Fired for Taking Legal Drugs? Why Drug Tests Don’t Always Work

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Urine sample in doctor's office

Should people who take legally prescribed painkillers on the job be fired for failing a drug test? A story in Monday’s New York Times examines the case of a woman who is part of a lawsuit against her employer for doing just that. The woman was fired after 22 years of employment for testing positive for hydrocodone, an opioid that she was taking on doctor’s orders to treat her back pain, and which a change in company drug policy had newly categorized as unsafe.

The Times reports:

What companies consider an effort to maintain a safe work environment is drawing complaints from employees who cite privacy concerns and contend that they should not be fired for taking legal medications, sometimes for injuries sustained on the job.

But in its lengthy discussion of drug testing, the Times article does not fully address the issue of performance impairment. It doesn’t cite any studies of people who have long taken high doses of opioid drugs, which show that if patients are on a stable dose and are not taking other drugs as well, these painkillers do not usually cause functional impairment. (More on Is Drug Use Really on the Rise?)

However, the article does quote a pain expert who explained:

In general,” said Dr. Seddon R. Savage, a pain specialist at Dartmouth College and president of the American Pain Society, “well-prescribed opioids at a stable dose that are well supervised in most healthy people won’t cause sedation or other cognitive problems.”

Given these factors, the story could have covered an alternative form of safety testing that can reduce accident risk while avoiding the legal perils and possible unfairness of drug testing. (More on Addiction Files: Recovering From Drug Addiction, Without Abstinence)

Performance testing — like the balance tests used by police to check for drunk driving, or the video game–based tests that measure reaction time — can test an employee’s performance on required skills and immediately determine whether that person is capable of doing the job. Unlike drug testing, which may identify workers who aren’t impaired as well as those who are, performance testing singles out only those who are not capable of functioning as they are required.

Performance tests can be done frequently (some are quick enough to do before every shift), randomly or on suspicion of impairment — and they don’t require the humiliation or cost of drug tests, which require a person to give blood or have staff monitor an employee while urinating. (More on See photos of cannabis conventions)

Of course, sometimes impairment on performance tests will be due to problems like exhaustion or distraction, not drugs. But if the real goal is safety, keeping any demonstrably unsafe worker off the job is more effective than measuring what’s in his or her blood or urine. And if a person is having a regular problem with job performance — regardless of the cause — that is the issue businesses should address, not trying to fight the government’s war on drugs.

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