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Preemployment Drug Screening

Eric D. Wish, PhD
JAMA. 1990;264(20):2676-2677. doi:10.1001/jama.1990.03450200084036.
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In 1977, Norman Zinberg, MD, invited me to join a panel that he was forming to prepare a report for President Carter's Commission on Mental Health. The title of the panel, the "Liaison Panel on Psychoactive Drug Use/Misuse," underscored the primary theme of the committee's discussions— that a distinction needed to be made between the relatively benign casual use of drugs vs the more serious and deleterious patterns of drug abuse. In 1977, it was politically acceptable to distinguish drug use from abuse. What a difference 10 years makes! David Musto, MD, professor of psychiatry and history of medicine at Yale University School of Medicine, has effectively placed the current extreme intolerance toward illicit drug use in the United States in its historical context of recurring cycles of tolerance and intolerance.1

Urine testing for drugs of abuse has come of age in the midst of an environment hostile to


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