Role of occupational health departments in a drug and alcohol testing programme

There are differences of opinion as to the involvement of occupational health teams in drug and alcohol testing in the workplace, which is a balance between avoiding a perception of acting in a policing capacity and maintaining the trust of the workforce. However, they may be better placed than an external contractor to ensure the process is carried out in a fair way and to acceptable professional standards. There is a requirement for medical involvement in drug screening programmes and there are benefits in maintaining an in-house MRO. If the OH team is involved, they must not assist in determining who is tested or have any part in the disciplinary process as this will compromise their professional relationship with employees In pre-employment screening, which can be done at the same time as the standard new entrant medical assessment, the drug screening process should be regarded as a management responsibility, delegated to the occupational health department. Separation of function can be achieved by separately reporting results so that the drug screening test is not perceived as part of the clinical procedure. It is possible to delegate collection of samples for ‘random’ and ‘for cause’ testing to an external company which might avoid any concerns over separation of policing and rehabilitation roles. If this is the case, the occupational physician should be involved in selection of the company and agreeing the necessary procedures.

Testing for impairment

As discussed earlier, breathalyser testing for alcohol can be related to impaired performance, but the same is not true of the results of most other types of testing for drugs in the workplace.

Direct tests of impairment would be more acceptable, and could be followed up with a drug test if impairment were demonstrated. Although there is potential for this in the future and various tests have been trialled in the USA, within the UK it is only possible to say whether drugs are present rather than what their effect is.

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