Drug use in the workplace, its effect on performance and safety, and the role of workplace drug testing has received much attention in the popular press. But what do we actually know about this troubling issue?

With an extensive and readable overview of the literature, the committee presents what we do know by examining the major issues:

• The extent and severity of drug use on and off the job.
• The strengths and weaknesses of methods for detecting drug use through standard drug tests.
• The effect of drug use on behavior, including the results of both laboratory and field studies that have examined work-related behavior and worker productivity.
• The effectiveness of interventions to deal with drug use, such as employee assistance programs, health promotion programs, and treatment programs for substance abuse.

Contents

• COMMITTEE ON DRUG USE IN THE WORKPLACE
• The National Academies
• Preface
• Summary: Conclusions and Recommendations
• I. Introduction
  • The Committee's Charge
  • Scope Of The Report
  • References
• I. Scope of Alcohol and Other Durg Use
  • 2. Etiology of Alcohol and Other Drug Use: An Overview of Potential Causes
    • Overview
    • Alcohol And Other Drug Use On The Job
    • Conclusions And Recommendations
    • References
  • 3. Epidemiological Evidence: The Dimensions of the Problem
    • Survey And Drug-Testing Approaches: Strengths And Limitations
    • Large-Scale Surveys
    • Work Site Drug Testing
    • Organization-Specific Prevalence Studies
    • Other Prevalence Studies Of Alcohol And Other Drug Use In The Workplace
    • Conclusions And Recommendations
    • References
• II. Effects Of Use
  • 4. Impact of Alcohol and Other Drug Use: Laboratory Studies
    • Strengths And Limitations Of Laboratory Studies
    • Drugs And Their Effects
    • Limits And Realities Of Laboratory Studies
    • General Findings
    • Conclusions And Recommendations
    • References
  • 5. Impact of Alcohol and Other Drug Use: Observational/Field Studies
    • Common Problems With Field Studies
    • Field Studies
    • Productivity Costs Of Alcohol And Other Drug Use
    • Interpreting The Empirical Results
    • Conclusions And Recommendations
    • References
• III. Effectiveness Of Workplace Interventions
  • 6. Detecting and Assessing Alcohol and Other Drug Use
    • Evolution Of Biochemical Drug Testing
    • Biochemical Methods For Detecting Drug Use
    • Indirect Methods Of Assessing Alcohol And Other Drug Use
    • Conclusions And Recommendations
    • References
  • 7. Impact of Drug-Testing Programs on Productivity
    • Types And Uses Of Drug-Testing Programs
    • Impact Of Drug-Testing Programs
    • Conceptual Incongruities In Research Methods
    • Effects Of Drug Testing On Attitudes And Morale
    • Conclusions And Recommendations
    • References
  • 8. Employee Assistance Programs
    • Prevention Activities
    • Employee Assistance Programs
    • Treatment
    • Conclusions And Recommendations
    • References
• Appendixes
  • A Methodological Issues
  • B The Legal Environment of Drug Testing
  • C Biographical Sketches

This study was supported by the National Institute on Drug Abuse, U.S. Department of Health and Human Services, under Contract No. 271-90-8203.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.