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Urine Testing History

If you’d take its advocates seriously, you’d believe that drug tests were intended solely for diagnostic, health-related reasons—and not for persecuting substance users or intimidating workers. Nothing surprising here. Favorable public perception is important to the Drug Industrial Complex and its advertising agencies, even if it means doctoring the truth. To workers caught with their pants down or skirts up, the manufacturer’s intent is academic. Who cares why the damn thing was invented when you still have to fill the cup?

Urine screening is detection in its rawest form. Guilt before innocence, chemical finger-pointing, surveillance—all associations the Reagan Enforcers are eager to avoid. Diagnosis, on the other hand, sounds therapeutic. Diagnosis, on the other hand, sounds therapeutic. Brochures and trade advertisements of the late seventies turned the privacy violation into an almost altruistic gesture, completely in line with modern medical procedures. “More than thirty EMIT assays are available to measure levels of therapeutic drugs […] such as those used to treat heart conditions, asthma, and epilepsy, to aid (physicians) in adjusting drug dosages for save and effective treatment,” reads a typical brochure put out by the Syva division of Syntex, a manufacturer of high-tech lab equipment. Ultimately, brochures get around to mentioning detection of drug abuse but always in the language of clinical diagnosis, not surveillance. This is tantamount to saying a urine test is good for you.

Testing consultants, the hundred-dollar-an-hour types, loved this angle. They first marketed their services to rehabilitation clinics as a means of ensuring that patients stay drug-free. “Establishing the diagnosis of chronic heroin addiction involves consideration of the patient’s history, physical examination, and results of the urine test […]. The earlier the problem is recognized, the easier it is to reverse,” recommended one study. No mention was ever made of test results being used for other than medical reasons, by the police or employers.

As the drug phobia intensified, test developers got bolder. They took less trouble discussing the real uses of the urine test, and eventually dropped all pretense: “Immediate reliable drug detection has never been this easy,” now boasts Syva. Meaning that within minutes you’d know whom to fire. Or bust. Or ship off to a rehabilitation program, needed or not.

The strategy paid off. The employers hungered to know, and the urine experts were more than ready to answer the call of nature. Almost overnight, hundreds of chemical companies and laboratories blossomed across America, some equipped with little more than a two thousand dollar machine, minimum wage specimen handlers, and a Yellow Pages ad. A billion-dollar industry was born.

In contrast to the flamboyant and violent history of drug empires, the history of the urine test is hardly Hollywood material. Despite little bloodshed, though, there are just as many power struggles and politics. Ultimately the plot reveals the havoc government and private enterprise can wreak when they work too closely together.

Chemical detection has long been an intrinsic component of science. In the days of the Roman Empire, physicians and oracles scanned, sniffed and tasted human by-products on their way to diagnosis and fortune-telling. Leonardo DaVinci was one of the many alchemists who studied compounds and excretions in the hope of turning them into gold. It’s been human nature to torture molecules, forcing them to confess their secrets of creation. Gradually the process became somewhat standardized.

As we might have expected, the breakthroughs leading to modern biochemical screening came not from academic curiosity, but military necessity. When the U. S. Government wanted a devastating new bomb in the forties, basic physics and chemistry became important business. Research funds led to particle accelerators, spectrum analysis, gas chromatography, and radiation identification, all methods of zeroing in on the basic component of the molecule—the atom. Along the way, scientists became good at positively identifying specific molecules as components of mysterious chemical soups.

At first the War Department (as it was more honestly named) didn’t consider applying this new science on people. During World War II the emphasis was on destruction, not detection. Only a small group of physicians saw its potential, first for forensic applications and later diagnostic needs. But the equipment was expensive, the domain of specialized hospitals and research facilities. For a long time, the technology lay dormant.

Drug testing of healthy individuals arrived comparatively late. In the sixties America became aware of “recreational” drug use. It began a counterculture and emerged as a social explosion. Conservative elements, alarmed over losing Vietnam and possibly a generation, banded together in an attempt to control “unacceptable social behavior.” One outgrowth was the National Institute of Drug Abuse (NIDA), a Washington money pit responsible for analysis—clinical and social—of the drug scene. NIDA was the institutional force which put the fear of widespread addiction into the public consciousness.

Paranoia seems inextricably linked to bureaucracy. The Defense Department was afraid the wide-scale heroin use among troops in Vietnam would take root in the States when the “grunts” came home. Behavior tolerated ten thousand miles away simply could not be allowed the same latitude stateside. Something had to be done. The solution lay in finding methods of screening GIs for heroin addiction. NIDA, which wanted nothing more than the chance to develop a drug test, found eager allies at the Pentagon. When NIDA applied for research money, the alliance conjured the nightmare of hordes of heroin addicts—bitter, trained to kill, and, of course, black—returning to our peaceful shores as an epidemic. Red tape was cut and grant money guaranteed.

As usual the public knew little of this. The Pentagon minimized the high level of addiction among returning veterans, so funding and research were removed from scrutiny, and always downplayed.

The urine test is as much a product of human persistence as technology. One of the industry pioneers, the Einstein of urine testing, is Dr. Robert L. DuPont, Jr. In 1971 DuPont started a seven year stewardship as the first head of NIDA, and later as Director of the Special Action Office for Drug Abuse Prevention. Right off he began a crusade to elevate drug abuse to the top echelon of governmental concern. In the mid-seventies, he emphasized honest drug education. NIDA even sponsored research into beneficial usage’s of illicit substances. With Carter as President, the nation developed a more relaxed, albeit cautious, attitude toward drugs. DuPont adapted to this style, even conferring with NORML, about the possibility of marijuana decriminalization. The nation’s real drug problems, he said publicly, were alcohol and tobacco. Commission reports and studies sponsored by NIDA just ten years ago would be considered overly permissive, even radical by today’s standards.

But DuPont, at heart a conservative, was preparing for a clamp down. While many states were decriminalizing possession of marijuana, NIDA quietly urged selected companies to improve methods of detecting individual drug use. Syntex had researched biochemical testing through its Syva division as early ads 1966 but had lost interest in the field until NIDA opened the door to government money.

The first joint success was the immunoassay, a complex test procedure utilizing chemical binders for illegal substances. “Working togeïùãù through the seventies, NIDA and Syva developed neat little EMIT urine tests for heroin, cocaine, speed and PCP that are still used,” noted Dean Lattimer, a general in the War on Urine Testing for High Times Magazine. The immunoassay met all NIDA’s requirements: It provided sensitivity to very low concentrations of drugs; it was a procedure that could be easily taught and performed; and it was relatively inexpensive. The mere fact that it wasn’t particularly accurate didn’t seem to bother anybody. Roche Diagnostics developed a competitive, equally flawed, screen—Abuscreen—alongside Syva.,

NIDA’s role in promoting the immunoassay became a prestigious and eventually a financial coup for DuPont. At first, like the test developers, he intimated that the procedures would be confined to medical applications. In his preface to a 1973 Urine Testing Guide, he wrote: “Urine screening for drugs of abuse has become a necessary adjunct to treatment (of addiction).” When it later became apparent that Regan was about to trounce Carter in the 1980 election, Carter administration appointees hoping to survive shifted to the right. It was no longer healthy to confer with NORML. In urine testing, diagnosis took a back seat to the possibility of mass surveillance. The repercussions of Watergate wore thin, and tight restrictions on FBI, CIA, DEA, and other intelligence gathering agencies were loosened. Open vials of cocaine, which had once enjoyed high status in Washington, were now kept out of sight. The atmosphere changed rapidly.

DuPont, despite a basic anti-drug attitude, was guilty by association with the trend toward liberalization. And at the time, he could find no niche in the New Order. He seemed to be soft on drugs and resigned (read: was squeezed out) from NIDA. He quickly signed on as head of the American Council on Marijuana (ACM, later the American Council on Drug Education), a quasi-scientific fear-mongering group.

Outlasting three Presidents, DuPont had developed survival instincts and a keen nose for shifting political winds. His “born-again” zeal on the dangers of drugs restored his hard-line image and caught the attention of the White House. The Reagans welcomed him back and urged him to resurrect the tests that he had helped create. He could be tough on drugs and gain power at the same time. What was once considered a conflict of interest had among the supply-siders become good efficient government.

DuPont forged the link between government, private agencies, and industry. The combination of large scale funding, new technology, and propaganda precipitated the rapid growth of the Testing Mentality. Speculative equipment houses and laboratories began training personnel and opening satellite facilities, some before the urine tests were even commercially available.

Ironically, the most prevalent of the illegal drugs—marijuana—proved to be the most elusive in terms of immunoassay delectability. Without a pot screen, EMIT had as much of a chance in the market as a breathalyzer that couldn’t recognize alcohol. The reason was obvious: marijuana, although relatively benign, had millions of users. It was really the symbol of the sixties counterculture and, through the decriminalization movement, gained dangerous widespread support. Alaska made possession of up to four ounces of pot legal in the confines of one’s home. Head shops were legitimate businesses. Cheech and Chong “pot” movies were big box office. But one of the hard-core tenets of the National Party Line is that pot leads to harder, more dangerous drugs. Therefore, stop pot and you nip drug abuse in the bud. The detection of marijuana usage became the primary focus of all research. Estimates are that fully ninety percent of all positive test results occurring today across the nation are for marijuana.

Researchers pursued the complex metabolic path of cannabis with the gusto of small-town dogcatchers, but even unlimited grant dollars couldn’t expedite an accurate test. Finally a compromise was reached. Instead of search for a primary THC metabolite—the one responsible for the high—an assay would look for a more accessible but inert chemical. Called THC carboxylic acid, it doesn’t produce the high, but remains in the body for weeks after exposure to the drug. The accuracy would suffer, but tests for the presence of marijuana, however old, were enough to satisfy the developers.

This logic paralleled that of drug detection in the thirties, when opiate testing was based not on finding opium but the more easily detected quinine, the most common “cut” for heroin. Screening for THC carboxylic acid means the equipment is not searching for the chemical that impairs job perf9ormance. As we shall alter see, it is mistaken for metabolites of other substances, which are quite legal.

Whatever scientific objections were raised got shouted down by the sales division. In 1980 excited public relations staffers at ACM and Syva revealed the EMIT cannaboid test. The Bladder Cops were now armed and dangerous. For the first time, the power brokers took notice. And they smiled. The EMIT assays, conceived as an adjunct to medical practice, were now being pedaled as the ultimate snitch.

What followed seemed more like a circus than the workings of responsible government. The ACM and NIDA, hand in hand, hawked the immunoassay as the final solution to the Drug Menace, which itself was being touted as the chief threat to “traditional social values. This symbiotic relationship between the urine test and the chief social evil allowed one to feed off the other. In a more rational era, all this would have been laughed off as pseudo-science. According to Dr. Oscar Janiger, a noted Los Angeles psychiatrist who has worked with drugs and addiction for over fifty years, “No respected scientist regards the urine test as anything more than quackery.”

Enter the three-martini lunch. Lavish banquet5s and conventions were instrumental in selling EMIT, in getting potential buyers hooked. Chemical cheerleaders wined and dined PTA groups, prison boards, corporation executives, rehabilitation counselors, and, of course, the military. Very few were in a position to question the basic science involved. Conferences took on the flavor of pep rallies. Can do, gung ho, U. S. A. all the way! A light to cast on the darkest evil scourge had been found.

Eureka! It Worked!

The entire medical diagnostic market by 1986 had total sales of $2 billion, six years after the THC test was launches. This includes all types of equipment, from CAT scans to microscope slides. Urine-screening devices, the youngest segment of that market, is easily the fastest-growing, representing sales of over $100 million. Wall street analysts predict a potential market in excess of $250 million annually by 1990. The Washington Post estimates sales of ancillary drug-testing paraphernalia could add another $150 million. And these are conservative estimates, made before Reagan announced his drug-free workplace in September 1986. Since then, as testing skyrocketed, analysts have doubled these projections.

Syva’s EMIT is currently the industry leader. An aggressive marketing staff and favorable political climate helped it ring up over $40 million sales in 1985, and almost $60 million in 1986. All this despite persistent negative evaluations by respected scientists. All this despite persistent negative evaluations by respected scientists. Hoffmann-LaRoche is second. Its Roche Diagnostic sold $20 million worth of abuscreen, its radioimmunoassay. A company spokesman predicts they will triple business by 1990.

But some folks are never satisfied. In an effort to boost sales, Syva established a consulting arm, called Performance Diagnostics. Armed with Syva’s client list, the division was “formed to help companies evaluate the presence or extent of the drug and alcohol problem in the workplace.” But it was really a front, another way to push the product.” But it was really a front, another way to push the product. Dr. John Morgan, Professor of Pharmacology and Medicine at Mt. Sinai Medical School, observed, “This service by Performance Diagnostics often included the recommendation of EMIT testing” (Morgan, Journal of Psychoactive Drugs, 10/84). To the surprise of no one.

Corporate giants are often successful in new markets if they go in with enough money, but urine testing isn’t just the domain of the big boys. It has attracted more than its fair share of entrepreneurs. After Reagan declared war on drugs, it seemed that everyone with a semester of high school chemistry was cashing in. Many have found success. The American Institute of Drug Detection in Rosemont, Illinois (which despite an academic-sounding name is a for-profit company), was founded in 1983 on a shoestring budget. Two years later it has tested over 100,000 specimens for major firms, including Exxon, General Mills, and my old jogging partners at the Chicago Police Department. This one small company experienced a 1985 sales increase of 450 percent over 1984. Profits for 1986 were expected to rise even higher. Keystone Medical Corporation, a subsidiary of Medical Diagnostics, sold nearly one million urine tests in its first year of operation, earning $4 million. And there are scores of others. Urine has literally and figuratively become the Gold Rush of the eighties.

Big money was made while researching urine testing, a lot of it off the taxpayers. During four administrations NIDA pumped millions in Syva and similar research programs. But the ones who really profited, both financially and in experience, were those in on the early development. Like Michael Deaver, who allegedly made millions on his friendships in the Oval Office, so too is the urine-testing industry saturated with influence selling.

Dr. Robert E. Willette was NIDA’s head of Clinical Research Technology. As a chemist, he oversaw development of EMIT from 1974 to 1981. When EMIT was on the brink of commercial success, Willette left the public sector and started his own consulting company—Duo Research in Annapolis, Maryland. Duo specializes in laboratory inspection and performance evaluation. For a sizable fee, a Duo team recommends improvements in technique, accuracy, publicity, and profitability. Above all, Willette exaggerates urine-test accuracy: “Chemical testing can be as close to 100% reliable as science permits.” Maybe someday, but not now, not with these tests.

Peter B. Bensinger, former director of the Department of Drug Enforcement, formed a partnership with Robert DuPont with the creative name B and D Associates. Together they effectively counsel corporations into establishing get-tough drug policies. Business is booming. Bensinger is probably the most outspoken proponent of mass testing. He has appeared on the Today show, and his articles appear regularly in national op/ed pages. The media regard him as the unofficial industry spokesman. Question on urine? Call Bensinger. It will be his job to destroy the premises of this book.

Robert T. Angarola, former general counsel to the White House Office of Drug Abuse Policy, is an attorney with the Washington firm of Hyman, Phelps & McNamara. He is also a urinalysis consultant. Angarola carried the Administration’s hardball approach to his private-sector clients: “The constitutional right to privacy protects people only against government (emphasis added) intrusion. Individuals acting as private citizens are not bound by these constitutional restrains. And this applies to private employers.” Sounds like Edwin Meese? Talk of giving such free reign to employers appeals to Angarola’s clients. These include Syva and Kidder Peabody, a brokerage house that started its drug-testing program in late 1985. Angarola’s job is to head off lawsuits by disgruntled employees. To avoid them, he urges workplace candor; a worker who knows about his company’s drug policy won’t mind having his privacy violated. So if you understand how the guillotine works, you won’t mind putting your head on the block.

In the small world of drug testing, these four—Angarola, Bensinger, DuPont and Willette—are affectionately referred to as the Gang of Four. Dr. John Morgan explains, “They are the ones responsible for a good deal of drug testing’s success, and some of the fear that goes along with it. Remember these names. These men are among the most competent and knowledgeable about drug testing—scientifically and politically. They are well-informed: they have to be. Their livelihoods depend upon their credibility. Unfortunately their expertise represents the greatest threat to the civil liberties we seek to protect. Know your enemy.

(Taken from Steal This Urine Test – Fighting Drug Hysteria In America – By Abbie Hoffman with Jonathan Silvers.)

Posted by A. Shapiro
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