Tracing The Evolution of Drug Testing - An Informative Overview of Drug Use, Integral Regulations, and Technological Advances in Testing Methods - May 2024

By Alison Adduono, Director of Marketing

Have you ever wondered how and when drug testing became a thing? Honestly, when I first moved to the US and started my first American job back in the late 90’s I was taken aback when I was instructed to go for a pre-employment drug test. I was stunned – did I look like a drug user? Now my first exposure to workplace drug testing was truly “all in” — fully observed. That was a shocker to me to say the least. Clearly, I was naïve and didn’t know that drug testing was commonplace in the US, nor did I know that years later I would also be working in the industry.

Drug use in itself dates back thousands of years with drug testing starting in the 1970’s. Let’s explore drug use history, the evolution of drug testing and how its legislation has developed over time.

Drug Use History – Substance Abuse Trends Over Time

For approximately 6,000 years people have been using drugs. The earliest recorded use of drugs was by the early Egyptian dynasties and marijuana has a long drug use history of medical and religious applications, tracing back nearly 5,000 years in China. And Soma, which is used is modern day pharmaceuticals, also has a past — mentioned in an ancient Hindu canonical text (Rgveda) it was said to be prepared as a ritual drink with hallucinogenic properties over 3,500 years ago.

Of course, drug use has been happening in the US since its inception. In fact, back in the late 1800’s individuals were even able to order a syringe of cocaine from the Sears Roebuck catalogue and Coca-Cola even had small amounts in its “patent medicine” soda. Of course, at that time it wasn’t illegal, and the purchase of cocaine, opium and marijuana was even taxed through a few different acts over a course of years. Fast forward to 1970 where The Controlled Substances Act (CSA) was signed into law by President Richard Nixon and regulated drugs into 5 different schedules:

Schedule I: Drugs with high potential for abuse and/or addiction with no current medical use.
Schedule II: Substances that have legitimate medical applications yet possess a high risk for misuse and dependency are available via prescription.
Schedule III: Medications classified as having a mild to moderate likelihood of misuse and/or addiction and are considered less hazardous than Schedule I or II substances, can be acquired with a prescription but are typically not sold over the counter.
Schedule IV: Medications that are recognized for their legitimate medical benefits and have a low potential for abuse or dependency.
Schedule V: Lower than Schedule IV, these drugs have a low potential for abuse.

The Early Days – The Evolution of Drug Testing

As for where drug testing got its start – it isn’t where you might think. The equine industry was actually the first to initiate testing for horse racing. In the early 1910’s European horse trainers brought doping techniques to the USA.

Jack Keene, founder of Keeneland Racetrack in Kentucky, was publicly suspected of doping horses while training horses overseas. Russian trainers with a chemist alongside tested horse saliva by force-feeding it to frogs. The frogs reacted erratically and as a result, Mr. Keene achieved the distinction of being banned from racing in Russia and became the first recorded trainer to be caught by the newly implemented saliva test.

During the 1930s-1950s, drug testing laboratories for the equine industry were established throughout the United States. This forensic toxicology development led to these labs primarily conducting horse saliva tests using microcrystalline testing. However, in the 1950s, chromatography emerged as the dominant technique for drug testing. This method involves separating and quantifying components that are dissolved in a solvent. By the 1970’s the first commercial Gas Chromatography-Mass Spectrometry (GC/MS) instrument was launched and now this methodology (in addition to LC/MS) is used in lab-based testing.

In 1959 immunoassays were developed and since that time they have evolved and are used in rapid point-of-care drug tests. As to who developed the first instant drug test for point of care, that one is up for debate I guess but suffice it to say there are many manufacturers in the industry now all employing the same lateral flow technology — they just look different. In fact, Origin even distributes both oral fluid and urine instant tests.

Drug Abuse Prevention History – The Evolution of Legislation

Digging into the United States’ drug abuse prevention history we can see that a lot of acts and agencies were formed. During the 60’s the US saw a rise in recreational drug use and then in 1970 Nixon declared the “War on Drugs” going so far as to saying drug abuse was “public enemy number one.” Shortly after the Vietnam War in 1971 he instructed the military to initiate a urine drug testing program (testing both active and non-active soldiers). As a result, the US Army discovered that many soldiers were using heroin. The armed forces in fact took a no-tolerance policy for drug use after a 1981 Marine Corp jet crash occurred (where marijuana played a part) onboard the USS Nimitz which had an estimated $150M in damages, 48 injured and 14 dead.

Nixon also went on to form the Special Action Office for Drug Abuse Prevention (SAODAP) and National Institute on Alcohol Abuse and Alcoholism (NIAAA) — the short lived predecessors for the National Institute on Drug Abuse (NIDA). The Drug Enforcement Administration (DEA) was also formed in 1973. Some question whether Nixon had another agenda behind his “War on Drugs”.

During the mid-70’s this “war” took a brief hiatus with some states decriminalizing marijuana possession followed up by former President Jimmy Carter’s efforts to decriminalize up to one ounce of marijuana.

But the real push for drug testing began in the 1980s due to workplace accidents. President Ronald Reagan picked up where Nixon left off. In 1984 his wife Nancy Reagan launched her “Just Say No” campaign. In the mid 80’s Quest Laboratories started employer drug testing and by 1986, Reagan had implemented the Drug-Free Workplace Program which allowed pre-employment testing and testing based on reasonable suspicion and that same year he also moved for Congress to pass the Anti-Drug Abuse Act which set strict prison sentence minimums for drug offenses.

By 1991 the Department of Transportation (DOT) became regulated with the Omnibus Transportation Employee Testing Act of 1991.

In recent decades the public war on drugs has waned with many states easing laws and reducing penalties and even in the last several years, we have seen some states look to legalize the recreational use of marijuana.

But despite that, workplace drug testing remains critical by helping to ensure safe, healthy and productive workplaces. While initially most focused on standard 5-panel tests such as the NIDA-5, the industry has seen expanded testing as more and more drugs are manufactured and abused.

Current Challenges

Positivity rates have dropped over the last 25 years among employers that are drug testing. However, US Department of Labor data reports that over 60% of adults are acquainted with someone who has shown up to work while affected by alcohol or illicit substances. This data suggests that there are higher rates of drug use than what is seen with drug testing employers which tends to lend itself towards the fact that drug testing programs deter drug use in the workplace.

Drug abuse is never going to go by the wayside, and neither will testing. There will however be a continual evolution of drug testing as they pace with substance abuse trends over time. Just as we see marijuana legalization occurring across the US — so do we see testing adapting to match these changes. As such with the growth in abuse of drugs like Fentanyl — more drug test manufacturers are creating and marketing tests that will meet that need.