The United States is a highly pharmacological society. It seems like everyone is taking a pill for one thing or another—pain relief, hypertension, depression, infection. Some people are managing chronic conditions like mental health issues, migraines, diabetes, COPD, or high cholesterol, while others are fighting cancer or acute infection. Still others are abusing opioids or benzodiazepines that might have been originally prescribed in good faith. In some states, medicinal marijuana is on the table too. How can employers sort out what is legitimate and what isn’t? And, given privacy restrictions, can they even try?
Private employers have a lot of leeway in whether or not to require drug testing and how to implement it. Some Federal regulations, such as the U.S. Department of Transportation (DOT) drug-testing rules, are not negotiable. States and local jurisdictions have more of a patchwork. Illegal drugs are surely off limits and can be tested according to local, state, and federal laws. Anyone obviously impaired and a clear danger to others can be removed from duty according to documented HR and/or union procedures.
However, all drugs have side effects to a greater or lesser extent. Even well-prescribed and legitimate treatments can affect some individuals more than others. Medications that are not well calibrated—intentionally or not—can cause catastrophic side effects. Not only is the individual person at risk, but drowsiness, mania, or another unexpected presentation can cause accident and injury for drivers, patients, or bystanders.
So what can an employer do? Legally, not much. Drug testing can rule out illegal drugs and the Americans with Disabilities Act (ADA) protects an employee’s use of over-the-counter or prescription drugs as long as those medications are not abused. Employers are required to make reasonable accommodations if employees report that medication might impair the ability to do a certain job. Medicinal marijuana is not covered under the ADA but may be covered under state law, although employers in every state can prohibit its use in the workplace.
The best way to avoid problems with drugs is to avoid the drugs in the first place. Implement workplace wellness initiatives that can help lower risk factors for chronic conditions like diabetes, cardiovascular disease, and obesity. Encourage employees to seek treatment before an illness or injury progresses. Provide resources for employees struggling with addictions. Make sure you have a solid written policy for a drug-free and alcohol-free work zone, encourage employees to speak up without fear of reprisal, and look to implement programs that might improve your workers’ overall health.