Positive drug test – how the employer handles it correctly
A structured action plan from the first positive rapid test to confirmation, MRO review, the conversation, rehabilitation and possible dismissal.
Few situations are as difficult for a manager as a positive drug test. Decisions must be made quickly, emotions run high and the legal position is strict. A prepared action plan – often as part of your alcohol and drug policy – makes all the difference.
Step 1: Immediate action – safety first
In the event of a positive rapid test in a safety-critical role (driver, machine operator, healthcare staff), the employee must immediately be removed from safety-critical duties. This is not a punishment – it is a work environment measure. The employee remains on paid working time; no action has been decided yet.
Step 2: Confirmation analysis
A rapid test is never final. The sample must be sent to the lab for confirmation using GC-MS or LC-MS-MS – read more about the full chain of custody. Allow 1–2 working days. During this time, the employee is still removed from safety-critical duties, but may be able to work in another role if one is available.
Step 3: MRO review
The MRO physician contacts the employee and asks about legitimate medical explanations – prescriptions for opioids, ADHD medication, codeine, etc. Many substances have cross-reactions that can explain a positive result. The MRO assesses whether the explanation is credible and makes the final report of "positive" or "negative".
Step 4: The conversation
In the event of a confirmed positive result (after the MRO review), the HR manager and the immediate manager hold a structured conversation with the employee. The presence of a union representative must be offered. During the conversation:
- Confirm what has happened – factually, without moralising
- Describe the consequence based on the policy
- Listen to the employee's explanation
- Offer rehabilitation in accordance with the employer's obligation
Step 5: Rehabilitation assessment
Under the Swedish Work Environment Act (Arbetsmiljölagen), the employer has a responsibility for rehabilitation. An assessment is carried out with the occupational health service or the MRO physician: is there a substance misuse problem? Is treatment needed? Can the person return to work with follow-up tests?
Skipping the rehabilitation assessment and going straight to dismissal is one of the most common – and most expensive – mistakes in drug incidents. On several occasions, the Labour Court has declared dismissals invalid where the rehabilitation responsibility had not been fulfilled.
Step 6: Structured return-to-work programme
If a return is possible: a written programme with defined requirements. Typical content:
- Being drug-free, demonstrated through regular follow-up tests (usually 6–24 months)
- Contact with treatment services where needed
- Clear consequences in the event of relapse
Step 7: Documentation
Everything is documented in the HR system in line with GDPR procedures. In any later proceedings, documentation is decisive – an undocumented action is as good as no action at all.
In the event of relapse or refusal
If the employee refuses rehabilitation, refuses follow-up tests or relapses, dismissal may become relevant. Prerequisites: that the rehabilitation responsibility has been fulfilled, that proportionality is maintained, and that negotiation under Section 14 of the Co-Determination Act (MBL) has been carried out if required.
Common mistakes
- Acting on a rapid test without confirmation
- Skipping the MRO review
- Failing to carry out a rehabilitation assessment
- Not offering union representation
- Inadequate documentation
Do you need support with a current incident?
Provsvaret can provide support during ongoing incidents – with MRO review, express analyses and advice on rehabilitation set-ups. Get in touch immediately.
Want to know more?
Contact us for personalized advice on drug testing and how we can help your organization.
