"Pee-phobia" (paruresis) and drug testing

Interesting guest column in the Post-Dispatch I just read at lunchtime: “Fairness vs. phobias”

By Steven Soifer, Executive Director of the International Paruresis Association, the article discusses persons who are psychologically unable to give a urine sample during a random drug test.

Sound crazy? Yes. But it happens more frequently than people realize, and not because the employee is a drug user.

[T]he culprit is an anxiety disorder known as paruresis, or shy bladder syndrome, which prevents sufferers from physically being able to produce urine samples on demand. According to a Harvard study, some 17 million men, women and children in the United States alone suffer from this social phobia.

After the fear of public speaking, it is the second most common social phobia. While symptoms range from mild to severe, many fall in the middle, when stress and anxiety make it virtually impossible to urinate when others are present.

This is exactly the situation during drug testing, and it is not recognized as a legitimate reason for the inability to produce a sample. In fact, the failure to produce a sample is automatically considered a positive for drug use, despite lack of any evidence to prove this allegation. . . .
A saner approach is available. The federal Substance Abuse and Mental Health Services Administration plans to revise the federal regulations concerning drug testing to allow alternative sampling such as hair and saliva to be used for drug testing of federal employees. Once adopted, these new federal regulations will spread through private industry. Some Fortune 500 companies already use alternative drug testing methods. . . .

Along with impotence and incontinence, paruresis is among the more embarrassing and humiliating health issues, one that sufferers are reluctant to discuss. Many capable people remain unemployed, underemployed or in low-level jobs because of drug testing issues, causing an uncounted amount of lost productivity as well as personal hardship.

This is an issue that companies should be prepared to address when they engage in drug testing.

Certainly, if alternative means of testing are equally accurate and no more expensive, they should be considered.

At a minimum, employers should be aware this is potentially a legitimate reason for “failure to cooperate” with urinalysis drug testing.

Obviously, the difficulty is it can also be a very convenient excuse for drug users seeking to avoid detection. I would suggest waiting for an employee to raise the issue and then requiring a professional medical opinion before allowing the employee to comply with mandatory testing through alternative means of testing.

More information on the condition here and here.

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