Book Review: Income and Social Security and Substandard Working Conditions: Under the Influence? Drugs and the American Work Force

As the war on drugs rages in this country, the issue of drug use in the workplace has gained wide attention. This volume provides a useful summary of our knowledge to date of the problem of drug and alcohol use in the work force. More important, it points out where our knowledge is lacking and makes recommendations for both policy and future research. Given the regularity with which participants in the political debate over drugs cite what appear to be unassailable empirical findings, the gaps in our scientific knowledge of the issue highlighted in this volume may surprise some readers. When, in 1991, the National Institute on Drug Abuse (NIDA) asked the National Research Council and the Institute of Medicine to study drug and alcohol use among the work force, the Committee on Drug Use in the Workplace was established. The Committee's mission, as its members defined it-to examine existing knowledge on the etiology and epidemiology of drug and alcohol use, the impact of drug and alcohol use on job-related behavior, and the effectiveness of organizational drug intervention programs, especially drug-testingresulted in the report on which this book is based. As the editors put it, the report provided a "snapshot" of knowledge on these three topics as of 1993. Although the focus of study and of policymaking concerning drug use has been in flux, the Committee succeeded in presenting a highdefinition picture by zooming in on the impact of drug use on the workplace. An examination of broad public health and social welfare concerns would require an additional focus on such issues as crime and health effects (AIDS, for example), a scope too broad for one volume, as the editors note. One strong point of the volume is its frank discussion of methodological issues, the strengths and weaknesses of previous studies, and potential directions for future research. Many studies of drug use in the workplace, and in society at large, suffer from methodological problems, questionable assumptions, or other flaws, but because these flaws vary by study, the authors are able to highlight the results that are convergent and thus most likely to be robust (p. 23). One change that would improve the quality of findings in this field, the authors observe, would be more extensive use of the peer-review process. They also recommend that organizations developing drug intervention programs adopt experimental designs so that the programs' effectiveness can be readily evaluated. While it is impossible to summarize the rich detail of the findings here, I would like to mention some results that undercut current dogma about drug use as presented in the popular media, and some others that have serious implications for organizations concerned about drug use among their members. Much drug use is infrequent and moderate, and most bouts of illicit drug use are short-lived and end without requiring treatment (p. 17). The researchers argue that the exclusion of alcohol and tobacco from the current war on drugs is an unfortunate oversight: these drugs cause almost 17 times as many deaths as all illicit drugs combined (p. 15), and there can be little question that drug use by workers in this country has been primarily a problem of alcohol use. The report concludes that since the late 1970s, illicit drug use has been occurring among a sizable though declining portion of the general population. The decrease may be occurring more among occasional users than among hardcore users. Heavy alcohol use, however, has remained stable. Workplace-intervention programs are not likely to solve the societal problem of drug use, given that employed people often have lower rates of drug use than do those not in the work force. The research to date on the effects of drugs, especially alcohol, on job performance has not generated consistent results. There is some evidence that drug and alcohol use are associated with poor job performance, but the authors conclude that a causal link between the two is not yet established; the relationship is quite complex and may involve prior general life style choices. Drug testing has become a big workplace issue as its use has expanded. The book provides a detailed history of the evolution of drug Sage Publications, Inc. is collaborating with JSTOR to digitize, preserve, and extend access to Industrial and Labor Relations Review