Workplace drug testing experiences: A qualitative analysis of structural challenges

Workplace drug testing (WDT) is common in high-risk occupations, yet the psychosocial and institutional impacts of false-positive results remain underexplored. This qualitative study conceptualizes unconfirmed false-positive WDT results not merely as analytical errors, but as workplace crises intersecting medical authority and employee vulnerability. This qualitative study is based on semi-structured interviews conducted with 14 participants who received false positive WDT results during pre-employment screening, drawn from a pool of 471 individuals tested over the past two years. The findings reveal five themes: the false-positive experience, perceptions of organizational processes, psychosocial effects, losses, and policy expectations. Participants reported profound psychological distress, fear of stigmatization, and severe erosion of trust in healthcare systems, exacerbated by poor communication and stigmatizing attitudes. Furthermore, these experiences translated into tangible losses, including stalled or abandoned careers and significant financial burdens during the waiting period for confirmatory tests. Highlighting a critical need for preventative clinical history taking and transparent communication, the study concludes that mismanaged WDT outcomes generate profound workplace stress. To protect employee well-being and prevent unfair material losses, organizations must integrate ethical and psychosocial considerations to foster a “just culture” within their WDT frameworks.