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Pre-Employment Tests

1.     In general, the common pre-employment urine screen is by far the easiest kind of test to deal with, insofar as prospective employees need only avoid incriminating substances for the time they are on the job market. However, a surprising number of ignorant job applicants are unaware that they should be prepared for urine tests in the first place. Most pot smokers appear to have little problem abstaining for job tests, given the low addictive quality of marijuana.

Nonetheless, pre-employment tests can still be a problem even for moderate users if they happen to encounter a surprise job opportunity. In addition, many companies require drug screens of employees when they are promoted. As a result, many workers whose efforts have won them a promotion end up being fired instead on account of bad urine chemistry. Employees may also face urine tests unexpectedly when their company is sold to new management. In such cases, the new owners may demand a sudden spot urine check of the entire workforce, effectively purging it of anyone who has had the bad luck to indulge a suspect substance too recently. Victim of such abuses generally have no legal recourse against dismissal, and can also expect to lose unemployment benefits. NORML has heard from many otherwise blameless pot smokers who have lost jobs than to drug testing. Few cases better illustrate the absurd lengths to which urinalysis is carried than that of a newly "promoted" radio programmer who found himself fired for a positive marijuana test. The employee, who admitted to being a weekend pot smoker, had been working for a San Francisco "60s golden oldies" FM station!

Many NORML callers complain of having been coerced into drug testing programs they don't understand or approve of, with little explanation of how the policy will be administered. "It was very manipulative," recounts one woman concerning her employer's efforts to make her sign a form consenting to urinalysis. "They told us of course we wouldn't be randomly tested; we would only be tested on cause,' she relates, "But the form specifically stated we would agree to random testing." Many employees receive no disclosure statements at all, leaving them vulnerable to arbitrary decisions. Some workers complain of being fired for a single bad test after being given the impression that they would be eligible for a rehabilitation program instead. Many employees complain about being "singled out" for drug tests because they are unpopular with their supervisor or manager. Others report being told by their managers that they will be protected from urine tests because they are valued employees. Some employees receive advance warnings about impending tests, giving them time to prepare; others are taken by surprise.

Because blood and urine samples are used for many other medical tests, subjects do not necessarily know when they are being drug tested. A Nevada mother told the NORML hotline that she had been unwittingly blood-tested for marijuana in a maternity ward, in what she had been told was a blood test for AIDS. She said her family was subsequently visited by plainclothes police demanding that they refer their newborn to a hospital ward for drug-addicted babies, or else give up custody. Another woman relates giving a urine specimen for what she was told was a pre-employment drug test, and losing the job when the employer inspected it to find out that she was pregnant instead!



Random Urinalysis

By far the most dreaded and inclusive form of drug testing is the random test, which is specifically designed to take workers by surprise. Under random testing, workers may be called on to provide a urine sample at any time, typically on no more than an hour or two's notice (however, in some shops, workers have been known to receive as much as a weeks' advance alert). A corollary of random urinalysis is to prevent workers from using any marijuana, even at home on weekends, at the risk of losing their jobs.

While private employers have tended to shy away from random testing on grounds of expense, government drug warriors have successfully campaigned to impose random testing through federal regulations. Random urinalysis is now required for the military, many public employees and contractors, and the nation's entire interstate transportation workforce - including not only airline pilots, train engineers and truck drivers, but also flight attendants, mechanics, and gas pipeline workers.

The NORML hotline receives many complaints about random testing from transportation workers. Most not only resent the intrusion on their Private lives, but also insist that illicit drug abuse is not a safety problem. "Alcohol is the worst abused drug especially by pilots, "say some angry flight attendant, a view repeatedly expressed by others in the industry.

According to air industry spokesmen, not a single passenger airline crash had been attributed to alcohol or drug abuse. 14 Administration officials lamely pointed to a 1988 plane crash in Durango, Colorado, in which the pilot's blood showed evidence of cocaine use. Yet investigators determined that the pilot was not high at the time of the crash, and it was the co-pilot who was controlling the plane at the time of the crash! 15 The fact that drug testing is widely opposed by the very airline workers whose lives are most at stake would seem to raise obvious questions about the supposed dangers of drug abuse in the air industry. Congress in response to a highly publicized 1987 train collision in which 16 passengers were killed. 16 The accident was blamed on the negligence of an engineer and brakeman, who were determined to have been smoking marijuana shortly before the crash.

A subsequent investigation revealed that both men had an extensive record of drunken driving offenses and were known to be problem drinkers. Furthermore, some of the train's safety equipment had been disabled. The engineer admitted to culpability for ignoring warning signals, but denied that marijuana had anything to do with the accident. An investigation by the National Transportation Safety Board concluded that the railroad should undertake management's reforms and equipment improvements, but did not recommend drug testing.

Nonetheless, Transportation Secretary James Burnley argued for drug testing, pointing to evidence that a significant percentage of accident-involved rail personnel tested positive for drugs. 17 In fact however, Federal Railroad Administration statistics showed that only 4 - 6% of "reasonable cause" urine tests were positive for drugs or alcohol, 18 half of what might have been expected for a normal cross-section of the workforce! 19

The ultimate impact of random testing regulations remains to be seen, as testing is still being phased in within the transportation industry. Many workers have responded by adjusting their drug use, however grudgingly. Others persist in risking a urine positive, relying on one or another evasion techniques to minimize their risks. Relatively few are actually caught: airlines report fewer than 1 % of employees test urine positive. 20 Included are an unfortunate number of very occasional users: NORML has heard from more than one flight attendant dismissed for indulging a rare joint with an old friend.

Many workers report turning to alcohol as a substitute for marijuana. "I'm drinking a lot more now," says one trucker, echoing a common complaint of many drug-tested workers who say they use pot to control alcoholism. Other drug-tested workers report widespread alcohol abuse among their fellows: "You see guys stumbling in here drunk from the management on down," says a Customs employee, "'There are guys drinking alcohol first thing in the morning." Another employee told NORML that workers at his job had started smoking heroin instead of pot. Meanwhile, in the military, LSD is said to have become the illicit drug of choice due to its relative undetectability. 21 It is tempting to speculate that recent reports of a parallel upsurge in alcohol and LSD use among young persons reflect a broader social trend created by the incentives of drug urinalysis. 22



Urinalysis: "On-Cause" or No Cause?

In many workplace, employees are subject to "on-cause" testing whenever they have an accident. While such testing might seem objectionable, it is often abused so as to inculpate innocent workers.

For instance, a diesel mechanic told NORML that he had been ordered to take a urine test following a minor workplace accident on a Friday, and that his drug test was scheduled for Monday, three days after the accident. The worker was rightly concerned that he might be fired because he had recently had he actually been under the influence of any other drug - cocaine, heroin, alcohol or speed - at the time of the accident!

In another case, a woman reported that her husband, a print shop worker with eight years' seniority, had flunked a drug test for marijuana after receiving a minor finger cut in an accident caused by another worker. Not only was her husband fired for an accident that wasn't his fault but the family also lost health insurance coverage for their son, who had serious medical problems costing $1200 per month. Like other urine testing victims, the woman charged that the company had financial motivations to fire her husband, namely the family's insurance costs.

Urinalysis abuse is a phenomenon that extends beyond the job market. For instance, some insurance companies require drug urinalysis as part of their physical exams. Applicants are routinely denied insurance if they are found to use marijuana, despite the fact that there is not an iota of actuarial evidence showing marijuana adversely affects life expectancy.

Urinalysis has also come to figure in custody battles between estranged couples. One husband told California NORML that he had been directed by a court to submit to urinalysis after his wife had accused him of being a marijuana smoker, a condition widely presumed to compromise parental fitness. He complained that he was given no time to prepare for the test despite the fact that his wife, who had demanded the test, had three weeks to prepare a clean sample of her own.

Another arena where urinalysis is widely abused is the prison system, where it is often imposed indiscriminately as a condition of probation or parole. As a result, many non-violent offenders face substantial prison time for simply smoking a joint. For instance, a California woman with a long history of medical marijuana use for migraines was sentenced to 8 months in jail on charges of marijuana transportation. The judge explained that he could not give her a suspended sentence because in that case she would be subject to drug testing, which she would almost certainly fail, thereby ending up with a substantial prison sentence! Drug test violations have been reported to constitute 45% of all parole violations in California, which in turn accounts for nearly half of all prison admissions. 23 The use of marijuana screening appears especially dubious in light of the fact that marijuana tends to suppress violence, whereas the nearest substitute, alcohol tends to aggravate it.

California NORML has heard from several medical marijuana patients with drug testing problems. "Pot makes me feel better, " complains a government worker with psoriatic arthritis, "I can't take alcohol." Other patients are threatened with drug testing program following convictions for marijuana offenses. Although marijuana is not an approved medication, patients may be able to pass urinalysis by obtaining a prescription for Marinol, the government-approved synthetic marijuana substitute. Since Marinol reacts exactly like marijuana, patients could presumably obtain a medical exemption for a positive urine test.

Unfortunately, however, prescriptions for Marinol are not easy to come by and federal regulations forbid its use outside of cancer chemotherapy.

One common concern about drug testing is the danger of "false positives," in which subjects are erroneously accused of drug use. Contrary to rumor, neither passive smoking nor drug interactions are likely to cause false marijuana positives. Only in the most unlikely conditions, such as sitting for hours on end in a closet full of heavy pot smokers, has passive smoking been shown to produce a level of urine metabolites high enough to be detected on the standard EMIT test. 24 Likewise, no drug is known to cause a false positive for marijuana, but certain over-the-counter medicines can trigger the test for amphetamines and poppy seeds can be confused with opiates (it used to be that ibuprofen interfered somewhat with marijuana tests, but this problem has been fixed). 25 Such problems are supposed to be sorted out by medical review officers, the reliability of whom can only be speculated on. However, NORML has not heard any complaints about false positives from drug interactions.

The important question remains whether false positives may be caused by lab error. Early surveys of drug testing labs reported remarkably high error rates. However, industry and government have taken steps to insure against false positives for the sake of public credibility and liability. By requiring accurate gas chromatography confirmation tests of positive samples and regulating the chain of custody, selected labs have demonstrated false positive rates as low as zero in 10,000 - 48,000 samples in proficiency tests (false negatives, in which drug use is not detected, run around 3%. ) 26 Nonetheless, given the profusion of unregulated labs, higher error rates may well be common. It should be noted that even if false positives occur in as few as one in 100,000 tests, hundreds of Americans per year can expect to be falsely branded as illicit drug users.

California NORML has heard from three or four persons claiming to be victims of "false positives" for marijuana. Claims of this kind are by nature suspicious and difficult to verify. On one occasion, however, I personally observed what appeared to be a serious lapse of security in a local clinic that administers drug tests to probationers for local corrections authorities. I had come there to have some experimental specimens tested, and was told to place them on a shelf. While I waited for an attendant to record and label the samples, a nurse came in and deposited another unleveled specimen jar on the shelf next to mine. Had I not brought the situation to the attendant's attention, it would have been child's play to switch and mislabel the samples by error or mischief.



Uromancy: An Obsolescent Technology? 

The full toll of drug urine victims has yet to be scientifically investigated. Nothing is known about the number of false positives, nor the number of responsible workers disqualified for urine positives, nor the costs to their families, the economy, and welfare roles, nor the extent to which drug urinalysis has aggravated abuse of alcohol, tobacco and other untested drugs.

As for the purported benefits of testing, these too are unclear. Given the potential for drug substitution, however, it may be doubted whether they will prove significant. Indeed, a pair of recent studies suggest that the recent decline in marijuana use has led to an increase in drug-abuse emergencies and auto fatalities due to alcohol and other drugs. 27 Meanwhile, the Bureau of Labor Statistics has reported a jump in job-related sickness and injuries to a record 6.8 million in 1990, or 8.8 out of 10 workers, tie highest rate since 1979, before drug testing began! All of this raises obvious questions about the purported benefits of drug urinalysis. Insofar as the evidence for drug testing rests more on faith than science, it might aptly be called "uromancy."

The case for drug urinalysis is further undermined by the fact that there exist alternative means for detecting impairment. Most promising of these are performance tests, which measure reaction time, alertness, and agility at various tasks. Computer-based performance tests are now on the market and have started to be used in some workplaces. 28 Performance tests have the obvious advantage of measuring actual impairment, regardless of the cause. Unlike urinalysis, they can detect problems caused by alcohol and other, untested drugs, as well as stress, fatigue, and emotional distress. In addition, they have the important advantage of disregarding private behavior that is irrelevant to job performance.

Another, often ignored alternative to urinalysis is blood testing. Although blood tests are even more physically invasive than urine tests, they provide a much better indication of current impairment, since they detect the active presence of psychoactive drugs in the system rather than inactive urine metabolites. Because blood tests are less sensitive to behaviorally irrelevant past drug use than urine tests, they are commonly used in forensic studies of accident victims to determine whether the subject was under the influence of drugs. Unfortunately, blood tests are at best an imperfect indicator of intoxication for drugs other than alcohol, and it is impossible to determine fixed thresholds for impairment. In the case of marijuana, THC blood levels decline quite rapidly to negligible levels in as little as two hours for recreational users, although chronic users can manifest detectable levels for a couple of days. Blood tests may therefore offer a useful way for occasional drug users to establish their innocence of being under the influence.

The case can be made that any worker accused of on-the-job drug abuse should have the option of taking a blood or impairment test to prove his or her competence (in California, motorists accused of driving under the influence of drugs have the option of blood or urine tests; unfortunately, few if any drivers understand the dramatic differences in sensitivity between the two). Another, more sinister alternative to urinalysis is hair testing, which is even more sensitive to past drug use than urinalysis. Promoters claim to detect drug use for months and even years, far longer than any pharmacological impact on health. Despite the fact that hair testing has unresolved technical problems and is considered to be an unproven technology by the scientific community, 29 it is already being marketed and used by some private employers and has been boosted by federal officials like Drug Czars William Bennett and Bob Martinez. The one advantage of hair testing is that it is less invasive of bodily privacy than blood or urine testing, although some persons, such as those of the Sikh religion, object to having their hair disturbed. However, because hair testing is also much more indiscriminate than other technologies in distinguishing harmless drug use from abuse, it poses even greater potential costs to society, the economy, and civil liberties.

The choice between hair testing and performance testing marks a crucial crossroads for the nation's drug policy. While the outcome remains to be seen, there are good reasons to think that urine and hair testing will eventually be rejected for all but forensic purposes, given their basic inability to measure competence.

Drug urine testing is perhaps best understood as a tool for imposing social conformity that has aptly been described as "chemical McCarthyism", 30 Like the loyalty oath of the fifties, urinalysis seeks to impose "politically correct" attitudes in the workforce. As drugs have replaced Communism as domestic enemy number one, so the question, 'Are you now or have you ever been a member of the Communist party?- has been replaced by, 'Are you-now or have you been the user of a controlled substance?' When the current and drug hysteria subsides, the absurdity of this question will become apparent.

Technologically, drug urine testing can best be compared to that other tool of McCarthyism--the polygraph. Like the polygraph, drug testing rests on the spurious premise that the human mind can be read via crude physiological measures. Like the polygraph, drug testing is inherently misleading and endangers innocent parties. Time has revealed the polygraph to be an essentially flawed technology, and it has now been outlawed for most purposes (ironically, by the very same Congress that eagerly embraced random urinalysis).

In the fullness of time, it can be expected that the same will happen to drug urinalysis. As the costs of drug testing are examined more closely, it is apt to be seen that human beings are best judged by their performance, not the chemicals in their urine.

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