Use Versus Abuse What’s the difference between use and abuse? At best, that’s a difficult distinction to make. Most drugs and other chemical
substances are helpful when used properly. Unfortunately, the misuse of medications and drugs, both legal and illegal, as well as alcohol and tobacco, is a problem. Te term “drug abuse” is generally defined as the use of chemical substances that lead to an increased risk of problems and an inability to control the use of the substance. On the surface, valid use can be
A
nne is a 34-year-old administrative assistant who works at the warehouse of a heating and air conditioning company. Anne has a medical condition and takes the medication prescribed by her doctor each day. When she came to work one day, she was told that she had been selected for a random drug test as part of the company’s drug-free workplace program. Anne quickly took an oral fluid test in the building, and the specimen was then sent to the nearest laboratory for testing.
Anne’s drug test came back positive from the laboratory. However, Anne provided the medical review officer (MRO) with a current, valid prescription for the medication and explained to the MRO that she is using it as directed by her prescribing physician. The MRO contacted the prescribing physician, who confirmed that Anne’s prescription was valid; however, after the conversation with the doctor, the MRO became concerned about Anne’s use of the drug while at work. Even when used as prescribed, can she adequately perform the functions of her job?
As employers, this is likely a situation that many of you have faced. Do you know how to handle it? Further, in light of the opioid epidemic sweeping America, how can you be confident this is use, not abuse? As drug testing service providers, are you able to provide policy and best practice recommendations to employers in cases such as this? And how does this same scenario apply to medical marijuana? Many donors, when faced with a laboratory positive drug test, are able to present a valid prescription to the MRO. But is it months or years old? Or perhaps they claim that they used marijuana weeks ago, but haven’t used any recently. After all, pot is legal for medicinal use in over 30 states and recreational use in more than 10.1
As an employer or provider,
understanding use, abuse, impairment, and under the influence is challenging. As with any complex issue, the first step toward solving the issue is understanding the nuances.
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determined through the drug screening and confirmation process along with the MRO’s receipt of a valid prescription, as well as speaking with the prescribing doctor. However, even employees with a valid prescription for a legal substance can still be abusing the drugs that they are prescribed. Determining when an employee crosses the line from use to abuse can be difficult, but is essential to protect your botom line and provide a safe workplace. An employee who is abusing a legal medication could be taking their medication in such large quantities that they would no longer be considered “fit” for their position were a doctor to know. However, if they were taking the medication at the appropriate, prescribed quantity, they may be permited to work as normal in their position. Tis distinction is especially critical when employees are performing in safety-sensitive roles. And remember, safety-sensitive isn’t just DOT- specific. Many employers have employees handling sensitive data, stocking shelves, working with children, providing medical services, managing cyber security . . . drug use and abuse affect all of them. As an employer, it is essential that you
be able to differentiate between your employee’s prescription drug use versus their abuse. A drug-abusing employee is a liability to your company and could cause a variety of issues that not only impact your botom line, but also your workplace
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