Washington Post Staff Writer

May 10, 1998

Congratulations—you’ve got the job.

Well, almost. At most big U.S. companies today, you still face the final hurdle of a drug test. Most likely they’ll ask you to take a urine test—which means you’ll have to pee into a plastic cup. That procedure has become an essential step to employment, and one that is changing the rules of the American workplace.

With little public debate, big corporations have adopted what amounts to a zero-tolerance policy toward illicit drug use, at least by new employees. Almost all of the nation’s Fortune 200 companies, for example, have instituted drug-testing programs in the past decade.

Surveys by the American Management Association, a trade group whose members are disproportionately large companies, estimates that about three-quarters of their members do drug testing—most on a pre-employment basis but with a growing number testing their workers randomly as well.

Employers who institute drug testing believe it causes the rate of employee drug use to fall. Indeed, according to statistics released last month by SmithKline Beecham Clinical Laboratories in Collegeville, Pa., positive drug-test results have plummeted to 5 percent, from 18.1 percent in 1987. Workers in safety-sensitive positions have the best records, according to the firm’s statistics, with only 3.5 percent testing positive for illegal drugs.

But back to practicalities. You’re hoping to get hired by one of those prosperous, drug-averse Fortune 200 companies. So what can you look forward to when it’s time for the mandatory pre-employment drug test?

You’ll report to what is called a "collection site," probably a small clinic or a doctor’s office. You’ll show a picture identification card and fill out some paperwork authorizing the facility to show these medical records to your prospective employer.

You’ll probably want to volunteer what prescriptions drugs you may be taking—a prescription painkiller authorized by your physician, say, which the lab technicians might confuse with an illegal substance. That drug disclosure, too, will become part of your record.

The nurse will ask you to remove your coat and place your purse or briefcase in a storage facility—making it more difficult for you to conceal anything you might have brought along to try to disguise the results. Drug-test experts know there are a variety of products for sale on the Internet that purport to conceal signs of drug use—THC Terminator Drink; teas made with roots and barks that flush out the system; herbal cleaning shampoo; the Wizard’s Randomizer. Experts say they’re mostly ineffective, but the collection facility still wants to make sure you don’t try.

You’ll be given a specimen container about the size of a coffee cup and ushered into a stall or powder room, which probably won’t have running water. The water in the toilet is likely to be colored blue. The testers will want to make sure you’re not trying to dilute the specimen you’re giving them.

You’ll urinate into the cup, or at least try. Some people can’t complete the task, stymied by a kind of performance anxiety. It’s the "shy bladder" problem, says Bernie McCann, a former consultant to the National Institute of Drug Abuse and the Laborers’ Health and Safety Fund’s in-house expert on substance abuse. People with shy bladders are invited to visit a doctor, who will examine them to make sure they have a legitimate medical problem and are not simply trying to avoid the test.

The specimen will be examined visually. Is the color right? How about the temperature? Some drug users have attempted to smuggle in other people’s urine, seeking to pass it off as their own. (It seems some people actually sell their drug-free urine to drug users.) The temperature must be exactly right, so drug users who have smuggled in someone else’s fluids sometimes try to heat it with a small hand warmer, like the ones hunters use to keep from getting frostbite.

The specimen will be sealed in a tamper-proof container, and you’ll initial it to witness that it was handled properly. Then it’s off to the laboratory, which will check for adulterants and then screen for metabolites—the chemical byproducts that show the person used a drug within the past few days or weeks.

If your results are negative, the laboratory will call the employer with the good news—and it’s time to start talking salary.

But if your results are positive—meaning they show the presence of drugs—the laboratory will conduct a second test that can screen the sample with almost 100 percent accuracy. If this second screen is positive, a medical review officer—a doctor with expertise in forensic medicine and substance abuse—will review the results. The doctor will call you to determine whether any unusual circumstances could have produced a false positive. One famous such exception: Poppy seeds—like the kind on the top of bagels—have at times falsely indicated heroin use.

Now it’s crunch time. The doctor makes a final determination that your test was positive for drugs and informs the employer. That usually means you’re back to square one.

Quick Acceptance

But how did workplace drug testing become so pervasive so quickly? The answer seems to be that corporations saw many benefits—especially in reducing the incidence of drug-related accidents in the workplace—and almost no drawbacks. Indeed, except from civil libertarians, there have been few public protests.

The spread of testing has been extraordinarily rapid, particularly at big companies that offer good pay, health insurance, benefits and pension plans. In 1983, only six firms out of the Fortune 200 were testing their workers for drugs, but by 1991, 196 of the 200 largest companies were doing it, said employment lawyer Mark de Bernardo, executive director of the D.C.-based Institute for a Drug-Free Workplace, an employer group.
(Ed. note: I have debated de Bernardo. He is heavily addicted to reefer madness, but that is probably a job requirement. Their own little version of "drug" testing.)

"To go from six to 196 of the Fortune 200 in only eight years, that’s really revolutionary," de Bernardo said. "Typically the wheels in Corporate America don’t turn that fast. This was a movement that spread from CEO to CEO."

De Bernardo said the trend was propelled by industry concerns about safety issues, absenteeism, productivity and liability for accidents, and its growth was hastened by waves of government regulation advocating drug crackdowns. Now, he said, it has spread outward to businesses of almost every size around the country—the notable exceptions being Hollywood and Wall Street.

In the entertainment business, companies fear losing celebrity employees who generate big profits despite their drug use, de Bernardo said. In the financial markets, he said, firms have what he called a "short-term mentality" that allows them to overlook drug dealers plying their trade on the streets of lower Manhattan and that enables brokerage houses to overlook high burnout levels and high turnover among their employees.
(Ed. note: In other words, people in the money business know that "drug" testing is a fraud.)

It’s unclear just how many firms are testing for drugs, although most experts believe the number is steadily growing. Pre-employment tests are the most common. But the American Management Association study found that about 60 percent of the firms that administer tests are also surprising current workers with random drug tests.

The Department of Labor, which surveys a much broader range of small firms in its surveys, has estimated that overall, only 20 percent of the nation’s employers are now testing for drugs, affecting about 40 percent of the country’s work force.

The big impetus to adopt testing, many experts say, is the simple fact that employers believe it successfully weeds out drug takers. They say it fends off serious users because they can’t keep clean, even for the short period of time required to wait for drug residues to disappear from their bodies before pre-employment screening. And it helps companies identify current drug users and potential drug abusers on their staffs.
(Ed. note: This means that they screen out marijuana users, but not hard drug users.)

SmithKline figures indicate that marijuana remains the primary drug of choice among users, making up about 60 percent of the test-positive samples. Cocaine use is second-favorite, though it is declining, dropping to 16 percent in 1997 from 23 percent one year earlier.

The risk of failing a drug test may actually cause some workers to give up illegal drugs entirely, particularly if they have just used them recreationally, and prods others to recognize they have a substance-abuse problem and seek help through company-provided employee assistance programs.

"Employers are saving lives," de Bernardo said. "People are going straight."
(Ed. note: By getting people to stop using marijuana and start using alcohol?)

But as drug testing has spread among the biggest firms, a kind of two-tiered structure has emerged in the workplace. As drug users know, there are workplaces that always test—and there are workplaces that never do.

"People who use drugs don’t apply at a company they know drug-tests," said Dale Masi, a professor of social work at the University of Maryland at Baltimore and president of Masi Research Consultants, a D.C.-based firm that advises major corporations on how to handled substance-abuse problems in the workplace.

"Companies know that if their competitors do it, they have to do it, or they will get all the users," Masi explained.

"The individual with behavioral problems goes to the place of least resistance, and that happens to be in small businesses," said Harold Green, president of Chamberlain Contractors Inc., a Laurel-based paving company. He instituted a drug-testing program 15 years ago, after a marijuana-smoking employee was involved in a serious truck accident. He fired the driver—and then established a drug treatment and employee assistance plan, including drug testing, that was one of the first of its kind in the country.
(Ed. note: Obviously, there is a relevant distinction missing here. Someone driving a truck stoned – or drunk -- is not at all the same thing as some one smoking – or drinking -- on weekends. W.C. Fields used to say that he hated sloppy drunks, because they gave drinking a bad name.)

When Green set up his drug-testing plan, it was nearly unprecedented, particularly among small firms like his. Many observers and critics considered it jarringly invasive to ask job hunters or employees to urinate in a cup to prove themselves drug-free. But such criticisms were gradually overwhelmed by a louder chorus of support.

Uncle Sam’s Example

Much of the push toward drug testing has come from the federal government. In 1982, the Navy began the first broad-scale random drug testing after an aircraft accident aboard the USS Nimitz uncovered widespread drug use about the ship. The practice soon spread to other branches of the military. Then drug testing was introduced in safety-sensitive government agencies such as the Nuclear Regulatory Commission, and mandated for government contractors with contracts worth more than $25,000.

Several horrific accidents spurred drug testing in the transportation industry. In 1987, two trains collided in Chase, Md., causing 16 deaths, and it was later revealed that one of the train’s engineers had been smoking marijuana before the collision.
(Ed. note: This story has become a part of the prohibitionist mythology. Obviously, an engineer has no business smoking a joint on or prior to duty, but that is not quite what happened here. The engineer said that he was in a hurry to get to a bar. The crew was eating and the emergency warning system had been disabled. But it is much easier to blame it all on marijuana.)

And in 1991, eight people were killed in a New York subway in which where the train’s driver later tested positive for alcohol. These incidents led to the passage of the Omnibus Transportation Employee Testing Act of 1991, which required the Department of Transportation to mandate drug and alcohol testing of employees in safety-sensitive transportation positions in private companies.

For many employers, the omnibus transportation law was key, because once a company began testing some workers—such as drivers who delivered merchandise to stores or who operated equipment in the warehouse—it became convenient to expand the policy company-wide.

Privacy, Other Concerns

Some critics say drug testing has gone too far. The American Civil Liberties Union has long opposed drug testing on philosophical grounds, saying that it is an invasion of privacy and that employers should not be allowed to dictate to workers about off-duty activities.

The ACLU also questions some of the research on increased productivity and lowered absenteeism touted by drug-testing enthusiasts as scientifically tainted by funding from the drug-testing industry.

"My impression, quite frankly, is that it has been the government and the testing industry that have driven this thing, more than the employers," said Lewis Maltby, director fo the ACLU’s national task force on civil liberties in the workplace.

Maltby and others also questioned whether recreational users of illegal drugs, who are not necessarily drug abusers, should be persecuted and perhaps fired if their drug use is not really a problem for their employers.

Employee assistance expert McCann, too, raises questions about the effectiveness of drug testing in screening out drug users. "Let’s face it: Pre-employment testing is an idiot test," he said. "All it proves is that you abstained for a week before the test."

He also wonders whether drug users are simply being pushed into smaller firms or into unemployment. "Are people just moving into self-employment, such as becoming taxi drivers, where they are not subject to this scrutiny?" he asks.

"Drug testing is keeping decent, hard working people out of jobs while alcoholics can run the [expletive] country," wrote one Web surfer, who said his doctor had told him that marijuana poses "no harmful effects to the body."

A snapshot of how drug testing works comes from Tom Warner, president of three D.C.-based plumbing, heating and air conditioning companies that together employ 92 workers.

He wasn’t pushed to his drug-testing policy because of any big disaster. Instead, it was little things, such as recurring minor accidents and foolish mistakes. He remembers one experienced technician, for example, who had inexplicably used his bare hands on a sewer-contaminated piece of machinery, rather than use his gloves. "It wasn’t something a rational person would do," he recalled thinking at the time.

Warner decided to introduce drug testing, and the first results startled him. About half of a group of new trainees failed, as did the worker who had failed to use his safety gloves. Some drug users quit rather than be tested.

Warner decided to clean out the problem workers by simply firing people who tested positive for drug use. They are invited to reapply after one year and will be rehired if they pledge to remain drug-free. Few drug users either apply or reapply now, Warner said.

"It’s known we’re a drug-free company," he said. "People who do drugs want to do drugs—and want to be in a place where they can."

Workers and Drug Use

The percentage of major firms requiring employee drug tests has escalated in the past decade* . . .
. . . and the percentage of employees who test positive has declined significantly.

*1997 data not included because the survey was conducted differently that year.
SOURCES: American Management Association, SmithKline Beecham

Construction workers are among the category of employees reporting the highest usage rate of illegal drugs.

Percentage of employees, 18-49, reporting use of illicit drugs in the past month

Construction -- 15.6%

Sales -- 11.4%

Wait staff, bartenders -- 11.2%

Handlers, laborers -- 10.6%

Machine operators -- 10.5%

Precision production -- 8.6%

Administrative support --5.9%

Other service -- 5.6%

Executive, managerial -- 5.5%

Technicians, related support -- 5.5%
SOURCE: National Institute on Drug Abuse

Which drugs were present in positive tests:

Marijuana -- 60%

Cocaine -- 16%

Opiates -- 9.4%

Amphetamines -- 4.9%

Barbiturates -- 3%

Other -- 6.7%

SOURCE: SmithKline Beecham