Why the “Standard” Drug Testing Panel Isn’t Enough

A close-up of a healthcare professional wearing a white lab coat and blue gloves, inserting a cotton swab into a transparent test tube, likely for oral fluid drug testing.

Many organizations still use the US DOT (Department of Transportation) 5-panel drug test. It’s familiar and referenced in many policies, but is it enough? Not anymore. Limiting your panel to cannabis, cocaine, amphetamines, opioids, and PCP leaves serious gaps. Substances like fentanyl, benzodiazepines (think Valium™), and many over-the-counter drugs (such as Wake-Ups™) are widely used … Read more

What Is a Substance Use Expert and Why You Need One

A woman sits on a couch with hands clasped nervously while a professional takes notes on a clipboard, suggesting a counseling or consultation session. The scene conveys a supportive and confidential environment, possibly related to health, substance use, or mental wellness.

In my work with safety-sensitive industries, I often hear the same questions when substance use becomes a workplace concern: “What happens next?” “How do we ensure fairness?” “Is this a safety risk or something deeper?” That’s where the role of a Substance Use Expert (SUE) comes in. Some of you may know this as a … Read more

Can We Objectively Measure Safety Risk? Why Testing Alone Isn’t Enough

Group of adult learners seated at desks in a bright classroom, attentively engaging in a training session. Some are taking notes while others work on laptops.

As workplaces continue to evolve their substance use policies, one recurring question is this: Can safety risk really be measured objectively? It’s a fair question and one that doesn’t have a simple answer. While alcohol impairment testing has been widely accepted and standardized for decades, cannabis and other substances present a more complicated picture. The … Read more

Why Medical Review Officers Matter

Close-up of a healthcare professional typing on a laptop with digital medical checklists and health data icons floating above the keyboard, representing electronic health records.

When we talk about fostering safe workplaces and healthy people, it’s easy to focus on policies, training, and testing. But behind the scenes, there’s a critical player ensuring those drug and alcohol testing programs are not only effective, but fair, accurate, and legally defensible. That player? The Medical Review Officer (MRO). As a workplace substance … Read more

Perception vs. Reality: How Views on Substance Use Complicate Workplace Safety

Female worker in a hard hat and safety vest sitting at a desk in a warehouse, holding her head with both hands in a stressed or focused posture.

As cannabis use becomes more normalized and socially accepted, employers face a growing challenge: how to balance shifting cultural attitudes with the ongoing need to maintain a safe work environment. Let’s continue the conversation about moving away from the vague and often unhelpful concept of “impairment” and focusing instead on safety risk. But even that … Read more

Understanding Safety Risk: It’s More Complicated Than You Think

Close-up of a safety carabiner clipped to an orange railing, with a worker in a safety harness in the background. Emphasizes workplace safety.

Workplace safety is a top priority, yet many employers still struggle with how to address substance use in a way that is practical, fair, and legally sound. The issue is often framed around impairment, but as I’ve discussed before, impairment is a subjective and emotionally charged term that does little to help workplaces make informed … Read more

Introducing the International Association of Medical Review Officers (IAMRO)

As Chair of the International Association of Medical Review Officers, I am pleased to introduce this recently formed not-for-profit specialty organization. Who We Are IAMRO is a professional membership association of physicians and medical practitioners who provide Medical Review Officer (MRO) services in their respective countries of practice, health professionals and auditors who are Subject … Read more

Impairment: The Most Misunderstood Word in Workplace Safety

Close-up of a person holding a joint, with smoke rising from the end, indicating cannabis use.

As a workplace substance use consultant, I’ve seen firsthand how society often oversimplifies “impairment” as a clear state of incapacity. But the reality is far more complex. Every one of us has experienced some form of impairment—whether from alcohol, fatigue, stress, or other factors—which makes the word profoundly emotional and often misunderstood. In workplace contexts, … Read more

Navigating Substance Use Policies During Holiday Gatherings

People celebrating at a festive event, joyfully blowing colorful confetti into the air. The vibrant scene captures a sense of fun and camaraderie, with bright decorations and cheerful energy.

With the holidays upon us, many companies are planning gatherings to celebrate. It’s a time for connection and relaxation and also an important moment to consider best practices around social hosting and workplace safety when alcohol or other substances are often a part of the festivities. For many of you, this won’t be new advice. … Read more