Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

4. Laboratory Testing 69Agency (USADA) monitors and conducts all Olympic-related events in theUnited States. In sports testing, as in DFW programs, there are two types oftesting: in-competition and out-of-competition programs. No advanced notice(NAN) out-of-competition testing is the preferred method of USADA and isreported by athletes themselves to be the best deterrent of drug use. As its nameimplies, this form of testing consists of approaching an athlete at any time, withoutprior notice, and obtaining a urine sample. Olympic caliber athletes mustconsent to participate in the program, which includes providing a personal log oftheir whereabouts at all times. Failure to comply leads to sanctions by the individualsport governing body (track and field, swimming, etc.).Testing Programs in Occupational SettingsThere are two types of workplace testing: regulated and nonregulated. Regulatedtesting refers to programs conducted under the Federal Testing Guidelinesand includes industries working with the Department of Transportation(DOT), Federal employees, and companies with Federal contracts over $25,000per year. Nonregulated programs are typically private sector employers who arenot federally required to have a DFW program but voluntarily choose to drugtestemployees. These programs are not required to have an MRO and are notfederally regulated.Drug testing in the workplace has seen dramatic growth since 1988. FormerPresident Ronald Reagan proclaimed the need for a drug-free workplace inAmerica during his years in office. This initiative resulted in the Drug-FreeWorkplace (DFW) Act signed into law in November 1988. This legislation(HR-5210-124 Section 5152) laid the groundwork for the existing regulations(49-CFR-40) for virtually all of the drug-testing policies and protocols currentlyenforced in the workplace today. Interestingly, the DFW legislation was a significantextension of the preexisting “catastrophe-driven” testing, in whichtesting was only done after a catastrophic event, such as a serious work-relatedaccident. This new policy offered a proactive deterrent philosophy.Each DFW program is mandated to include five elements: (1) a formalwritten policy, (2) an Employee Assistance Program, (3) formal training forsupervisors, (4) formal employee education, and (5) a drug-testing protocol.Five participants are involved with every DFW drug test: (1) the employer, (2)the donor/employee, (3) the specimen collection site, (4) the laboratory analyzingthe sample, and (5) the MRO. The employer is responsible for informingthe employee in writing of the Drug-Testing Policy, including all policiesand procedures of the test, circumstances warranting testing in addition topreemployment testing, and consequences of a positive test. Employees mustsign a form acknowledging that they are aware of the program and the existenceof an Employee Assistance Program, and participate in a DFW educational presentation.They must also sign an informed consent document, agreeing to betested under the circumstances described in the policy handbook. The collec-