[3] (*) JOURNAL OF ADDICTIVE DISEASES, Vol 12(2) 1993 pp. 9-21 "Barbarians at the Gates'' by Stanley Gitlow, M.D.

 

President Reagan signed Executive Order #12564 establishing the goal of a ``drug free'' work-place. It made federal employment illegal for anyone using illicit drugs on or off the job. By december 1989, over 5 million Americans required urine testing ... in order to keep their jobs. ... The acceptance of such procedures in the work- place resulted in their application to non mandated employees as well; this resulted in the testing of 8 million workers in 1989. This figure was to rise to 13 million during 1990.

 

In the meantime, the public had been frightened by stories of drunken pilots, pot smoking railroad engineers, and nonfunctional captains of oil tankers. ... the terrified American people have leaned progressively toward demanding that their government guarantee each of them the right to live without responsibility for self or personal risk. In point of fact, during the past ten years only two commercial aviation crashes led to the discovery of illicit drug use by the flight crews: in March of 1983 a cargo aircraft crashed during the night at Newark and both pilots revealed previous use of THC, and in January of 1988 Continental Express flight #2286 crashed near Durango, CO while the non-flying pilot-in-command had evidence of cocaine. In neither incident did the NTSB establish a causal relationship between illicit drug use and the accidents. Nonetheless, within a year of the latter accident almost all of commercial aviation in the United States was mandated to apply tests of employees designed to rule out illicit drug use.

 

... by the Spring of 1988 the government had completed 30,300 random urine tests of their regular employees. Positive results ... were found in 0.7%. The direct costs for the first year were $15,000,000 ...

Until recently, only testing for the 5 drugs [or categories] were allowed under law. This, despite the fact that the relationship of alcohol ... to accidents had been more clearly established and the magnitude of this problem in the area of public safety was far and away greater ...

 

... our government quite apparently felt more comfortable writing highly restrictive legislation for ``illicit drugs'' despite the fact that the magnitude of the public health problem was minor in comparison to that associated with alcohol.

 

... the MRO finds him/herself in the position of having to reveal to employers and federal authorities certain other medical data which happened to be revealed in the course of the urine assay, *even though having no connection whatever to the use of ``illicit'' drugs*. ...

 

Sadly, it is not incumbent upon any employer to recommend treatment for an employee with a positive test for ``illicit'' drugs ... Some MRO's embrace the whiz quiz in the belief that it offers early detection and therapy, but in truth the overwhelming majority of companies that become aware of a positive test simply discharge the employee at the present time. ...

 

... The commercial transport system data reveal a statistically minuscule incidence of what appears to be drug related accidents. ... If any threat to safety in the work-place existed, all of our information pointed to the need to control drinking. ...

 

A DOT study in May of 1988 stated repeatedly ``No statistical conclusions regarding the relationship between drug use and...accidents were possible.'' And there were ``...no relevant performance studies of any of the hard drugs...[but this is] *not critical because use is already a criminal act. ... the very fact that an individual uses such a drug indicates a lack of respect for the law that in itself is prejudicial to safety.'' So ended the major scientific study which led to regulation by the DOT.*

 

... A well-known physician from Charter Corporation was quoted on 5/26/89 in American Medical News that he favored urine testing because it led to earlier diagnosis and increased likelihood of recovery from addiction. ... even were it to be true, he failed to mention whether his country should switch immediately to *mandated* PAP smears and mammogram.

 

... our concern is neither health maintenance nor safety, but rather morality and control. If we were not primarily concerned with fixing those ``nonconformists' '' wagons, we might have embraced the use of cognitive systems measurements instead of the whiz quiz. There exists hand - eye coordination tests not unlike those of some video games, by which real time measurements of the functional capacities of key employees may be assayed and have been found to detect reliably various forms of human impairment [resulting from drugs, stress, and fatigue]. The test results were immediately available [real time]. Nonetheless the DOT safety study dismissed such tests because they cannot predict the presence of a precise drug or drug level; they did not even evaluate its potential for safety. Gary Howard, the Employee Relations Director of Motorola Inc., when questioned about the use of neuromuscular real time tests, was quoted recently as saying that they were not even considered and that even if a drug user were not impaired from off-duty use of drugs, ``We're not particularly concerned about impairment ... as we are about having a work force that doesn't use drugs.'' R=82 their desire to use best-in-class employees, ``Best-in-class people to us don't use drugs. They don't abuse alcohol either...'' ... Even in those instances wherein a causal relationship between a drug and an adverse consequence has been proven [alcohol and accidents; cigarette smoking and lung cancer], there is good reason to eschew outright legal prohibition. ... Loss of liberties by law, momentarily accepted by society, leads ultimately to a reactive change. We seem to ``pay'' for periods in which we even voluntarily give up our freedoms. A more definitive answer is usually achieved by early education and experience leading to attitudinal change.