Pee in the Cup

Back in 1983, I had my head examined when I went to work for a government contractor. I didn't like people probing my thoughts, but I felt it was warranted since the job dealt with national defense secrets. For the nice, fat salary and benefits package they were offering me, I might have grinned and agreed to a cavity search too.Eleven years later, I was instructed to swing by a drug test laboratory before reporting to a temporary assignment. After the initial shock, I agreed that the company has reason be highly selective -- it was in grave financial trouble, crawling with auditors. I took the test.I am not alone. Employee drug-testing has climbed 277 percent in ten years, according to the "1996 Survey on Workplace Drug Testing and Drug Abuse Policies," a report compiled by the American Management Association (AMA). The numbers? 81.1 percent of private companies and a slightly higher percentage of public organizations test for illegal drug use.What has happened to mutual trust? Submitting to a drug test is a lot different than handing over a cup of urine to your doctor for diagnostic purposes. In my various experiences I felt like a culprit, guilty until proven innocent. The nightly news fueled my own growing distrust to the extent that I began scrutinizing conservative-looking people and speculating on what secrets their bladders held. Had the world become so depraved that compulsory urination was necessary to weed out the bad and protect the good? I wanted to know.Employee drug testing is a creepy topic. People regard it like the sight of toilet paper stuck to their shoes and this makes discussing it on the job lethal. So, I relegated my interviews to off-hours, starting with three chemists who were just as ignorant as myself on the subject. They had worked at the same company for about twenty years and their only awareness of drug testing was that it applied to new hires. Since it wasn't something they had to deal with personally, they weren't concerned. "Is drug testing legal?" they asked.A college professor was incredulous that her students were being tested for internship positions. A factory worker who said his company only tested new hires went on a rant about his employee manual which forbids "amoral" and "questionable" behavior on and off of the job. "Questionable according to who?" he asked. Then there was the steel mill worker who remembered a reign of fear after a fellow employee was fired on the spot for not submitting to a drug test.A decade ago, employee drug testing was a hot issue, a test of wills and of democracy itself. But the publicly-stated reason for it -- safety -- was something people unanimously supported and so it came to be. Testing can accomplish what the threat of legal retaliation once blocked employers from doing -- remove potentially dangerous people from inherently dangerous situations -- and do what concerned co-workers have no authority to do -- force problem employees to get help.Ronald W. Jackson, Sr., president of the Amalgamated Transit Union, Local 268, says that some Cleveland Rapid Transit Authority workers want more testing. They think it's unfair and unsafe to test some job categories and not others. Jackson acknowledges that drug testing combined with other policies helps improve workplace safety, but he believes the perceived security comes at a high price."I've seen guys just about die because of employee drug testing," Jackson told me. "One individual was on the job for twenty years without a write-up until the day his random test showed positive. He was fired immediately -- that's the rule. It ruined his life." After many months passed, the employee called Jackson about getting rehired, but there was nothing the union leader could do to help him. Strict RTA rules do not permit second chances to employees whose records are tainted by drug use.A commercial excavator I talked to thinks that employee drug testing undermines mutual respect between employers and employees. "If I can't tell one of my men is intoxicated on the job, and talk to him about it, I'm not much of a boss, am I?" he asks. "The government has enough control over my business without drug testing and anyway, what an employee does in his own time is his own business so long as it doesn't affect his work."He may be an unusual boss; most bosses and unions go along with drug testing. Increasingly, drug testing is done up front to keep users outside the company doors and because, as a former human resources manger put it, applicants and temporaries have fewer rights than employees. The AMA estimates that just over half of the firms performing periodic or random drug tests do so to comply with federal law, most of them following Department of Transportation regulations. Employers also may use drug testing as a "just cause" inquiry after accidents, or when there is "reasonable suspicion" that an employee is using or selling illegal substances at work.Private employers fell in line with government policy propelled by what can be seen now as fuzzy drug war logic. While the losses borne by American firms due to employee substance abuse are legendary -- once reported in the media as high as $100 billion -- most companies, it seems, did not even know the extent of their home-front substance abuse costs. Arrived at through highly complex and arcane methodology, the colossal figures hit like speedballs sending executives scrambling to cover their assets. Do such figures represent actual business losses due to drug abuse? Do they warrant mass urinalysis?In a U.S. Department of Health and Human Services-funded study entitled The Economic Costs of Alcohol, Drug Abuse and Mental Illness: 1985, a reference to "other related costs" may hold a partial answer to these question. The study, released in 1990, puts the aggregate cost of alcohol, drug abuse and mental illness at $218.1 billion. Individually, mental illness costs were estimated to be the highest -- $103.7 billion -- followed by $70.3 billion for alcohol abuse, and $44.1 billion for drug abuse. The study employed the "human capital" approach to estimating direct and indirect costs of these illnesses -- using data to figure an individual's value to society based on his or her earnings potential. Direct costs are those for which payments are made and indirect costs are those for which resources are lost.The value of lost productivity costs related to drug abuse are estimated to be $6 billion. Accounting for 76 percent ($32.5 billion) of the drug abuse losses are "other related costs" which include direct costs of crime such as law enforcement expenditures, private legal and defense costs, and property destruction. Indirect costs include the value of productivity losses for victims of crime, incarceration, and time spent caring for ill family members.Of the three -- drug abuse, mental illness and alcohol abuse -- the study cites a lower drug abuse prevalence rate than either alcohol abuse or mental illness. The AMA estimates that its respondents are spending an average of $50,000 a year, and those with ten thousand or more employees may spend closer to $300,000 to test employees. With initial tests priced at $35, and confirmatory tests running at least three times that, volume discounts and combination services are usually negotiated. Most companies doing drug testing also sponsor employee assistance programs, or EAPs as they are commonly called. EAPs are there for all employees who want counseling and treatment for substance abuse, not just those caught by positive drug tests.In the AMA's 1995 survey, 25 companies reported having undertook their own studies. Ten of them decided that drug testing was not cost effective. Eric Greenberg, director of Management Studies for the AMA, could not divulge names of the companies, but said that this year, 18 of the 961 respondents re-evaluated their policies and six quit drug testing entirely. Most companies surveyed indicated that drug testing alone was not a major expenditure.Cutting treatment programs from benefits packages can save money, however, and Dave Stohler, a consultant in Georgia who belonged to the 7000-member Employee Assistance Professionals Association, Inc. (EAPA), hopes that this does not become a trend. He wants companies to consider what they may lose. "The combination gives a good return on a company's investment -- five to fifteen dollars for every one dollar spent on drug testing, treatment, and prevention costs," he said.Stohler and other treatment professionals I spoke with are concerned that some employers may continue drug testing to satisfy legal requirements and scrap employee assistance programs, which offer counseling and other services. If this happens on a large scale, they warn that more habitual users would be out of work and ultimately, on the take.Arguably, the drug test/EAP combo has value. Compared to million-dollar liability lawsuits arising from crimes against customers or job-related injuries, for example, treatment bills of $5,000 to $25,000 per employee are a drop in the bucket. EAPs balance the punitive impact of drug testing - the employee gets to keep his or her job - and the company saves money on hiring and firing costs. But there's an even greater incentive for companies to keep drug testing: insurance underwriters give discounts of 5-10 percent to employers with drug-free workplace polices. Here is that return that Stohler was talking about.You don't need to have an MBA to guess that medical and legal costs related to substance abuse are astronomical, accounting for the major portion of reported losses. We live in a society where doctors and lawyers charge the highest fees of any professionals, and both the healthcare industry and litigation have grown steadily through economic recessions. One man's loss is another's gain.What is surprising, however, is this. The number of workers testing positive for drugs is very low and continues to decrease: Less than 2 percent test positive, according to the AMA membership survey; according to the SmithKline Beecham Clinical Laboratories March 1996 index, 6.7 percent test positive.The AMA survey is considered important even though only 9 percent of the Association's 8,00 members respond. The nation's large and influential Fortune 500 companies employing a quarter of the workforce are part of the group.SmithKline's workplace index is based on 3.75 million tests over a six-month period. It notes a 63 percent decline in positives since 1987 and a 10.6 percent decrease between 1994 and 1995. Of the positives, it is traces of marijuana, not harder drugs, that keep showing up in more than half, meaning that sometime in the month prior to testing these individuals used pot. Evidently, millions are not totally buying the Partnership for a Drug-Free America ads.Destined to be remembered as one of this century's colossal social experiments, employee drug testing has created far-reaching effects. Mass urinalysis of American workers has delivered numbers to crunch, users to treat, and in some cases, people to bust. It's kind of like beating the dog before it barks. So you might assume that drug testing has helped save many bright minds and able bodies from excess and irresponsible behavior. AMA researchers say that in nine years of surveys, there is nothing to prove this. Nor have lower rates of on-the-job accidents been directly correlated with drug testing. Fatigue seems to cause the lion's share of workplace accidents (the National Commission on Sleep Disorder Research estimates direct costs at $15.9 billion in 1990).Despite an ever-increasing test pool, positive rates have remained constant when policies are consistent from year to year, according to the AMA survey. Was the workplace drug problem overblown at the start? Ironically, without drug testing, ascertaining this would have been like, well, watering the flower bed at midnight. If, as a I have heard treatment professionals say, 8-10 percent of the populace is addiction-prone regardless of whether drinking and drugging is fashionable, then the goal of a drug-free workplace is but a fool's dream and politician's ploy for votes.Proponents of drug testing are now in a difficult position -- if they thump their chests too hard, foes will say it's time to end the practice; if they say that test positives have decreased for other reasons, they will have egg on their faces.There are, in fact, many reasons for the drop in positives. In the beginning, false positives due to test inaccuracy and foul-ups were common; even five years ago, there were charges that the tests were incorrect 30 percent of the time. But accuracy has improved dramatically. Large-scale drug testing has given pharmaceutical companies a built-in feedback loop, allowing them to perfect the technology procedures. Also, most labs employ medical review officers to interpret test results.Five major pharmaceutical companies (SmithKline Beecham, Hoffman-LaRoche, Metpath, CompuChem, and Damon Laboratories) command the highly lucrative market in drug testing and related services -- approximately $173 million in 1989 according to quotes by industry analysts. The AMA 1996 survey estimates that a fair estimate of total spending by all 9,500 AMA-member companies on drug testing would approach a quarter of a billion dollars.And the test market is ever-expanding. The University of Michigan forecasts an onslaught of some forty million teenagers with potential drug dependencies and criminal tendencies marching through high school into the employment ranks. Roche Diagnostic Systems is currently advertising drug tests for parents to use at home. Is this coincidence?If the substance abuse explosion actually occurs, revenues generated by the drug testing industry, insurance premiums, medical treatment, counseling services, advertising, publishing, government and privately-funded grants for studies and programs, bureaucrat salaries, attorney fees, law enforcement budgets, prison construction -- in short, any and all expenditures related to substance abuse -- will total an amount rivaling our national debt. If they don't already.What we've got is a vertically integrated, highly profitable and self-perpetuating economic eco-system built upon Prohibition.All this delving into personal lives could go to Orwellian extremes. Take, for example, the pre-election proposals for drug testing of welfare recipients and inner-city students. This targets an already volatile drug war zone for political aims. Some politicians' answers to deeply-rooted economic problems amount to sanitization, where wrongdoers cornered by urinalysis and stepped-up busts would either conform or self- destruct.Similarly, the focus on workplace substance abuse, the "blame the worker" mentality, and Draconian measures such as drug testing, have successfully distracted the public from other gargantuan losses. What about the underexposed costs of executive blunders and the influence of stupidity, greed and cut-throat competition erasing millions of American jobs? We all pay for those abuses. Consider, too, that the cost of theft, embezzlement and fraud to American businesses is estimated to be between $60-$100 billion annually, according to the Association of Certified Fraud Examiners.Certain observers think a roll-back is in order. Washington, D.C. attorney Kevin Zeese explains, "Some companies are deciding that drug testing is not working for the purpose it was intended -- to help ensure safety and to weed out heavy users." The AMA predicts that future tests, hair sampling, for example, may differentiate between occasional and habitual users. For now, Zeese says, "Too many people getting caught in the net require costly treatment because company policy dictates it."Meanwhile, a group left over from the Reagan and Bush administrations is doing all it can to keep drug testing institutionalized by promoting Model State Drug Laws. Sherry Green, executive director of the National Alliance for Model State Drug Laws says that these draft bills, (actually, tailorable policies and recommendations) offering a comprehensive approach to substance abuse, are under consideration in 42 state legislatures. Along with state-mandated drug testing for all job classifications and group insurance rates for companies with drug-free workplace policies, law enforcement, treatment, prevention and education roles are spelled out. If enacted, the model laws would force small and mid-sized private companies to comply.During an interview, Cleveland attorney Wally Mueller commented, "Attempts to legislate more of people's lives are criticized, but the reality is that there is greater freedom now than ever before. From the employers' point of view, employees have more protections today. Businesses have many regulations to contend with and it gets expensive. They have rights, too -- including the right to run their companies the way they want."I agreed with him, at first. But, upon reflection, it occurred to me that in America we masquerade as free citizens. We readily forsake precious freedoms when we become captive of our fears. Drug testing perpetuates fear and undermines personal integrity. If we can't trust each other now, what is to come next? Does saying the Pledge of Alliance need to be followed by peeing in a cup?

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