[net.med] Drug testing

dsi@unccvax.UUCP (Dataspan Inc) (10/04/85)

     Not that my employer is involved in this (and I wouldn't care if it
were) but this business about urinalysis for drugs is getting out of hand.
There have been recent reports of job applicants who have been rejected 
"for reasons so confidential we can't tell the applicant." Horse-hockey!!!

     I can see it now. Let's screen people for:

     Phenothiazines - obviously, this person is mentally deranged.
                      People who take Compazine, Stelazine, or (for that
                      matter) ethical pain medication containing a
                      phenothiazine - these persons obviously are under
                      medical care for severe mental illness. Although
                       YOU might use Compazine suppositories for nausea
                      or motion sickness, employers can't take the chance...

     Butyropheonones -(drugs such as haloperidol or droperidol) - well,
                      you go to outpatient surgery for having your 
                      oral cysts removed, and you have Innovar (droperidol-
                      fentanyl) as an adjunct to anaesthesia. But, not
                      only do you get a positive for opiates, but for
                      these as well. You must be a really crazy drug
                      addict!! (haloperidol is used in psychotic management
                      and Tourette syndrome, and is very similar to 
                      droperidol)

     Iminostilbines - (I'm not sure of the class here - drugs of the
                       class of imipramine) - well, you must be either
                       a bed-wetter or depressed. There are some non-
                       steroidal anti-inflammatory agents which are
                       chemically related to imipramine. But, your 
                       employer gives you the boot because we can't
                       take the chance that your naproxen prescription
                       is **really** what raised the imipramine flag..

     Carbamazepine  -  you must have non-grand-mal epilepsy. Never mind
                       that people take this for severe, debilitating
                       facial pain (I can state from experience that no
                       one would take this for fun. The side effects 
                       really are very bad indeed)

     Barbituates    -  a sure sign of a downers addict. Of course, people
                       who take Mysoline (which is changed to one of the
                       barbaturic acid derivatives by the liver) and/or 
                       innocuous things such as Donnatal for gastric
                       hypermotility get snared here.

     Opiates        -  Well, do you have ulcerative colitis, and use
                       Lomotil? Just been to the dentist? To heck with
                       you! !

     Diazepam, etc.  - (including oxzepam,clonazepam,chlordiazepoxide,
                       flurazepam,alzropam[sp]) - you can't handle stress
                       young man! Yeah, yeah, we hear you about your
                       gall bladder cramps and diarrhoea, and you need
                       Librax (yet another GI medication).....

     Phenytoin      -  (and their analogues)-you're an epileptic, thus,
                       are dangerous to you and everyone else. Some neuro
                       surgeons give this as a measure after head injury
                       to PREVENT injury-induced seizure activity. 

     Mannitol       -  Did people ever consider that this is used as
                       an *antihypertensive*, sometimes during kidney
                       dialysis? Despite the popular use as a coke cut,
                       I can see overzealous people substituting coke cuts
                       for the real item.

     5-fluorouracil  - an antineoplastic. But, we can't hire you, you
                       have cancer and a short life expectancy. 

     I could think of a zillion more scenarios. When someone says "we can't
tell a prospective employee why we can't hire them because of their drug
screen" instead of "We found enough cocaine in this person's urine to start
a Revco franchise..." this is a problem.  Any first year med student can
come up with at least 1000 "undersirable" cross-correlations between the
drugs one takes and the possible indications.  The attitude of most employers
doing drug screening is that "a positive find is prima facie evidence of a
drughead, and sufficient grounds to fire or not hire", and I can certainly
see how a prejudiced and bigoted individual could bend the drug screening
game to eliminate all kinds of people. Who is to say that racial motivations
could "bend" a borderline drug screen.  

     Before anyone is fired or refused to be hired due to the results of
a drug screen, they had better damned sure be sure of the facts. Many people
aren't going to do electron-capture or HPLC studies, and instead, are relying
on "quickie" tests ordinarily reserved for management of OD victims. Let's
see, now, why not pick people at random and give them a big, fat shot of
naloxone (a narcotic antagonist).. if they get irritable, throw up, and sweat,
they're druggies, right? Why not give Antabuse (disulfriam) as a condition
of employment... to see if these people are boozers! (a very, very small
BAC, in combination with Antabuse, results in quite a profound change in one's
well being!!!)

     I'd be interested in comments and corrections to the list (it hasen't
been adequately researched).  In my opinion, if someone has honest to god
heroin, or cocaine, or LSD in their urine or blood, you've a problem which 
reduces to the old "invasion of privacy" issue. However, things sure look
as if screens are used not to look for drug ABUSE, but rather simple drug
USE, and matching their disease to some undesirable characteristic.

      What is next, brain biopsies and spinal taps?

David Anthony
CDE
DataSpan, Inc.
.
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usenet@ucbvax.ARPA (USENET News Administration) (10/05/85)

First, I think drug use can be dangerous to ones well-being.
(the only drug I use is caffeine, which is bad enough.)
Second, I think treating drug use as a crime is absurd.
There are many arguments in favor of legalizing, regulating,
and taxing drug sales (i.e. quality control, economic
benefits, crime reduction, social benefits, medical benefits,
ending subsidies to lefist groups in Latin America, etc.)
This whole nonsense about treating drug users as criminals
has gone on too long. It's time to stop ...
The article I'm responding to gives another excellent example of
the absurd consequences that can result from anti-drug policies.