Dear Ms. *********,

Let me review some principles that are important in the workplace pertaining the concept of being drug free. Please forgive me if I go over things already known, or if I make starting place assumptions too fundamental.

The most important thing to have is a published "Drug Free Workplace" policy. Each of our clients has a different setting with different needs so I have never seen two policies that are the same. Each employee needs to agree to the policy at the time of their employment. If you do not have one in place then you should create one; give everyone adequate time to read or complain; have them sign it; and put the signed copy in their personnel file.

Your drug free workplace policy will create the privileges that you need to manage the problem. If you do not have a written policy or if you have a written policy and do not follow it... your employees may believe you have acted in a discriminatory fashion and claim improprieties. I can not tell you how important it is to have an established policy and then function in accordance with the policy.

Your policy should contain the provisions to perform random drug screens and breath alcohol testing on all categories of employees. It is a fair practice to treat different categories differently, but you must be careful. For instance DOT (Department of Transportation) related staff must have NIDA drug screens where as others that are not associated with the DOT do not have to have NIDA drug screens; staff members that do not function within DOT guidelines could have one of our quick screens that we call an EcScreen. In particular you should have good testing for safety sensitive positions, but you may not have to have such stringent controls on clerical positions. Now that I have said this it has been my experience if the management of a company also submits to the same protocols as your front line staff members, the policies are accepted without much fanfare. If the management of a company does not submit in the same manner as the front line there are some problems that have to be managed.

Your policy should contain provision for you to perform screening at the time of any injury, or return to work. The part related to a return to work is actually just as important as an injury because patients can be off work for medical problems that require the use of prescribed mind altering pharmaceuticals like tranquilizers or narcotics.

Your policy should contain provision for you to perform screening at the time of suspicion. This is an important provision, but I can tell you that the exercise of this provision can be difficult. When an employee is not able to function they should be tested, but their lack of function could be as simple as a situational depression related to a fight with their spouse or having their mind occupied by financial difficulties. Sometimes it is not an easy judgment to look at someone and have clear confidence that they are taking drugs or alcohol

Your policy should contain the kind of drug screen you are going to perform, or give you latitude to obtain what is needed. By way of cursive summary the 5 panel drug screens usually test for the use of illegal drugs. This includes marijuana, PCP, and other drugs your employee might purchase off the street. The 10 panel drug screens test for the use of illegal and legal drugs. The largest problem in the workplace is not illegal drugs, but rather it is the use of legal drugs. Legal drugs are obtained by the filling of prescriptions. If an employee is sedated by muscle relaxers, prescribed narcotics, mild or major tranquilizers he or she has the potential to place your company at risk in the same manner as someone using illegal drugs.

Your policy should contain what you are going to do if the drug screen is positive. I would encourage you to have a policy that includes remediation. However some of our clients have policies that require termination after one occasion. It is important to remember that the management has to live with whatever guidance the policy provides. Some issues related to this subject may involve having EAP (Employee Assistance Programs), but we also have many clients that do not have EAP programs. If the employee has a positive drug screen that is related to a legal medication you may want to have the privilege to have the employee's medical care reviewed by a physician of your choice in order to determine fitness for duty.

Your policy should contain what you are going to do if an employee fails to submit to a drug screen and alcohol test that is related to any cause ie random, probable cause, injury, return to work etc.

Your desire to have your managers trained to manage these problems is very very good. I will be pleased to prepare a 2 hour presentation that includes materials, testing, and maybe some role playing. The answers to each of your questions is closely related to your "Drug Free Workplace" policies. The first thing I would like to do is to review your policies related to this. After I make my review I will use your policies to develop the seminar.

If you do not have a policy we can help you create one.

Please let me know how you want to proceed.

Gregory P. Ennis, M.D.
Medical Director
Medical Review Officer
EcCare Health Centers