Do away with drugs

Workplace drug testing policies are the result of legal requirements for employers to ensure that the workplace is safe and without risk of harm to their employees. Ilse Britz, national business unit manager of Homemed, provides some insight.

Section 8 (1) of the Occupational Health and Safety Act (OHSA), Act 58 of 1993, states that: “Every employer shall provide and maintain, as far as is reasonably practicable, a working environment that is safe and without risk to the health of their employees.”

Regulation 2A of OHSA addresses the issue of intoxication. “An employer may subsequently not permit any person who is, or who appears to be, under the influence of intoxicating liquor or drugs, to enter or to remain at a workplace.”

Thus, workplace drug testing policies are a legal requirement for employers to ensure a safe workplace. Drug testing is often implemented as a condition of employment (pre-employment screening). Most companies also have a random drug testing policy in place, which acts as a deterrent to the use of illicit drugs. Drug testing can, however, also form part of annual employee physical examinations, and be performed when there is reasonable suspicion or as part of post-treatment testing of employees returning to work after completing a rehabilitation programme.

Drug testing is especially important in certain environments, like hazardous chemical process areas and places where heavy machinery is operated. This can prevent accidents in the workplace that result in downtime, financial losses, and potentially fatalities.

Which substances are usually tested for?

There is no mandatory battery of tests for employers in South Africa. Drug testing is, however, becoming more prevalent in the country as employers aim to address risk and drug abuse in the workplace.

South African companies generally follow the guidelines implemented in the US, UK, and Australia. The guidelines from the Substance Abuse and Mental Health Services Administration (SAMHSA), a branch of the US Department of Health and Human Service, define which drugs should be included in workplace drug testing policies, collection criteria, and the cut-off levels to be used for screening and confirmation testing.

The most commonly tested substances in South Africa are:

• Amphetamine
• Methamphetamine
• Benzodiazepines
• Cocaine
• Opiates
• Marijuana

Some companies also test for Mandrax (methaqualone), as it is a commonly abused drug in South Africa.

How does a drug screening test work?

It is vital for companies to implement a workplace drug testing policy, outlining the comprehensive process from employee selection, collection of specimens, interpretation of results, and confirmation of results all the way through to the next steps and/or consequences.

Drug screening is usually performed on urine or saliva fluid samples, with rapid tests providing a result within five minutes. Drug detection times in urine can be anything from hours to weeks, depending on the drug, quantity, and frequency consumed. Drug detection times in saliva, however, are much shorter, generally ranging from five to 48 hours. Oral fluid is therefore one of the fastest growing matrices used in testing for drugs of abuse.

Saliva drug screening offers the advantages of easy collection, difficulty in adulteration, and a tighter window of detection. These tests also provide a clearer picture of a person’s current intoxication and insight on recent drug use.

SAMHSA offers the following explanation in support of oral drug testing: “Oral fluid collection can require less time than urine collection, reducing employee time away from the workplace and therefore reducing costs to the employer.”

It is important to realise that some medications, such as cold and flu medicines, can result in a positive drug screening result. This is important in light of Regulation 2A of the OHSA: “An employer may only allow a person taking medication to perform his/her duties at the workplace if the side effects of such medicines do not constitute a threat to the health or safety of the person concerned or other persons at such workplace.”

What is the difference between drug screening and a confirmation test?

A confirmatory drug test is usually ordered in response to a positive result from an initial screening drug test. This confirmation test is performed on a different sample, taken from the same specimen. The confirmatory drug test is used to determine the type and quantity of drug or drug metabolite present in the sample. A confirmation test uses different technology to confirm the initial results and provide further metrics.

Typically, a screening test is an immunoassay test, while gas chromatography-mass spectrometry (GC-MS) is considered the most rigorous confirmation method for drugs of abuse.

So where do companies start?

Employers should have a policy in place that clearly and accurately reflects their stance. Furthermore, companies need to consider whether urine or saliva drug testing are best suited to their specific requirements and amend their workplace drug testing policies accordingly.

The policy should prohibit any trace of alcohol or drugs in an employee’s system when the employee reports for duty and/or performs their work. If an employer does not have a policy in place, they cannot take disciplinary action against an employee for breaking a rule that does not exist!