A Child's Primer of Drug Testing
(August 28, 2018)
If you encountered the phrase “drug testing” newly, as a little child, never having heard it before and having no context for it, you might naively think it to be a tool of conventional medicine. Maybe designed to help the health care gods figure out ahead of time if a medication is dangerous or not, or even whether or not an individual patient might get side effects from one that’s been proposed for them. Kids are cute, aren't they?
But as jaded adults, we know that that is not the world we live in. We know that the phrase “drug testing” does not generally refer to something that is meant to help us. It’s more like something that was designed to help The Rulers keep a little closer tabs on The Ruled than they might otherwise be able to. Not that there’s necessarily anything wrong with that, mind you. I’m just sayin’.
There are very good reasons for a lot of drug testing. There are very poor reasons for a lot more of it, hence the attitude you probably detected in the previous paragraph. The societal aspects of drug testing are many and varied, among them the fact that the people who really SHOULD be regularly drug tested (politicians and CEOs) are the ones least likely to be.
But although I would dearly love to continue in that vein for a while, your time is valuable. So instead of more of all that, I will instead proceed to a few brief basics on workplace drug testing.
First, I plagiarize from Wikipedia:
A drug test is a technical analysis of a biological specimen, for example urine, hair, blood, breath, sweat, and/or oral fluid/saliva — to determine the presence or absence of specified parent drugs or their metabolites.
What that means in normal talk is that you take a little piece of someone and you use fancy scientific equipment to analyze it to see if there is an eyebrow-raising amount of a particular drug or its metabolites (breakdown chemicals) present. Various types of this kind of testing are done in medicine to see how well organs are functioning (blood and urine tests), in law enforcement to nail drunk and chemically impaired drivers (breath and blood tests) and, as I implied earlier, at Taco Bell to see whether that new cashier is actually stoned all the time or just very strange (urine testing. Dude!).
The thing is, except when it is mandated by federal guidelines for jobs where safety is an issue, drug testing in the private sector is completely optional for the employer. Which means that most of the time, it is a valid question as to whether most of the drug testing that is routinely done is really necessary.
Moreover, most drug tests can only tell you when the patient (yes, s/he is a patient – employer drug testing is usually subject to HIPAA privacy laws) has used a particular drug within a certain window of time. With very rare exceptions, they do not measure IMPAIRMENT. Which again brings up the question of how relevant they are for most employers and most jobs.
Drugs can persist in your body in one place or another for quite a while, but after a bit the amount present is so small that your basic drug test won’t find it. So just for giggles, following is a list of what is generally tested for per federal guidelines (plus alcohol), and how long said substances are detectable in urinalysis.
Private employers frequently and gleefully add items to that list that can result in people who are innocently taking prescription medications of all kinds (not just the ones that are listed above) testing positive. If you’re taking any at all and you're subject to workplace drug testing, you might want to look into that a bit further.
(You diabetics out there, I know you know that your Hgb A1C will show your doctor that you cheated on your diet as far back as three months. Longer than ANY of those druggies listed above would get nailed for. I feel for you guys, I really do. I mean, tests for Fentanyl are negative after 24 hours. Life is NOT fair.)
If you do any reading about non-mandatory drug testing, you will quickly notice that the writer smoothly glosses over not just the difference between legal and illegal drugs, but the difference between “use” and “impairment”. Because, I repeat, workplace drug testing does NOT measure impairment. It measures past use within the time windows above, period.
An alcohol breathalyzer test can tell if you’re impaired from alcohol, but that's because (1) we know what breath levels equate to what blood levels, and furthermore (2) what blood levels translate into real-life impaired driving. I don't think that research has been successfully accomplished yet for anything else that's tested for.
But. Since there are some people out there making huge amounts of money from selling drug testing and said people make large political donations, plus employers often get a nice break on their workers’ compensation premiums if they drug test their employees, these things aren’t going away soon.
I’m not actually promoting drug use of any kind. It’s simply that I think that life is too hard for most people to deal with unless they have at least an occasional chemical release. And if there is anyone out there who would like to take issue with that statement, I'd like them first to consider that one in six Americans is currently taking an antidepressant -- or something even stronger.
I said that about life being hard somewhat lightly but I believe it firmly. I also believe that maybe because of some bizarre Puritan mutation in our collective genes, our culture considers deliberately altering one's mood through any means but positive thinking to be a bad thing and that people who do so are bad as well. Even when no one is harmed by it and it makes life a little easier. I say phooey to them. And thus, today's essay.
--dr. diane holmes
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