at roughly the same time as the Department of Defense (Burt & Biegel, 1980) and the Congress (House Select Committee on Narcotics, 1981) independently reported the survey results of drug use by MILITARY personnel. The results of these two surveys indicated high rates of drug use by military personnel and brought about considerable congressional scrutiny. The accident on the aircraft carrier U.S.S. Nimitz in May 1981, in which drug use was discovered by the postmortems of the crew members, increased political pressure on the military to do something about the drug-abuse problem. The juxtaposition of these eventshe availability of drug-testing technology and congressional demands for the Defense Department to address drug taking in the militaryas pivotal in justifying the widespread application of drug testing and the formulation of strict policies forbidding the illegal use of drugs on or off the job.
The development of such policies in the military received wide media coverage and generated much discussion in 1981. Shortly thereafter (1982-1983), similar policies began to be adopted in the transportation and utility industries for employees in safety-sensitive positions. The National Transportation Safety Board documentation of drug involvement in railroad and airline accidents more than justified the increasing concerns about workplace drug abuse.
Early military and private-sector policies were punitive in nature; employees found to be using drugs were summarily dismissed. This created a dilemma for many major corporations that recognized they had a drug problem but didn't feel comfortable firing employees, especially when there was no safety or security nexus. The rationale for workplace drug policies and the use of drug testing has evolved considerably since 1981. The philosophy of why to test and what to do with the results changed dramatically during the 1980s and early 1990s. At the outset, the primary purpose of a drug policy was to identify users and to fire them without evaluating the circumstances of the drug use. Subsequently a more positive, helping-hand philosophy evolved.
The basic purpose of today's model corporate drug policy is twofold:
- to minimize the risk of hiring drug users by denying employment to applicants who use illegal drugs (as manifested by a positive preemployment drug test); and
- to provide active programs to get the substance-abusing employee into treatment, to afford the opportunity to get help, and to get the individual back on the job.
This philosophical change to a more politically acceptable, socially responsible policy in dealing with drug abuse evoked about 1986 and allowed major corporations and professional organizations to involve themselves in antidrug workplace initiatives.
The federal government facilitated, encouraged, and in some instances required the development of private- and public-sector workplace antidrug programs. The Federal Railroad Administration began hearings on drug rules for the railroad industry in 1984 and issued regulations requiring written policies and the testing of employees; after a number of legal delays, the regulations went into effect in 1986. In September 1986, President Ronald W. Reagan issued an executive order (EO 12564) that required all federal agencies to develop drug-free workplace programs to ensure that the more than 2 million federal employees were not illegally using drugs on or off the job. In 1988 the Department of Transportation issued regulations for the airline, maritime, trucking, railroad, pipeline, mass transit, and other transportation industries, requiring (1) written policies prohibiting the illegal use of drugs on or off the job and (2) preemployment, reasonable-suspicion, postaccident, and "random" drug testing without cause for employees in specified safety-sensitive occupations. By 1992 the regulations were extended to cover intrastate as well as interstate transportation, a move that increased the number of transportation workers affected by the regulations to ten million, or nearly 10 percent of the total U.S. workforce. The Nuclear Regulatory Commission also issued regulations requiring written policies and extensive testing of personnel at nuclear sites.
Congress got on the bandwagon and passed the Drug-Free Workplace Act of 1988, which requires all federal grant recipients and federal contractors (whose contracts exceed $25,000) to certify that they will provide a drug-free workplace. The final rules describing the requirements for such grantees and contractors were published in the Federal Register on May 25, 1990. In general, the law requires covered employers to:
- Develop and publish a written policy and ensure that employees read and consent to the policy as a condition of employment;
- Initiate an awareness program to educate employees about:
the dangers of drug abuse
the company's drug-free workplace policy
any available drug counseling, rehabilitation,
and employee-assistance programs
the penalties that may be imposed on employees
for drug-abuse violations;
- Require that all employees notify the employer or contractor of any conviction for a drug offense in the workplace;
- Make an ongoing effort to maintain a drug-free workplace.
In 1988, the Bureau of Labor Statistics (BLS) surveyed business establishments throughout the United States about their policies on drug abuse (BLS, 1989). The survey found that half the nation's nonagricultural workforce was employed by organizations with a formal policy on drugs, and that 20 percent of payroll workers were employed in establishments with some type of drug-testing program. More than 90 percent of the establishments surveyed had an EMPLOYEE-ASSISTANCE PROGRAM available to employees. In the years since the BLS survey, the number of corporate and other employers and the employees covered by these policies continued to grow exponentially. The American Management Association (Greenberg, 1993) has surveyed its membership about their workplace drug policies annually since 1987. The 1993 survey indicated that 84 percent of respondents believe that drug testing is an effective way to deal with workplace drug abuse, compared with 50 percent in 1987. The share of surveyed firms that test for drugs rose to 85 percent in 1993. Since 1987, drug testing has increased nearly 300 percent. From the drug-treatment perspective, more than half of all companies (54%) have indicated that employees who test positive are referred for counseling and treatment.
As indicated above, progress in using the work site to intervene in individual substance abuse has not happened without controversy. Generally, employees and workers have no problem with supervisory training or employee education. However, the utilization of drug testing to make employment decisions and the involvement of employee-assistance programs (EAPs) in what many feel is a policing action generates an emotional, gut-level response from both labor and management. The drug testing and EAP components are so critical to any workplace effort that a detailed discussion of the issues is required.
When drug testing is considered, it is important to be familiar with the basic issues with which management and labor have been struggling (a full range of issues are discussed in Walsh & Trumble, 1991). The question of whether to utilize drug-testing technology evokes a complex array of moral, social, ethical, medical, scientific, and legal issues for many Americans. Although most citizens do not condone drug abuse, their concerns about the erosion of civil liberties generate feelings of uncertainty as to whether the end justifies the means. "Where will it stop? Where do you draw the line?" are questions raised by unions, civil libertarians, and others who worry that employee AIDS testing and pregnancy testing will be the next battlegrounds.
Many Americans view the drug-testing process (i.e., collection of urine) as degrading and dehumanizing. Government employees, unions, and civil libertarians argue strongly that drug testing is an invasion of privacy, that it constitutes an illegal search and seizure (i.e., of body fluids) and therefore violates individual rights guaranteed by the Constitution. In general, the constitutional protections apply only to testing conducted by the government (federal, state, and local). Therefore, testing conducted by private employers is not covered by the constitutional safeguards. However, government-mandated drug testing of private-sector employeesor example, in the federally regulated transportation and nuclear-power industriesust also pass constitutional muster. Although several of these constitutional questions have been brought before the Supreme Court and have generally been upheld, many specific issues may not be resolved by the current cases and will likely continue to be the subject of litigation for some time. This legal uncertaintyhether testing will be upheld and programs go forward or will be found unconstitutional and therefore be restrictedas created confusion for policymakers as well as for employees and unions.
Medical and scientific questions about the accuracy and reliability of drug testing were and are continually raised by those who oppose testing. Concerns have been voiced that many laboratories offering drug-testing services do not have the expertise or capability to perform the assays required. In addition, many employers may be using inappropriate technology and falsely accusing employees of drug use. Congressional support for these concerns has been manifested by the passage of legislation (P.L. 100-71, sec. 503, July 11, 1987) that requires stringent technical and scientific procedures for federal workplace drug-testing programs, as well as standards for the certification of laboratories engaged in drug testing for federal agencies. Similar legislation has been introduced in both the U.S. Senate and House of Representatives that would require such standards and lab certification for the private sector.
In response to concerns about the accuracy and reliability of drug testing, the U.S. Department of Health and Human Services (HHS) issued Technical and Scientific Guidelines for Federal Drug Testing Programs (Walsh, 1988). These guidelines are mandatory for federal programs and have rapidly become the gold standard for private-sector programs as well. By 1993, the rigor of the federal standards virtually eliminated concerns regarding accuracy and reliability. The issue of the quality of laboratories has also been addressed by HHS through the establishment of a national laboratory certification program. The College of American Pathologists has also established a forensic urine drug-testing certification program making certified labs available in virtually every state. The use of a certified lab has become the standard by which drug-testing programs are measured. A consensus report from HHS on the scientific issues of drug testing provides detailed information (Finkle et al., 1990).
A discussion of the pros and cons of drug testing provides no clear answers (Walsh & Trumble, 1991). The American Civil Liberties Union (ACLU) has been among the most vocal organizations actively lobbying against drug testing. In addition to constitutional issues, a major concern has been the potential for abuse by managers and supervisors to discriminate against and harass employees. The focus of the ACLU argument is that a positive urinalysis does not prove intoxication or impairment of performance; therefore it cannot be used to draw a nexus between drug use and job performance.
For their part, employers have wrestled with competing objectives and values to develop substance-abuse policies that fulfill multifaceted obligations. On the one hand, many employers feel a moral obligation to do all they can to achieve a drug-free workplace. They have corporate responsibilities to provide a healthy and safe workplace for all employees and to protect shareholders from losses resulting from drug abuse. On the other hand, employers have obligations to their workerso respect the individual rights and civil liberties of loyal and trustworthy employees (who for the most part are not involved with drugs).
This is an exceedingly difficult balancing act, and, as workplace policies are designed, the balance will shift depending on the individual work site and the nature of the particular job.
EAPs have become the key component of model workplace policies (Masi, 1984). Although drug testing has provided the major turning point in the evolution of workplace antidrug programs, the EAPs have expanded, grown more sophisticated, and become a vital part of the antidrug initiative. EAP programs were developed in the 1970s to focus on ALCOHOL abuse and to assist employees in dealing with the stresses of employment and personal life. Typically EAP programs provide short-term counseling and serve as a referral source for those employees who need treatment or long-term counseling. So-called broad-brush EAP programs provide a variety of services, in addition to crisis intervention, including management training and health workshops and seminars (e.g., SMOKING CESSATION, weight reduction).
As managers began to develop antidrug policies, the question was raised: What will we do if we find an employee using drugs? Generally, corporate lawyers and security officers would suggest termination, while corporate medical and EAP staff would recommend treatment. The issue proved difficult to resolve for many corporations when the cost of treatment and the uncertainty of success weighed heavily on the minds of financial officers responsible for making a profit in a bad economy. Fortunately, most corporations have EAP resources to implement the "helping-hand" approach that management sought.
The involvement of the EAP program in the antidrug effort was also not without problems. Initially some EAP providers had difficulty expanding their programs to deal with illegal drug users, a different type of client from ones with whom they had previously worked. The illegal aspect of drug behavior was troublesome in a field where confidentiality is the cornerstone of the therapeutic relationship. Also the advent of drug testing created an ethical dilemma for the EAP provider who was accustomed to being an ombudsman between management and labor. A good percentage of EAP referrals were coming from the drug-testing program in a last-chance situation in which the pressure was on the EAP to "cure" the problemr management would fire the employee. In the past, many employees using EAP services had sought assistance on their own, and management was never aware of the employee's initiative.
Despite these problems, the EAP field has expanded its efforts to treat substance abuse and has proven to be integral to the entire program. Employers have recognized that EAP programs not only help employees but are cost-effective. New materials, training programs in substance abuse, and certification programs have developed that have made the EAP provider more skilled in dealing with the drug-using employee.
Although drug abuse in the workplace is still a significant concern of American employers, substantial progress has been made since the early 1980s. Companies with comprehensive programs report significant reductions in accidents, absenteeism, and positive drug tests. There continues to be progressive growth in small and mid-size businesses, as resources for EAP, testing, management training, and legal services are being made available through local business consortia. The business community has developed a consensus that the workplace is an appropriate site for confronting drug abuse and has sent a clear message to the workforce and to the community that drug use will not be tolerated.
For the future, we are likely to see continued growth and expansion of workplace programs. As the country has gained confidence in the accuracy and reliability of drug testing, lower thresholds will be permitted that will make it much more difficult for the casual user to escape detection. We will probably see federal legislation setting additional standards for workplace programs, including standards for testing and for protection of employees.
Educating high school and college students that they must be drug-free to get and hold a job will in the long run contribute significantly to the reduction of drug abuse in the student population. And finally, because the workplace efforts are the most organized drug education, prevention, and treatment initiatives in the country today, they represent the best prospect for turning around the drug problem in America.
(SEE ALSO: Accidents and Injuries From Drugs; Drug Metabolism; Hair Analysis as a Test for Drug Use; Prevention)
BUREAU OF LABOR STATISTICS. (1989). News release USDL 89-7 (January 11). Washington, DC: U.S. Department of Labor.
BURT, M. R., & BIEGEL, M. M. (1980). Worldwide survey of nonmedical drug use and alcohol among military personnel. Bethesda, MD: Burt Associates.
FINKLE, B. S., ET AL. (1990). Technical, scientific, and procedural issues of employee drug testing: A consensus report. DHHS Publication no. (ADM) 90-1684. Washington, DC: U.S. Department of Health and Human Services.
GREENBERG, E. (1993). 1993 American Management Association survey of workplace drug testing and drug abuse policies. New York: American Management Association.
GUST, S. W., & WALSH, J.M. (EDS.). (1989). Drugs in the workplace: Research and evaluation data. DHHS Publication no. (ADM) 80-1612. Rockville, MD: U.S. Department of Health and Human Services.
GUST, S. W., ET AL. (EDS.). (1901). Drugs in the workplace: Research and evaluation data (Vol. II). DHHS Publication no. (ADM) 91-1730. Rockville, MD: U.S. Department of Health and Human Services.
HOUSE SELECT COMMITTEE ON NARCOTICS. (1981). Results: Personal drug use survey (study mission to Italy and the Federal Republic of Germany). U.S. House of Representatives. Washington, DC: U.S. Government Printing Office.
MASI, D. A. (1984). Designing employee assistance programs. New York: American Management Association.
WALSH, J.M. (ED.). (1988). Mandatory guidelines for federal workplace drug testing programs: Final guidelines. Federal Register. Washington, DC: U.S. Government Printing Office.
WALSH, J. M., & GUST, S.W. (EDS.) (1989). Workplace drug abuse policy: Considerations and experience in the business community. DHHS Publication no. (ADM) 89-1610. U.S. Department of Health and Human Services. Washington, DC: U.S. Government Printing Office.
WALSH, J. M., & TRUMBLE, J. G. (1991). The politics of drug testing. In R. H. Coombs & L. J. West (Eds.), Drug testing: Issues and options. New York: Oxford University Press.
WALSH, J. M., & YOHAY, S. C. (1987). Drug and alcohol abuse in the workplace: A guide to the issues. Washington, DC: National Foundation for the Study of Equal Employment Policy.