Physician Drug Testing Is Unscientific and Is Unlikely to Achieve Stated Aims
Authors: Martin Donohoe
Journal: Annals of Internal Medicine (2015)

Letters21 April 2015Physician Drug Testing Is Unscientific and Is Unlikely to Achieve Stated AimsMartin Donohoe, MDMartin Donohoe, MDFrom School of Community Health, Portland State University, Portland, Oregon.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-0078 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Pham and Pronovost (1) rightly criticize California's failed Proposition 46. Although their desire to identify impaired physicians and improve patient safety is laudable, it cannot be achieved through random, preemployment, not-for-cause, and possibly even sentinel event–based drug and alcohol testing. This last type of testing will miss alcoholics in withdrawal and, when done after the event, may produce false-negative results for many agents.The explosive growth of such testing in industry and health care has been fueled by popular misconceptions surrounding substance use and abuse, junk science, and business interests (Institute for a Drug-Free Workplace, pharmaceutical firms, ...References1. Pham JC, Pronovost PJ. California's Proposition 46: a wolf in sheep's wool. Ann Intern Med. 2014;161:913-4. [PMID: 25265344] doi:10.7326/M14-2167 LinkGoogle Scholar2. Donohoe M. Urine trouble: practical, legal, and ethical issues surrounding mandated drug testing of physicians. J Clin Ethics. 2005;16:85-96. [PMID: 15915849] MedlineGoogle Scholar3. Lundberg GD. Mandatory unindicated urine drug screening: still chemical McCarthyism. JAMA. 1986;256:3003-5. [PMID: 3773220] CrossrefMedlineGoogle Scholar4. Maltby LL. Drug Testing: A Bad Investment. 1st ed. New York: American Civil Liberties Union; 1999. Accessed at www.aclu.org/drug-law-reform/drug-testing-bad-investment/ on 9 May 2013. Google Scholar5. Pham JC, Pronovost PJ, Skipper GE. Identification of physician impairment. JAMA. 2013;309:2101-2. [PMID: 23629590] doi:10.1001/jama.2013.4635 CrossrefMedlineGoogle Scholar6. Fitzsimons MG, Baker KH, Lowenstein E, Zapol WM. Random drug testing to reduce the incidence of addiction in anesthesia residents: preliminary results from one program. Anesth Analg. 2008;107:630-5. [PMID: 18633044] doi:10.1213/ane.0b013e318176fefa CrossrefMedlineGoogle Scholar7. Normand J. Under the Influence? Drugs and the American Workforce. Washington, DC: National Academies Pr; 1994. Google Scholar Author, Article, and Disclosure InformationAffiliations: From School of Community Health, Portland State University, Portland, Oregon.Disclosures: The author has disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterest Forms.do?msNum=L15-0078. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCalifornia's Proposition 46: A Wolf in Sheep's Wool Julius Cuong Pham and Peter J. Pronovost California's Proposition 46: A Wolf in Sheep's Wool Julius Cuong Pham and Peter J. Pronovost Physician Drug Testing Is Unscientific and Is Unlikely to Achieve Stated Aims Gregory E. Skipper , Julius Cuong Pham , and Peter J. Pronovost Physician Drug Testing Is Unscientific and Is Unlikely to Achieve Stated Aims Gregory E. Skipper , Julius Cuong Pham , and Peter J. Pronovost Metrics 21 April 2015Volume 162, Issue 8Page: 597-598KeywordsAddictsAlcoholsDrug abuseDrug policyDrugsSafetySedativesSleep deprivationSubstance abuseVision ePublished: 21 April 2015 Issue Published: 21 April 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...