A study of records for 1 large U.S. company revealed that employees with positive drug screens were fired, whereas workers who self-disclosed drug/alcohol problems remained employed. Both groups were offered substance abuse intervention, and some previously fired workers were rehired after they received treatment. Accident results showed that drug-test positive employees, as compared with self-referred workers, had a significantly higher accident rate in all categories. Treatment data revealed that drug-test positive workers had significantly higher accident rates before and after treatment than self-referred employees. Posttreatment results showed that drug-test positive employees had a significant decrease in accidents after services, whereas the self-referred group showed no change.