COERCED TREATMENT FOR SUBSTANCE-ABUSE PROBLEMS DETECTED THROUGH WORKPLACE URINE SURVEILLANCE - IS IT EFFECTIVE

With the advent of on-site urine testing and other initiatives designe d to reduce substance abuse at the workplace, employees who are found to have used alcohol and/or drugs have been coerced into substance abu se treatments under threat of job loss. This widespread practice has p roduced three questions relative to these practices. First, do these e mployees have significant substance abuse problems or are they merely ''recreational users'' who have gotten caught? Second, will these empl oyees participate in standard treatments or will they resist them? Fin ally, will standard substance abuse treatments provide any benefits to these coerced patients relative to other self-referred patients in tr eatment? We compared the pretreatment problems, during treatment perfo rmance and posttreatment outcomes of 96 employed, insured participants who were coerced into treatment at four private treatment programs du e to detection of drug use on the job, to the same measures collected on a comparison group of 161 patients from the same job sites who were self-referred admissions to the same four treatment programs. Results showed that the coerced group, had significant substance abuse and ot her life problems at the start of treatment, but that these problems w ere generally less severe or chronic than those of the self-referred g roup. Coerced participants were significantly more likely to remain in treatment (either inpatient or outpatient) than the self-referred par ticipants. Posttreatment follow-up of coerced patients indicated marke d improvements in alcohol and drug use, employment, medical, family, a nd psychiatric problems. These levels of improvement were comparable t o those shown by the self-referred patients. We conclude that workplac e urine surveillance was successful in detecting employees with signif icant substance abuse related problems, and that referral to standard treatment was associated with substantial improvements in those proble ms.