Background: Most employers of labor in the US require potential employees to undergo mandatory urine drug screen (UDS). Though UDS is not regarded as a medical exam, it is often done post offer pre hire. Other reasons for UDS in the workplace include, post-accident, reasonable suspicion, deterrent and random testing among others. Some studies have noted a negative correlation between workplace drug testing and employee substance use. Objectives: To gain an understanding of the pattern of drugs of abuse use by health care workers who care for the sick compared to the general US work force. Methods: We reviewed drug test results reported by a toxicology laboratory and a medical review officer (MRO) from January 2011 to December 2014 for a health care facility that employs over 16,000 workers. We then compared the results with the drugs consumed by the donor prior to donating the specimen as documented by the MRO. We also compared the result with the pattern of drug use by the general US work force. Results: A total of 4166 urine drug screens (UDS) were done at the medical center over the study period. Dextroamphetamine and lisdexamfetamine were the predominant drugs used by the health care providers resulting in a positive UDS for amphetamine (1.3%), followed by marijuana (0.56%) Marijuana was the predominant drug of abuse (1.9%) in the combined US work force followed by amphetamine (0.90%). Conclusion: Legally prescribed medications for attention deficit disorder (ADD) were responsible for over 50% of the positive UDS result. These scheduled drugs with abuse potential are not without significant side effects. The UDS immunoassay and gas chromatography/mass spectroscopy (GC/MS) currently in use cannot determine whether someone is abusing a legally prescribed medication or not. There is need for future research to determine from the UDS whether an employee is abusing a legally prescribed medication.
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