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Substance abuse screening in the workplace is common today, yet the rate of substance abuse at work seems to be increasing across North America. Many argue that employers should not be allowed to engage in substance abuse screening in the workplace, but others argue that the safety of all workers is paramount. Substance abuse at work does not just affect the user, everyone around the individual is also at a higher risk of injury because of the actions of the user. Employers have a responsibility to provide safe working conditions. In the USA most places of employment are substance abuse free, and few employers skip substance abuse screening and testing. For cause substance abuse testing is viewed more favorably than random testing and pre employment screening.

If substance abuse screening in the workplace is not performed many employers are concerned that they may be held liable for any substance abuse at work if an employee is injured because of this fact. If an individual is engaging in substance abuse at work then they could be less likely to work safety and use all of the proper precautions. There have been instances of people being seriously injured or even killed because someone else was drunk, high, or under the influence of drugs. Substance abuse testing by employers can identify any issues, and the employer can insist on substance abuse treatment in order to get the individual the help that they need. Many companies have policies in place to prevent an employee who admits to substance abuse from being terminated as long as the individual gets substance abuse treatment.