This information is provided for educational purposes only. Reader retains full responsibility for the use of the information contained herein. 

Drugs of abuse have become a major concern in the United States. The impact of drug use on the workplace is significant. In 2021, 57.5 million adults used illicit drugs and while marijuana remains the most used drug, a broad range of drugs continue to be used and abused across the country.i Today, more than ever, employers are facing the challenge of managing a workforce that is affected by drug use and consequently, at a higher risk of workplace accidents. Unfortunately, the widespread legalization of marijuana has contributed to a shifting trend among companies to reduce or eliminate drug testing in efforts to retain employees. The overall trend to move away from drug testing is cause for concern considering that the rate of positive drug tests results among America’s workforce in 2021 was the highest it has been since 2001. And while the overall positivity rate is concerning, perhaps more alarming is the increase in post-accident positive drug tests results of the general workforce, up 26% in the last five years.ii This article will address some important trends impacting the workplace with a focus on who is using drugs, what drugs are being used, and whether they are working impaired.
 
Who Is Using Drugs?
Interestingly, drug use in the workplace is not limited to any particular demographic nor industry. For instance, between 2017 and 2021, America’s general workforce experienced an increase in positivity rates in nearly all 17 major industries.iii However, while drug use affects employees of all ages and at all levels of an organization, some groups are more likely to use drugs than others. The National Survey on Drug Use and Health (NSDUH) is published yearly and is the most detailed report on substance use in the United States. The 2021 report included data on people’s experiences with using illicit drugs and demographics, such as employment status. Survey results show that young adults between the ages of 18 and 25 are more likely to use drugs than any other age group, followed by adults aged 26 or older. Among young adults between the ages of 18 and 25, 2 in 3 who used illicit drugs in the past year reported being employed part-time or full-time. Among adults aged 26 or older, 3 in 5 who used illicit drugs in the past year also reported being employed part-time or full-time.iv
 
It goes without saying that with more than 50% of the workforce admittingly using drugs and positivity rates at a two-decade all-time high, the implications for workplace safety are dangerous and costly. Furthermore, the 2022 annual Drug Testing Index (DTI) from Quest Diagnostics highlights the direct impact that increased drug use has on workplace safety. The report points out that positivity rates among safety-sensitive workers—the individuals responsible for ensuring public safety—saw a rise after a 5-year steady decline in several drug categories. The report further addresses the negative impact of increased drug use among safety-sensitive employees by citing an increase of 41.9% in post-accident positivity rates since 2017.v
 
What Drugs Are People Using?
According to the NSDUH, the most commonly used illicit drug is marijuana. In 2021, among people aged 18 or older, 49.7 million used marijuana in the past year, and as many as 34.8 million used marijuana in the past month.vi Therefore, it is no surprise that the DTI reported the highest workplace positivity rates, among the drugs commonly tested, to be for marijuana. According to data collected from over 6 million urine tests, the positivity rates for marijuana use in the U.S. workforce have increased steadily, with the latest figures showing an 8.3% increase from the previous year. This is the highest positivity rate ever recorded in the DTI. Over the course of 5 years, the positivity rate for marijuana use among the U.S. workforce has gone up by 50%.vii
 
Relative to marijuana, the NSDUH data on the use of other illicit drugs, like misused prescription pain relievers, hallucinogens, cocaine, and other stimulants, is significantly lower within the general population. However, the DTI does offer additional insights into workforce trends regarding several drugs. For instance, amphetamines/methamphetamines are the second most detected drugs in the U.S. workforce. Other leading drugs, specifically, benzodiazepines, misused prescription pain relievers, and cocaine are also detected at similar rates. In addition, the DTI reports the construction industry as having the highest positivity rates for cocaine and methamphetamine use. However, the retail trade industry has the highest overall positivity rate and is the only industry to experience a rise in methamphetamine positivity rates year-over-year, with an increase of 55.6% since 2017. viii
 
Are People Working Impaired?
While drug use is a concern in and of itself, the real question for employers is whether their employees are impaired and what effect is the impairment having on the employee, the company and the customer?  The effects of drugs on an individual's ability to work can vary depending on the substance used, the amount consumed, when the drug was used, and the individual's tolerance. However, even small amounts of drugs can impair an individual's judgment, coordination, and reaction time.
 
While employers might be keen on foregoing employee drug testing to attract more workers, in doing so, they increase the likelihood of drug-related impairment that may lead to mistakes, negative employee interactions, theft of company property as well as on-the-job accidents that endanger not only their employees but also the public at large.
 
Remember a positive drug test does not prove impairment, it does identify that drugs were present in an individual at the time of testing.
 
 
Conclusion
The latest annual reports on substance abuse and drug testing reveal negative trends that continue to underscore the growing problem of drug abuse and its impact on the workplace. By and large, marijuana continues to be the most common illicit drug used in this country with the highest positivity rates among employees. However, positivity rates for other drugs of abuse continue to increase throughout the general and federally mandated, safety-sensitive workforces alike, which makes this not only a pervasive issue but a problem of grave concern in this country. The information presented in this article emphasizes a need for employers to continue addressing drug abuse trends in the workplace and reassess their drug-free workplace policies.

© 2010-2023 DrugPak – No portion of this article may be reproduced, retransmitted, posted on a website, or used in any manner without the written consent of DrugPak. When permission is granted to reproduce this article in any way, full attribution to the author and copyright holder is required. 
 

i National Survey on Drug Use and Health. SAMHSA. December 2022.  https://www.samhsa.gov/data/sites/default/files/reports/rpt39443/2021NSDUHFFRRev010323.pdf
ii 2022 Annual Report and Industry Insights. Drug Testing Index™ and Industry Insights. A comprehensive analysis of workforce drug use trends. Quest Diagnostics. 2022.
https://filecache.mediaroom.com/mr5mr_questdiagnostics/203415/quest_drug_testing_index_2022.pdf
iii Ibid.
iv National Survey on Drug Use and Health. SAMHSA. December 2022.  https://www.samhsa.gov/data/sites/default/files/reports/rpt39443/2021NSDUHFFRRev010323.pdf
v 2022 Annual Report and Industry Insights. Drug Testing Index™ and Industry Insights. A comprehensive analysis of workforce drug use trends. Quest Diagnostics. 2022.
https://filecache.mediaroom.com/mr5mr_questdiagnostics/203415/quest_drug_testing_index_2022.pdf
vi National Survey on Drug Use and Health. SAMHSA. December 2022.  https://www.samhsa.gov/data/sites/default/files/reports/rpt39443/2021NSDUHFFRRev010323.pdf
vii 2022 Annual Report and Industry Insights. Drug Testing Index™ and Industry Insights. A comprehensive analysis of workforce drug use trends. Quest Diagnostics. 2022.
https://filecache.mediaroom.com/mr5mr_questdiagnostics/203415/quest_drug_testing_index_2022.pdf
viii Ibid.
ix Ibid.

This information is provided for educational purposes only. Reader retains full responsibility for the use of the information contained herein.
 
Federal regulations largely impact company drug testing policies. Nationwide, employers in transportation fields are often required to adhere to rules and regulations defined by the Department of Transportation (DOT). The DOT regulations have clear language regarding circumstances under which drug and alcohol testing can or should be performed. These reasons include pre-employment, random, post-accident, reasonable suspicion, follow-up, and return to duty. Knowledge of which test is applicable for each situation is critical to maintaining compliance with the DOT regulations.

Pre-employment Testing
Pre-employment testing is the most common reason for testing. All DOT-covered employees must pass a DOT drug screen prior to working in a safety-sensitive position. The most common mistake employers make when it comes to pre-employment testing is prematurely hiring an individual before the employer receives a negative drug test result. To avoid this, the simplest way to think of pre-employment testing is post-offer, pre-hire. In other words, an individual’s employment is contingent on the prospective employer receiving a negative result. Employers who put employees to work in a safety-sensitive position prior to receiving a negative result are considered non-compliant.

Random Testing
Random testing is another staple for any DOT drug testing program. With random testing, there are a few key things an employer should consider. First, all participants in a random pool must have an equal chance of selection at any time. If an individual is selected for a random test in the first quarter, they must not be excluded from the pool of employees for the second, third, or fourth quarter random selection. Random selection rates are dictated independently by the agencies that fall under DOT, such as the Federal Motor Carrier Safety Administration (FMCSA), the Federal Railroad Administration (FRA), the Federal Aviation Administration (FAA), the Pipeline & Hazardous Materials Safety Administration (PHMSA) and the Federal Transit Administration (FTA). Next, random selections are completed using DOT-approved methodology. Contrary to what some believe, names are not drawn out of a hat, or selected by biased management. If a company is not using DOT-approved random selection software, it is not a true random selection, and they are not compliant with DOT regulations.

Post-accident Testing
Post-accident testing follows an accident as defined by the applicable DOT agency. Depending on the severity of the accident, DOT testing may not apply. Each DOT agency clearly defines what an accident is under their respective sections in the regulations. Often, companies will have policies dictating when non-DOT drug testing policies may be utilized to ensure impairment was not the cause of the accident, even if the accident does not qualify for testing at the DOT level. Regardless of the classification, the key thing for employers to remember with post-accident testing is to have the test completed as soon as possible. Additionally, any employee subject to post-accident testing should be escorted to the collection site. This is usually handled by a manager on duty or another employee in a supervisory role.

Reasonable Suspicion Testing
Reasonable suspicion testing is used when an employee is believed to be under the influence of a substance or impaired by a substance. Similar to other reasons for testing, DOT agencies may have different criteria for implementing this form of testing. For example, the FAA requires two supervisors of the employee, one of whom has completed signs and symptom training, to substantiate and concur in the decision to test the employee who is reasonably suspected of drug or alcohol use. The FMCSA differs because only one supervisor is necessary to make this determination. As with post-accident testing, some companies may develop a non-DOT protocol for reasonable suspicion testing should they not meet the criteria outlined by the DOT. This test should also be carried out as soon as possible and the employee should be escorted to the collection site.

Return to Duty and Follow-up Testing
Return to duty and follow-up testing occur only after a violation has taken place. Once an employee in a safety-sensitive position has failed or refused a drug screen, the only way they can return to safety-sensitive work, as defined by the DOT, is to complete an evaluation with a Substance Abuse Professional (SAP). The SAP’s responsibility is to evaluate the employee who violated a DOT policy, determine an appropriate rehabilitation program for the employee, and establish the frequency and duration of a follow-up testing program. Once the employee has completed the prescribed rehabilitation program, they must pass a return to duty test before performing safety-sensitive functions again and successfully complete follow-up tests for an appropriate period as determined by the SAP. The important thing for an employer to remember is that this type of testing is only used following a violation. If an employee is returning to work after an extended absence but no violation was committed, this would require a new pre-employment test. 
Using these reasons for testing appropriately and accurately builds compliance each time you do a test.  Having the ability to run reports that account for each reason to test over a given period is a valuable and necessary part of demonstrating compliance in your program.  Reporting details and specifics about individual tests are in the scope of many, if not all, DOT audits.  DrugPak has evolved over time, adding and storing necessary data and details of each test to maintain and document these details allowing users the ability to demonstrate compliance quickly and effectively. 

Conclusion
It is safe to say that the DOT regulations clearly outline the reasons that an employer may test, but it is also important to understand that a non-DOT drug testing policy can define numerous other reasons that an employee may be required to test. DOT regulations will always come before a company’s non-DOT policy; however, an employee may be covered under both a DOT and non-DOT testing policy. This helps to fully protect an employer from potential substance abusers in the workplace.
It is also worth noting that some state drug testing laws require employers to adhere to federal government drug testing procedures, sometimes referred to in a law as the “DOT” regulations, even if they are not mandated to comply with any federal drug testing regulations. In essence, 49 CFR part 40 of the federal regulations, where the DOT drug and alcohol testing procedures can be found, have become a de facto gold standard for lab-based drug testing.


© 2010-2023 DrugPak – No portion of this article may be reproduced, retransmitted, posted on a website, or used in any manner without the written consent of DrugPak. When permission is granted to reproduce this article in any way, full attribution to the author and copyright holder is required.

This information is provided for educational purposes only. Reader retains full responsibility for the use of the information contained herein.
​
According to the 2020 National Survey on Drug Use and Health (NSDUH), 40.3 million Americans, aged 12 or older, had a substance use disorder (SUD) in the past year.[1] Substance use disorders (SUDs) continue to be an important health issue in our country.
Substance abuse in the workplace is a serious problem and statistics show that substance abuse is on the rise. Drug use and abuse is constantly making headlines, and the need for employers to combat drug abuse has never been greater. 
SUDs are treatable, chronic diseases characterized by a problematic pattern of use of a substance or substances leading to impairments in health, safety, social function, and control over substance use. Drug use impairs the decision-making abilities of employees and can create physical impairments as well, and in the workplace, this could be a dangerous combination.

How Can Employers Help?
To lessen the impact of drug use in the workplace, an employer may adopt and implement a drug and alcohol testing program. It is well documented that drug testing in the workplace can be an effective deterrent to substance abuse and helps employers maintain a safe working environment. Especially one that includes random testing on a regular basis.  A testing program is also implemented to minimize the risk of hiring new employees who are actively using drugs and therefore reduces the chances of a drug user from gaining entrance in the workplace.
Running an effective program by using tools like DrugPak software helps house all the details of a company program.  It aids by allowing users to set all details of their program outlining reasons to test and the frequency of random tests.  The ability to generate randoms on the set frequency and account for all tests done in a given period. 
However, there is another important step that employers can accomplish in helping those suffering from drug addiction. Early intervention through training and education is key in assisting individuals in recognizing and preventing substance misuse in the workplace. Early intervention has an astounding effect to limit drug use and abuse while protecting the health and safety of workers. The goal of early intervention is to reduce the harms associated with substance misuse, to reduce risk behaviors before they lead to injury, and to prevent progression of the disease.
While it may be difficult to eliminate the nationwide epidemic of substance abuse, a testing program coupled with training and education can make a huge impact in reducing the harmful effects related with drug abuse.

The Importance of Education and Training of Supervisors and Employees
Understanding the impact of alcohol and other drugs is undoubtedly an invaluable strength. Knowing how drugs impact the body, the long and short-term effects of substance abuse, and the possible risk factors involved are all key parts of the prevention strategy.
Drug awareness through education is a means to distribute information and facts to expose the possible risks and impacts of drug use and abuse. Education is relatively low cost and is highly effective for employees to self-diagnose a potential problem to seek help on their own. Education is the main driver of delivering results for a successful drug and alcohol testing program.
There are several training initiatives to support educating employees and supervisors about the effects of substance use on health, job duties, and work safety. For supervisors, it is crucial that they understand their specific responsibilities for initiating and managing the drug free workplace policy and program. Additionally, they should also be trained to recognize and deal with employees who have job performance, personal, and family problems that could be related to alcohol or other drugs.
Given the importance of the supervisor's position in a company’s drug testing program, it's no surprise that several state laws and the Department of Transportation (DOT) mandate supervisor training and regulate the content of that training. Over 30 states and municipalities in the United States have drug testing laws, whether they are mandatory, voluntary, or industry specific. Of those states, approximately 12 of them have laws that require and regulate supervisor training in some way.[2] The most common supervisor training program requirements in drug testing laws are number of hours of training, annual training renewal, and training content.
Regarding training content, all 12 states that require supervisor training mention recognizing the signs of substance abuse and alcohol misuse as part of the training. Regardless of legal requirements, well-trained supervisors can make a significant difference in establishing and maintaining a drug-free workplace program that produces desired results. Untrained and uninformed supervisors could lead to redundant, unnecessary, and costly mistakes. More importantly, they could produce opportunities for legal confrontations from mistreated employees. In all cases, whether the law requires it or not, supervisor training is strongly recommended to ensure a well-received and effective drug testing program. 
To reinforce the benefits of education below are some points to consider for training and staff development.
 
Employee Training 
Training is not just for those in a managerial role. Employee training is just as important as training supervisors and managers. Employee awareness training is for all employees who are subject to drug and alcohol testing in accordance with a workplace drug and alcohol testing policy.  It provides awareness and education on policy related to drug and alcohol, how drug and alcohol testing is conducted, and health effects of drug and alcohol use and abuse. 
Employee training on the effects and consequences of prohibited drug use on personal health, safety, and work environment and manifestations and behavioral cues that may indicate drug use and abuse. The goal of employee training is to provide knowledge to:
 
·       Understand the purpose and procedures of drug testing​.
·       Recognize workplace problems that may be related to alcohol and other drugs. ​
·       Be familiar with signs and symptoms that may be the result of substance abuse​.                                                                            
Supervisor Training
Supervisor training emphasizes responsibilities regarding “reasonable suspicion” determinations, detection, the recognition of substance use and alcohol abuse, methods of confronting an individual who may be under the influence of drugs or alcohol, and how to document behaviors that lead to the determination to test. 
The reasonable suspicion training aims to give the supervisor the proper knowledge to: 
 
·       Understand the purpose and procedures of drug testing​.
·       Recognize workplace problems that may be related to alcohol and other drugs. ​
·       Be familiar with signs and symptoms that may be the result of substance abuse​.
·       Intervene in problem and crisis situations​.
·       Be able to approach employees​.
·       Initiate reasonable suspicion testing and complete proper documentation​.
·       Feel confident about your responsibility for reasonable suspicion​.
·       Protect employee confidentiality​.
·       Continue to supervise employees who have been referred to assistance​.
·       Avoid common supervisor traps.
 
 Designated Employer Representative (DER) Training
A DER is the person in charge of an employer’s drug and alcohol testing program as the testing program manager. A DER has a very important position, so it is essential to have a responsible person or persons to manage the drug testing program.  
A DER wears many hats, and training is necessary to avoid any setbacks in the drug testing program. The DER role is critical to an effective drug free workplace program and has the responsibility of knowing the company policy as well as any Federal or any state regulations that may affect the company. They also work together with service agents (MRO, labs, Substance Abuse Professionals (SAPs), etc.) who can assist the DER in managing the program. A DER is an essential part of maintaining a drug-free workplace and is authorized by the employer to take immediate actions for removing individuals from duty and to make decisions regarding the testing program and test results.
With the enormous obligations involved with the management of the testing program, training programs provide DERs insight on how to do their job and do it well. The DER training allows an employee to feel equipped and confident to lead your company’s drug and alcohol testing program as well as assist your company’s management with any decisions that must be made in relation to the program. 

Conclusion
Drug testing programs work to deter drug use in the workplace and beyond.  Accurate information, education, and training all play a part in creating a better-informed workforce.  Companies that invest in knowing the realities of the war on drugs in the workplace can make a big difference by offering accurate and clear information about why they drug test to their employees. 
DOT mandates supervisor training for this and other reasons. We encourage companies to invest in training all their employees on why and how they drug test.
If you have questions about how to create a more effective drug and alcohol program, or you have questions about training your employees and supervisors, please reach out to the DrugPak team.  At DrugPak we have invested in this industry from the beginning, and we are committed to continuing to make the industry appropriately stronger. 


© 2010-2023 DrugPak – No portion of this article may be reproduced, retransmitted, posted on a website, or used in any manner without the written consent of DrugPak. When permission is granted to reproduce this article in any way, full attribution to the author and copyright holder is required.
 


[1] “2020 National Survey of Drug Use and Health (NSDUH) Releases.” SAMHSA.gov, The Substance Abuse and Mental Health Services Administration, https://www.samhsa.gov/data/release/2020-national-survey-drug-use-and-health-nsduh-releases. 

[2] Alabama, Alaska, Arkansas, Georgia, Iowa, Kentucky, Maine, Mississippi, Montana, Ohio, Tennessee, and Wyoming.