The Wake-Up Call We Forget We're Delivering: The Human Side of Drug Testing

Process protects organizations. Compassion protects people.

I have been in this industry for more than twenty years. I have worked collections, managed programs, consulted with employers, and sat across from more people than I can count who were about to have one of the worst days of their professional lives.

I know the look. The person who walks into a collection site already knowing what the result is going to say. They are not thinking about their substance use in that moment. They are running through the math in their head. What does this mean for my job? What do I tell my family tonight? How do I pay my mortgage next month? How do I afford...anything?

Those are the questions I hear. Sometimes out loud. Sometimes just written across someone's face.

What I almost never hear and what stopped me cold when I read a recent post from Dr. Melissa Snider-Adler, an Addiction Medicine Physician I connected with at the NDASA Annual Conference last week, is this:

"I really need this."

Or this: "Thank God. My life has been saved."

Dr. Snider-Adler shared a story about an employee she spoke with who had tested positive and, in that conversation, told her he needed help. He had been trying to stop on his own. The problem had grown bigger than he was. And the test, the result that most people in our industry treat as an endpoint, was for him a beginning. He thanked her for being non-judgmental. For listening. And then he said he wished he had been tested months earlier, when he first knew he needed help.

I have been thinking about that story ever since.

We Have Become Very Good at the Process

What we rarely talk about is the human side of drug testing.

Our industry is exceptionally good at the mechanics of drug testing. Collection protocols. Chain of custody. Turnaround times. Compliance thresholds. Result reporting. We have built systems that are efficient, defensible, and scalable.

What we have not always been good at is remembering what sits on the other side of those systems.

A person.

Not a specimen. Not a file number. Not a liability exposure. A person with a family, a mortgage, a history, and in some cases, a problem that has grown bigger than they can manage alone. The positive result that ends their employment may also be the first time anyone in authority has ever said, through action if not words, that what is happening to them cannot continue.

That is not nothing. That is potentially everything.

Compassion Is Not the Opposite of Compliance

I want to be clear about something, because this is where I think the industry gets uncomfortable with this conversation.

Compassion in drug testing does not mean lowering standards. It does not mean overlooking policy violations or creating exceptions that undermine the integrity of a program. Safety sensitive environments exist for a reason, and the consequences of impaired employees are real and sometimes fatal. None of that changes.

What changes is the orientation of the people administering and enforcing these programs. The collector who processes a specimen without making eye contact. The manager who recites policy without acknowledging the human being sitting across from them. The employer who treats a positive result as a transaction to be processed rather than a moment that may genuinely alter the course of someone's life.

Compassion does not require changing the process. It requires remembering why the process exists.

What the Person Walking In Is Thinking

When someone comes in for a post-incident test or a reasonable suspicion test and they already know what the result will say, their mind goes immediately to the surface. The job. The income. The conversation they are going to have to have at home tonight. These are real and legitimate fears and I do not minimize them.

But underneath those surface fears is often something they are not yet ready to look at directly. An acknowledgment that things have gotten out of hand. A quiet understanding that the path they are on is not sustainable. A part of them that has been waiting, maybe for a long time, for something external to force the change they have not been able to make on their own.

The test is that something. It does not feel like relief in the moment. But for some people, it becomes that.

Dr. Snider-Adler's post reminded me that our industry touches people at one of the most vulnerable moments of their professional and personal lives. What we do with that moment matters beyond the compliance outcome.

What This Means for Safety Managers

This conversation started at NDASA among drug testing and compliance professionals. But it belongs in the safety world too, and it connects directly to what I will be presenting at ASSP Safety '26 in Anaheim on June 17th.

A safety manager initiating a reasonable suspicion test is not just executing a compliance process. They are intervening in a human situation. The way that conversation is handled, the tone, the language, the presence of judgment or the absence of it, shapes what happens next for that employee far beyond the test result.

That does not mean the process changes. It means the person running the process understands what they are actually doing.

A supervisor who has been trained not just in what to look for but in how to handle the moment with professionalism and basic human decency is a supervisor who gets better outcomes. Better documentation. Less resistance. And occasionally, they are part of a chain of events that genuinely changes someone's life.

That is not a soft argument. That is a practical one.

The Industry Conversation Worth Having

I left NDASA thinking about this more than almost anything else from the conference. Compassion is not a word that comes up often in compliance circles. It feels at odds with the language of policy enforcement and regulatory frameworks.

But Dr. Snider-Adler's story about that phone call, and the words "I wish I had been tested months ago," is a reminder that the machinery we have built exists to serve people. All of them. Including the ones on the hardest side of a positive result.

We do not have to choose between running a tight program and being human about it.

We never did.

If this conversation resonates with you, I would welcome the chance to continue it. Whether that is at ASSP Safety '26 in June or directly, reach out.