title: Drug testing: technical complications of a complex social issue.
abstract: To control the adverse effects of substance abuse, urinary drug testing has become common practice in some occupational settings. Although it is virtually impossible to assess accurately the impact of drug abuse at work, increased accidents and absenteeism as well as impaired productivity have been attributed to drug abuse. The major analytical techniques used to screen for illegal drug use are thin-layer chromatography and enzyme- and radioimmunoassays. Gas chromatography-mass spectrometry is uniformly recommended to confirm any positive screening test. The major technical problem in interpreting screening tests is that the presence of a substance in the urine indicates merely exposure to the drug, not necessarily intoxication, habituation, or addiction. Since no certifying criteria are available to insure quality control among laboratories performing urinary drug testing, results may vary widely. In fact, a study conducted by the Centers for Disease Control suggests that poor performance of some laboratories may adversely affect the treatment of drug abuse. The Federal Rehabilitation Act (1973, section 504) prohibits discrimination against the handicapped, which includes both drug abuse and alcoholism. Legal challenges to urinary drug testing have focused on issues related to the right to privacy and freedom from unreasonable searches. Because of the wide-ranging legal, ethical, and medical ramifications of drug-screening programs, careful review of these issues is recommended before an organization establishes such a program.
authors.affiliation: Cabot Corporation, Waltham, Massachusetts 02254.
authors.forename: R J
authors.initials: RJ
authors.lastname: McCunney
mesh_terms: D000437:Alcoholism / Q000652:urine*; D002961:Civil Rights; D004650:Employee Performance Appraisal; D004989:Ethics; D006801:Humans; D007603:Jurisprudence; D007753:Laboratories / Q000592:standards*; D011863:Radioimmunoassay; D019966:Substance-Related Disorders / Q000652:urine*; D014481:United States