Wednesday, October 27, 2010

Testing for Legally Prescribed Drugs in the Workplace

A piece in the New York Times earlier this week tells the story of employers testing for legally prescribed drugs and then being able to terminate employees who are found to be on these drugs. There are economic, legal, and ethical considerations here.

From the perspective of an economic cost-benefit analysis, the first question is what is the workplace risk caused by individuals taking legally prescribed drugs? In certain situations (transportation and nuclear energy were noted in the article) the potential severity of the consequences of the risks of taking legally prescribed drugs that could be impairing is quite high. To address this, we have to determine how to identify whether a person is impaired. There is a cost to determining whether a person is impaired.

Additionally, we have to focus on the magnitude of the risk and the magnitude of the consequences of the risk being realized. These two together indicate the cost of not identifying and changing the risk.

Another question is whether the only solution for a person found to be taking drugs that are causing (or could be causing) impairment is termination. This is a particularly important question if the person who is found to be taking legally prescribed drugs that could be impairing is taking the drugs because of an on the job injury that occurred when the person was following all appropriate safety recommendations.

However, we must realize that there are many jobs that cause a risk to the people performing them and to others regardless of whether those performing the jobs are impaired because of prescription drugs. For example, how many automobile accidents occur at construction sites that may not have occurred if the construction were not going on? What an employer (and society--in terms of public policy) has to decide is how being impaired due to prescription drugs changes the risks and changes the decision making process about performing the jobs at all and who should perform them.


  1. at my job they make you fill out a medical form each year asking what medicines you are on and what conditions you have. so no testing necessary, the information is already given! so far I haven't heard of anyone being let go, but who knows?

  2. The blog raises some important considerations related to evaluation of an employee on prescribed medications. I would add to an important question raised about the solution to dealing with an employee on legally prescribed drugs. I do not think that termination is a solution.Rsther I think it has the potential of creating more problems particularly for someone who has health problems and is dependent on health insurance for follow-up of his medical problems. Losing a job and a health insurance leads to increase utilization of societal resources from unnnecessary ER visis, hospitalizations and treatment of complications as a result of non-adherence to meds. The employer should be responsible for making a sincere attempt to find another job and support their health insurance atleast for the period of time they are looking for an employment.

  3. Whether someone is abusing legally prescribed drugs or illegal drugs, termination should not be the only choice considered by a company. Counseling and rehabilitation should also be considered, especially when there is a significant cost to the company to hire and train a replacement. Providing counseling could also be considered an attractive fringe benefit to prospective employees as well.