MEDICAL CONDITION KEEPS SOME FROM DRUG TESTS - AND JOBS

The only thing standing between Vicki White and a new job as a bank
teller was a plastic cup.

Like job candidates at many companies, she was required to undergo
drug screening. But she has a condition called paruresis, which can
make providing a urine sample difficult, if not impossible.

Paruresis (pronounced: par-YOU-ree-sis) is a type of social anxiety
disorder that prevents a person from using the toilet in a public restroom.

To prepare for the test, White, 19, of Wentzville, guzzled water
nonstop before showing up at a West County testing laboratory last
month. Still, even after waiting almost two hours, she could not urinate.

Her friends and family had sometimes ribbed her about the problem. But
now it was no laughing matter.

White called New Frontier Bank in O'Fallon, Mo., and asked for a
second chance, but a manager told her the job offer had been
rescinded, she said.

New Frontier Bank declined to answer questions about White's
situation, referring questions instead to ADP TotalSource, a human
resources and employee assistance company. ADP TotalSource did not
respond to requests for an interview.

In an era of widespread drug testing - in workplaces, schools and
elsewhere - the inability to urinate on demand is a serious matter.

White is one of about 17 million people nationwide who are unable to
use the toilet in close proximity with others or when they are under
time pressure, being observed or traveling on moving vehicles.

The condition is also called Shy Bladder and Bashful Bladder.

Having a job rescinded without first being given an opportunity to be
drug tested by an alternative method, such as with a hair or blood
sample, is "simply outrageous," said Steven Soifer, staff director of
the International Paruresis Association, based in Baltimore.

The group advocates for people who say they have been unfairly
discriminated against in drug testing because of their condition.

Soifer, an associate professor of social work at University of
Maryland, Baltimore, said he had been involved with hundreds of cases
like White's since he started the group a decade ago.

"It's a very common situation - and that's just the cases we hear
about," he said. "I can't tell you how prevalent this kind of
discrimination is."

Soifer started the group after he realized at age 40 that he wasn't
"the only person in the world with this problem."

He struggled from childhood with shy bladder until he read a magazine
article 10 years ago.

He said the condition develops in childhood. It affects men and women
equally, but more men seek treatment, probably because public
restrooms for men offer less privacy, he said.

Genetics also seems to play a role, he said. Soifer's 7-year-old son
has it.

The condition occurs on a continuum - from mild to severe.

Those with a severe case are unable to use the toilet, even at home,
if others are nearby.

"They experience this problem all the time in public situations,"
Soifer said. "They worry about it and obsess about it. It becomes an
albatross around their neck. I know people who never travel, never
date, never marry, never have children, can't take the job or
promotion they want, all because of this disorder."

Some people working in jobs that require frequent drug testing even
carry a catheter.

White has had the condition for as long as she can remember. She can't
use bathrooms unless she is alone or her surroundings are really loud,
such as at a baseball game.

"When I found out it had a name, it was kind of a relief," she said.
"It was nice to know that it's not just me, that I'm not alone."

Her mother, Trish White, who lives in Defiance, said that when her
daughter was growing up, she avoided urinating for as long as 15
hours. As a result, she had frequent bladder infections.

"This is not an excuse to get out of a drug test, and in no way is she
trying to imply that," Trish White said. "She just wants a second
chance, or another way, to do this."

Vicki White has been screened for drugs three times before, twice
under a nerve-wracking four-minute deadline. Each time, she succeeded
only after being allowed a second chance - and sometimes, extra time.

Soifer said some people had sued for discrimination and won.

"It's one of these really gray areas," he said. "Once our lawyer gets
involved and contacts the company's legal counsel and explains the
situation, and explains that it could be a violation under the
Americans with Disabilities Act, the company often realizes they
should provide reasonable accommodation."

He recommended tests that utilize saliva, blood or hair samples
instead of urine.

Some companies already use such tests because they are easier to
administer, Soifer said.

The federal government is proposing new regulations for federal
employees that would expand drug screening methods to hair, saliva,
blood and sweat tests, which would prevent the dilemma.

No medications can cure shy bladder, but cognitive behavioral therapy
is effective in about 90 percent of cases, Soifer said. Using
techniques that he learned and that helped him, Soifer now provides
the therapy in his social work practice.

He recently worked successfully with a 73-year-old man who had not
been able to use a public urinal since he was 7.