Have you ever sent an employee for a drug screen only to have them not be able to provide a specimen for testing? If so, were you prepared with a backup plan? If not, you should review your testing policies and make sure you have a plan in place. Being unable to provide a specimen or having a “shy bladder” could be caused by a medical issue and may be covered under the Americans with Disabilities Act (ADA).

Some people suffer from paruresis which is commonly referred to as shy bladder syndrome. Shy bladder is a social anxiety disorder and people with this condition have difficulty urinating in public and in extreme cases the person can only urinate in total privacy. According to the International Paruresis Association studies have shown that approximately 21 million Americans suffer from this condition.

There is no one single cause for this affliction, but some of the causes are:

• Being scolded or embarrassed by parents

• Being teased or harassed in a public restroom

• Being sexually abused in a rest room

Another cause could be benign prostatic hyperplasia, or prostate gland enlargement. This is a condition common in older men and can block their ability to urinate, thus leaving them unable to provide a specimen for a drug test.

Prescription medications may also cause the inability to urinate, or “urinary retention”. Some of these types of medications are:

• Antihistamines

• Anticholinergics/antispasmodics

• Tricyclic antidepressants

• Decongestants

• Amphetamines

So, what does all of this have to do with the ADA? While the ADA has not given any conclusive guidance or an official opinion, they did provide information in a response to P. David Lopez, General Counsel for the EEOC.

In the letter they reiterated that determination of a disability is based on individual assessment. The ADA definition of a disability is:

1.      a physical or mental impairment that substantially limits one or more major life activities (sometimes referred to in the regulations as an “actual disability”); or

2.      a record of a physical or mental impairment that substantially limited a major life activity (“record of”); or

3.      when a covered entity takes an action prohibited by the ADA because of an actual or perceived impairment that is not both transitory and minor (“regarded as”).

Basically, employers should look at these conditions as they would any other disability and provide reasonable accommodations. With drug testing there are other options such as hair and saliva testing, that are readily available alternatives, so implementing a back-up plan should be painless.

As with all corporate policy, make sure you review your policy with all applicable laws/regulations, and review with your corporate counsel before enacting the policy.

Additional ASE Resources
ASE Drug Screening - ASE can accommodate all of your drug screening needs, including: pre-employment, random,  reasonable suspicion, and post-incident testing. For more information contact Susan Chance.

ASE Handbook Development- If you would like your current drug testing policy reviewed, revised, or a new policy created ASE can help.  Contact Mike Burns.