“You’ve got to fight ... for your right ...to par-tay” –  Beastie Boys, 1986

The first was through the common law system, employing precedents philosophically derived from the idiosyncratic rules governing the "king's forest" and the "king's highway."  From these arcane precepts are derived the laws which allow legal authorities to detain and test persons under suspicion of driving under the influence of alcohol or drugs.

The second route originated after a plane crashed on the USS Nimitz in 1981, when naval drug testing and regulation was instituted immediately.  These interventions were then adopted by other branches of the service over a three-year period.  From these actions was derived the concept of a "drug-free workplace."  In consultation with drug-czar Dr. Carlton Turner, Ronald Reagan issued Executive Order 12564.  In doing so, he instituted mandatory drug-testing for all safety-sensitive executive-level and civil-service Federal employees, requiring these employees to refrain from using illegal substances in specified DOT regulated occupations.

This was challenged in the courts by the Natl. Treasury Employees Union.  In 1988, this challenge was considered by the US Supreme Court. A similar challenge resulted in the Court extending the drug-free workplace concept to the private sector.  These decisions were then incorporated into the White House Drug Control Strategy directive issued by President George H.W. Bush in 1989.

Drug tests in the USA can be divided into two general groups, federally and non-federally regulated testing

Drug testing guidelines and processes are established and regulated by the Substance Abuse and Mental Health Services Administration (SAMHSA) to test federally regulated people for the presence of certain drugs.

These drug classes were established decades ago, and include five specific drug groups - marijuana, cocaine, amphetamines, opiates and PCP.  While SAMHSA/NIDA guidelines only allow laboratories to report results for the "NIDA-5" many drug testing laboratories offer a wider set of screens .  (Hallucinogens other than cannabis and PCP, such as mushrooms, LSD, Ketamine and peyote are currently rarely tested for.)

Pre-employment drug testing

This is by far the most common type of drug test used by businesses.  It is considered to be an "intelligence test" by drug testing professionals. Companies and testing centers that do not use witnesses normally disconnect sources of water from the testing room to discourage dilution, and if there is water in the toilet, it is dyed blue.  Other countermeasures, such as making the donor change into a gown, may also be used.

Random drug testing

Random drug testing is considered a most effective format.  In the USA, random drug testing is used by a growing number of corporations, drug rehab centers, prisons, the military, police and fire departments, government agencies, and schools. Currently, this method is used in 23 of the 50 United States. It may also be used on teens by their parents or mandated to be performed at school. The objective of a random drug test is deterrence, as the threat of detection is much higher versus other testing methods.  (Government-mandated testing requires a scientifically provable method of randomization.)  Random testing is likely to catch cannabis users, since THC metabolites are fat soluble and have a longer duration in the body than those of many other drugs.

“Drug testing is one action an employer can take to determine if employees or job applicants are using drugs.  It can identify evidence of recent use of alcohol, prescription drugs and illicit drugs.  Currently, drug testing does not test for impairment or whether a person’s behavior is, or was, impacted by drugs.  Drug testing works best when implemented based on a clear, written policy that is shared with all employees, along with employee education about the dangers of alcohol and drug abuse, supervisor training on the signs and symptoms of alcohol and drug abuse, and an Employee Assistance Program (EAP) to provide help for employees who may have an alcohol or drug problem”  (US Dept. of Labor)

Typical drug test policy for employers usually includes the following:

The initial positive test for use and/or abuse of alcohol in violation of this Policy will be treated as a medical issue requiring evaluation for alcohol rehabilitation treatment.

All subsequent positive tests for alcohol-related violations of this Policy shall be treated as disciplinary matters in accordance with this Policy. 

A refusal to submit to a drug test shall be treated as a positive test for disciplinary and all other purposes pursuant to this Policy.

Child Custody/Family Court

Generally speaking the issue before the court is what is in the best interest of the child.  As such drug and alcohol testing, evaluations and ordered rehab is the norm not the exception.  (Child custody drug testing protocol includes zero tolerance testing.)

As one divorce lawyer writes:  “If one parent has been accused or has admitted using and abusing drugs and/or alcohol, then you may wish to add contingent agreements in your parenting plan that include drug and alcohol testing.  The agreement may designate a certain duration, the frequency, the location of a drug and alcohol testing facility, and who is responsible to pay for the testing.  Also, the agreement may reflect the conditions that occur when a drug and alcohol test is not passed. Sometimes the Court will order such conditions as part of the parenting plan.  However, the parties may agree to such testing as well.  If you would like to know more about having your parenting plan include a drug and alcohol testing prerequisite, please contact [name withheld]."  

Pain Meds and Doctors, Organ Transplants

Recent developments have increased the pressure to conduct drug screening of pain patients.  First, pain doctors have suffered a string of stinging legal judgments for over-prescribing opioids to patients who subsequently overdosed.  This February, a prestigious panel of the American Pain Society issued “New Guidelines for Prescribing Opioid Pain Drugs” which counsels that “diligent monitoring of patients is essential. “ The report specifically recommends periodic drug screens for chronic opioid patients.

As noted elsewhere on OS – organ transplant panels require testing and a commitment to abstinence and complete sobriety.

Welfare/public assistance

Politicians routinely press for drug-testing of these populations.  This year West Virginia legislator Craig Blair introduced a bill requiring random drug testing of individuals filing for unemployment benefits.  The bill would "require random drug testing for any government assistance" and someone who failed their drug test "would get the benefits and 60 days to clean up."  A failure of a subsequent drug test would result in an individual losing their benefits for two years.

Needless to say, the insurance industry, the rehab/health care industries, the corrections  industry, labs/labworkers and lawyers all have a stake in this.  Better put down your “High Times” magazine and start reading “Drug Detection Report” ("a biweekly newsletter for drug-testing professionals in all drug-testing areas, including schools, the workplace, post-accident testing, etc.  It provides news, information on and analysis of state and federal drug testing regulations, federal and state court decisions, statistics, and industry developments”)

Next Up:   See you (and your “Higher Power”) in treatment

In the meantime: please tell Noah YOUR drug test stories