WHEN IS A DRUG NOT A DRUG?

WHEN IS A DRUG NOT A DRUG?

BY CARL E. KING

WE CAN'T TURN ON A Television or pick up a newspaper these days without hearing or reading about drug testing. Most large companies are either testing applicants and employees for drugs or are considering doing so. Drug testing through urinalysis is one of this country's fastest-growing businesses. The US government has not only endorsed testing in general but in fact ordered it for private companies regulated by the Department of Transportation.

The current interest in drug screening is commendable. Since widespread testing has begun, the national use of every illicit substance except crack has declined. Clearly, workplace testing is one of the only strategies in the 20-year war on illegal drugs that seems to be working.

But our battle plan has a flaw. While we've been testing diligently for drugs, a single substance has escaped notice, a substance that causes twice the problems of all illegal drugs combined: alcohol.

Alcohol is the most abused substance in the United States today and affects seemingly normal men and women from every walk of life. Its cost to society is staggering. The Research Triangle Institute of North Carolina reports alcohol abuse was responsible for $50.6 billion in reduced productivity in 1988, compared with $25.7 billion in losses from drug abuse. Our nation spent $9.5 billion in health care costs for alcohol-related problems, compared with $1.2 billion for drug-related problems.

The Employee Assistance Society of North America states absenteeism among alcoholics and problem drinkers is as much as 8.3 times higher than for other employees. Alcohol abusers also have a two to three times greater risk of being involved in industrial accidents. The society's studies show that up to 40 percent of industrial fatalities and 47 percent of industrial injuries are due to alcohol abuse. Even nonalcoholic members of an alcoholic's family use 10 times more sick leave than other employees.

Alcohol problems are not limited to the workplace. The US Department of Health and Human Services reports that alcohol was involved in half of all highway deaths last year, resulting in 25,000 fatalities. It is also a factor in 50 to 70 percent of all murders, fatal accidents, and fire deaths and in over half of all arrests. Considering alcohol's dramatic impact on our nation and businesses, any responsible substance abuse program should screen for it.

Why alcohol is not routinely tested for is unclear. However, there are probable causes for its omission. Urinalysis is legally acceptable for drug testing but is not a good test for alcohol. Alcohol evaporates from urine during shipment, causing the final reported content to be less than it was at collection. Also, because alcohol eventually moves to the kidneys and is held there until expelled, a urine test can report an alcohol level consistent with being legally intoxicated even though the person providing the sample is no longer affected by the intoxicant.

Intoximeters, or breath-testing machines, are an excellent means of alcohol detection and constitute legally acceptable evidence. However, they are costly, require certified operators, and must be calibrated continually. These drawbacks make them difficult for the average company to use in substance screening programs.

Saliva tests are inexpensive. They are, also generally acceptable for establishing probable cause to move forward to a confirmatory urine or blood test. Unfortunately, the test materials have a limited shelf life and must be kept cool.

Blood testing is the only accurate method of proving alcohol intoxication, but it is intrusive and costly. Blood tests are practical only when there is a reasonable suspicion that the person being tested has alcohol in his or her system.

Considering that most available alcohol testing methods have some drawbacks, it is understandable why some executives choose not to screen for alcohol. However, new technologies provide us with accurate, easily-administered, cost-effective screening methods that should now be considered.

For example, new disposable breath testers are an effective way to check for alcohol in a subject's system while testing for other drugs. If a breath test is positive, the subject is then required to provide a blood sample for shipment along with the urine sample. A laboratory tests the blood to confirm the presence of alcohol while the urine is tested for other drugs.

Adding alcohol to corporate substance abuse testing programs makes sense.

Since disposable breath testers cost $3 or less, they are a cost-effective screening method. They allow employers to eliminate from suspicion employees who have no alcohol in their systems and concentrate on those who test positive. Since a breath test can be confirmed by a blood test, they make good sense in a screen-and-confirm program.

When choosing a disposable breath tester, managers should select one that has been properly verified and validated. It's a good idea to review those that have received favorable scrutiny from the Department of Transportation and that match a police intoximeter for accuracy. Blood and urine tests should be conducted by a forensic laboratory, preferably one certified by the National Institute on Drug Abuse (NIDA). NIDA-certified labs have excellent quality control and chain-of-custody procedures and are likely to survive court challenges.

Since accurate and cost-effective methods of alcohol screening are available, and since alcohol abuse is far more costly and damaging to American business than drug abuse, adding alcohol screening to corporate substance abuse testing programs makes sense. Any company that tests for drugs and not for alcohol is open to the criticism that its testing is incomplete.

About the Author . . . Carl E. King is CEO of Team Building Systems Inc., which specializes in employee and applicant screening, in Houston. He is a member of ASIS.