Over the last decade, workplace drug testing has become increasingly common in the United States. In 1980, only the military and the nuclear industry tested routinely. Today, most large corporations require preemployment drug screens. Federal drug testing requirements apply to some 7 million Americans. While the manufacture of equipment and chemicals used in drug testing cost $300 million in 1990, more recent estimates suggest that drug testing is now a billion-dollar-a-year industry.
The rapid growth of drug testing has given rise to a new role for physicians: medical review officer (MRO). First defined in the 1988 guidelines for drug testing in the federal workplace, an MRO is a physician who reviews the results of drug tests. The MRO offers the employee the chance to provide an explanation for a positive result, such as a prescription for a controlled substance.
In addition, MROs have come to serve an important quality control
Zwerling C. The Medical Review Officer's Guide to Drug Testing. JAMA. 1994;271(6):475-476. doi:10.1001/jama.1994.03510300087048