The cost of substance abuse in the workplace is staggering. Beyond the expenses—and employer headaches—of drug-related accidents, workers affect the bottom line in many other ways. According to Troy Boughan, a consultant with the Ohio Bureau of Workers’ Compensation, employees who abuse drugs can cost the company $7,000 to $25,000 every year due to less productivity, absenteeism, and medical expenses. Substance abuse can even impact inventory: 50 to 80 percent of company theft or loss is related to substance abusers. These figures don’t even take into account the cost of workplace accidents or injuries, as well as safety risks to co-workers. (Learn more in "Everything Employers Need to Know About Workplace Drug Testing".)

All Department of Transportation (DOT) employees, such as truck drivers and airline pilots, as well as companies who contract with the Department of Transportation (DOT) are required to follow drug testing mandates for all safety-sensitive jobs. The most recent update to “Part 40 Final Rule” went into effect on January 1, 2018. DOT drug testing protocol uses a urine sample to conduct a 5-panel screen, checking for the presence of street drugs: marijuana, cocaine, opiates (opium and codeine derivatives), amphetamines/methamphetamines, and phencyclidine, known as PCP.

Can I Use Non-DOT Drug Testing?

What about employers who do not have DOT contracts, but want a safe and productive workplace? The courts have ruled that every employer may conduct drug screenings. Non-DOT testing follows the same laboratory standards as DOT, including review and interpretation of results by a Medical Review Officer.

There are several differences with non-DOT testing, giving employers more options and flexibility:

• Saliva and hair samples may be used instead of urine, or in any combination.
• Employers can choose to test for other substances besides the 5-panel screen.
• When to conduct testing (pre-employment, random, etc.) can be determined by the company.
• If DOT testing is also conducted for some employees, non-DOT testing may also be performed after their DOT screen is completed.

Should I Use a Non-DOT Drug Test?

When deciding whether to perform non-DOT tests or to add non-DOT tests to current screening procedures, a company can look at its employee demographics, accident or incident rate, and health costs to determine if a additional testing would be beneficial. The 10-panel urine screen is the most common non-DOT test. This is often used by medical facilities or law enforcement agencies for pre-employment drug testing. (Learn more in "Drug Test Types: When to Use 5, 7, or 12 Panel Urine Screening".)

The expanded screening also adds prescription drugs in classes that can easily be abused. The 10 panel test includes amphetamines, cocaine, marijuana, opioids (i.e., heroin and/or morphine), phencyclidine (PCP), barbiturates, benzodiazepines, methadone, propoxyphene, and methaqualone. An employer can also add hallucinogens, anabolic steroids, prescription painkillers, and ecstasy. One of the most common positive results on this expanded testing is for amphetamines because many ADHD medications are in this class. Because of this, it is vital to use a Medical Review Officer to clarify any positive results before disqualifying a candidate.

Additional drug panels and alternative testing methods can be costly, so the employer should analyze the pros and cons of each. All testing methods produce accurate results. Actual costs are dependent on volume, testing method, and other factors.

Screening Test Types

Urine Screening

PROS:

• Least expensive of drug screens.
• Most common and reliable.
• Simple to collect, transport, and test.
• Detects drug use within 4 to 72 hours.

CONS:

• Easily adulterated (although proper collection decreases the chance).
• Does not detect frequency of use or level of abuse.

Saliva/Oral Fluid Screening

PROS:

• Inexpensive
• Sample is collected under direct observation.
• Detects drug use within previous 48 hours.
• Detects drug use within minutes of use.

CONS:

• ·Not currently approved by federal agencies.
• ·Not effective after 48 hours of drug use.

Hair Follicle Screening

PROS:

• Cannot be adulterated.
• Can detect drug use for up to 90 days.

CONS:

• More expensive.
• 5-10 days from drug use till hair is long enough to be tested.
• Limited number of drugs can be detected.

Because non-DOT employers are not constrained by DOT urine-only drug testing, they are able to utilize different methods for specific circumstances. For example, in a pre-employment situation, a hair follicle screen can reveal possible long-term abuse. In a workplace accident, a saliva screen will show drug use within hours. Random screens can utilize the least expensive urine analysis. (Learn more in "Oral Fluid, Urine, and Hair Testing: What's the Difference?")

How to Select a Drug Testing Method

1. Verify with employment attorneys that any tests or methods comply federal, state, and local laws. All regulations must be considered regarding worker’s compensation and unemployment. (Learn more in "State Drug Testing Laws: What Should Employers Know?")
2. Examine current rates and trends regarding specific drugs being abused within the company’s geographic area. Don’t test for drugs that are not common.
3. Compare all costs, including testing fees, projected outcomes from extra panels, and employee time away from work, related to the testing process.
4. Consider how changes in testing will be relayed to all employees. Company-wide training must be conducted, including specific instruction for supervisors and managers.

Company Policy Must be Accurate

After the decision is made to expand a testing panel or to add screening methods, the company must revise its workplace drug and alcohol policy along with the Purpose Statement. Use of each method for specific circumstances should also be documented, such as what test will be used for job candidates, random, post-accident, reasonable suspicion, return-to-work, and follow-up screening. (Learn more in "What is Considered Reasonable Suspicion? A Look at the Criteria for With Cause Drug Testing in the Workplace".)

Employers are wise to include established drug testing policies and procedures as standard company practice. The Substance Abuse and Mental Health Services Administration (SAMHSA) offers excellent resources and guidelines.