‘Positives’ drop among transportation workers
Positives’ drop among transportation workers
Is it testing, or better workplace strategies?
In a June 7 address in Denver to members of 10 different trade unions, Dennis Ritz, MS, JD, a forensic toxicologist and director of LabCorp Occupational Testing Services in San Diego, noted a significant drop in the percentage of drug-positive employees in safety-sensitive positions in the nation’s work force.
Ritz said his laboratory processes about 2,000 urine specimens a day as part of mandatory drug testing procedures. "About 6% of them indicate the tested employee has a detectable level of drugs in his or her system," says Ritz. (His lab’s overall positive rate for all workplace testing, including pre-employment testing, is about 9%). "This is down from about 25% when mandatory drug testing went into effect five years ago under the Omnibus Transportation Employee Testing Act."
A causal relationship?
The act, Ritz explains, covers about 8 million workers, including over-the-road truckers, airline captains, the Coast Guard, and pipeline workers. "Positive results must be reported to a medical review officer, who then contacts the individual to see if they have a prescription for the drugs that were detected," Ritz explains. "They are not required report this to the government."
Does Ritz see a causal relationship between the passage of this legislation and the significant reduction in positive test results? "There are a number of reasons," he posits. "People realize it’s part of most pre-employment physicals now, and the population is aging."
But Ritz affirms that testing is the most effective means of preventing drug abuse. "Of course, my background is as a toxicologist, not a behaviorist," he admits. "I’m the lab guy."
There are other programs available which do not directly measure drug use, such as machines that will measure a person’s reaction times, Ritz notes. "There’s been some strong reaction to that," he says. "There could be many more reasons for a diminished reaction time. For example, the worker could have been up all night."
Dominic Taurone, director of PacifiCare Behavioral Health’s Labor and Trust Division in Laguna Hills, CA, does not believe drug testing is the most effective means of preventing drug abuse; he also says that the statistics showing such a dramatic reduction in "positives" could be misleading.
"The most effective way to deal with this issue is to educate workers and provide an avenue for an individual who might be experiencing a problem," he asserts. "Confidentiality and easy access will help you reach a good portion of a population."
As for testing, Taurone has seen the effects firsthand. "When we began random testing for transportation employees, I was actually in the field," he recalls. "Drivers who were using drugs who were not addicted, when faced with the reality of random testing, chose not to use rather than to lose their jobs. Addicts, on other hand didn’t have that choice. So in the first few years, most of those workers who could stop did. Those who didn’t eventually got caught up in the system."
A different system for unions
Another possible contributory factor to the drop in positives among transportation workers is the unique manner in which behavioral health is addressed at companies that employ union workers — so unique, in fact, that Taurone was hired by PacifiCare three years ago specifically to set up a Labor and Trust Division.
"The level of service is intensified because in essence when you deal with a Taft Hartley Trust fund, you work with two sides: labor, which negotiates for the benefits, and the boss, who pays for it. Then you have your member, who is your primary concern," Taurone explains.
Taft-Hartley Labor Act
Under the Taft-Hartley Labor Act, says Taurone, unions and companies get together to form a trust fund for health, welfare, and pensions, to which the employer contributes. The "purchaser," in essence, is represented on both sides of the table, with an equal number of labor and management trustees.
The behavioral health programs delivered to union members are called MAPs, or member-assistance programs, rather than employee assistance programs. "When you say member-assistance program,’ there is an extra level of comfort," says Taurone."
The difference doesn’t end there, however. "What we will do typically, which is not done in an EAP, is to provide account managers in the field who go to employer sites and to local union halls," Taurone notes. "They are highly visible, creating program awareness and resolving any problems that arise.
"We actually look for utilization; we want it in an MAP," he continues. "Our feeling is that early intervention reduces costs in the long term. We get in early by designing very specific collateral material that targets a specific market segment. For example, we may show a guy wearing work boots and jeans walking on a tightrope, with a net under the rope. We are the net. We spend a lot of time in market research determining what it is that would interest members."
Taurone employs a number of strategies he believes contribute to lower positives. "We go out and run education programs on DOT [Department of Transportation] rules and regulations as they apply to alcohol and drug testing. We will bring in a forensic toxicologist to explain how specific and scientific the analysis of urine specimen is," he explains.
Another strategy involves benefit awareness presentations. An account manager will visit a union hall and give an explicit explanation of the MAP benefits members have available to them. "The phone will ring off the hook," says Taurone.
But by far the most dramatic response Taurone’s group gets is from its collateral material. "We will target specific times of the year — like our depression’ mailing, which we call the blues,’ at Christ-mas or during the holidays. We will actually see spikes in utilization," he notes.
One of the most important interventions, Taurone contends, is the program itself. "Given time with a program, confidence develops in the population," he explains. "Even if people don’t come out and say they’ve been in treatment, other employees will note a visible change." Everything revolves around employee confidence and confidentiality, he says. "People are afraid to pick up the phone. We spend a lot time talking about federally mandated confidentiality requirements and our ethical beliefs about it. As far I am concerned, confidentiality is the backbone of any MAP."
As for employers, Taurone says it is to their benefit to have employees with a substance abuse problem take advantage of an MAP or EAP. "Some employers do choose to rehab the employee, although they are not required to," he notes. "My feeling is, you have somebody who is trained in your operation and has a problem. Let us work with them in a formal environment and return that individual to the workplace. When the employer terminates such an individual, there is a very good chance the person he hires next will have a problem equal to or greater than that of the one he let go."
In conclusion, says Ritz, drug testing should be kept in perspective. It is one of the tools for evaluating fitness for work, he says. "It may not be appropriate for every type of workplace; I would personally go with safety-sensitive companies. There may be no cost benefit to testing janitors, if all you want to know is whether or not your floors are clean." Ritz notes that he has heard estimates that as many as 80% of all employers do use some form of drug testing. n
• Dennis Ritz, LabCorp Occupational Testing Services, 7272 Claremont Mesa Blvd., San Diego, CA 92111. Telephone: (800) 882-7272.
• Dominic Taurone, PacifiCare Behavioral Health, Laguna Hills, CA. Telephone: (949) 348-5555.
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