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July 12, 2004
The International
Paruresis Association (IPA) submitted comments to the US Substance
Abuse and Mental Health Services Administration (SAMHSA) regarding
proposed revisions to the guidelines for workplace drug testing
to include alternatives to urine testing. The IPA submitted its
comment along with 130 others addressing the issue of paruresis
and its impact on violations of fair employment practices. The
IPA’s response is available as a PDF file (340KB). Adobe
Acrobat Reader is required.
The complete
list of public comments to SAMHSA can be viewed here as well.
More than one
third of the 284 public comments SAMHSA received concerned paruresis
and the unjust effects of existing drug testing regulations.
In particular,
the most vexing aspects of current SAMHSA regulations for donors
with paruresis are:
- The unjust
insistence by SAMHSA, employers, and MROs that failure to provide
a specimen equates with refusal to take a drug test, and that
such "refusal" is grounds for not hiring or for firing.
- The "shy bladder protocols" which require donors with
paruresis to remain at a testing site for three hours, even though
in many cases subjects are in severe pain of urgency and cannot
produce a sample. Many paruretics find this physically arduous
and mentally devastating, in short—barbaric.
- Failure of SAMHSA to provide for the mandatory use of alternative
testing technology to any applicant who requests accommodation
for a shy bladder condition.
- Failure of SAMHSA to provide for medical evaluation of a paruretic,
at which time a nurse or physician could obtain blood or urine
samples.
- Absence of specific regulations permitting people to provide
urine samples by self-catheterization, which is how many paruretics
routinely empty their bladders.
- Failure to accept reasonable documentation or a written statement
from personal physicians that:
- the employee
or applicant suffers from paruresis;
- the employee
or applicant has been examined and is not believed to be a user
based on clinical criteria.
- An unfortunate institutional mindset at SAMHSA (and certainly
within the MRO community) that has for the most part been very
skeptical of the validity of shy bladder syndrome.
- Inadequate training requirements for urine collectors.
- Lack of adequate, if any, administrative appeal process and
redress.
- The high false positive testing rate for shy bladder donors.
IPA is committed
to working with SAMHSA, the Medical Review Officer (MRO) community,
and drug testing manufacturers. Our goal is to improve regulations
and procedures so that people with paruresis are provided reasonable
accommodation and not denied employment or access to any kind of
activity.
The International Paruresis Association (IPA) is a 501(c)(3) non-profit
organization whose purpose is to help those afflicted with paruresis
overcome the stigma, embarrassment, and isolation associated with
the condition by educating the public, advocating effective treatments,
and advancing related research. Since the founding of IPA in 1996,
the organization has grown to over 800 members in the USA.
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