How Cognitive Impairment Testing Can Improve Your Drug Testing Program

Marijuana has been legalized in our state. How do we adjust our drug-testing program to avoid penalizing workers for legal consumption that does not impact their alertness and safety at work?

Our random drug tests are time-consuming and don’t seem to be deterring enough workers from drug use. How do we strengthen the deterrent effect of random drug testing without increasing the time and money we spend on it?

Our drug test positivity rates are high. How can we more effectively vet the workers we hire without aggravating the current labor shortages we are experiencing?

If these concerns sound familiar to you, you are in good company.

These three concerns have become very common throughout safety-sensitive industries in the US especially since cannabis remains illegal in only 6 states and legalization is also spreading globally.

To complicate matters, drug positivity rates in 2020 were reported to be quite high across several safety-sensitive industries even as many drug-testing professionals agree that overall positivity is significantly under-reported industry-wide.

Finally, labor shortages and mental health issues have put a strain on employers and confused their ability to address increased workplace impairment. In many companies experiencing labor shortages, managing fatigue has also become a key safety concern.

The culmination of these issues has made many companies question the efficacy and sustainability of their existing drug testing programs. They are having to make sacrifices to choose between safety and productivity, putting their business and their employees at constant risk.

But a solution is at hand:

The AlertMeter® is a cognitive impairment testing app that has had great success in combatting these problems.

Employers find that it has helped to:

  • Manage legalized marijuana
  • Improve consistency and objectivity in drug-testing programs
  • Strengthen the deterrent effect of drug-tests
  • Hire better workers and reduce turnover
  • Improve safety
  • Reduce costs

This article will provide guidance on how cognitive impairment testing with AlertMeter® can improve your company’s drug-testing program especially in locations where cannabis has been legalized. It will also demonstrate how AlertMeter® can help manage issues like fatigue and mental distress without aggravating existing labor shortages, sending employees home, or making hiring decisions more difficult than they should be.

Additionally, we will address the limitations your company may face in adjusting your drug-testing program, give recommendations for improvement, and provide a case example of how a company similar to yours has succeeded in introducing cognitive impairment testing.  This information will be presented for each of the following types of safety-sensitive industries:

  • DOT-regulated industries
  • PMHSA-regulated industries
  • Non-regulated safety-sensitive industries

How DOT-Regulated Industries can improve their drug testing programs

According to the Omnibus Transportation Employee Testing Act of 1991, safety-sensitive transportation employees in aviation, trucking, railroads, mass transit, pipelines, and other transportation industries must be drug and alcohol tested at the following times:

-Pre-employment: before being hired or before beginning safety-sensitive work for the first time.
-Reasonable cause or suspicion: Upon observation of abnormal behavior.
-Random: workplaces must have a random drug testing program in place. What that program looks like might vary across specific industries, states, and companies.
-Post-accident: Immediately after an employee is involved in an accident and before allowing an employee to return to duty following a testing violation.

In addition to these requirements, DOT-regulated industries must utilize the services of a Medical Review Officer to review drug test results and to provide employees with consultation services before the test result is reported to an employer.

Opportunities for Improvement:

Since DOT-regulated industries have very little flexibility within their drug testing programs, the best way to reduce drug-test positivity in these industries would be through increased education and coaching opportunities, and the introduction of cognitive impairment testing.

Increased education and coaching would provide supervisors with the knowledge and confidence to use reasonable suspicion testing more effectively. By knowing how to identify subtle signs of impairment, supervisors can become more objective and consistent in their application of reasonable suspicion testing. Secondly, by having the confidence to use it when necessary, they can strengthen the deterrent effect of reasonable suspicion testing.

Additionally, providing your supervisors with a real-time cognitive impairment test is a powerful way to make your workplace more productive, time-efficient, and proactive in identifying and managing workplace drug impairment. The test takes 60 seconds at the start of a shift and accurately reveals impairment in real-time. Although DOT-regulated industries must retain their random drug testing programs, there is no federal requirement mandating how frequently they must be used. Since cognitive impairment testing increases real-time impairment awareness on-site, DOT-regulated industries that utilize cognitive impairment testing often find a reduced need for random drug testing.

Application Example:

A transportation company integrated cognitive impairment testing into their existing truck-based tablets currently supporting their ELD/Telematics system. The drivers take the 60-second test before taking off, and each time a driver is struggling with alertness, their dispatch manager receives a notification. They contact the driver to have an objective conversation regarding their ability to work safely.

“The platform is really well aligned with our expectations and it allows us to have the technology behind what our
drivers are doing as well as compliance with DOT requirements.”

Read the full case study here.

How PMHSA Regulated Industries can improve their drug testing programs

According to the Pipeline Management and Hazardous Materials Safety Administration, operators, and contractors of natural gas and other gas pipeline transportation, hazardous liquids pipeline transportation, and liquefied natural gas pipeline facilities must conduct drug and alcohol testing at the following times:

  • Pre-employment
  • Return to duty
  • Reasonable cause or suspicion
  • Randomly
  • Post-accident
  • Upon failure or refusal of the test (additional random follow-ups with a Substance Abuse Professional)

Opportunities for Improvement:

Since these industries are also strictly regulated in terms of their drug-testing requirements, the opportunities for improvement are similar to those of DOT-regulated industries. Pipeline supervisors can benefit from increased training in recognizing the signs and symptoms of impairment. Cognitive impairment testing can be utilized in addition to random drug testing to increase real-time insights, increase communication, and reduce time spent traveling to get random drug tested. Adding a 60-second cognitive impairment test can quickly improve productivity and ensure workers are reporting to work in an alert state of mind.

Besides reducing the overreliance on random drug testing, cognitive impairment testing can be utilized to increase the objectivity and consistency that is required to make reasonable suspicion testing effective. A 60-second test can quickly and objectively identify workers who might be struggling, instantly notify supervisors to start a conversation, and result in a much more consistent application of reasonable suspicion testing regulations than the mere reliance on subjective and often inadequate supervisory vigilance.

Application Example:

A 24/7 oil and gas control room with 30 employees on 5-week rotating shifts utilizes cognitive impairment testing. Alarms are set at regular intervals throughout a shift to prompt operators to take the 60-second cognitive impairment test. This ensures that the operators remain awake and alert throughout long night shifts and that countermeasures are taken when required to stay alert. By mounting an iPad with the AlertMeter® app on it, and taking the test during fatigue hot spots, the control room has increased visibility into fatigue and helped highlight potential problems in shift schedules. It has also increased workers’ personal awareness of their cognitive well-being, empowering them to make decisions that support their alertness and giving them the feedback to take countermeasures when necessary.

Read the full case study here.

How non-DOT regulated safety-sensitive industries can improve their drug testing programs

In non-DOT regulated safety-sensitive industries, there is more flexibility in adjusting drug testing programs. If the business or organization has received a federal contract of $100,000 or more, or a grant of any size, “the Drug-Free Workplace Act of 1988 requires the creation and distribution of a drug-free workplace policy. Drug testing is not explicitly required” (Concentra). However, state regulations, union requirements, and insurance agreements may have stricter requirements for your company’s drug testing programs.

Regardless, in light of the latest data from Quest Diagnostics on rising positivity rates, the improvement of drug testing programs is something unions and insurance companies could, should, and often do support:

Transportation and Warehousing: 41.9% increase in overall drug positivity between 2016 and 2020. 123.5% increase in marijuana positivity between 2016 and 2020.

Construction: At 0.3%, had the highest cocaine and methamphetamine positivity out of all industries in 2020.

Drug Positivity Rates by Industry Sector

Beyond the obvious substance abuse problem that drug testing has not adequately addressed, these industries are also suffering from labor shortages and a lack of guidance on how to manage legalized marijuana. A successful drug-testing program should be able to address these issues by improving safety without risking the viability of the business.

The current application of drug testing in many industries falls short in all of the above. Drug testing programs aim to improve safety by reducing workplace impairment. However, the data indicate that it is failing to achieve either outcome:

1. Impaired workers are not being adequately filtered out of the workplace as indicated by the fact that post-accident positivity is rising faster than pre-employment positivity.

2. Safety hasn’t been improved for the same reason–increased overall drug test positivity and increased post-accident drug test positivity indicate that the tests are not strong deterrents to drug use.

3. Drug tests do not provide a way to test for real-time impairment from marijuana. This further complicates matters when there is a labor shortage and it is difficult enough to find quality workers, let alone a quality worker who hasn’t smoked marijuana anytime in the past month.

4. Labor-intensive industries like construction are at higher risk of false positives due to higher usage of pain medication among workers. (Concentra)

Opportunities for Improvement:

Non-regulated industries such as manufacturing and construction can resolve the aforementioned problems and improve their drug testing programs in one of three ways:

1. Remove THC from pre-employment drug screens and treat marijuana like alcohol.

Amazon announced that they would go this route with all of their non-DOT regulated workers. Read all about it here. Their approach directly tackles the labor shortage problem by instantly qualifying thousands of previously unqualified workers, including both medical and recreational marijuana users. By removing THC from pre-employment screenings, companies can become more attractive to employees. this is crucial, especially in a time of severe labor shortages, as the ability to attract employees can be a significant competitive advantage for the business. Read about 3 solutions to labor shortages here.

This option might be preferred by companies in states/countries where marijuana has already been legalized or is about to be legalized. See map below from

In addition to the wider access to quality workers, removing THC from pre-employment screenings allow workplaces to focus on safety measures that are stronger and more proactive deterrents to drug use and impairment. This is the perfect opportunity to introduce a cognitive impairment test as employees will prefer it to invasive drug testing practices and HR/safety leaders will appreciate its proactive and comprehensive approach thus benefiting your whole organization from improved safety, reduced risks, and reduced costs.

Application example:

A Colorado manufacturing company removed THC from their pre-employment drug screens and entirely ended random drug testing. At the same time, they introduced daily cognitive impairment testing with The AlertMeter®. This had several positive impacts within the first two years of implementation (verified by independent insurance provider):

1. Drug testing costs reduced by 90%.

2. Worker’s compensation claims reduced by 70%.

3. Worker turnover reduced by 35%.

4. Productivity increased by 11%.

In addition to these numbers was the company’s ability to retain their quality employees who consumed cannabis outside of work in a manner that did not affect their alertness and safety while at work. It widened their applicant pool and gave the company a competitive edge while many other Colorado companies continued to struggle with labor shortages aggravated by marijuana legalization.

In the video below, Zach Galbreath, a manager at Denver-based V-Forge, Inc., shares his takeaways on the impact AlertMeter® has had in effectively managing a workforce and creating a culture of safety in marijuana-friendly Colorado.

2. End all random drug testing and use cognitive impairment testing instead.

As mentioned above, this approach proved extremely beneficial to a manufacturing company operating in a state where marijuana and CBC products have been legalized.

Since random drug testing has already been established as a weak deterrent to drug use, replacing it with cognitive impairment testing that detects impairment independent of cause is an easy choice for many companies. Consider the following:

  • For random drug testing to be effective, it requires consistent and frequent testing which quickly becomes costly in both money and lost productivity.
  • The inconsistency of application in random drug testing can lead workers to feel they are being singled out while actually impaired workers can go unnoticed or overlooked. This can lead to decreased morale and turnover without any improvement in safety.
  • As drug positivity rates for cannabis continue to climb, supervisors will grow increasingly reluctant to randomly test employees for fear of having a valuable employee test positive although being currently unimpaired. This reluctance can further decrease the overall effectiveness of the drug-testing program.

On the other hand, cognitive impairment testing offers the following benefits:

  • Workers can be objectively assessed for impairment and alertness against a personal baseline in just 60 seconds – no body fluids required.
  • Objective and non-discriminatory, the global use of AlertMeter® for all workers, every shift, means there’s no risk of supervisors signaling out some workers for random testing.
  • Since cognitive impairment tests only reveal impairment in real-time, neither supervisors nor workers need to fear retribution for off-time behavior. As a cognitive impairment test, AlertMeter will detect real-time impairment, not last weekend’s impairment. This means workers who are alert and sober don’t need to show up to work fearing for their livelihood, and managers don’t need to fear losing valuable employees.

3. Leave everything the same, add cognitive impairment testing.

For workplaces that are reluctant or unable to adjust their drug testing programs — significant improvements to safety and significant reductions in cost can be achieved by the addition of cognitive impairment testing to your existing drug-testing program.

There is very wide room for impairment between the pre-employment test and the post-accident test.

Unless your supervisors have the time to meet with every worker every day, they’re unlikely to pick up on every opportunity to utilize reasonable suspicion testing. The frequency and predictability of random testing differ between workplaces, but workers who intend to get away with drug use often find a way to do it, as indicated by the Quest Diagnostics data cited above.

Cognitive impairment testing fills these gaps.

If your workplace is concerned with the costs of using both drug testing and cognitive impairment testing, consider this:

Workplaces that utilize cognitive impairment testing experience reductions in costs of accidents ranging between 15 and 55% and reductions in worker’s compensation claims ranging between 25 and 75%.


“Impairment, whether it be by drugs, alcohol, fatigue or stress, decreases the safety of the workforce.” – Jenny Burke, Senior Director of Impairment Practice, National Safety Council. (SHRM)

Between all the rules, regulations, and paperwork, it’s easy to forget that the entire purpose of drug testing is to improve workplace safety and reduce your company’s risk of costly accidents and errors. With drug positivity rates increasing, it’s time to rethink whether drug testing is actually serving this purpose, or whether it’s just a costly pat on the back that allows workplaces to overlook other dangerous and complex sources of human impairment and increased risk.

As society undergoes significant changes including increased mental health issues, improved detective and predictive technologies, legalized cannabis, and labor shortages, more companies are questioning if traditional drug testing programs are still the best way to manage human risk factors?

Legalized marijuana use is no longer a pressing safety risk for many workplaces. Current intoxication is. Real-time, detective technologies are more effective than ever in this regard.

Mental health issues, emotional distress, and fatigue are significantly greater safety risks than the possibility of a worker having smoked marijuana a month ago. Predictive, proactive, comprehensive, and communicative risk mitigation is a more effective method of combatting these complex issues than the punitive and narrow-focus of traditional drug testing programs.

Of course, it’s not one or the other. The greatest benefit of cognitive impairment testing is that it looks at every cause of impairment. If something is anything is affecting an employee’s ability to focus and work safely and productively, the test will detect it.

Regardless of the regulations of your industry, there is always room to improve safety, productivity, and efficiency.

When you choose to assess cognitive impairment using AlertMeter®, you can overcome your safety and productivity concerns and maintain a healthy and productive workforce. Schedule a time today to get a quote for AlertMeter® and learn more about how cognitive impairment testing can be implemented into your specific workplace and industry regulations.

Safer, More Productive Shifts Can Start Today

Request a no-obligation Discovery Meeting, and a member of our team of fatigue-risk mitigation experts will walk you through this revolutionary technology so you can run safer, more productive shifts.

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