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The Comprehensive Guide To Drug Testing
Law enforcement officials, doctors, schools, and employers use drug testing to determine whether there are any substances in your body. Today, hundreds of thousands of these tests are performed every year in work environments, hospitals, and schools.
In the guide below, we have compiled information about the subject, with factual knowledge to help you understand everything there is to know about drug testing. Read on to learn more:
What Is Drug Testing?
Otherwise referred to as drug screening, drug testing relates to any medical test performed to analyze biological specimen from the body. During such screening, the medics will examine your sweat, hair, saliva, blood, and just about any other part of your body.
The tests are perfect to detect the presence of or any prior use of illicit drugs and their metabolites. In such a case, metabolites refer to the inactive metabolizing form of the parent drug.
For most users, drug testing is a nightmare. This is because the substances you abused yesterday, over the weekend, or even during the last party you attended might still be lodged inside your body.
The Aims Of Drug Testing
Drug testing is performed to detect the abuse of any illicit drug among criminal offenders, athletes, job applicants, and participants in a rehabilitation program, among others. If the testing experts detect such use, you might typically have to endure some dire consequence.
Recent scientific advances have birthed sophisticated drug test types. As such, you might have to deal with the consequences of getting found with illicit substances in your body. The earlier you clean up, such as by attending rehab and undergoing detoxification, the easier it will be for you.
In the case of employment, drug and alcohol abuse tends to create significant health and safety hazards. Such abuse might also result in poor employee morale and decreased productivity, while also leading to additional costs for employers in the form of short term disability claims among other health care claims.
To this end, many employers have implemented drug testing to:
- Deter their employees from abusing drugs, alcohol, and other substances
- Protect the company from having to hire individuals who regularly abuse illicit drugs
- Be in a better position to identify employees who have alcohol and drug problems and appropriately refer them to the right rehabilitation facilities
- Provide safer work spaces for employees
- Improve consumer confidence in the safe practices of their employees
- Protect their customers and the general public
- Comply with federal regulations and state laws
- Benefit from premium discount programs on Workers' Compensation schemes
Types Of Drug Tests
In general, there are many types of drug testing. These types are divided into two broad categories: professional tests performed by qualified experts in sophisticated facilities and drug testing performed at home.
1. Drug Testing at Home
Some drug tests can easily be performed at home. These include oral fluid and saliva tests and urine tests. All you have to do is purchase the home drug test over the counter, collect a sample of saliva or urine, dip the kit in the collected sample and check the reading.
In many cases, you might also be able to buy home drug testing kits over the internet.
Pros of Home Drug Testing
- The testing kits are usually easy to use
- Testing strips are widely available both in stores and online
- Most of them will come with highly detailed instructions
Cons of Home Drug Testing
- Results from most of the cheap test kits are typically incorrect and misleading
The secret to successful drug testing at home lies in getting a high-quality test kits. However, even these types of kits might still not work correctly. To counter the problem, you need to do tons of research, improve your knowledge of how testing works, and approach the test carefully.
That said, some home drug test kits might be able to provide fairly accurate results. However, this will only happen if you perform the test carefully and correctly.
2. Professional Drug Testing
Among all types of drug tests, professionally conducted ones tend to be more accurate. As such, they are also more likely to provide you with deeper insight. However, this also means that they are usually more expensive than home kits.
Among these professional tests, there are many sub-types, including but not limited to:
Urinalysis is so popular that 90% of the more than 55 million drug tests done in 2015 were of this kind. In fact, it is so popular that it is now considered to the gold standard in the drug testing industry.
Drugs tend to metabolize when you abuse them. As such, urine tests are not usually performed with the popular of detecting the presence of illicit parent drugs. Instead, they will be done to check for the presence of certain non-psychoactive substance metabolites. For instance, the primary metabolite for marijuana is THC-COOH, a fat soluble substance which is detectable in urine for close to 14 days.
The only flaw with urine testing is that it is quite easy to beat. This is one of the reasons why urinalysis will only be part of the comprehensive drug testing performed in many professional settings.
b) Blood Test
Blood tests are the most accurate and invasive forms of testing. Unlike with urinalysis, these types of tests are more likely to detect the presence of a parent drug (and not just their metabolites). This is because many drugs - including marijuana and nicotine - will be absorbed instantly into your blood stream, making it easy to detect them.
However, blood testing is quite expensive. As such, it is less common and might only be administered if the law or a lot of money is on the line. Similarly, many drugs won't stay in the bloodstream for long. For instance, blood tests will not detect marijuana a couple of hours after you used it. Still, the tests might detect the drug if you are a chronic user and you abuse it less than 24 hours before the testing.
c) Swab/Saliva Testing
Saliva or swab testing might be administered in the hope of detecting the presence of a parent drug. This type of test is popular because it is less expensive than blood testing and less invasive compared to urine tests.
However, the accuracy of swab testing might be questionable unless it is done right. For instance, tiny amounts of nicotine from smoking tobacco and THC from using marijuana will be released into the saliva.
Therefore, the window for detecting illicit substances in saliva tends to be quite small, usually within a couple of hours after you abuse the drugs. Still, some drugs do seep into the oral fluid by diffusing from the blood stream. These types of drugs might be detected a little longer after you use them.
That said, the key factors behind the growing popularity of saliva and swab testing include the ease of use as well as the relatively low cost of administering these types of tests.
d) Hair Follicle Testing
This type of test is usually applied in research settings because it is quite hard to beat. However, it is one of the least accurate of all approaches to drug testing for many reasons.
For instance, hair follicle testing is designed to detect the presence of metabolites from parent drugs that have diffused into the follicle from the blood stream. Still, the test is useful because it offers unique data. If performed well, it might help the tester to detect the drug you have been abusing as well as your general patterns of abuse. As such, if you used a drug but abstained after a while before abusing it again, hair follicle testing might be able to reveal all this data.
The main problem affecting hair testing lies in the fact that the samples might be contaminated from the surroundings. This means that even the smallest amount of smoke or powder might get stuck in the hair and lead to a false-positive test.
Although some renowned labs have tried to dismiss this claim, many experts still believed that dark hair tends to attract contaminants more than white hair does. This makes Latinos, Africans, and Asians highly prone to receiving false positive results after a hair follicle test.
Applications Of Drug Testing
Today, the Federal Government is the biggest drug tester in the country. However, there are several other instances where drug testing might happen. Consider the following:
- Testing by employers to check for the use/abuse of illicit substances
- Screening of sportspeople and athletes to detect any illegal performance enhancing drugs
- Testing by the police such as for those who seem to be driving under the influence of alcohol, drugs, and other substances
- Drug testing by insurance companies before allowing new clients to purchase a plan
- Testing after a court order, such as after allegations of using date rape drugs, or in cases of child custody
- Testing by health professionals to check for the cause of diseases the patient might be suffering from
- Testing to monitor abstinent individuals after they join support programs
- Screening before you undergo pulmonary therapy, organ transplantation, wound revision, spinal fusion, plastic surgery, or orthopedic surgery
When Is Employment Drug Testing Conducted?
There are many circumstances under which you might be required to undergo a drug test. These situations include but are not limited to:
Most employers will ask that you undergo drug testing before they give you a job. This is mostly done to ensure that the employer does not hire individuals who use illicit drugs and harmful substances.
In many cases, pre-employment drug testing will take place after the employer makes a conditional offer of employment. As an applicant, you need to agree to get tested, and you will not get the position if you receive positive results.
However, some applicants might prepare for the pre-employment test by keeping away from drugs and other illicit substances for several days before the test is performed. For this reason, you might still get the job but be placed on probation before you are fully absorbed into the organization. After some time, you will get tested with no prior warning.
Still, this process is restricted in some states. Similarly, the ADA (Americans with Disabilities Act) of 1990 has prohibited the application of pre-employment drug testing for alcohol abuse/use.
Here, the drug testing might involve an announced test to check that you are ready to go back to work. In many cases, this happens after you tested positive and were compelled to undergo treatment for drug abuse. This means that the employer will want to check whether you are clean.
However, some employers might also apply return-to-duty testing if you have been absent from work for a long time.
3. Reasonable Suspicion
Reasonable suspicion drug testing is also referred to as for-cause or probable-cause testing. It is usually performed when a supervisor documents observable symptoms and signs that lead them to suspect that you have been using drugs, or that you have violated existing drug-free workplace policies.
For reasonable suspicion testing to work, it is vital that there are clear and consistent definitions of the types of behavior that justify the testing. Similarly, the suspicion must be corroborated by more than one manager or supervisor.
Probable-cause testing is typically at the discretion of the management at an organization. This means that it often requires the careful and comprehensive training of managers and supervisors.
Additionally, employees who are suspected of violating drug use policies or of regular substance abuse should not return to work as they continue waiting for the results of the test.
4. Random Drug Testing
Random testing tends to be performed on an unpredictable and unannounced basis on those employees with identifying information is placed in a drug testing pool. From this pool, the employees are picked out arbitrarily for testing, using the identifying information (employee number or social security number).
The selection is usually generated by a computer to make it as random as possible. Through this system, everyone in the workforce has an equal chance of getting selected for the test - regardless of whether or not they were recently tested.
Many employers perform random drug testing because the fact that it comes with no notice ensures that it serves as the perfect deterrent.
Personal injury and property damage might result from an accident. As such, when drug testing is performed after an accident, it will mostly be to determine whether the accident was caused by alcohol or drug use.
However, for this to happen, the organization requiring the test needs to establish objective criteria to trigger the test and determine who will perform the test and document the results.
Examples of the criteria used to require a post-accident drug test include but are not limited to:
- Police-issued citations
- Injuries that required someone to be removed from the accident scene for medical purposes
- Damage to property or vehicles worth more than a certain monetary value
Although results from such a test will determine the certain use of illicit substances, a positive result might not be enough to prove that the accident was as direct result of such use.
While such testing is being conducted, the employer needs to keep the employees involved in the accident away from work. It is also vital that the employer sets guidelines specifying how soon after an accident the testing should be conducted. This ensures that the results are more relevant.
In many cases, different illicit drugs and other addictive substances tend to remain in the system for varying periods. This is why it is highly recommended that post-accident drug testing happens within the first 12 hours following an accident.
That said, some employers have expanded the testing trigger to serious incidents. This means that even in those situations where an injury or accident was averted, testing will still be performed.
Periodic drug testing is typically uniformly administered and scheduled in advance. In many instances, your employer might use it every year - especially if your job requires a physical.
Due to their nature, periodic testing is more acceptable to employees, particularly in comparison to unannounced tests. However, you might be able to prepare for them by stopping your drug and alcohol abuse several days before the test - which might make the results less reliable.
7. Post-Rehabilitation Testing
Otherwise referred to as follow-up testing, post rehab test are conducted after you return to work upon your completion of rehabilitation treatment for a known alcohol or drug problem.
To ensure its veracity, many employers will perform follow-up testing on an unpredictable and unannounced basis for a given period - as specified in the drug-free policy at the work place.
8. Blanket Testing
Blanket drug testing is quite similar to random testing. This is in the sense that it is unannounced but isn't based on suspicion. Rather, everyone at work will be tested - instead of a percentage that was selected randomly.
Employers use a wide variety of other tests to detect drug and substance abuse. These include:
- Voluntary drug testing
- Return-after-illness testing
- Probationary drug testing
- Pre-promotion drug testing
The Accuracy And Reliability Of Drug Testing
If done properly, drug testing is usually accurate. However, it can also be beaten easily, and the results might be misleading. Accuracy usually depends on the strictness of the collection. Such collection must also be done within the detection window of the substance. Further, the accuracy will be based on whether the drug testing was random or if the subject knew that they would get tested.
With regards to the strictness of collecting a specimen, consider the case of urine. When the tester collects urine, the temperature must be anywhere from 96 to 99 degrees otherwise the subject might contaminate the urine and cause misleading results.
Apart from the above, illicit substances tend to have different detection windows depending on the type of testing that is performed. As such, a specimen that is collected too late or too soon might not offer correct results.
That said, most drugs appear in the blood stream quickly but get extracted by the system shortly after you use them. Similarly, testing oral fluid for drugs will only yield correct results if it is done some hours after the drug was used.
The best way to ensure that drug testing provides the right results is to perform it when the subjects have no prior knowledge that they will be tested. This way, they won't get the opportunity to try and beat the testing or to abstain from their usual drug use.
How Is Drug Testing Conducted?
As mentioned earlier, urinalysis is the most common type of drug testing. This test can be performed at work (such as in the health unit), at a doctor's office, or on any other site chosen by the organization.
The applicant or employee will provide a sample for testing. In many cases, precautions need to be taken to ensure that the test subjects do not substitute specimen or adulterate it. For instance, the organization might put blue dye in the toilet and turn off the water supply. By so doing, the employer will ensure that test subjects collect samples in privacy and without direct observation.
According to SAMHSA's guidelines, after the subject provides a sample, it should be sent to a certified drug testing laboratory. This is because drug tests performed at these kinds of labs tend to be highly accurate. However, this type of certification only applies to alcohol and the 5 substances usually tested for in most federal drug testing programs.
The procedures stipulated in the SAMHSA guidelines to ensure the validity and accuracy of the testing process include:
1. Chain of Custody
During drug testing, chain of custody forms should be used to document the receipt, handling, and storage of specimen from the point at which it was collected all the way to its disposal. This document will link test subjects to their samples. It also acts as veritable written proof of everything that happens to samples both at the point of collection and at the testing laboratory.
2. Initial Screen
This is the first analysis done on a specimen. However, the initial test by itself is not always reliable or accurate, and there might be a possibility of false positive readings. To this end, when the initial screening provides a positive reading, the tester will have to perform a confirmatory test.
3. Confirmation Test
This is the second test required to verify the readings from the initial screening. It is usually performed using a GS/MS (gas chromatography or mass spectrometry). As such, confirmation tests tend to be more accurate, especially because they provide the specificity that helps rule out false positives and mistakes from the initial screen test.
For the complete test results to be considered conclusive, results from both the initial screening and the confirmatory tests must agree.
4. Split Sample
In many cases, the initial urine specimen might be split into two to create a split sample. One sample will be used during the initial screening. If it is found to be positive, the second specimen sample will be run through a confirmation test.
If the result is positive, the subject might request for another confirmation test from a different laboratory. The drug and alcohol testing regulations outlined by the DOT require that all types of drug testing be performed using the split sample collection process.
If the confirmation test and the initial screening test yield positive results, a licensed medical doctor with special training in substance abuse will review the result to verify that everything went by the book.
They will, for instance, ensure that the professionals handling the specimen and performing the test followed the chain of custody procedures. After that, they will get in touch with the test subject to ensure that the result wasn't caused by any other reason (medical or not). At this point, the doctor will report the positive results to the organization.
However, certain medications are known to lead to positive results from drug tests. When this happens, and it is found that the subject was used medication from a doctor's prescription in the right amounts and at the right times, the test results will be reported as negative.
Detection Times For Commonly-Abused Drugs
Drug detection times are used to indicate the point in time within which drug testing can conclusively reveal the presence of parent drugs and/or their metabolites in a sample of saliva, hair, urine, or blood. It will include the time from when the substances are first detectable to the point where you are going to test clean.
For most drugs, drug detection times tend to vary. They range from a couple of hours to several months depending on the following factors:
- The type of drug testing conducted
- The specific substances abused
- The period during which you have been using the drug
- Your health status
- Activity levels
- Other factors unique to the test subject
Similarly, the testing of OTC (over the counter) medications, prescription drugs, and some foods might yield false detection times and lead you to fail the drug testing even if you are completely innocent. In such a case, the test would be considered a false positive.
Still, many drugs can be detected in a specimen sample of saliva or urine within 2 to 8 hours after use. Blood tests, however, detect drugs almost immediately. In the case of hair, the drug might still show up about 5 to 7 days after you used it. This happens because body hair tends to grow slowly.
In many cases, drug testing will not look for the actual substance you might have abused. Rather, it will be performed to check for metabolites. When you ingest illicit substances, your body will metabolize (change) the substance into a metabolite. As such, drug tests will look for these metabolites.
The metabolites that your system does not use are more likely to be stored in fast growing cells (such as the nails, hair, and the body's fatty cells). Therefore, if your body has more fatty cells, the drug detection time might be longer than another person with fewer of these cells.
However, the exact timetable showing how long illicit substances will remain detectable might be impossible to determine exactly. This is because there are many factors which might affect how your body processes and stores drug metabolites.
Many tests also come with different cut off levels, which might decrease or increase the drug detection times. For instance, drug tests for amphetamine are available in cut-off levels ranging from 500 to 1000 pg/mg. The detection times are correspondingly longer for higher cut off levels.
That said, drug detection times tend to vary based on the following factors:
Human metabolism tends to slow down with age. Therefore, older subjects tend to have longer drug detection times.
b) Frequency and Amount of Use
Small or single doses of illicit substances might not be as easily detected as long term or chronic use.
c) Body Mass
Increased body mass might slow down your metabolism. Therefore, if you have larger body mass, the drug detection time might be longer.
d) Drug Tolerance
Frequent users might metabolize their drug of choice faster once their bodies establish tolerance to the illicit substance. This will shorten the detection time.
e) Metabolic Rate
If you have a slow body metabolism rate, the detection time might be longer.
f) Overall Health
Metabolism tends to slow down when you are in poor health, which might result in longer detection times.
g) Physical Activity
If you are physically inactive and your body fat percentage is relatively high in relation to your total body mass, you might be prone to longer detection times. This is due to the increase in the excess drug metabolites getting stored in your body's fatty cells.
h) Urine pH
The pH of your urine might impact the detection of illicit substance abuse. This is because highly acidic urine tends to shorten the drug detection time.
Consider the detection times for the following commonly abused drugs:
- Alcohol (1 hour to between 10 and 12 hours)
- Amphetamines (1 to 2 Days)
- Anabolic Steroids (Injected 3 to 6 months, Oral 3 Weeks)
- Barbiturates (2 to 3 Days)
- Benzodiazepines (Most 2 to 3 Days, Some 4 to 8 Days)
- Cocaine (1 to 2 Days)
- Codeine (1 to 2 Days)
- GHB (1 to 2 Days)
- Inhalants (A couple of Hours)
- Ketamine (2 to 4 Days)
- LSD (A couple of hours to 5 Days)
- Marijuana (2-5 Days*)
- MDMA (Ecstasy) (1 to 5 Days)
- Methadone (1 to 7 Days)
- Methamphetamines (2 to 4 Days)
- Methaqualone (10 to 15 Days)
- Nicotine (1 to 2 Days)
- Opiates (1 to 2 Days)
- Oxycodone (1 to 2 Days)
- PCP (1 to 8 Days)
If you are a chronic user, the drugs might be retained within the body system much longer after your last use. For instance, PCP and marijuana might stay in the system and be detectable for more than 30 days if you have been using them heavily.
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