Drug testing is an excellent tool for individuals in early recovery: not to catch people if they use drugs, but to act as a continual reminder for total abstinence from all mood altering addictive substances. Drug testing is also an excellent tool to help convince an active user of mood altering addictive substances that it is difficult to overcome drug abuse and addiction, and that they may need help to accomplish long-term sustained sobriety. In either situation, the function of drug testing serves to provide accountability for the subject’s alcohol and drug using behavior.
For many, drug testing is surrounded by misunderstandings, myths, and controversy. For the most part, the myths and controversy are propagated by the individuals that are attempting to avoid the accountability of drug testing procedure: for example, someone who wants to continue drug use without negative consequences. As for the misunderstandings, this article is intended to clarify most of them.
In my experience as a drug and alcohol counselor, I have found regular drug testing to be one of the most powerful accountability measures for my patients. At the transitional sober living facility for which I am the Program Director, regular drug testing is a requirement for every person. Note that I am using the term ‘regular’ drug testing. In my opinion, testing every person at least once every three days is necessary to obtain comprehensive accountability. This is because almost all abused mood altering addictive substances will remain in the urine for at least 3 days, with the exception of alcohol.
Urine tests are the most common and easy to use drug test method. When combined with laboratory testing for positive outcomes, a urine test is one of the most reliable test methods as well. Because urine tests are so common, people that are attempting to ”beat the test” will often purchase any number of products available on the internet or at the local smoke shop that claim to invalidate the test or cause a passing test result. In today’s marketplace, there is no reason why a urine test should not have an adulterant strip and thermometer attached to the panel of testing strips. The adulterant strip indicates whether the urine sample has been potentially tampered with or if there is the presence of any number of indicators that would potentially impede the validity of the urine test, and the thermometer indicates if the temperature of the urine is body temperature. If a urine test with an adulterant strip and thermometer is used and there is any indication that the test is invalid, it is a simple task to conduct the test again using a new urine test and to be extra vigilant in the collection procedure.
Other forms of drug testing include saliva tests, spray (sweat) tests, and hair tests. All of these tests require laboratory testing and results are highly reliable. The disadvantage to laboratory testing is that it can take between 2 to 5 days to get the results. When drug testing for accountability, I feel it is important to have immediate results in order to celebrate continued abstinence, or to intervene early if there has been drug use. In my experience, the rapid urine tests with a minimum of 10 drug panels, adulterant indicators, and thermometer are tremendously effective in creating an accountability system. Urine tests cost between $10 and $50 retail.
For testing alcohol use, a breathalyzer is the most common and simplest method, however it requires the purchase of a calibrated piece of equipment which must be maintained on an annual basis. Breathalyzers range in cost from $200 to $3000 retail. Alcohol may also be laboratory tested and with recent technology, positive test results can be obtained looking back nearly 30 days. For alcohol use, it is normally obvious if someone has been drinking, and for accountability purposes, a breathalyzer given at the time an individual is showing signs of intoxication is usually sufficient.
Myths around drug testing are abundant: some are incredibly creative and others have a sliver of truth to them, but all are simply ineffective in beating a drug test.
Drug testing is best performed at agencies that are trained in testing procedures and have experience with various forms of attempted cheating. The test results will be far more accurate if an agency performs the test. However, drug tests can also be conducted at home very effectively.
In order for the drug tests to be integrated into a comprehensive accountability system which assists the person remaining abstinent and/or the person trying to remain abstinent, it is important to remember the motivation behind the drug testing. First and foremost, a drug testing program is designed to motivate someone to stay abstinent. Each negative test should be celebrated with encouragement and praise. Should a positive result be obtained, the person should not be shamed for using, rather they should be approached with concern for their wellbeing. Someone who has used drugs is likely already tremendously ashamed of their use, and they likely do not know what to do. A positive test is an opportunity to help that person get the type of assistance they need in order to dissuade another occurrence of drug use. In this way, the drug testing accountability system provides an intervention tool that can be effectively used to motivate treatment, therapy, and self-help participation for the drug user.
Another important point to make regarding drug testing as an accountability system: the testing should never be a surprise. Drug testing that is performed regularly is the most effective method of providing motivation for abstinence. Drug testing that is random or upon suspicion is quite simply a form of punishment or enforcement rather than encouragement. While punishment and enforcement does have its place, it does not belong in a drug testing program designed for accountability.
While we are on the subject of punishment and enforcement, I would like to also express a simple philosophy. If someone sets up an enforcement system that threatens to take action, should a positive test result be received, then that action must absolutely take place without exception. It does no one any good to make false promises of punishment and then not follow through. The drug user will only interpret this behavior as enabling and will find other ways to manipulate the boundaries to their benefit. On the other hand, there must be a clear set of consequences outlined so the drug user knows that a positive test will result in action. This is one of the reasons I suggest an agency conduct the testing, so alternatives and next step can be discussed without the cloudiness of family system issues and prideful emphasis. In this way, the drug user and the family members are able to take appropriate action upon a positive drug test result.
Naturally, there are certain instances where drug testing is used to make a very clear boundary, such as operating equipment or machinery, or living in a sober environment. In these instances, the safety of others is dependent upon all individuals remaining abstinent. In these certain instances, a policy of immediate ejection is justified and all people involved should be very aware of the consequences of using mood altering addictive substances.
By Andrew Martin, MBA, LAADC, SAP, CA-CCS