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November 9, 1994

Under the Influence? Drugs and the American Work Force

Author Affiliations

The University of Iowa Iowa City

JAMA. 1994;272(18):1467-1468. doi:10.1001/jama.1994.03520180097048

Commissioned by the National Institute on Drug Abuse (NIDA), the Committee on Drug Use in the Workplace of the National Research Council and of the Institute of Medicine prepared this book to assess the scope of drug use by the workforce, the impact of drug use on work performance, and the effectiveness of drug intervention programs.

The committee noted that in the United States, about 24 million urine drug tests are performed annually—18 million by NIDA-certified laboratories, 6 million by noncertified laboratories. Assuming a cost per test of $50 (including laboratory fees, collection site costs, medical review officer costs, and quality control costs, but excluding costs to recruit replacement workers, costs of treatment, and costs of workers' time for the test), the committee estimated that we spend about $1.2 billion per year on drug testing. Such substantial expenditures justify careful attention to the following questions: How prevalent is drug use

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