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Greenville Business Magazine

Employee Drug Screening: The Decision for a Better Intervention

Aug 15, 2022 10:15AM ● By Sandy Hardee

According to 2018 data from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health, nearly 9 percent of all employed adults (approximately 13.6 million workers) have current alcohol or illicit drug use disorders, while a relatively equal number (approximately 13.4 million workers) report that they are in recovery or have recovered from a substance use problem. 

While not a fun topic to introduce, employers may wonder if drug screening would be an effective tool to promote workplace wellness. At Prisma Health, my team of dedicated providers and I help employers navigate drug screening in the workplace to keep employees healthy and safe in the workplace. 

Why do employers conduct drug screenings, and when should

they be completed?

Simply put, according to the statistics, many people in the United States use drugs, and this has potential to have an impact on work performance. Just how many people does this include? According to SAMHSA, nearly 50 million Americans report using marijuana in 2019. Another 10 million people apiece use central nervous system stimulants or opioids. 

Screenings are an important tool to support a healthy and sustainable workplace, improving worker safety and health, as well as adding value to your business. They are also effective in preventing injuries and absenteeism among your workforce. 

Once an employer determines there is value in utilizing drug screening, they are likely to have questions about how best to go about it. There really is no right or wrong answer as to when to do a drug screen, as it may be based on several factors. The most common scenarios our team sees are for pre-employment, post-accident, random or suspicious causes, or a return to duty if someone has been out of work for an extended period of time.

Prisma Health offers all these services across the state and for larger companies, we can provide on-site random drug testing for a smoother employee experience.

What can employees be tested for? How is a test conducted?

At Prisma Health, we offer two types of tests: five-panel and 10-panel screens. In the five-panel screen, employees get tested for marijuana (THC), amphetamines, opiates, PCP, and cocaine.  In the 10-panel screen employees get tested for everything in a five-panel plus benzodiazepines, barbiturates, methadone, propoxyphene, and methaqualone. 

The most common way a drug test is conducted is through a urine sample. These urine collections and processing follow very strict procedures. The process uses a chain of custody that is traceable from origin to final result to ensure validity. Our team is trained on this method annually. 

Our medical review officers (MRO) interpret the test results based on information the donor has provided as well as information the clinical scientist reports on the tests. If a test is positive, the MRO will contact the tested employee to discuss results and facilitate proper actions if a medical explanation is needed. An example of this would be when an employee might be on a medication they forget to mention in advance. Our MRO will ask the employee to provide a valid prescription for documentation.  

Another benefit of our MROs reviewing results in detail is we take into consideration medication-related workplace safety concerns. For instance, if someone takes a prescribed medication that makes them drowsy, our MRO can recommend the safest possible dosing schedule. 

The drug detection windows for urine tests are narrower than people usually realize. We often think that if someone uses a drug that it is going to be in their system for a long time but that is not the case. Most drugs can be detected for only a couple of days, but the outlier is THC. THC is stored in fat cells and can stay in your system for a longer time, depending on how often someone might be using it. 

What about CBD supplements? 

Cannabidiol (CBD) poses a drug testing challenge. All CBD supplements are made from the hemp plant which should contain less than 0.3 percent active THC. 

THC is the psychoactive component found in marijuana that produces the high. CBD products are widely touted to help with anxiety, insomnia, fibromyalgia, and other pain syndromes.

CBD products are not regulated by the FDA, so there is a possibility that they contain more than the 0.3 percent THC and will cause a positive result on a drug screen for marijuana. Employees could be using over-the-counter CBD products and unknowingly test positive for marijuana. When the MRO receives a positive marijuana result, we cannot distinguish between CBD  or marijuana use, so it is reported as a positive result.

This may seem confusing as to why a product like this can be sold. The federal Dietary Supplement Act of 1994 allows supplement manufacturers to market their products without demonstrating their safety or efficacy – meaning any supplement can be sold freely, while the FDA has only a limited capacity to monitor and regulate the products for adverse reactions. The CBD industry is now a $5 billion industry and expected to grow to $47 billion by 2028. With this rapid growth, hemp plant farmers may produce plants with higher levels than 0.3 percent THC, which is very difficult to monitor. 

As a business owner, your workforce is your greatest asset. Protecting the health and safety of that workforce is an important piece of your company’s success. Drug screening may be an effective tool to both support your emphasis on team wellness and contribute to efficient business operations. 

Dr. Sandra Hardee is medical director of Business Health Solutions-Occupational Health Solutions for Prisma Health.