Are there standardised guidelines for workplace drug testing in the UK?

Much of the background, science and theory which form the basis of workplace alcohol and drug testing originated in the United States where mandatory testing is carried out by employers. However European Guidelines exist and the laboratory which will carries out testing on your specimen conforms to these guidelines and is fully accredited.

Why bother?

Many companies are concerned with the welfare, health and safety of its employees. Consequently they may have in place a policy which covers aspects of alcohol and drug abuse.

What types of testing are there?

Depending upon your company policy, testing may occur on recruits before they are employed (pre-employment testing), on employees (unannounced or random testing), or if a safety critical incident occurs (for-cause testing).

Isn't drug testing an invasion of privacy?

If the program is properly administered and within agreed guidelines, the courts have determined that drug testing is not an invasion of your privacy. The primary factor (among others) with respect to court decisions is the welfare and safety of others.

Do employers have the right to require that employees be tested for drugs and alcohol?

Yes on both counts. But a company has to do it fairly.

Are my records truly confidential?

Your name is not shown on the documentation that goes with your specimen to the laboratory. Your employer and the MRO are required to keep test result records confidential, in a safe, restricted place. Testing records cannot be released to others without your consent.

What is a MRO?

Medical Review Officer - If your urine result is ‘negative’, this information is normally given directly to your employer. However a ‘positive’ test result is sent directly to a nominated Medical Review Officer (MRO), a qualified physician who reviews and interprets the results. The doctor may consider your medical history and prescribed medication when assessing the results. Sometimes he may ask to speak with you.

What information do they put on the forms that go with my sample?

For laboratory testing, a special chain-of-custody form is required. It is designed to provide anonymity for the donor and will not have your name on it.

What kinds of tests would I have to take? What drugs would be tested for?

Your employer has the right to set up a testing program for illicit drugs and/or alcohol and drug abuse. Under most circumstances, the types of tests, the drugs tested for and the cut-off levels can all be determined by your employer. There are ‘standard panels’ which are used by many employers. However local drug abuse patterns may also be taken into consideration by your employer when choosing a drug panel.

What are cut-off levels?

A cut-off level is a concentration value set to determine whether the sample is positive or negative for the presence of a drug. Much research has been carried out to determine optimum cut-off levels. For example, if the cannabis test were too sensitive (low cut-offs), there could be the danger of a positive results being given for ‘passive’ smoking of cannabis.

How reliable is drug testing?

When both screening and confirmatory tests are conducted, the combined tests themselves become virtually 100% dependable.

What rights do I have in a testing program?

Your basic rights extend primarily to the right to privacy and the right to question the legitimacy of a test result.

What happens if I decline to be tested?

Most company drug testing policies call for some form of disciplinary action up to and including dismissal.

Where would I be tested?

Most testing occurs on company premises if suitable accommodation is available. For smaller companies, you may provide your sample at a collection site - usually off company premises or in a mobile testing unit.

What are the collection site requirements?

A collection site must at a minimum provide:

What actually happens when I go to be tested?

Most drug testing methods today involve analysing urine specimens. Test results are reported as POSITIVE or NEGATIVE for illicit drugs. A positive test means the drug has been used in the recent past, usually a period of days. A urinalysis cannot determine if a particular individual is "impaired" by the drug level found, and it cannot tell when an employee last used a drug.
Testing is a two-stage process. First, an initial (screening) test is administered. If it is positive for one or more drugs, then a second, confirmatory test is usually conducted for each identified drug. The confirmation test uses a different, more sophisticated chemical process. It ensures that substances such as over-the-counter medicines are not reported as positive.

At the collection site, an employee usually provides the specimen in private. A person, who is trained in the collection process, seals and labels the specimen, then prepares both the specimen and its accompanying paperwork for shipment to the drug testing laboratory. Each step of the process is documented on a "chain of custody" form. The collection and chain of custody procedures ensure the specimen is properly identified and tracked throughout the testing process.
The urine specimen is divided into 2 or 3 portions. All bottles are sent to the laboratory, but only the primary specimen is opened and used for the initial screening and confirmatory tests. The secondary specimen bottle remains sealed and stored at the laboratory.

If the confirmation test on the primary specimen is positive, the employee can request that the split specimen be sent to another accredited laboratory for analysis. The split specimen procedure essentially gives employees an opportunity for a "second opinion" if their drug test comes out positive.

May donors be required to strip, wear a hospital gown or empty pockets?

You do not have to strip or wear a gown. The collector however can ask the individual to remove any unnecessary outer garments such as a coat or jacket that might conceal items or substances that could be used to tamper with or adulterate the individual's urine specimen.

It should also be noted that if a collector, during the course of a collection procedure, suspects an individual may attempt to tamper with or adulterate a specimen, as evidenced by a bulging or overstuffed pocket, for example, the collector may request that the donor empty his or her pockets, display the items and explain the need for them during the collection.

How much urine must I provide for the drug testing sample?

Not very much. Fifty (50) milliliters is necessary, i.e. about 1 – 1 ½ fluid ounces.

What if I just can't "go" at the time of collection?

If the donor is unable to provide a specimen initially, fluids are provided, with the dual objective of assisting the willing donor and encouraging the non-willing donor. If after a reasonable waiting time (3 hours or more) a specimen is not forthcoming, an ‘unable to provide’ form should be completed and is retained by the employer.

If fluid is taken during this time period it is highly unlikely that a sample could not be provided. If so, it may be necessary to determine if there is a medical reason for this. The Medical Review Officer (MRO) could, after a thorough examination of the individual's circumstance, notify the employer that the individual could not provide a urine specimen.

How long after use can drugs be detected in the urine?

That depends on the drug, the amount of drug and your metabolism. Many of the tested drugs can be detected for several days after use. Cannabis metabolite can be detected for up to several weeks, particularly in regular users.

Can I test positive for secondhand smoke?

No. Research experiments have been conducted where non-smoking individuals have been exposed to heavy concentrations of marijuana smoke in confined quarters. The nonsmoking individuals could not absorb enough smoke, even after several hours of exposure, to cause a positive result (above the cut-off value) in subsequent urinalysis.

Should I avoid taking any foods or medicines before the test?

If you are taking prescribed medications for a specific condition, you should continue taking it. You will be given the opportunity to declare any medication at the time of sampling and advise the MRO of this fact. As for food and drink, there's no reason not to eat and drink as usual. Women need not declare use of the birth control pill.

What does testing "positive" mean? What does testing "negative" mean?

Testing laboratories use "cutoff limits" to determine if a specimen is positive or negative. Cut-off limit guidelines are used for both alcohol and urine drug testing. A negative result indicates the level of a drug or alcohol being tested for is either not present or is below the cut-off limit. A positive result indicates the substance is present at a level above the cutoff limit.

Who establishes the cutoff limits?

Standard cut-offs are normally used for this type of work. However your employer, using MRO advice, can alter these cut-offs.

What level of drug in the urine indicates that an individual is impaired?

Physical impairment according to a given level is not the issue. The issue is whether or not illegal drugs are being used at all, and whether or not drug and alcohol abuse is taking place.

What is a "false" positive, and how can they occur?

This is probably the most confusing issue regarding drug testing. Simply put, the tests are very accurate. If, during screening, they detect a drug, it is called a "presumed" positive. If the drug detected is one you are taking through prescription from your doctor, it is a negated positive. Some over-the-counter medications will test presumptive positive, but the confirmatory tests will rule out any illicit substances. What is generally called a "false" positive is simply a result which has not been confirmed.

What qualifications are the MRO required to have?

The MRO shall be a registered physician with knowledge of substance abuse disorders. Typically an MRO is a qualified occupational physician.

What can I do if I'm wrongfully accused?

You can request, in writing, a re-test. You will not be permitted to provide a new specimen. The secondary specimen taken at the time of donation will be opened and tested to confirm or refute the first positive report. You will normally have to pay for this re-test.

What should I do if someone I work with has a drug problem?

That's a question you have to answer for yourself. But you owe it to yourself, the people who work with you and the person with the problem to seriously consider discussing it with your supervisor, shop steward or union representative. Whether or not you discuss it with the person who has the problem depends to a great extent on your relationship with that person. Most of the time it's not advisable. A person with a serious problem, whether it's drugs or alcohol, usually needs professional help.

Can I go to management for assistance if I have a drug or alcohol problem? What would happen?

That depends on your company and its Policies and Procedures. However as a rule company policy will often facilitate treatment.

What will be done to me if I test positive?

Study your company's Policies and Procedures carefully.

Will I have to pay for a confirmation test out of my own pocket?

Usually not. However, if you dispute a test and request a re-test, you will normally be expected to pay for it.

Why is most workplace testing directed towards urine sample collection?

Urine alcohol and drug testing is well established. Since the 1980’s many millions of specimens have been collected throughout the world for this purpose and much research has taken place with respect to workplace urine testing.

What are the alternatives to urine testing?

Because of health and safety issues the sampling of blood from individuals for workplace testing is not recommended.

Alcohol - breathtesting is an excellent alternative for alcohol detection. The technology for breathtesting is well established and the principles are enshrined within drink-drive legislation.

Drugs - saliva (oral fluid) testing represents an attractive alternative to urine drug testing:

(a) saliva drug concentrations can be related to plasma free-drug concentrations, and hence to the pharmacological effects of drugs. The presence of drugs in saliva therefore is more likely to correlate with effect or impairment. Studies of drugged drivers have generally shown a high correlation between saliva drug levels and observed impairment.

(b) Saliva collection is non-invasive and is likely to be more acceptable than urine. Collection is easy and requires minimal facilities to carry it out. It is also faster.

(c) The sampling of saliva is always in sight of the collector; it is more difficult for a donor to adulterate the sample.

(d) Objective electronic measuring devices for screening saliva samples are now available.

(e) Saliva samples can be taken quickly following an incident. Toilet facilities are not necessary.

(f) Saliva testing is more likely to measure impairment at the time of sampling; therefore it may well be preferable as a testing basis under Information Commissioners Guidelines.

How about Hair Testing?

Hair Testing can be appropriate if retrospective drug abuse is to be detected. The detection of drugs in urine is only possible for a finite time after the last instance of use (several days, although cannabis can be detected for weeks). Drugs however become incorporated into growing hair and the analysis of a hair sample can provide useful historical drug abuse information. Hair grows at about 1 cm per month.