Testing for Alcohol and Other Drugs

11. Effectiveness of Drug Testing vs. Management and Supervision

"While the inquiry team could see a role for employee drug testing within safety-critical areas (although even here they were far from convinced that such drug testing was effective), there was deep scepticism as to the value of such testing more broadly. Indeed, the inquiry team noted that ‘For the most part, it is unclear that anything can be achieved through drug and alcohol testing that could not be done better through other managerial and supervisory processes’"

Lloyd, Charlie and McKeganey, Neil, "Drugs Research: An overview of evidence and questions for policy," Joseph Rowntree Foundation (London, United Kingdom: June 2010), p. 54.

12. Drug Testing of Arrestees in the US

"Illegal drugs are widely used among the arrestee population. Two thirds of all arrestees tested positive for at least one substance in their system at the time of arrest and 15 percent or more in all sites test positive for more than one substance. The most common substances in all but three sites are marijuana, cocaine, opiates and methamphetamine."

Office of National Drug Control Policy. ADAM II Annual Report (Arrestee Drug Abuse Monitoring Program). Washington DC: Office of the President. p. 37.

13. Cost of TANF Drug Screening Programs

"The estimated cost of drug testing TANF applicants and recipients varies by State and proposed law, depending on the proposed number of individuals who would be tested and the range of activities for which costs were estimated. Aggregate cost estimates of proposed welfare drug testing legislation were identified for twelve States (see Appendix C for details). The estimated costs in these States ranged from $92,487, for drug testing 20% of recipients and treating 2% of those tested in Louisiana, to $20 million, for just the testing of all public assistance applicants and recipients in New York. Other estimates include the cost of increasing staff to monitor or administer the tests, as in Maryland and
Missouri. Idaho’s estimate includes the cost of making programming changes to the State’s information system. Florida’s law and Alabama’s proposal require the applicant or recipient to pay for the up?front costs of the drug test, though both would reimburse those who test negative. Most estimates do not incorporate costs relating to increased substance abuse treatment utilization or to increased child welfare interventions."

"Drug Testing Welfare Recipients: Recent Proposals and Continuing Controversies," Office of the Assistant Secretary for Planning and Evaluation (Washington, DC: October 2011), pp. 6-7.

14. Testing Costs

"None of the State cost estimates identified for this paper showed net savings resulting from proposed drug testing programs, though these are all legislative cost estimates rather than rigorous cost?benefit analyses. Also, none of the State cost estimates identified described anticipated unit costs of drug testing programs. However, an article from a magazine published by The Society for Human Resources Management reported in 2005 that, “testing an applicant or employee ranges from $25 to $44 for urinalysis... [while] hair follicle testing costs $75 to $150 per test.”35 News reports regarding the implementation of Florida’s new drug testing policy have cited an estimate of $30 per TANF recipient for the drug tests being required of applicants,36 though the State’s drug testing pilot program in the early 2000s cost $90 per test once staff costs and other program costs were included.37 Testing costs among the Indian Tribes that currently administer drug tests in their TANF programs ranges from $15 per client to $89 per client, with most reporting unit costs in the range of $30 to $50.38"

"Drug Testing Welfare Recipients: Recent Proposals and Continuing Controversies," Office of the Assistant Secretary for Planning and Evaluation (Washington, DC: October 2011), p. 7.

15. TANF Drug Testing Legislation

"During 2010 and the first half of 2011, legislators in 31 states have proposed 82 bills that would require drug tests of TANF applicants and/or recipients.31 There was also one proposal each in the U.S. House of Representatives and Senate."
"The legislative proposals identified differ in the populations that would be subject to drug testing. Of the bills, 50 State bills plus the two congressional bills would require that applicants be tested, 35 State bills would require suspicionless testing of current recipients, and an additional 26 would test current recipients for cause. In addition, while nearly all bills focus on testing adult applicants or recipients, a small minority of State bills would require youth aged 13 or older be tested and proposed legislation in one State would require that all benefit recipients, including children under 12, be tested."

Note: The source for this fact also contains a list of 2010 and 2011 federal and state legislative proposals concerning TANF drug testing and legislative cost estimates from 12 states.

"Drug Testing Welfare Recipients: Recent Proposals and Continuing Controversies," Office of the Assistant Secretary for Planning and Evaluation (Washington, DC: October 2011), p. 5.

16. Possibility of Positive THC Test Through Exposure to Hemp Products

"Results of the hemp products tested indicate the amount of THC present in commercially available products is significantly less in products available today than those reported in the past (15-22). As a result, the probability that these products will produce urine THC metabolite levels greater than the DoD and HHS confirmation cutoff of 15 ng/mL is significantly reduced and should not be considered as a realistic cause for a positive urine analysis result."

Holler, Justin M., Bosy, Thomas Z., et al., "Delta9-Tetrahydrocannabinol Content of Commercially Available Hemp Products," Journal of Analytical Toxicology, Vol. 32, July/August 2008, p. 431.

17. Hemp and Detection of THC Through Urinalysis

"Hemp seeds represent the manufacturing starting point for the vast majority of hemp products marketed since the mid-1990s. Hemp seeds are a good source of essential fatty acids, primarily alpha-linolenic acid (omega-3) and ]inoleic acid (omega-6). They are also found in fish, flaxseed, rapeseed oil, pumpkin seeds, and sunflowerseeds. Essential fatty acids (EFA) are necessary fats that humans cannot synthesize, so they must be obtained through diet. EFAs support the cardiovascular, reproductive,immune, and nervous systems. The human body needs EFAs to manufacture and repair cell membranes, enabling the cells to obtain optimum nutrition and expel harmful waste products (9). THC found in manufactured products is present via contamination from resin produced in the leaves and buds that come into contact with the seed shell. Seed decontamination and manufacturing processes including wash steps and cold pressing for hemp products have improved since the mid-1990s, leading to the much lower THC concentrations currently found in today's commercial products.
"The presence of THC in these products has been a source of concern for the military and other workplace drug-testing programs. Ingestion of hemp products has been historically used as a defense in military and civilian trials for many years and continues today despite decreased concentrations of THC in hemp products (10-12). The Division of Forensic Toxicology, Armed Forces Institute of Pathology is often asked to analyze hemp products to determine their THC content in addition to rendering an opinion as to whether or not this THC concentration could be a reasonable cause for a positive THC metabolite urine analysis result."

Holler, Justin M., Bosy, Thomas Z., et al., "Delta9-Tetrahydrocannabinol Content of Commercially Available Hemp Products," Journal of Analytical Toxicology, Vol. 32, July/August 2008, pp. 428-429.

18. Testing in the Context of Drug Courts

"For a drug court program, drug testing is conducted primarily to monitor a defendant’s progress in treatment — to determine whether he or she has been using drugs and, if so, the type and quantity of substances being ingested. The drug test result may be used as a basis for imposing sanctions and/or enhancing treatment services, on the one hand, or reducing treatment service requirements, on the other. Drug test results may also indicate a participant’s progress in reducing drug use when he or she has not eliminated it altogether.
"Although drug test results are frequently reported in terms of 'positive' or 'negative,' in reality, the determination of the presence or absence of a particular drug in the system is not always a black-and-white determination. Ultimately, for a drug court program, a positive or negative result reflects the presence or absence of certain drug metabolites in the sample at a concentration above or below the established cutoff concentration."

Robinson, Jerome J. and Jones, James W., "Drug Testing in a Drug Court Environment: Common Issues to Address," part of the Drug Court Resource Series, Drug Court Clearinghouse and Technical Assistance Project of American University (Washington, DC: Office of Justice Programs, U.S. Department of Justice, May 2000), p. 2.

19. Post-Accident Drug Testing As A Disincentive to Accident Reporting

"Occupational safety and health stakeholders we interviewed and occupational health practitioners we surveyed told us that primary factors affecting the accuracy of injury and illness data include disincentives that affect workers’ decisions to report work-related injuries and illnesses and employers’ decisions to record them. Stakeholders most often cited workers' fear of job loss and other disciplinary actions as disincentives that can affect workers' decisions to report injuries and illnesses. Occupational health practitioners concurred: 67 percent reported observing worker fear of disciplinary action for reporting an injury or illness, and 46 percent said that this fear of disciplinary action has at least a minor impact on the accuracy of employers' injury and illness records. Workers’ fear of disciplinary actions may be compounded by policies at some worksites that require workers to undergo mandatory drug testing following incidents resulting in reported injuries or illnesses, regardless of any evidence of drug use. Several labor representatives described mandatory drug testing policies as a disincentive that affects workers’ decisions to report injuries and illnesses, and 67 percent of health practitioners reported they were aware of this practice at the worksites where they treated workers in 2008."

"Report to Congressional Requesters: Workplace Safety and Health: Enhancing OSHA’s Records Audit Process Could Improve the Accuracy of Worker Injury and Illness Data" United States General Accountability Office, (Washington, DC: October 2009), pp. 17-18.

20. DRUID Project Evaluation of Oral Fluid (Saliva) Testing Devices for DUI Enforcement

"Using the above model of evaluation it can be seen that the DrugWipe 5 delivers the best results for sensitivity (91%) whilst also performing very highly in terms of specificity (95%). However the margins of error (95% confidence interval) displayed in Figure 43 show that this value could vary between 78-97%, this margin of error would seem to be due to the size of the study population (135 tests performed) since the device was only tested in Finland. The strong results for this device probably reflect largely on the device?s high performing individual amphetamines test in a country with a relatively high prevalence for amphetamines. However, this overall sensitivity is still higher than the individual sensitivity of the amphetamines test for DrugWipe 5 (87%) indicating that the device was successful in screening for other drugs. Both DrugTest 5000 and Rapid STAT also performed strongly in this evaluation both for sensitivity (85% and 82% respectively) and specificity (86% and 88% respectively), which is a reflection of their generally relatively good performance for each individual substance test. The sensitivity error margins are also somewhat narrower for these two devices that were tested on a greater number of subjects (220 and 342 tests performed respectively). The OrAlert device also performs at a high level of sensitivity (81%) in this evaluation, however the specificity is somewhat lower at 70% - which is the lowest score for any of the devices. The sensitivities of the other four devices included in the study range between 64% and 32%, which are quite low values. The specificities are, however, very high, or excellent, at between 93% and 100%. The relatively large error bars for the Oratect III device and BIOSENS can be attributed to the number of successful evaluations (58 and 25 respectively)."

Tom Blencowe, Anna Pehrsson and Pirjo Lillsunde, Editors. "Analytical evaluation of oral fluid screening devices and preceding selection procedures." Project Funded by the European Commission under the Transport RTD Programme of the 6th Framework Program, Project No: TREN-05-FP6TR-S07.61320-518404-DRUID (National Institute For Health and Welfare, Finland, Sept. 2010), pp. 93-94.