Professional and societal debate regarding drug taking and drug-use problems occurs in cycles. In recent years a number of contentious issues have developed about the testing of urine, blood, saliva, and breath for evidence of drug use. Substances evaluated include alcohol, steroids, stimulants, sedatives, opiates, hallucinogens, and a variety of other chemicals both legal and illegal. Legal issues have been raised concerning the validity of testing procedures used and the reliability of evidence obtained, especially with preemployment drug screening. Other controversies center on the right to privacy versus the needs of society, and a variety of related topics. These issues and suggestions for maximizing the effectiveness of drug testing programs while minimizing legal challenges are discussed.
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References
1.
AMA Council on Scientific Affairs1987Issues in employee drug testing. Journal of the American Medical Association257(22):3110–4.
2.
AngarolaR. T.1991Substance abuse testing in the workplace: Legal issues and corporate responses. In Drug testing: Issues and options, ed. CoombsR. H.WestL. J., New York: Oxford Univ. Press.
3.
ChristoffelT.1984Using roadblocks to reduce drunk driving: Public health or law and order. American Journal of Public Health74(9):1028–30.
4.
ClarkeE. G. C.1969Dope and doping. Medicine, Science, and the Law9(4):218–23.
5.
CrossL. B.Jr.HaneyD. C.1987Workplace medical testing harbors legal pitfalls; caution suggested. Occupational Health and Safety56(13):26,28,36.
6.
DupongW. G.1971Urine chromatography in testing for drugs in applicants for work. Journal of Occupational Medicine13(10):459–64.
7.
EubanksP.1992Hospitals begin to implement worker drug-testing programs. Hospitals66(20):38–42.
8.
FringsC. S.WhiteR. M.BattagliaD. J.1987Status of drugs-of-abuse testing in urine: An AACC study. Clinical Chemistry33(9):1683–6.
9.
GoldsmithM. F.1988Drug testing upheld, decried; physicians asked to help decide [news]. Journal of the American Medical Association259(16):2341–2.
10.
HalperinE. C.1991Suspicionless drug testing of physicians. North Carolina Medical Journal52(4):131–5.
11.
HawksR. L.ChiangC. N., eds. 1986Urine testing for drugs of abuse. NIDA Research Monograph no. 73. Washington, D.C.
12.
HilkerR. R. J.AsmaF. E.DaghestaniA. N.RossR. L.1975A drug abuse rehabilitation program. Journal of Occupational Medicine17(6): 351–4.
13.
HomelR.1983The impact of random breath testing in New South Wales, December 1982 to February 1983. Medical Journal of Australia 25 June: 616–9.
14.
ImwinkelriedE. J.1987Some preliminary thoughts on the wisdom of governmental prohibition or regulation of private employee urinalysis testing. Clinical Chemistry33 (suppl. 11):19B–32B.
15.
LewyR. M.1983Preemployment qualitative urine toxicology screening. Journal of Occupational Medicine25(8):579–80.
16.
LewyR. M.1991Pre-employment drug testing of housestaff physicians at a large urban hospital. Academic Medicine66(10):618–9.
17.
LubranM. M.JasperK. T.1988Drug abuse in the workplace. Annals of Clinical and Laboratory Science18(1):6–12.
18.
LundbergG. D.1972Urine drug screening: Chemical McCarthyism. New England Journal of Medicine287(14):723–4.
19.
LundbergG. D.1986Mandatory unindicated urine drug screening: Still chemical McCarthyism. Journal of the American Medical Association256(21): 3003–5.
20.
MontagneM.PughC. B.FinkJ. L.III1988a. Testing for drug use, Part 1: Analytical methods. American Journal of Hospital Pharmacy45(6):1297–1305.
21.
MontagneM.PughC. B.FinkJ. L.III1988bTesting for drug use, Part 2: Legal, social, and ethical concerns. American Journal of Hospital Pharmacy45(6): 1509–22.
22.
MorganJ. P.1984Problems of mass urine screening for misused drugs. Journal of Psychoactive Drugs16(4):305–17.
23.
NormandJ.SalyardsS.1989An empirical evaluation of preemployment drug testing in the United States Postal Service: Interim report and findings. In Drugs in the workplace, ed. GustS. W.WalshJ. M., NIDA Research Monograph no. 91. Washington, D.C.
24.
ParishD. C.1989Relation of the preemployment drug testing result to employment status: A one-year follow-up. Journal of General Internal Medicine4(1): 44–47.
25.
SelavkaC. M.1991Poppy seed ingestion as a contributing factor to opiate-positive urinalysis results: The Pacific perspective. Journal of Forensic Sciences36(3):685–96.
26.
U.S. Department of Health and Human Services1988Mandatory guidelines for federal workplace drug testing programs: Final guidelines. Washington, D.C.: U.S. Government Printing Office.
27.
U.S. Department of Health and Human Services1990Seventh special report to the U.S. Congress on alcohol and health. Washington, D.C.: U.S. Government Printing Office.
28.
WickR. L.BrawleyW. L.BergerB. T.1992A survey of preplacement urinalysis drug findings. Aviation, Space, and Environmental Medicine63:56–59.
29.
WilletteR. E.1991Techniques of reliable drug testing. In Drug testing: Issues and options, ed. CoombsR. H.WestL. J., New York: Oxford Univ. Press.
30.
WolfeA. C.1974U.S. national roadside breathtesting survey: Procedures and results. Interim report. Prepared for the National Highway Safety Administration. Washington, D.C.: U.S. Government Printing Office.
31.
ZwerlingC.RyanJ.OravE. J.1990The efficacy of preemployment drug screening for marijuana and cocaine in predicting employment outcome. Journal of the American Medical Association264(20):2639–43.
