It is my hope that this book will be used both by scientists and the policymakers who determine where the research dollars are spent. Anyone who takes the time to read more than a few pages of this Handbook will encounter quite a few surprises, some good and some bad. The good news is that during the last decade, a tremendous amount has been learned about abused drugs. The bad news is that progress has not been equally rapid on all fronts. Molecular biologists and neurochemists who, perhaps not coincidentally receive the lion’s share of federal funding, have made breathtaking advances. They are tantalizingly close to characterizing the basic mechanisms of addiction. Progress has been somewhat less dramatic on other fronts.
Testing workers for drugs has become a huge, competitive business. Market forces have ensured that the necessary research was done. Regulated urine drug testing is now a reliable and reasonably well-understood process. Yet, desperately needed studies to test the efficacy (as opposed to the accuracy) of workplace drug testing programs are not on the horizon, and we still do not know with any certainty whether the enormous amount of money being spent really has an effect on worker absenteeism, accident rates, and productivity.
In areas where government and industry share common interests, there has been impressive progress. Researchers interested in impairment testing have received sufficient funding to finally place this discipline on firm scientific footing. But practical workplace applications for impairment testing are hampered by the paucity of data relating blood, hair, sweat, and saliva drug concentrations with other workplace performance measures.
The use of alternate testing matrices poses a daunting challenge. Until very recently, alternate approaches to workplace testing were not permitted. There was little government interest, and no potential market in sight. With no money to be made, industry leaders saw no reason to invest in new technologies. Now it appears that pressure from private industry has altered government perceptions, and changes may be imminent. But a great deal of science remains to be done. In particular, basic pharamcokinetic research is needed to describe the disposition of abused drugs in alternate specimens. Without such data, the utility of alternate specimens is limited, and reliable interpretation of test results is nearly impossible.