For most of us, experimentation may lead to regular or recreational use. When we get together with friends, we use the substance of choice to help us relax at the end of the day or week or as part of a celebration. Occasionally, we might overindulge and end up with a terrible hangover. We tell ourselves and anyone who witnesses our behavior that we learned our lesson and “we won’t be doing that again!” Most people mean it and don’t overindulge again, but some quickly forget the lesson.
People for whom experimentation quickly leads to problems, and those whose recreational use turns problematic often enter a period of binge, risky, and heavy use. Heavy or binge use of alcohol is associated with an increase in motor vehicle crashes, alcohol poisoning, and physical violence, including intimate partner violence, sexual assault, and in extreme circumstances, violence may end in death. The consequences of heavy or binge use of other drugs vary by the drug used. As an example, approximately seventy percent of overdose deaths are linked to narcotic/opioid abuse.
If the heavy or binge use continues despite negative consequences, the user has likely become dependent on their drug of choice at this point and is no longer able to control their use. Those adverse consequences include lost relationships (family, friends, spouse & children), financial hardships, legal entanglements, and the loss of a job or jobs. According to the National Institute of Drug Abuse (NIDA), about 9% of those who use drugs will develop a substance use disorder (addiction). In comparison, 6% of adults in the United States have an alcohol use disorder (addiction). A dependent person no longer uses the drug of choice to feel better; they continue to use it to avoid feeling worse or to avoid being sick or detoxing.
There is no singular correct path to recovery from dependence or addiction. The person who fails a workplace drug test is very often upset, angry, and perhaps embarrassed. They may or may not be addicted, but their drug use behavior has created a crisis for them. The next step is a referral to their assistance program for an assessment and recommendation for education or treatment. If education is what the assistance program recommends, the experience of testing positive combined with required education may be enough to change the pattern of substance use and reduce the risk of addiction. For the person assessed to require some level of treatment, moving from a substance-using lifestyle to a sober or abstinent lifestyle represents an enormous transformation, and the transition can be daunting even when the goal is highly desirable!
A high-quality workplace testing program offers follow-up testing for the person with a previous positive test. R elapse is a part of all chronic illnesses. For the person in a follow-up testing program because of an earlier workplace positive , the follow-up testing can be an external motivation to maintain sobriety until the internal motivation to embrace a sober lifestyle has developed.
