Impairment in the Workplace - How Does Impairment Testing Compare to Drug Testing?

Impairment in the workplace is a serious and sometimes confusing topic. The causes of impairment are varied, the effects mixed and remediation efforts, until now, have been difficult to implement. 

This guide to impairment in the workplace is designed to answer your questions and get your organization on the right track.

Impairment in the Workplace - How Does Impairment Testing Compare to Drug Testing? 

In "Drug Testing vs. Impairment Testing: What Makes a Safer Workplace?", we cite a variety of reasons drug testing falls short in creating a positive safety culture and serving as an effective safety procedure: 

• “Most people who have accidents on the job are not drug users, and drugs have nothing to do with [most] accidents. Most accidents are caused by fatigue or alcohol" (Maltby).
  
  
• Drug testing is not a screen for alcohol intoxication, and many employees are randomly tested for drugs but may drink regularly or to excess. Though they may not be acutely or visibly drunk at work, they may sometimes be hungover, and a random drug test doesn’t prevent them from undertaking safety-sensitive work.
  
  
• Drug testing cannot identify heightened safety risk before it culminates in an accident. But pre-task or pre-shift impairment testing can do this, and thus allow for supervisor intervention when such circumstances arise.
  
  
• Pre-employment drug screens don’t detect drug use on the job, nor do they dissuade it, and thus do not improve safety. Instead, job applicants merely take a break from using drugs so they are clean for the pre-employment drug screen.
  
  
• "It may be perceived as politically expedient to demonstrate that ‘something’ is being done [but] has proven to be ineffective, costly and potentially prone to ‘false positives’—with negative repercussions for [employees] whilst giving the false impression of safety" (European Cockpit Association).
  
  
• "The implementation of drug testing programs can lead to resentment and a subsequent increase in grievance rates, deteriorating labor-management relations, decreased morale, and difficulties in attracting and hiring qualified candidates” (Seijts and O’Farrell).
  
  
• “Employers know that [drug testing] doesn’t mean anything. Anyone who smokes pot will just stop for a few days. It’s an empty ritual that nobody wants to be the first to give up,” (Maltby).
  

Despite its flaws, drug testing remains an essential component of company policy, and is further enforced by state and federal laws. Companies that have a "zero-tolerance" policy rely on drug tests as an objective, scientific measure to enforce these policies. Due to its strict enforcement and punitive nature, drug tests can keep habitual drug users from being hired to safety-sensitive roles and get them promptly fired if proof of use emerges later. Although workers who are experienced with drug tests have found ways to circumvent getting caught, drug tests are still largely effective at dissuading heavy drug use during employment. 

Further, although imprecise in their timeframe of measurement, drug tests are highly accurate at detecting the presence of specific substances in a worker's system. This often means that the cognitive detriment caused by non-illicit substances such as over-the-counter medications is overlooked. However, it also means that workplaces can be confident as they filter out heavy drug users from amongst their workforces. 

Drug testing has a clear focus and objective in the workplace and, despite its shortcomings and oversights, is a well-established policy that is here to stay. However, this doesn't mean it can't be improved upon or complemented by a more proactive and positive safety procedure like impairment testing. 

Impairment testing in the workplace can help overcome the flaws of drug testing because: 

• Impairment testing focuses on workplace rather than leisure behavior. In other words, impairment testing works to prevent safety risks because it “focuses primarily on impairment, not on the cause of impairment. The objective of [impairment] testing is to assess fitness for work, not to detect drug use.” (Workforce)
  
  
• Impairment testing is non-invasive and protects employee privacy. It also protects employees who use medical marijuana from the flaws of drug testing, which can lead to false positives.
  
  

Depending on your company policies and local laws where your company is situated, your implementation of impairment testing may either strongly curb your use of drug testing or be utilized entirely independent of your drug-testing policies. 

For example, one manufacturing company located in Colorado was able to reduce the cost of drug testing by 90% by replacing all random drug tests with daily AlertMeter^® use. At the same time, their safety metrics improved substantially. They reduced worker's compensation claims by 70% across 2 years of AlertMeter^® use. They also improved productivity by 11% and reduced employee turnover by 35%. (See video below.)

Other companies in other locations or industries may not have such flexibility with their drug-testing policies. There, they use impairment testing to complement existing procedures rather than to replace them. Sometimes, impairment testing provides the real-time insight needed to get a supervisor's attention and prompt a more thorough assessment of impairment based on company policies.

The following stories from AlertMeter^® use at various companies portray how impairment testing has been shown to successfully complement zero-tolerance policies and drug-testing practices: 

When employees in a division of a large company received word from management that they would begin using AlertMeter^®, an employee came forward to admit having a substance abuse problem and chose to seek help for his addiction.

An administrative employee scored abnormally on consecutive tests and admitted to having inadequate sleep and to taking cold medications. The supervisor observed unusual and inconsistent behavior from the employee, who still could not score normally on a third attempt. The supervisor referred the employee to human resources. (Stories from the Field). 

Now that you are more familiar with what impairment testing is; what forms it takes; how it compares with and complements drug-testing policies and procedures, you can begin to evaluate whether it is a viable option for your company. 

More Resources:

Analyzing Fit for Work in the Top 5 Most Common Workplace Accidents

What's the Science Behind Impairment Testing?

How AlertMeter^® Fits into a Workplace Drug and Alcohol Testing Program

What is Occupational Impairment? Here's Why Drug Testing Isn't Enough

What Occupational Impairment Tests are Available Today

Will Employees Buy-in to an Impairment Test Program

69% of Your Employees Are Drunk at Work

Signs of Impairment in the Workplace

Workplace Impairment Policy to Reduce Errors and Increase Productivity at Work

How AlertMeter^® Fits into a Workplace Drug and Alcohol Testing Program

NSC Impairment Detection Technology & Workplace Safety Report

Recognizing Impairment in the Workplace

What are the Benefits of Cognitive Impairment Testing?

What Occupational Impairment Tests are Available Today

Is Workplace Impairment Testing Right for Your Company?

References

Basner, Mathias, and Joshua Rubinstein. “Fitness for duty: a 3-minute version of the Psychomotor Vigilance Test predicts fatigue-related declines in luggage-screening performance.” Journal of occupational and environmental medicine vol. 53,10 (2011): 1146-54. doi:10.1097/JOM.0b013e31822b8356

Butler B, Tranter D. Behavioral tests to assess performance. In: Macdonald S, Roman P, editors. Research Advances in the Workplace: Volume 11. Drug Testing in the Workplace. New York: Plenum Press; 1994. pp. 231–255. [Google Scholar]

Czeisler MÉ , Lane RI, Petrosky E, et al. Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1049–1057. DOI: http://dx.doi.org/10.15585/mmwr.mm6932a1external icon.

Dawson, D., Reid, K. Fatigue, alcohol and performance impairment. Nature 388, 235 (1997). https://doi.org/10.1038/40775

ECA. (2016). Problematic substance abuse in aviation: Testing & peer support programmes. European Cockpit Association AISBL. Retrieved from https://www.eurocockpit.be/sites/default/files/problematic_substance_

use_prevention_in_aviation_eca_position_pp_15_1120_f_1.pdf

Fell, James C, and Robert B Voas. “The effectiveness of a 0.05 blood alcohol concentration (BAC) limit for driving in the United States.” Addiction (Abingdon, England) vol. 109,6 (2014): 869-74. doi:10.1111/add.12365

Lamond N, Dawson D. "Quantifying the performance impairment associated with fatigue." J Sleep Res. 1999 Dec;8(4):255-62. doi: 10.1046/j.1365-2869.1999.00167.x. PMID: 10646165.

Maltby, L. (2010). Impairment testing—Does it work? National Workrights Institute. Retrieved from http://www.workrights.org/nwi_drugTesting_impairmentTesting.html

Seijts, G. H. & O’Farrell, G. (2005). Urine collection jars versus video games: Perceptions of three stakeholder groups

toward drug and impairment testing programs. Journal of Drug Issues 35(4): 885–916. doi:10.1177/002204260503500411

Zhang, Jiawei. "Cognitive functions of the brain: Perception, attention and memory." arXiv preprint arXiv:1907.02863 (2019).