Conclusion

Despite the legitimate concern with false-positive and false-negative test results, the weakest link in the "chain" of drug testing is chain-of-custody violations. Regardless of the sophistication of laboratory technology, human error in completing the requisite paperwork at the drug-testing site remains the single most important inconsistent aspect of the testing process. Given the variety of available methods to cheat, it is likely that drug testing will not catch all drug users.

As is the case in all aspects of clinical medicine, an accurate diagnosis of substance abuse is based on a comprehensive clinical workup; drug testing is only one, albeit important, component of the process. Workplace drug testing hopefully will not only deter drug use by employees while on the job (eliminating costly accidents and errors) but may also assist in initially identifying individuals with drug use disorders. In the world of sports, drug testing is intended to create a level playing field for all competitors and promote the health of athletes by deterring the use of potentially harmful agents. The role of educating the public, particularly those at highest risk for drug use, cannot be overstated and needs to be the keystone of any drug-free program.

REFERENCES

Chappell, J. S., Meyn, A. W., & Ngim, K. K. (2004). The extraction and infrared indentification of gamma-hydroxybutyric acid (GHB) from aqueous solutions. J Forensic Sci, 49(1), 52-59. Cody, J., & Valtier, S. (2001). Effects of stealth adulterant on immunoassay testing for drugs of abuse. J Anal Toxicol, 25, 466-470. Cone, E. J. (1996). Mechanisms of drug incorporation into hair. Ther DrugMonit, 18, 438-443.

Hansen, H. J., Caudill, S. P., & Boone, D. J. (1985). Crisis in drug testing: Results of

CDC blind study. JAMA, 253, 2382-2387. Hoffman, J. P., Brittingham, A., & Larison, C. (1996). Drug use among U.S. workers: Prevalence and trends by occupation and industry categories (DHHS Publication No. [SMA] 96-3089). Rockville, MD: SAMHSA Office of Applied Studies. National Institute on Drug Abuse. (1989). Drug abuse curriculum for employee assistance program professionals (DHHS Publication No. ADM 89-1587, pp. i-vi, 98). Washington, DC: U.S. Government Printing Office. Schwab, M., & Syne, S. L. (1997). On paradigms, community participation, and the future of public health. Am J Public Health, 87, 2049-2052.

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Anxiety and Depression 101

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