Substance Abuse Program

How to Navigate and Benefit from a Drug-Free Workplace

April 13, 2018
Opioid abuse is an issue that continues to devastate hard-working middle-class communities.

As employers continue to tackle the issues surrounding drug abuse in the workplace, they are discovering that they are well positioned to play a key role in impacting a national health crisis that transcends every community across America.

With a greater understanding of the far-reaching effects of opioid abuse on America’s workforce, both government and private sectors will gain a more comprehensive appreciation of how deeply this issue cuts and be better prepared to take action.

Employment drug testing is a powerful risk mitigation tool that provides far-reaching organizational and societal benefits. In addition to promoting a safer, more productive workplace, it can help decrease worker turnover and absenteeism, reduce employer risk and lower workers’ compensation incidence rates.[1]

The Workplace Impact

Consider these eye-opening numbers: 70 percent of the 14.8 million Americans who abuse drugs are employed.[2] When an employee abuses drugs, employers take on the risk of: workplace injuries, compromised productivity due to absenteeism and presenteeism and liability.[3]

Drug abuse can cost U.S. business owners more than $140 billion dollars every year, which includes turnover rates for employees who abuse drugs.[4] The key problem drugs include cocaine, heroin, ecstasy, methamphetamine and prescription drugs.

Employees who abuse prescription drugs are two to five times more likely to take unexcused absences, be late for work, be injured or violent at work, file workers' compensation claims and quit or be fired within one year of employment. In contrast, employees in recovery for substance abuse save a company more than $3,200 a year.[5]

Know the Facts

New federal mandatory guidelines[6] for workplace drug testing became effective on Oct. 1, 2017 and include the authority to test for four semi-synthetic opioids: oxycodone, oxymorphone, hydrocodone and hydromorphone. These prescription opioid pain medications, which are commonly known as OxyContin, Vicodin, Percocet and Dilaudid, were added to the standard testing panel because data indicates that although they are prescribed; they are the prescription pain medications that are most frequently used without medical authority.

Under the revised mandatory guidelines, positive drug testing results that are supported by a valid prescription, as determined by a medical review officer (MRO), will not be reported to federal agencies. These revised andatory guidelines for federal workplace drug testing programs using urine (UrMG) affects all federal workers in a testing designated position, which is defined by each agency’s drug-free workplace program.

In 1986, the Federal Drug-Free Workplace Program was initiated by Executive Order 12564 to establish the goal of a drug-free federal workplace. The program made it a condition of employment for all federal employees to refrain from using illegal drugs on or off duty.

Employers should consider working with worker assistance programs to develop policies that include conducting pre- and post-employment drug testing for prescription drugs, teaching managers to spot addiction and developing a strategy to intervene. They also should find insurance plans that cover treatment, a system for supporting employees returning to work post-treatment and an assessment of whether the company culture encourages substance abuse.[7]

Testing Best Practices

In terms of the cost of workplace drug testing, a standard 5 or 10 panel urine drug screen typically costs between $30 to $60, but failing to have a drug testing program can cost dramatically more for the employer. In fact, abuse of tobacco, alcohol and illicit drugs is costly to the U.S., exacting more than $740 billion annually in costs related to crime, lost work productivity and healthcare.[8] Keep in mind that healthcare accounts for about one-third of costs attributable to the prescription opioid epidemic, while one-fourth of costs are carried by the public sector.[9]

Workplace drug testing makes the stakes of drug use and abuse even higher, encouraging employees to be less inclined to use drugs if they know it could threaten their employment. A random testing program is a key component in making drug testing truly effective. According to the Office of Health and Safety Services, ongoing employee drug testing lowers the number of workers who test positive.[10]

Drug testing today is highly accurate, with a number of methods to ensure validity, coupled with incentives in some states that include reduced insurance costs and workers’ comp discounts.[11] Typically, employers are concerned about safety as the primary framework for drug testing. It’s much more preferable to avoid the accident rather than determine what happened after the event has occurred.  

Currently, only a few jobs have federally mandated drug testing: pilots, truck drivers, train operators and occupations deemed “safety sensitive.” The National Safety Council recommends employers be proactive and take the following steps to create a drug-free work environment:[12]

  • Partner with prescription drug and health plan providers to help gatekeep, monitor, and intervene on the use of prescription drugs.
  • Review the company’s drug-free workplace policy to protect employees and reduce liability.
  • Ensure that any employee drug-testing program includes testing for the most commonly prescribed opioid painkiller drugs.
  • Educate employees about confidential help available through an employee assistance program.
  •  Remind employees about the drug-free workplace policy, testing policies and confidential help available through an employee assistance program.

Keep in mind that Medicaid, Medicare and major insurance companies face increased costs for drug test screening. These costs are not caused by a spike in the use of narcotics by subscribers, but from unnecessary testing and overbilling by doctors and drug screening companies. Therefore, it’s important for employers to partner with a highly reputable drug testing facility that offers fast, accurate, high-quality laboratory and genomic testing and serves as a collaborator with employers, payers and clinicians by providing an extensive range of testing services, including specialized diagnosis, screening and evaluation.

[1] 01, 2. M. (n.d.). Drug Testing Promotes Workplace Safety. Retrieved October 18, 2017, from Articles/2012/10/01/Drug-Testing-Promotes-Workplace-Safety.aspx
[2] Wilcox, S. (2015, April 26) Drugs and Alcohol in the Workplace. Retrieved October 18, 2017, from https://www.ncadd. org/about-addiction/addiction-update/drugs-and-alcohol-in-the-workplace
[3] Yogoda, Robert. (2016, August 4). Addiction in the Workplace: Tips for Employers. Retrieved October 18, 2017, from
[4] Why is Drug Testing Important for Employers? (2014, March 28). Retrieved October 18, 2017, from
[5] Elejalde-Ruiz, A. (2017, April 10). Cost of substance abuse hits employers hard, new tool shows. Retrieved October 18, 2017, from
[6] B. (2017, September 29). Mandatory Guidelines for Urine Testing Updated to Include Four Semi-Synthetic Opioids. Retrieved October 18, 2017, from
[7] Elejalde-Ruiz, 2017.
[8] Abuse, N. I. (n.d.). National Survey of Drug Use and Health. Retrieved October 18, 2017, from https://www.drugabuse. gov/national-survey-drug-use-health
[9] Costs of US Prescription Opioid Epidemic Estimated at $78.5 Billion. (n.d.). Retrieved October 18, 2017, from http:// billion.html
[10] Drug Testing. (n.d.). Retrieved October 18, 2017, from
[11] Screening, N. D. (n.d.). Why Workplace Drug Testing is Essential in 2016. Retrieved October 18, 2017, from https://
[12] As Opioid Epidemic Rages, 2017.

Scott Howell, M.D., MPH &TM, CPE is the chief medical officer at Tenet Diagnostics (, a provider of laboratory and genomic testing and evidence-based research.

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