THE PRYING GAME

LSD turns up in a woman's urine sample. If this was one of the
increasingly common workplace drugs tests, she'd probably be out of
job. But the woman is an 82-year-old intensive care patient who had
never taken LSD in her life. The only fun she had was taking ambroxol,
an over-the-counter medicine, which in addition to clearing mucus from
her lungs, caused the bogus test result.

Drugs tests are supposed to be a fast and accurate way for employers
to spot workers who are indulging in illicit thrills. But mounting
evidence suggests otherwise. Last year, after "finding LSD" in the
82-year-old woman's urine by serendipity, the same German researchers
uncovered 11 other false positives for the drug following urine tests
of a kind widely used in German drugs screening labs.

This is disturbing, since drug testing is a growth industry. According
to Lewis Maltby, director of the American Civil Liberties Union's
workplace rights office, 80 per cent of large US companies now test
their employees. Britain and Europe are catching on. The British
government's Forensic Science Service is coy about the number of UK
companies paying for its drug-testing service, but a spokeswoman said
that "demand is growing all the time". Last month, the Police
Superintendents' Association of England and Wales called for the law
to be changed so that random drugs tests can be carried out on all
police officers. Existing British laws such as The Transport and Works
Act of 1992 require some employers, such as providers of public
transport, to ensure their staff are drug-free on the job. As a result
these organisations perform random testing on employees--although less
extensively than counterparts in the US. However, doubts about the
validity of such tests remain.

Apart from the question marks over reliability, it is unclear whether
companies are harmed by drug use or even whether testing employees
actually helps business.

The most recent survey from the US National Institute on Drug Abuse
(NIDA) estimated that drug misuse by employees cost the country $14.2
billion in lost productivity in 1992, and their employers had to pay
twice as much in medical and compensation claims as for their
drug-free colleagues. But last year, researchers from Le Moyne
College's Institute of Industrial Relations in Syracuse, New York
state, examined the productivity of 63 high-tech firms and found that
companies testing workers were less productive than firms which
trusted their staff to be "clean". The reasons are unclear, but
testing is time-consuming and expensive, and can undermine the morale
and loyalty of staff. And some workers may even use drugs to boost
their performance, the researchers say.

Private Lives

Civil rights groups are quick to point out that the tests may identify
substances at insignificant doses because of recreational drug use
outside working hours and that such activity has no bearing on their
performance as employees.

Owen Tudor, policy officer of the British Trades Union Congress says:
"We're very concerned there is a creeping intrusion into people's
private lives." Such fears haven't deterred American society from
embracing the drugs testing culture, and tying itself in some legal
knots in the process. For example, in 1997, the Supreme Court ruled
that a Georgia law requiring political candidates to be drug tested
violated the Fourth Amendment's prohibition against unreasonable
searches. But in March last year, the same court upheld the legality
of compulsory random drugs tests for White House employees, presumably
to ensure the President is not served by drug-addled interns or worse,
senior advisers under the influence of narcotics.

But it's important to recognise the distinction between tests applied
to public workers and the tests carried out by private companies, says
Marilyn Huestis, acting chief of NIDA's drug metabolism programs.
Federal employees working in sensitive departments, the military, and
those covered by transport regulations routinely have their urine
tested for five key drugs--marijuana, cocaine, opiates, amphetamines
(including "speed") and PCP, the hallucinogen known as "angel dust".
Seventy-odd labs certified by the Substance Abuse Mental Health
Services Administration (SAMHSA), which has responsibility for federal
testing standards, perform the tests on samples kept under strictly
controlled conditions. Samples that come up positive are double
checked by a gas chromatograph mass spectrometer, the "gold standard"
test that identifies a substance's exact molecular structure. A doctor
then reviews the findings.

In contrast, some private employers work to lower standards. While
some do follow SAMHSA procedures and use federal laboratories, others
use poorly trained staff and commercial drugs testing kits to perform
on-site tests that are never confirmed, says Huestis. "You go from one
extreme to the other," she says. It all depends on the company and the
laws of the particular state. In the UK, the respected Forensic
Science Service does much of the testing for private companies. But a
number of smaller private testing services are also vying for business.

Earlier this year, Howard Taylor, director of laboratory services at
the US National Safety Alliance, a firm which runs drugs testing
programs for over 5000 companies, tested five commonly used commercial
kits for testing urine samples on site. All the manufacturers claimed
their tests were as accurate as any done in a lab. But that's not what
Taylor found. "The results indicated discrepancies between claims and
performance for all products," he says.

Four out of five kits recorded positives for tetrahydrocannabinol
(THC), the active ingredient in marijuana, at levels 25 per cent below
the SAMHSA's cut-off. Three kits recorded positives for morphine and
two kits registered PCP below similar cut-off levels (Journal of
Analytical Toxicology, vol 23, p 119).

Some employers may regard the SAMHSA cut-off levels to be as redundant
as workers with even the minutest amounts of an illegal drug in their
system. But what if someone tests positive without taking any illegal
substances?

It can happen--just by eating lunch. In 1997, Judith Bonicamp and Ida
Santana, chemists at Middle Tennessee State University, Murfreesboro,
showed that poppy seed dressings contain enough opiates to make you
test positive for morphine (Microchemical Journal, vol 58, p 73).

Sex is a more bizarre reason for failing a cocaine test. NIDA studies
have shown cocaine can be passed on in semen and absorbed through the
vagina, although the amounts are too small to register in most tests.
However, if drugs such as cocaine are placed on the lips or other
areas of the body, the risk is higher. It's quite likely that enough
could be transferred to another person through kissing or other oral
contact to produce a positive drugs test, says Dan Berkable, president
of the American Toxicology Institute in Las Vegas.

The problems associated with urine testing have sparked interest in
alternative techniques, mainly hair, sweat and saliva testing, says
Huestis. Proponents of hair testing argue that it is less invasive and
offers a much larger window of detection, as drugs stay in hair long
after they have been metabolised by the body.

But hair testing is controversial too, mainly because natural hair
colour can affect the amount of drug detected. Edward Cone, now
retired from NIDA, found that significantly more cocaine binds to the
very dark hair of male Afro-Americans than to hair of other groups.

SAMHSA's Drug Testing Advisory Board is looking at whether hair, sweat
or saliva tests could be appropriate for federal test programs. Each
may prove to be faster, cheaper and more sensitive than current
methods. But they come with their own problems, and the Board is
trying to draw up stringent guidelines to govern their use.

Regardless of the tests used, civil rights groups remain concerned.
"Of course we want employees to come to work sober," says Maltby of
the American Civil Liberties Union. "But private companies that
indiscriminately test are inevitably going to fire innocent people."