Questioning the Justifications For Drug Screening
It’s been almost 40 years since President Reagan signed an executive order in 1986 mandating testing for illicit drugs. Perceived benefits of drug testing are: preventing accidents that cause injury or fatalities, increasing productivity, and intervening to treat substance abuse. With more than three decades under this executive order, there should be sufficient evidence to substantiate its continuation. Unfortunately, the analysis is thin and routinely uses words like “suggests,” “potentially,” and “correlates,” which undermine their veracity.
The rates at which employers test employees vary considerably. About 13% of small companies (fewer than 20 employees) drug test, while almost 70% of those with over 500 personnel utilize drug screening.
By now, there should be solid evidence of benefits, especially since drug testing has a substantial negative impact through disqualification for employment, housing, social services, professional sports, sports competitions, organ transplant wait lists, and may be used to influence conditions of incarceration.
A personal example happened recently. A friend has Multiple Sclerosis. Medical cannabis, available legally in their state, replaces a pharmaceutical that causes debilitating impairment. After disclosing participation in the medical cannabis program at hiring, then working for a year, a random drug test initiated another disclosure of private health information, followed by immediate suspension and termination. Imagine suddenly losing your job and insurance.
Lives are permanently damaged due to these disqualifications, while drug screenings are inadequate in many ways. They result in a false-negative in 10-15% of all tests. Cannabis, as the most consumed federally prohibited substance, causes the majority of positive tests. Also, cannabis can be detected 7-30 days after consumption, while the other substances are undetectable after 4 days. Drug screenings may deter drug use; however, “systematic review found no rigorous evaluations of employer‐led efforts to prevent or reduce the ill effects of substance abuse disorder.”
A positive result on a drug screen does not prove either impairment or substance abuse disorder. Around 20% of on-the-job fatalities test positive for drugs or alcohol, leaving 80% that test negative. This brings attention to consuming alcohol, which is undetectable with standard screens after 12 hours. Employers don’t usually test for alcohol because it violates privacy during off-duty hours. However, damage from alcohol is well-documented. Annual deaths in the US are estimated at 95,000, AND $249 billion in economic loss.
Another substance that bypasses consideration is tobacco. Tobacco causes 480,000 deaths per year in the U.S. In 2019, Tobacco companies spent $1M every hour on marketing ($8.2B), while costing the U.S. more than $600B in healthcare, lost productivity, and premature death due to secondhand exposure.
Lastly, if drug screening were as effective as perceived, we would not have suffered the death of 100,000 U. S. citizens in the 12 months prior to April 2021, costing $1 trillion of economic loss in 2017 exclusively from opioids.
After assessing the limited benefits of drug screening compared to the negative impacts of labeling people as “drug abusers” while disqualifying them for opportunities, it’s important to question this long-accepted policy. Recently, the FBI doubled down on their disqualifying policy by including CBD, demanding abstinence for a year prior to applying. Meanwhile, the Prime Minister of Finland submitted to a drug test after a report of her having fun at home with friends. The most valid excuse for perpetuating drug screens is the discounts on premiums provided by insurance companies. These discounts are well-known, but justifiable statistics are guarded (or don’t exist).
If solid statistics were required to substantiate higher rates for cannabis consumers, they would not be able to provide them. “Contrary to our hypothesis, reasonable cause drug testing was not significantly related to the change in facility accident and illness rates.” The DEA recently dropped its effort to ban psychedelic compounds when scientists testified on their research value, yet cannabis remains marginalized and federally prohibited. It is noteworthy that in millennia of documented use, cannabis has never caused death from overdose, while having a U.S. patent 6630507: Cannabinoids As Antioxidants And Neuroprotectants.
Creating safer workplaces and healthier residents is a worthy cause. Impairment is the real problem that can be observed through behavior. Impairment can be caused by fatigue, stress, grief, break-ups, medications, alcohol, and drugs. Worker fatigue has the same symptoms as drug impairment. Having realistic goals and taking breaks improves overall safety and performance. A lack of mental health treatment costs $193.2B/yr in lost earnings. Substance abuse at work causes 65% of on-the-job accidents. A main cause of any substance abuse is childhood trauma. Exceptional employment management can provide supportive and well-received mental and physical quality-of-life improvements through EAPs (Employee Assistance Programs).
Disqualifying potential hires for cannabis consumption is beginning to hurt employers. Violating privacy and firing medical cannabis patients risks expensive and embarrassing litigation. Michigan State Police recently discovered their blood tests couldn’t differentiate between THC and CBD, causing them to halt the tests after using them for 2 decades and question past plea agreements and convictions.
Continuing drug testing is posturing to seem conscious of 1) providing a safe work environment and 2) the risks of drug abuse, with only the appearance of scientific validity. Even the DOJ validates that drug testing is a bad idea: “More importantly, drug testing tests for the wrong thing -- an effective and serious workplace safety program realizes that worker impairment, not drug use per se, is the real problem that must be tested for. While drug testing provides a simple and cheap approach to workplace drug abuse, it is ineffective.” As more states expand access to legal and regulated cannabis, the violation of privacy and civil rights becomes more apparent.
It has been argued that drug testing is a violation of the 4th amendment: Illegal Search and Seizure, although the Supreme Court ruled against that defense used by the ACLU in the case of drug testing financial assistance recipients in Florida. Cannabis use has the lowest level of dependence and withdrawal symptoms, warranting its removal from all drug screenings.
It’s time for this executive order to be reversed. At the very least, scientific proof should justify tests for NON-cannabis drugs of abuse. Perhaps the perpetuation of drug testing is a commitment to the drug testing industry, with a global revenue of $6B.