RASTREIO DE SUBSTÂNCIAS PSICOATIVAS NO TRABALHO: Workplace Psychoactive Substance Screening: Clinical Utility and Legal Framework in Portugal

Authors

Filipa Duarte Costa, Unidade Local de Saúde do Alto Ave; Juliana Rodrigues, Unidade Local de Saúde do Alto Ave; Bárbara Oliveira e Silva, Unidade Local de Saúde do Alto Ave; Joana Peixoto, Unidade Local de Saúde do Alto Ave; Pedro Matos, Unidade Local de Saúde do Alto Ave; Sílvia Oliveira, Unidade Local de Saúde do Alto Ave

Synopsis

The use of alcohol and other psychoactive substances in the workplace represents a significant occupational health concern, affecting work performance, safety and accident rates. Toxicological screening has been increasingly used as a risk management tool, although it raises technical, clinical, and ethical-legal challenges. Objectives: To critically analyze the clinical usefulness, technical  limitations, and legal framework of workplace psychoactive substance screening in Portugal within the
scope of Occupational Medicine. Methodology: A narrative literature review was conducted,  complemented by technical and regulatory document analysis. Searches were performed in biomedical databases and occupational health journals, alongside relevant national legislation and guidelines. Results: Evidence shows that workplace screening programs mainly rely on rapid  immunoassays, with mandatory confirmation by highly specific chromatographic methods. Biological matrices differ in detection windows and interpretative limitations, requiring careful clinical integration by the occupational physician. Conclusions: Toxicological screening should be framed as a preventive, non-punitive strategy aimed at health promotion, risk reduction, and safe worker rehabilitation, with Occupational Medicine playing a central and irreplaceable role.

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Published

1 March 2026

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This work is licensed under a Creative Commons Attribution 4.0 International License.