ISSN:0279-1072    

DOI:10.1080/02791072.1990.10472212

出版商:Taylor&Francis Group    

年代:1990

数据来源: Taylor

摘要:

AbstractA realistic program for managing drug abuse in the workplace requires a clear understanding of the nature and effects of both licit and illicit drugs, as well as a knowledge of reliable methods for identifying and responding to both industry and individual needs. This article reviews the nature and effects of psychoactive drugs and discusses the medical steps to be taken when they are being abused. In addition, an overview of the means for identifying workplace drug abusers is presented. Testing methods and procedures are described, and such problems as false-positive and false-negative test results are clarified. The formation of corporate drug abuse policies is discussed and a continuum of industry interaction with health and drug abuse treatment professionals is presented. The roles of industry medical review officers, employee assistance programs, and other pertinent groups and individuals are also discussed.

ISSN:0279-1072    

DOI:10.1080/02791072.1990.10472213

出版商:Taylor&Francis Group    

年代:1990

数据来源: Taylor

摘要:

AbstractUrine testing for drug use in the workplace is now widespread, with the prevalence of positive drug tests in the work force being 0% to 15%. The prevalence of marijuana use is highest of the illicit drugs being tested. Highly prevalent drugs can be reliably tested. Although it is prudent to rid the workplace of drug use, there is little scientific study on the relationship of drug use and workplace outcomes, such as productivity and safety. Probable-cause testing and preemployment testing are the most common applications. Random testing has been less accepted owing to its higher costs, unresolved legal issues, and predictably poor test reliability. Legal issues have focused on the right to privacy, policy agreements, discrimination, and the lack of due process. The legal cornerstone of a good program is a policy that is planned and agreed on by both labor and management, which serves both as a contract and as a procedure in which expectations and consequences are known. Moreover, NIDA is certifying laboratories doing employee drug testing. Testing methods, when done correctly, are less prone to error than in the past, but screening tests can be defeated by adulterants. Although the incidence of false-positive results is low, such tests are less reliable when the prevalence of drug abuse is also low.

ISSN:0279-1072    

DOI:10.1080/02791072.1990.10472214

出版商:Taylor&Francis Group    

年代:1990

数据来源: Taylor

摘要:

AbstractThe methods used by laboratories to analyze urine collected from employees are described. Federally designed procedures designed for analyzing government employee samples have become the highest standard for performing such tests, although at present there are no guidelines that specifically address drug testing in the private sector. Samples and analysis should be handled in a manner that ensures that test results are legally defensible. Enzyme immunoassay is the technique used to perform the initial test on these samples. Positive test samples identified by this method are tested again by gas chromatography- mass spectrometry. Potential problems with these analytical methods, additional safeguards, and data demonstrating the reliability of this approach are presented.

ISSN:0279-1072    

DOI:10.1080/02791072.1990.10472215

出版商:Taylor&Francis Group    

年代:1990

数据来源: Taylor

摘要:

AbstractThe role and responsibilities of the medical review officer are considered in relation to drug testing in the workplace. Knowledge of substance abuse disorders, pharmacology and toxicology, laboratory techniques for screening and confirmation, forensic collection techniques, and the relevant rules and regulations that govern drug testing is essential. The means for detecting adulterated urine samples are offered, and a procedure for the management of urine-testing results is provided.

ISSN:0279-1072    

DOI:10.1080/02791072.1990.10472216

出版商:Taylor&Francis Group    

年代:1990

数据来源: Taylor

摘要:

AbstractRational drug-testing programs attempt to balance the need for accuracy of the process with the need to preserve the rights and dignity of the people being tested. U.S. Department of Transportation regulations prescribe the specifics of how urine specimens are to be collected, how to inform the specimen donor of the process to which he or she will be subjected, and certification of laboratories by the National Institute of Drug Abuse. These guidelines are an effort to assure that each collection site and each laboratory testing the urine of employees adheres to certain basic standards of quality control.

ISSN:0279-1072    

DOI:10.1080/02791072.1990.10472217

出版商:Taylor&Francis Group    

年代:1990

数据来源: Taylor

摘要:

AbstractMonitoring and reentry programs for chemically dependent health care professionals are increasingly being recognized as important components of recovery efforts targeted at this population. Such monitoring and preventive programs should incorporate certain eligibility requirements, patient-monitoring program contracts, recovery maintenance activities and adjuncts, work-site assessments and reentry recommendations, random body fluid analysis, relapse management, and clear explanations of financial responsibility. Monitoring and reentry programs need to be fully integrated within the spectrum of resources available to health care professionals.

ISSN:0279-1072    

DOI:10.1080/02791072.1990.10472218

出版商:Taylor&Francis Group    

年代:1990

数据来源: Taylor

摘要:

AbstractDrug testing at work is rapidly becoming the standard in the United States. For drug testing to fulfill its promise as a vital part of the effort to end the drug abuse epidemic, it is essential that the tests be reliable so that people who are not using drugs are not falsely accused and that legitimate medical use of controlled substances not expose employees to harassment or labeling as drug abusers. To merit employee confidence, workplace drug testing needs to be made part of a program that includes these basic elements: (1) a clear and comprehensive policy; (2) secure collection; (3) chain-of-custody procedures; (4) retained positive samples; (5) an initial screening test; (6) a sophisticated confrrrnatory test; (7) a medical review officer; (8) a retest of retained positive samples in disputed cases; and (9) a system of quality control. In addition, this drug testing program needs to be built on a solid foundation that distinguishes between legitimate use of prescribed medicines and nonmedical drug use. This differentiation is the primary responsibility of the medical review officer.

ISSN:0279-1072    

DOI:10.1080/02791072.1990.10472219

出版商:Taylor&Francis Group    

年代:1990

数据来源: Taylor

摘要:

AbstractBenzodiazepines differ from many of the other abused substances in that there are legitimate medical indications for their use. Any prescription for benzodiazepines must be preceded by a careful risk-benefit analysis that considers the specifics of an individual's particular life situation, personality style, and psychiatric diagnosis. The risk of benzodiazepine abuse by chemically dependent individuals and the problems of cognitive and/or psychomotor impairment and dependence for all individuals have to be balanced against the therapeutic benefits of these drugs for patients who experience disabling anxiety disorders or anxiety that accompanies chronic medical illness. Problems of dependence can be minimized by utilizing a variety of pharmacologic and psychotherapeutic strategies to ameliorate withdrawal symptoms that might accompany the discontinuation of long-term benzodiazepine treatment.

ISSN:0279-1072    

DOI:10.1080/02791072.1990.10472220

出版商:Taylor&Francis Group    

年代:1990

数据来源: Taylor

摘要:

AbstractFindings of formal and subjective mental health problems among Swedish employees are presented as well as reviews of current Swedish policies on substance abuse and drug screening in the workplace. The focus is on the potential violation of medical confidentiality for employees with legitimate psychoactive drug medications and the lack of evidence linking the detection of various substances with impaired work performance. Data are drawn from a study of a sample of working Swedes, which revealed that approximately 3% reported taking psychoactive medications regularly. This was correlated with increases in long-term sick leave, periods of unemployment, and frequent job changes by both sexes. These workers also scored high for neuroticism, and had high rates of inpatient psychiatric treatment and suicide. With these high rates of formal mental health problems among employees who self-medicate with psychoactive drugs, discriminatory personnel management, including drug screening, jeopardizes confidentiality of treatment and civil rights.

ISSN:0279-1072    

DOI:10.1080/02791072.1990.10472221

出版商:Taylor&Francis Group    

年代:1990

数据来源: Taylor