Transcript Dr_Cameron_Wild_Drug_Testing_Presentation

Work-Place Alcohol and
Other Drug Testing
Dr. Cameron Wild
Associate Professor
University of Alberta
Addiction and Mental Health Research Laboratory
Centre for Health Promotion Studies, and
Department of Public Health Sciences
Drug Testing in the Workplace
Work-Place Alcohol and
Other Drug Testing
1.
2.
3.
4.
History and context of the issue
Technologies for drug testing
Evidence underpinning drug testing
Prevalence of drug use and industrial
accidents
5. Alcohol and other drug use in Alberta
6. National workplace drug policy survey:
Preliminary results
7. Unintended negative effects of drug testing
Drug Testing in the Workplace
1. History and context of the issue
•
In 1986, an Executive Order was signed promoting the
establishment of a drug-free federal workplace in the
USA
•
A policy was adopted to implement random drug
testing in aviation, rail, mass transit, trucking, and
pipeline occupations
•
A 1993 survey reported that 85% of large US firms had
instituted testing programs for illicit drug use
•
Alcohol testing in US workplaces is much less
common
Drug Testing in the Workplace
1. History and context of the issue
•
In Canada, random drug testing in workplaces is
generally occurs much less often
•
However, following the US lead, testing for illicit
substance use is much more prevalent than alcohol
testing
•
Recent court cases (TD Bank, Imperial Oil) in
Canadian worksites have challenged the practice of
random drug testing
Drug Testing in the Workplace
1. History and context of the issue
Why do firms engage in alcohol and other drug testing?
•
•
Reason #1. Workplace safety. Policy statements from
Canada, Australia, Netherlands, France, Sweden
reveal either explicitly or implicitly that workplace
safety is the most frequently offered justification for
workplace drug testing programs. This rationale relies
on economic costs and cost-saving arguments.
Reason #2. Identifying employees engaging in illegal
behaviour. This rationale likely accounts for the
imbalance of existing testing programs toward
detection of illicit drug use, rather than alcohol use.
Drug Testing in the Workplace
1. History and context of the issue
Why do firms engage in alcohol and other drug testing?
•
Reason #3. Corporate symbolism. Many firms believe
that it is simply good public relations to promote “drug
free workplaces”.
Drug Testing in the Workplace
1. History and context of the issue
Why do firms engage in alcohol and other drug testing?
•
All 3 reasons raise important questions: What is the
scientific evidence for or against alcohol and other
drug testing? Do they actually improve workplace
safety? Do they effectively identify employees
engaging in illegal activities? What are the impacts of
symbolic policies toward employees?
Drug Testing in the Workplace
2. Technologies for drug testing
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Alcohol testing: administration of a breathalyser to
employees to determine Blood Alcohol Content (BAC)
•
Other drug testing: obtaining a urine sample from
employees, which is then analyzed in a laboratory for
the presence of drug metabolites
•
These tests can be implemented in different ways:
random testing, testing in situations of probable cause,
and pre-employment drug tests
Drug Testing in the Workplace
2. Technologies for drug testing
Drug effects and intoxication need to be understood from
a dose-response perspective
Drug Testing in the Workplace
2. Technologies for drug testing
Techniques for detection depend on drug elimination –
Elimination time varies across different drug classes
Percent
Half-tim e System ic Drug Elim ination
120
100
80
60
40
20
0
t0
t1
t2
t3
t4
Half-tim e
Drug Testing in the Workplace
t5
t6
t7
2. Technologies for drug testing
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•
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Alcohol testing: breathalyser test results can detect
level of alcohol in the blood. Can be administered in
the workplace and results can be obtained almost
immediately
Other drug testing: obtaining a urine sample can only
determine whether drug metabolites are present in the
body. Urine tests therefore cannot be used to
determine when or how much of a drug was taken.
Detection periods (time between ingestion of a drug
and a positive test) vary across drugs. Morphine can
be detected for a couple of days, cannabis for several
weeks
Drug Testing in the Workplace
3. Evidence underpinning drug testing
Laboratory evidence
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Over 50 years of laboratory evidence shows that psychomotor
abilities deteriorate considerably with ingestion of alcohol
•
For other drugs, some produce large performance deficits; others
produce minor or no changes
•
Examples: benzodiazepines (e.g., valium) reduce psychomotor
performance; opiates do not affect human performance at low –
moderate doses; stimulants (amphetamines, cocaine) do not
undermine performance; mixed evidence for cannabis
•
Pharmacological properties and effects on human performance
varies considerably across drugs
Drug Testing in the Workplace
3. Evidence underpinning drug testing
Epidemiological evidence
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Useful for determining whether alcohol/other drug use causes
workplace accidents
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Alcohol: most studies of BACs among injured workers are
methodologically weak (no control groups) and are too few to
conclude that drinking is a major factor for work injuries/accidents
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Alcohol: alcohol involvement in work injuries is small, estimated to
be between 3-4% in one review and 4-11% in another review
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Extremely reliable dose-response relationship between BAC and
traffic collisions. Relative risk of collision with a BAC of .08 mg%
is about 2 and rises to between 12 and 100 at .16 mg%
Drug Testing in the Workplace
3. Evidence underpinning drug testing
Epidemiological evidence
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Other drug use: existing evidence is sparse and inconclusive with
respect to a causal link between other drug use and workplace
accidents
•
For studies in this area, it is generally unknown whether any
individuals involved in job accidents were actually under the
influence of other drugs at the time of accident
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A 1991 study in Alberta: toxicology reports from 459 deaths from
work injuries found that 8.5% tested positive for cannabinoid
metabolites, 6.7% tested positive for other nonprescription drug
metabolites
Drug Testing in the Workplace
4. Prevalence of drug use and industrial
accidents
Survey research
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Alcohol use = by far the most used drug (80% of the population in
most industrialized countries)
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Other drug use = much less prevalent (in order: benzodiazepams,
cannabis, amphetamine, cocaine)
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If few people use other drugs, and fewer still use drugs on the job,
then the proportion of job accidents caused by other drug use is
probably low
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Less than 10% of respondents who use other drugs also report
using at the workplace at least once
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Newcomb: “Little justification…for the widespread concern if not
hysteria regarding drug abuse” at work
Drug Testing in the Workplace
4. Prevalence of drug use and industrial
accidents
Keeping things in perspective
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Workplace accidents/injuries are caused by a wide
range of factors: poorly maintained equipment,
inadequate training/supervision, sleep problems
(possibly the most important lifestyle contributor to
industrial accidents)
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Given the relatively small contribution of alcohol/other
drug use to work injuries, the most effective programs
should target a broad range of factors in addition to
alcohol/drug use
Drug Testing in the Workplace
5. Alcohol and other drug use in Alberta
Use among Alberta Adults
– Current drinkers: 79.3% AB, 74.1% CAN
(National Population Health Survey, 1998/1999)
– Litres alcohol/person: 8.7L AB, 7.7L CAN
(Statistics Canada, year ending March, 2002)
– Sales per capita: 111.6L AB, 104.2 L CAN
(Statistics Canada, year ending March, 2002)
– Heavy drinkers: 22.5% AB, 20.1% CAN
(5+ drinks on 1 occasion, 12+ times/year; Canadian Community Health Survey, 2000/2001)
– Alcohol dependent: 3.5% AB, 2.6% CAN
(Canadian Community Health Survey, Mental Health and Well-being, 2002)
Drug Testing in the Workplace
5. Alcohol and other drug use in Alberta
Alberta Alcohol Survey
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Population survey of over 10,000 Alberta adults
18+ years of age
Designed to describe prevalence of alcohol
problems across the province
Alberta Addiction Survey
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Population survey of over 3500 Alberta adults 18+
years of age
Designed to describe prevalence of other drug use
Drug Testing in the Workplace
5. Alcohol and other drug use in Alberta
• Use: Edmonton Adults
Alcohol use among adults residing in the
Capital Health Authority
– Current drinkers: 81.0%
– Problem drinkers: 14.7%
350
-be problem drinkers
-be alcohol dependent
-believe they cannot cut
down without help
-be willing to cut down
-seek treatment
Women more likely to:
-abstain
-have interest in self-help
Count
Men more likely to:
300
18-24
250
25-34
200
35-44
150
45-54
100
55-64
65+
50
0
Current Drinker
Abstainer
Source: Alberta Alcohol Survey (2002)
Drug Testing in the Workplace
5. Alcohol and other drug use in Alberta
Alberta-wide data on problem drinking
Problem Drinking:
Age x Education Interaction
Percentage of Problem Drinkers
50
40
30
Education
20
Lacking high school
10
0
18-24
High school diploma
Post-secondary
25-34
35-44
45-54
55-64
Age
Source: Alberta Alcohol Survey (2002)
Drug Testing in the Workplace
65+
5. Alcohol and other drug use in Alberta
Self-reported use of other drugs in previous 12
months
4
SEDATIVES
TRANQUILIZERS
2
AMPHETAMINES
6
PAINKILLERS
INHALANTS
MARIJUANA
14
COCAINE
2
HALLUCINOGENS
2
HEROIN
0
2
4
6
8
PERCENT
Source: Alberta Addiction Survey (2002)
Drug Testing in the Workplace
10
12
14
16
5. Alcohol and other drug use in Alberta
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Alcohol continues to be the most-used drug across the Province
(80% of adults surveyed)
Of those who drank alcohol in the previous year, about 15% can be
classified “problem drinkers” (more likely to be young, male, low
levels of education)
Of those who drink alcohol, 4% or less exhibit clinical symptoms
of alcohol dependence
Cannabis use is reported by about 14% of Alberta adults (i.e., used
once or more in previous 12 months)
Nonmedical use of painkillers, sedatives = next most popular drug
of use
Drug Testing in the Workplace
6. National workplace drug policy survey
Proportion of firms with 100+ employees reporting EAP
programs (preliminary sample of 476 companies)
Eastern
provinces
Ontario
Western
provinces
National
55
60
65
70
Proportion of Companies
Drug Testing in the Workplace
75
6. National workplace drug policy survey
Proportion of firms with 100+ employees reporting health
promotion programs (preliminary sample of 476 companies)
Eastern
provinces
Ontario
Western
provinces
National
0
20
40
60
Proportion of Companies
Drug Testing in the Workplace
80
6. National workplace drug policy survey
Proportion of firms with 100+ employees reporting worksite
alcohol/drug screening (preliminary sample of 476
companies)
Eastern
provinces
Ontario
Western
provinces
National
0
5
10
15
20
Proportion of Companies
Drug Testing in the Workplace
25
7. Unintended negative effects of drug
testing
•
Crant & Bateman (1990) gave descriptions of a potential employer
to respondents and manipulated drug testing (present or absent)
and need for drug testing (high or low). Results were that people
had more positive attitudes and intentions toward companies that
did not have drug testing programs and toward companies that
did not need a testing program
•
Konovsky & Cropanzano (1991) reported that perceived fairness
of drug testing procedures predicted trust in management, job
satisfaction, commitment to the organization, turnover intentions
Drug Testing in the Workplace
Summary
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Current alcohol and other drug detection technologies
are not uniformly effective in determining whether
workers are intoxicated on the job
Alcohol use = by far the most likely problem in relation
to worksite safety
Remember that best evidence to date indicates that
alcohol and other drug use accounts for a small
proportion of worksite injuries. Other factors, such as
sleep deprivation, need to be addressed in
comprehensive employee programs
Drug Testing in the Workplace
Summary
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Larger Western Canadian companies may have more
employee programs, including drug testing programs,
compared to other areas of Canada
Remember that evidence suggests that employee
loyalty, intentions to leave, etc. are strongly affected by
how employees perceive implementation of drug
testing policies
Be honest about whether the goals of implementing a
worksite drug testing program are to serve safety,
criminal, or symbolic purposes
Drug Testing in the Workplace