Never been randomly tested , had a D&A at my medical prior to starting and have had one for cause following an incident which was later found to be not my fault . Both times even though I knew I had not consumed Alcohol for plus 24hrs prior to the test and have not taken any drugs I had a slight bit of anxiety for sure .
Never had a random in 10 years but have known others be called up more than once in that time . As said it seems totally random , even known someone have a for cause following an incident then get a random a month or so later .
Ive never known anybody sacked following random screening although I know a few who have come clean and resigned prior to taking the test , there have been a few I know of that have been sacked following for cause testing after incidents .
The thing is even for cause testing can be random as other people have pointed , you could have a signal go back on you or have some other incident that is not your fault and still be required to have a sample tested .
Not always a formality if someone has been away for a long period - there might be a medical to ensure someone remains able to do safety-critical work or will need to be on restricted duties. But yes, it might not require D&A.
Ive never heard of a resumption medical including a D&A but then again they usually just focus on the area causing absence unless a periodical medical has been due whilst off sick but my experience is that periodical medicals dont automatically feature a D&A .
I would hope that a D&A might be considered if someone has been off sick seeking assistance for a D or A problem .