Drug Testing In Life Underwriting

As most producers know, life insurers screen for one drug of abuse routinely. That drug, of course, is cocaine, and the industry has been testing for it in both urine and oral fluid for many years.

However, cocaine is not the only abused substance that has attracted underwriters’ attention. While nearly all carriers include cocaine testing in their urine profiles, both marijuana and methamphetamine are also under “surveillance” on some basis by certain insurers.

When underwriters started screening for cocaine (actually, for its primary metabolite, benzoylecgonine), the main concern was what underwriters did not know about users. Cocaine use is a formidable risk-taking behavior, typically associated with heavy alcohol and tobacco use, unsavory associates and many other insurability red flags.

In recent years, cardiology studies have provided a second motive for doing this “nose candy” testing: the prevalence of circulatory consequences linked to both occasional and habitual use.

A surprising number of heart attacks under age 40 are induced by the acute effects of cocaine ingestion. Cocaine also enhances the risk of early-onset atherosclerosis, no doubt in part due to other undesirable health habits so often seen in regular users.

Overall, labs now report that two specimens per 1,000 are cocaine-positive, with the rate almost twice as high in men. This rate has declined by almost 50% in the last decade, consistent with the rise of “crystal meth” as the Number One abused stimulant in America.

Lab data show that the highest incidence of cocaine positives in both genders is–believe it or not–at ages 40-49, and while the likelihood is greater at lower face amounts, seven-figure (and even larger) applications are often seen with telltale evidence of cocaine abuse.

Toxicology studies have shown that widely-spaced use is probably detected only within 4 days or less after ingestion. Heavier indulgence, on the other hand, can be unmasked after a week or more of abstinence.

The confirmation test used by insurance laboratories is as fool-proof as any in laboratory science. In other words, if you test positive, you used cocaine! However, there are rare scenarios wherein the proposed insured could do so unwittingly.