IPA Responds to SAMHSA Workplace Urine Drug Testing Regulations

July 12, 2004

The International Paruresis Association (IPA) submitted comments to the US Substance Abuse and Mental Health Services Administration (SAMHSA) regarding proposed revisions to the guidelines for workplace drug testing to include alternatives to urine testing. The IPA submitted its comment along with 130 others addressing the issue of paruresis and its impact on violations of fair employment practices.

The complete list of public comments to SAMHSA can be viewed here as well.

More than one third of the 284 public comments SAMHSA received concerned paruresis and the unjust effects of existing drug testing regulations.

In particular, the most vexing aspects of current SAMHSA regulations for donors with paruresis are:

1. The unjust insistence by SAMHSA, employers, and MROs that failure to provide a specimen equates with refusal to take a drug test, and that such “refusal” is grounds for not hiring or for firing.
2. The “shy bladder protocols” which require donors with paruresis to remain at a testing site for three hours, even though in many cases subjects are in severe pain of urgency and cannot produce a sample. Many paruretics find this physically arduous and mentally devastating, in short—barbaric.
3. Failure of SAMHSA to provide for the mandatory use of alternative testing technology to any applicant who requests accommodation for a shy bladder condition.
4. Failure of SAMHSA to provide for medical evaluation of a paruretic, at which time a nurse or physician could obtain blood or urine samples.
5. Absence of specific regulations permitting people to provide urine samples by self-catheterization, which is how many paruretics routinely empty their bladders.
6. Failure to accept reasonable documentation or a written statement from personal physicians that:
   • the employee or applicant suffers from paruresis;
   • the employee or applicant has been examined and is not believed to be a user based on clinical criteria.
7. An unfortunate institutional mindset at SAMHSA (and certainly within the MRO community) that has for the most part been very skeptical of the validity of shy bladder syndrome.
8. Inadequate training requirements for urine collectors.
9. Lack of adequate, if any, administrative appeal process and redress.
10. The high false positive testing rate for shy bladder donors.

IPA is committed to working with SAMHSA, the Medical Review Officer (MRO) community, and drug testing manufacturers. Our goal is to improve regulations and procedures so that people with paruresis are provided reasonable accommodation and not denied employment or access to any kind of activity.

The International Paruresis Association (IPA) is a 501(c)(3) non-profit organization whose purpose is to help those afflicted with paruresis overcome the stigma, embarrassment, and isolation associated with the condition by educating the public, advocating effective treatments, and advancing related research. Since the founding of IPA in 1996, the organization has grown to over 800 members in the USA.