ADHD affects around one in twenty Australians and the number of people diagnosed with the disorder is on the rise. In recent years in particular, there has been a steep increase in the number of adults diagnosed with ADHD. But what’s this got to do with workplace drug testing?
Brief information on ADHD
According to ADHD Australia, ADHD, or Attention Hyperactivity Disorder, is a complex neuro-developmental disorder characterised by patterns of inattentive, impulsive and sometimes hyperactive behaviour. Often, people with ADHD also face emotional regulation challenges.
These behaviours stem from underlying neurological differences. Without intervention, ADHD can lead to significant functional disability across all areas of life. However, with evidence-based treatment and support, individuals with ADHD can learn to manage challenges, embrace strengths and lead fulfilling lives.
This support can include medication. There has been a lot of media attention in recent years on the significant rise in ADHD sufferers being prescribed medication. In a Sydney Morning Herald article published a few months ago, they claimed that the number of Australians being prescribed ADHD medication has doubled in five years. In 2022, there were over 400,000 Australians who were prescribed medication for ADHD.
What’s the link between ADHD and workplace drug testing?
While there are many medicines and combinations of medicines that can be prescribed for ADHD, often a stimulant medicine is part of the mix. Stimulants help improve behaviour, attention and memory in ADHD by adjusting chemical messengers in the brain.
While there are different stimulants that can be prescribed for ADHD, some are what can be described in layman terms as amphetamine-like. This includes popular ADHD medication such as Adderall, Concerta and Ritalin. The later is the most common ADHD medicines prescribed to Australians with ADHD. In 2023, 1.2 million prescriptions of Ritalin were dispensed.
The fact that these medications are essentially amphetamines is the important aspect. It’s why some people on ADHD medication can provide a non-negative test during workplace drug testing.
While the drugs that can be detected by testing can vary, depending on the workplace drug testing provider and the client, for Integrity Sampling we do regularly check for amphetamines. That’s because, while amphetamines can be prescribed for various conditions, including ADHD, it can also be taken illegally for recreational purposes.
An example is an illicit drug that it is commonly called speed. While speed can often contain a mix of drugs, binding agents and other substances, amphetamines is the generally the psychoactive ingredient that gives user feelings of happiness, confidence and energy. It can also lead to an increase in heartbeat and breathing, fits, passing out, paranoia, hallucinations, confusion and more, which is why it has no place in a workplace where safety is important.
It should be highlighted that when taken as prescribed, such as by people with ADHD, amphetamine-like medication is generally perfectly safe. While side effects can occur, for most people the medication has proven to be safe and effective. Most people who are on ADHD medication are also safe to go to work and to drive a vehicle.
ADHD medication not alone
While ADHD medication is getting a lot of attention and it is one of the prescribed medications that can lead to non-negative workplace drug testing results, it’s certainly not alone. Many other prescribed drugs also function similarly to illegal drugs.
Some drugs can even lead to the person taking the medication being unsafe to drive or work in safety-focussed roles, even when the drug is taken as directed. Examples can include codeine, morphine and fentanyl, all opioids, which belong to the same drug family as heroin. Another example which is very topical of late is medicinal cannabis. You can find out more about this subject on our page on Medicinal cannabis in the workplace.
While most doctors should and do discuss side effects with their patients, there is also an onus on people who are prescribed medication, particularly if they work in a job were workplace drug testing is carried out or if they plan to operate a vehicle. Questioning a doctor about side effects and whether a drug could affect your ability to drive or work should always be part of the conversation.
Could someone face consequences for failing workplace drug testing while on ADHD medication?
What happens when someone does fail workplace drug testing because of their ADHD medication? Could someone – perhaps wrongly – lose their job or face significant consequences?
In general the answer is no, although it can depend on the rigour of the business and the workplace drug testing provider.
Initial testing, which may produce a non-negative test for amphetamines, should always be followed by confirmation testing, using more accurate and definitive independent laboratory analysis. This testing will be able to distinguish between the different forms of amphetamines taken.
An initial non-negative result does not mean that illicit substances are involved. Prescription medications can trigger a non-negative result too and a laboratory report can only tell you if the medication is consistent with the declared use. The lab report can’t tell you whether the medication being used has been legitimately prescribed, is being used as directed or if it was taken to mask the use of an illicit drug. Even if the medication is legitimate, how do you know if you should be concerned about potential work safety implications of the prescribed medication?
A Medical Review Officer (MRO) can provide advice on whether the medication is reasonably safe to take for the worker, depending on the job role, considering the medical condition the medication is treating. Furthermore, the MRO can also verify a positive result, determine if the drug test is consistent with declared medication and give you the tools you need to manage the individual via your company’s drug and alcohol policies.
If you are an employee who is on ADHD medication that is amphetamine-like, and your workplace carries out drug testing, it’s a good idea to let your employer know. While you certainly aren’t required to do so, it can be smart to be proactive rather than having to explain a non-negative result after the fact.
For workplaces, there are also some key messages:
- Firstly, it’s important to include detailed information in your workplace drug and alcohol management policy about prescribed medication, including ADHD medication.
- Educate your workforce on the risks of coming to work after taking certain types of prescription drugs.
- Reiterate to your workforce that the aim of managing prescription drugs properly is to improve workplace safety.
- Encourage your workforce to report to their manager or supervisor if they have been prescribed medication that could make them unsafe to work or could potentially lead to a non-negative drug test.
- Implement random workplace drug testing to improve workplace safety. Drug and alcohol testing is the only way to know if someone may be under the influence of a drug or alcohol and is unsafe to be in the workplace.
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Could a prescription for ADHD medication end up in a failed workplace drug testing result? Credit National Cancer Institute https://unsplash.com/photos/man-in-white-dress-shirt-holding-white-box-byGTytEGjBo and Draeger.
