New technology and new initiatives in U.S. workplace testing

Area of Science:

• Forensic Toxicology
• Occupational Health
• Drug Policy

Background:

• Workplace drug testing is a significant component of occupational health and safety in the USA.
• Existing drug testing methods face challenges related to accuracy and consistency with self-reported data.
• Technological advancements and outreach initiatives are crucial for effective workplace anti-drug programs.

Purpose of the Study:

• To present a comprehensive overview of workplace drug testing in the USA.
• To analyze epidemiological data, evaluate new testing technologies, and discuss support for small businesses.
• To identify inconsistencies between laboratory results and self-reported drug use and assess new testing devices.

Main Methods:

• Comparison of national self-reported drug-use survey data with national laboratory drug testing results (1988-2004).
• Examination of factors contributing to discrepancies, including drug panels, immunoassay specificity, adulteration, and substitution.
• Review of state-of-the-science in rapid point-of-collection (POCT) oral fluid drug-testing devices and evaluation findings.

Main Results:

• A 66% decrease in laboratory positive drug test results contrasted with a 30% increase in self-reported drug use from 1988-2004.
• Oral fluid POCT devices generally detect methamphetamine, amphetamines, and opiates effectively, but show variable results for cocaine and poor detection for cannabis.
• Initiatives to support small businesses in developing workplace anti-drug programs are discussed, referencing European Union models.

Conclusions:

• Significant inconsistencies exist between self-reported drug use and laboratory drug testing results in the USA.
• Oral fluid POCT devices represent a developing technology with specific strengths and weaknesses for workplace drug testing.
• Continued development of effective workplace anti-drug programs, with support for small businesses, is essential.