Racial Disparities in Workplace Drug Testing and Termination Following a First Positive Test

Workplace drug testing is common, but its impact is unclear. While some studies suggest that it reduces substance use, there are concerns that its implementation targets minorities disproportionately. Researchers used data from the 2002–2019 US National Survey on Drug Use and Health to examine differences in drug testing and positive drug test policies between ethnoracial groups (Black, Hispanic, or White). The sample included 121,988 employed individuals aged ≥18 years.

• Black workers were more likely to report being subject to workplace drug testing than White or Hispanic workers (adjusted odds ratio, 2.0).
• Following a first positive drug test, Black and Hispanic workers were more likely to be fired than White workers (relative risk [RR], 1.6 and 1.4, respectively).
• Black workers were more likely to be referred to treatment (RR, 1.4), while Hispanic workers were less likely to be referred to treatment (RR, 0.8), compared with White workers.

Comments: This study shows another way in which policies exacerbate disparities. Even if some of the differences may be due to the type of work that these groups were engaged in, policies that result in the firing of workers rather than providing them with supportive services are unnecessarily punitive and contribute to harmful outcomes.

Darius A. Rastegar, MD

Reference: Oh S, Hodges J, Salas-Wright C, et al. Ethnoracial differences in workplace drug testing and policies on positive drug tests in the United States. Drug Alcohol Depend. 2023;247:109898.