Category: Drug Testing

Drug Tests use a biological sample to detect the presence of illegal or prescription drugs and their metabolites in urine, blood, saliva, or hair. Drug testing plays a pivotal role in the practice of medicine, job candidate selection, post accident investigation, mental health services, and many other aspects of society.

The purpose of soliciting a drug test is to detect illegal or prescription drugs and identify prescription drug misuse. For example, doctors need to know if a patient is abusing drugs before prescribing pain medication or other narcotics. The same doctor also needs to know if the patient is taking the drugs being prescribed to them. By examining the patient’s drug test result, healthcare providers can ensure they are providing safe and effective care.

Professionals can choose from a wide variety of panel configurations and sample types. They can also choose whether a point-of-care test that is performed on site or a laboratory test is best suited for their application. Parents will often perform at home drug tests on their children if they expect them of using drugs.

Drug testing may be used as a preventative measure by employers or authorities, or by doctors and patient service centers to confirm the presence of a prescription drug. Modern drug testing is quick an easy. Results are generally available within 5 minutes for on site drug tests and within 2 days for laboratory tests.

What Drugs do Drug Tests Test For?

Drug testing can detect any substance of abuse that a client wishes to investigate. Laboratories using liquid gas chromatography and mass spectrometry can separate any organic compound and measure it’s concentration.

Most drug tests will test for 5-12 drugs of abuse. The most common drugs tested for are:

• Marijuana (THC)
• Cocaine
• Opiates & Morphine
• Amphetamines
• Methamphetamine
• Barbiturates
• Ecstasy (MDMA)
• Benzodiazepines
• Oxycodone
• Methadone
• Buprenorphine (Suboxone)
• PCP
• Tricyclic Antidepressants
• Fentanyl
• Alcohol

The mix of drugs included on a test depends on the application, budget, and availability. For medical use, a comprehensive drug test with at least 12 panels is standard. For employment and DOT testing, 5 panel and 10 panel drug tests that focus on illegal drugs are more common.

 

Because humans metabolize drugs in their body, urine tests will often check for a drug’s metabolite instead of the original compound. Metabolites are more consistently expelled and provide more accurate results.

What Are The Types of Drug Testing?

You can perform drug tests using samples of urine, blood, saliva, or sweat. Each type of drug test offers it’s own benefits and challenges. Professionals consider the invasiveness, cost, detection period. and accuracy when choosing which type of drug test best fits their application.

There are 3 levels of drug testing complexity that affect their regulation and use. High complexity, medium complexity, and low complexity. We relegate high and medium complexity tests to laboratory testing except for forensic use. Low complexity drug tests can qualify for a CLIA waiver, which makes them eligible for use by trained staff at a facility that has a CLIA certificate.

Urine Drug Tests

Urine drug testing is the most common type of test, and provides an appealing mix of simplicity, accuracy, and affordability. Companies can complete urine tests on site with an easy-to-use drug test cup in under five minutes. They can also send the sample to a lab to be completed in 1-5 days for a more comprehensive and accurate urine drug test.

Both point-of-care and laboratory testing offer accurate urinalysis. The key difference is that a laboratory test is quantitative, providing the amounts of each drug present in the sample. Laboratories are also more sophisticated at detecting adulteration.

The biggest drawback to urine drug testing is that urine specimen collection is considered slightly invasive.

A 12 panel urine drug test is standard for medical practices, rehabs, and court systems. For these applications it’s important to detect pharmaceuticals and maintenance drugs such as methadone and Suboxone. The detection times range from 3 to 7 days on most drugs, which helps identify drug addiction even if the subject has abstained from drug use for a day or two.

Blood Drug Tests

Law enforcement uses blood drug tests when there is a possibility of a court challenge, and the shorter detection period of 1-4 days is more appropriate. Blood tests are always performed at a medical facility by a trained professional due to the risk of infection by blood-borne pathogens.

Experts consider blood tests more accurate, and they detect the presence of drugs sooner than urinalysis. This is important for criminal investigations, where investigators need to link intoxication to the time a suspect commits a crime. Also, the blood concentration of a substance is more applicable to intoxication than urine concentration.

Urine tests have become more accurate as the technology and quality control have improved. It has replaced blood testing in almost all use cases unless users desire shorter detection windows or more accurate concentration levels.

Saliva Drug Tests

Saliva drug tests have become a popular alternative for workplace and pre-employment drug testing. They are less invasive than urine tests and can test for most of the same drugs. Companies consider them more convenient for hiring. Their shorter detection time isn’t a concern for organizations that only need to confirm that an employee isn’t using drugs on the job.

The detection time for saliva drug tests is shorter, and they are not as reliable as urine drug screens. They also require a technician that can confirm they collected enough saliva for the test to be viable.

Newer mouth swab drug tests feature an indicator line on the swab that shows when technicians have collected enough saliva. This feature has cut down on the number of inviable and inaccurate tests. It’s also a viable alternative to urine drug screening when a patient cannot produce a urine sample.

Hair Follicle Drug Tests

Hair drug testing is exclusively conducted in laboratories, and is preferable when users need a wider detection window. Drugs that are present in the blood are then deposited into hair at the follicle as it grows, leaving a timeline of drug use that can go back as long as the hair growth.

A hair drug test requires 100mg of hair, 90 -120 strands that are a minimum of 1 1/2 inch long. Generally, technicians only test the first 1 1/2 inches of hair. Since hair grows at a rate of 1/2 inch a month, tests will only detect drug use from the past 90 days.

Hair follicle testing is most commonly used for employment testing by government agencies. It’s also popular with other organizations that have a zero tolerance policy on drug use. It’s used during forensic testing to identify historic or recent drug use.

There are some obvious disadvantages to hair follicle testing. Dyes and other hair products can complicate testing. Physical contamination from exposure to drugs that are smoked can cause false positives. Studies have found that races with coarse hair such as African Americans can have as much as 2-12 times the amount of cocaine present in their hair after use.

Sweat Drug Tests

Experts do not consider sweat drug tests as accurate or as affordable as urinalysis. Sweat drug tests have found use in outpatient drug treatment and court monitoring programs. They typically have a longer detection window of 7 to 14 days and are more sensitive than other drug tests.

The obvious benefit to sweat drug testing is that it’s less invasive than traditional drug testing. Users consider the increased sensitivity a negative feature except in zero tolerance applications. It increases false positives and lengthens detection times. Most organizations that use sweat drug tests only use them for preliminary detection. A confirmatory urine or blood test is completed if there is a positive result.

A technician affixes the sweat patch to the subject for a week or more. They only detect the primary illegal drugs of abuse, such as marijuana, cocaine, opiates, amphetamine, methamphetamines, and PCP.

What Happens During a Drug test?

Drug testing involves a technician collecting a sample of either urine, saliva, hair, or sweat in a controlled environment. During urine testing, the subject voluntarily provides the sample by collecting their urine in a cup. However, they are often monitored to prevent adulteration or contamination.

During a saliva test, the subject places a collecting swab into their mouth for a pre-determined amount of time. Once the swab collects enough saliva, it is combined with a point-of-care testing apparatus or sealed and sent to a laboratory for analysis.

Law enforcement uses blood drug tests for criminal investigations. Driving under the influence and crimes where intoxication is an aggravating factor are the most common applications. Law enforcement will either require consent or a warrant to draw blood. A medical professional will draw the blood at a hospital or clinic.

Designated employees will test your sample on site while you wait, or will ship it to a lab for high complexity testing. Point of care drug tests take less than 5 minutes and they will record the results onto a document that is signed by the subject and the technician.

Some drug tests will offer the opportunity to challenge results if you believe there is a false positive. However, technicians will not accept a new sample in these instances. Instead, they will test a partial amount of the original sample.

Negative Test Result

A negative test result means that there were no drugs or metabolites found in the sample, or the concentrations were below the prescribed cutoff levels. In most cases, a negative drug testing UDT is the desired result. In the case of prescribed medication, a negative drug test could indicate that a patient is not taking their medication properly.

Positive Test Result

A positive test result means that the concentrations or metabolites found in the sample were above the prescribed cutoff level. In most cases a positive drug test means that the subject has been using drugs they aren’t supposed to, and may suffer from a substance abuse disorder. They may be recommended for substance abuse treatment, or other mental health services.

How to Prepare for a Drug Test

If you are expecting to undergo a drug test, you can ease your anxiety by becoming informed and prepared for the procedure. Do not take any drugs and avoid over-the-counter medications if possible. It’s possible for a legal medication to cause a false positive, and it’s sometimes difficult to challenge results.

Drink Recommended Amounts of Water

Stay hydrated the day of testing. You will need to produce a urine sample, a saliva sample, or have blood drawn at a moment’s notice. Dehydration makes it difficult for test subjects to produce a sample, or for nurses to complete a successful blood draw. Dehydration also elevates the concentration of drugs and metabolites in your sample, if you have used drugs recently.

Do not drink too much water because it can dilute your sample to the point it’s considered a dilute adulteration. Analysts check color, creatinine levels, and temperature to ensure excessive water intake has not diluted the sample.

Provide Information About Legal Drug Use

Inform the technician of any medications you are taking. Most of the time, a legally prescribed drug will absolve a positive result for that drug or class. Exceptions are zero tolerance policies, and situations where taking the legal drug can impair your coordination. Be sure to report over-the-counter and non-narcotic medication in case it results in a false positive.

Ask the technician questions about appealing a positive result or the consequences of a failed test. Workplace policies often include opportunities for recovery or a second chance after a specified time period. Ask what you’re being tested for, the reason you’re being tested, and how the organization will use the results. Knowing the specifics of the organization’s drug testing policies will benefit an appeal.

Are Drug Tests Safe?

There are no known risks associated with drug testing, but many proven risks associated with drug use and impaired employees. A positive drug screen can have negative implications for someone’s livelihood. These include:

• Probation revocation
• Jail time
• Loss of employment or wages
• Aggravating a related crime
• Personal shame and anxiety

According to a study performed by the National Safety Council employees with a substance abuse disorder miss 50% more work. Workers that are addicted to pain medication miss 300% more days. Drug users are 3.6 times more likely to injure themselves or others on the job and 5 times more likely to file a worker’s compensation claim.

Drug Testing Resources

If you or a loved one are struggling with a substance use disorder, check out these drug abuse and crisis assistance resources. When sharing sensitive information make sure you are connected to a trusted source.

To learn more about the substances that are generally included in a drug test, check out what’s on a 12 panel drug test.

It’s important to understand the laws and regulations related to drug testing. Below are some answers and links to appropriate federal government websites regarding drug testing and the federal drugfree workplace act.

Who Regulates Drug Tests in the US?

The Food and Drug Administration (FDA), and the Centers for Medicare & Medicaid Services regulate drug testing on the federal level. Various laws such as the Clinical Laboratory Improvement Amendment (CLIA) apply to testing to ensure it’s done correctly. The Department of Health and Human Services certifies laboratories for drug testing federal employees. OSHA provides guidance on different types of employment drug testing.

FDA: The FDA approves or clears products for commercial availability, and assigned a complexity to the testing.

CMS: Regulates laboratory testing and requires labs to get certifications from their state and the CMS before labs can test human samples.

HHS: Certifies labs for drug testing federal employees.

CLIA: Regulates the laboratory testing of human specimens and ensures they provide accurate, reliable, and timely results.

OSHA: Provides guidance on the permissability of workplace drug testing

What Federal Laws Apply to Drug Testing?

The Violent Crime Control & Law Enforcement Act of 1994, Drug-Free Workplace Act of 1988, and the Americans with Disabilities Act are the most prominent laws that regulate drug testing.

Violent Crime Control & Law Enforcement Act of 1994

The Violent Crime Control & Law Enforcement Act of 1994 requires mandatory drug testing for all offenders who committed their offense after September 13, 1994. Only the court can waive the condition. Knowing and willful use of a controlled substance constitutes possession under this law. Providing a positive drug screen is grounds for revocation.

Drug-Free Workplace Act of 1988

Under the Drug-Free Workplace Act of 1988, federal workplaces and organizations with a federal contract of $100,000 or more must implement a Drug-Free Workplace Program. This includes requirements and guidance for drug testing.

Americans with Disabilities Act

Drug testing is not considered a medical examination under the Americans with Disabilities Act. Therefore, employers may conduct drug testing of applicants or employees, and make employment decisions based on the results.

Family and Medical Leave Act of 1993

Other laws like H.R.1 – Family and Medical Leave Act of 1993, which applies to all employers with over 50 workers, allows employees that have worked for more than 1 year to take 12 weeks of unpaid, job protected leave due to a serious health condition.

The FMLA medical leave covers treatment for drug or alcohol addiction, as well as treatment of a physical illness related to substance use, and caring for a close family member who is undergoing substance abuse treatment. Workers can take advantage of this law by declaring leave under the FMLA if they know a drug test they are likely to fail is imminent.

Drug Testing Challenges

Drug tests are a polarizing subject for some communities that believe they are invasive and violate individual privacy. Advances in drug testing have helped mitigate their invasiveness and target only the pertinent detection periods.

Organizations have to be on constant guard against individuals that are attempting to adulterate, swap, or compromise tests. Since a possible employment opportunity or punishment could result from a positive drug test, the stakes are high. People will go to great lengths to alter positive results.

 

New state laws legalizing the recreational use of marijuana have complicated drug testing in some regions. It’s important to consult with a legal advisor regarding testing procedures, and the inclusion of drugs that have recently changed legal status.

The drug testing industry is expected to grow from $13.34 billion in 2023 to $20.31 billion in 2028. More medical treatments are requiring preventative drug testing and more employers are integrating drug test programs.

Conclusion

Organizations use drug testing to ensure the safety and professionalism of employees, meet insurance requirements, and ensure compliance with medical treatments. They have proven to benefit overall employee performance and mitigate costs. Drug tests improve treatment outcomes by alerting physicians to drug abuse.

Modern drug testing is minimally invasive, accurate, and quick. If you’d like to learn more about drug testing, check out our available drug tests on our product page.

At home drug tests detect the presence of illicit substances in urine and saliva samples, and are optimized for ease of use. Home use tests are accurate and cost effective alternative to laboratory drug tests. Drug test kits marketed for personal use have clear labeling, are offered in individual quantities, and are often CLIA waived.

What Are At Home Drug Tests?

At home drug tests are generally instant drug tests used for detecting illicit drug use by family members. Drug testing kits are also quantitative, meaning that the result is pass or fail. It does not provide the exact quantity of drugs. Medical professionals often use the same tests to get quick results, and will have further lab testing completed on the sample.

Drug testing is an important countermeasure parents can use to help protect their children from drug use. Over two million teens aged 12-17, approximately 8%, admitted to using drugs in the past month. In 2020, 4,777 Americans aged 15 to 24 years old died of an overdose.

Drug tests can test for one or multiple substances. Larger companies often design packaging and devices targeted at consumers. This can raise costs substantially. The actual test is a thin strip that contains a regent. The regent interacts with the biomarker, either the drug itself or a metabolite that is produced by the drug’s breakdown in the liver.

The most common types of personal drug tests are urine drug screens and oral saliva drug screens. Tests that use urine are considered more accurate, but can be adulterated if the person taking the test isn’t observed. Many people have an aversion to handling urine samples as well. An oral test is not as accurate, can be hard to administer correctly, but avoids the taboo of handling urine.

What Are The Best At Home Drug Tests?

People enjoy the ease of picking up medical products from Walgreens, but the actual tests are over priced when you buy a single panel test from a big box store. Ordering online from a company like Drug Test City or one of our competitors is discreet, convenient, and fast. An order will usually arrive within 3 business days.

Urine Drug Test

The best at home drug test is a CLIA waived drug testing cup that is approved by the FDA. It offers multiple drug screens in a convenient collection container. This product represents the best value because there is a competitive market for industry and medical use. Manufacturers produce them in higher numbers, so they have a lower manufacturing cost. Some companies charge $10-$20 for a single panel marijuana test. You can purchase an individual UDT for about $6, and as low as $3 if you purchase 25 or more. A CLIA waiver means that the manufacturer designed the test to be simple enough that it doesn’t require a lab technician to interpret the results.

Best Saliva Drug Test

The best at home saliva instant drug test is currently the T-square. It tests for 2 additional drugs over a 10 panel test, is convenient to use, and features a sample indicator. You can purchase a comprehensive saliva test for about $6, or as low as $5 if you purchase a box of 25. These tests are for forensic use only because they are a little more difficult to use correctly and saliva is an inferior sample type. They are popular with employers because they are non-invasive.

 

What Drugs Do At Home Drug Tests Test For?

An instant drug test can test for a single drug, or up to 14 different drugs. They usually check for commonly abused drugs, and popular prescription narcotics. Our 14 panel drug test, which is for forensic use, tests for

• Marijuana (THC) 50 ng/mL
• Cocaine (COC) 300 ng/mL
• Opiates (OPI) 2000 ng/mL
• Amphetamines (AMP) 1000 ng/mL
• Methamphetamines (MET) 1000 ng/mL
• Benzodiazepines (BZO) 300 ng/mL
• Ecstasy (MDMA) 500 ng/mL
• Methadone (MTD) 300 ng/mL
• Oxycodone (OXY) 100 ng/mL
• Buprenorphine (BUP) 10 ng/mL
• Barbituates (BAR) 300 ng/mL
• Tricyclic Antidepressants (TRA) 200 ng/mL
• Fentanyl (FYL) 10 ng/ml
• Alcohol (ETG) 500 ng/ml

A comprehensive multi-drug test is ideal. An opiate test does not detect oxycodone, a popular pharmaceutical drug that is widely abused. Also, drug users that use heroin are more often than not using fentanyl. Because of fentanyl’s potency, it takes a very sensitive test to detect in urine. For this reason, fentanyl tests are not currently CLIA waived, so no multi-test that contains them is CLIA waived.

A positive drug test is shown by a missing line on the test strip. A faint line is always considered negative.

Pros and Cons

Pros

There are several advantages to drug testing in the privacy of your own home compared to an on-site drug test.

• Cost effective: An at home drug test is 90% cheaper than a full lab panel.
• Fast: You can view results in less than 5 minutes.
• Non-invasive: Users do not have to be observed or adhere to lab protocols.

Cons

• Lab tests are qualitative, meaning they give levels of each drug in part of their results.
• Oral tests are not as user friendly. We developed a swab indicator to help alleviate this.
• Observation is recommended because subjects are known to substitute samples.

All drug test kits are susceptible to malfunction. Because of the delicate nature of producing thousands of regent strips and combining them with a collection container, some tests will not be accurate. Drug tests need to be stored properly in a climate controlled environment and used prior to their expiration date.

Tips for Drug Testing At Home

Modern drug tests are user friendly, sanitary, and accurate.

• Always observe the drug test. If you don’t see the urine coming out, there is a possibility that the subject could switch the sample.
• Check for color. Users are known to dilute their urine prior to testing, which affects results. Use samples no lighter than a straw color.
• Read the instructions carefully. Everything from how much of a sample is required to how long to wait for results should be covered.
• Faint lines on a drug test are still negative results, and they do not indicate that there is a low level of drug in the urine.

Always make sure that the drugs you need to test for are included in the test. If someone abuses opiates, you need a test for opiates, oxycodone, fentanyl and methadone. We suggest using a drug test that is approved for use in the United States by the FDA. You can search the over-the-counter FDA database and the CLIA database for approved manufacturers.

The most common factors in getting inaccurate results is human error and adulteration. Follow the instructions closely and be alert to possible adulteration attempts.

What types of drugs can be tested for at home?

Many at-home drug tests can screen for a variety of substances, including marijuana, cocaine, opiates (like heroin, morphine, and codeine), methamphetamines, ecstasy, amphetamines, and some prescription drugs like oxycodone and Xanax. The substances that can be detected will depend on the specific drug test.

How accurate are at-home drug tests?

At-home drug tests are 99% accurate and can be a useful tool for preliminary screening. However, factors like the timing, the type of sample used, and the specific drug being tested for can affect results. False positives and false negatives can occur, but are rare. Taking specific over-the-counter medications may cause false positives for similar substances. Drinking too much water may produce a negative even though there was recent drug use.

How long after drug use can a test detect substances?

The detection window for drugs can vary based on the substance and the individual’s metabolism, frequency of use, and other factors. Drug tests may identify the metabolites for up to 90 days. Home use kits are usually more sensitive, and will show a positive test result for longer than a lab test. For a full list of detection times, check out detection times for common drugs of abuse.

Can other medications or certain foods cause a false positive?

Some substances, including certain foods and medications, can potentially lead to a false positive. It’s important to consider any substances you’ve consumed prior to taking the test. Consult with a healthcare professional if you’re concerned about potential interactions and always keep a list of your medications for reference.

What should I do if I get a positive result on an at-home drug test?

A positive test result on a point-of-care drug test is a preliminary indication of drug use and should be confirmed with a laboratory test. If you or someone else tests positive on a home use test, consider consulting a substance abuse counselor for further advice.

 

 

 

 

 

The cutoff level for urine in drug tests is 50ng/ml. Regular smokers will have significantly higher levels of THC. A level of 300ng/ml is considered to be a high level of THC in urine.

The THC level itself isn’t necessarily indicative of high levels of consumption. By drinking water a user of marijuana can cut the level of THC in their urine in half, and have it test in a higher range the very next day. For this reason drug test technicians look at the ratio of THC to creatinine to determine if the level of THC in a user’s urine is decreasing. A ratio of 2.5 to 1 (THC to creatinine) is considered high.

THC levels in drug tests are increasing in line with the potency of cannabis. National Institute of Drug Abuse data shows that the potency of cannabis is increasing steadily since the 1990s.

Quantitative vs. Qualitative Drug testing

It’s important to understand that in most drug tests a high level of THC does not matter. In a quantitative drug test, like 12 panel urine test cups, the sample is either pass or fail. Any urine with more than 50ng/ml is considered a fail and urine with under 50ng/ml is a pass.

Drug tests for probation, court, rehabs, and medical prescriptions are almost always quantitative drug tests that do not provide the actual level of metabolite.

Qualitative drug tests that accurately indicate the levels of THC are mostly used for medical diagnosis and autopsy.

Importance of Measuring THC in Urine

The measurement of THC (Tetrahydrocannabinol) levels in urine is a common practice used in various fields. THC is the main psychoactive compound found in marijuana and is the primary cause of its mind-altering effects. Understanding the importance of measuring THC in urine can provide valuable insights into drug usage, particularly in scenarios such as pre-employment screenings, medical examinations, and rehabilitation programs.

Medical and Legal Significance

The measurement of THC levels in urine is sometimes crucial for both medical and legal reasons. Medical professionals sometimes require this information to assess the frequency and extent of marijuana use in patients. Such evaluations can aid in determining the effectiveness of medical treatments, assessing potential drug interactions, and monitoring patient compliance with prescribed medications.

From a legal standpoint, the measurement of THC in urine is frequently conducted to fulfill workplace drug testing requirements. Many companies enforce drug-free policies to ensure a safe and productive working environment. By measuring THC levels, employers can identify individuals who may be impaired while on the job, promoting a risk-free workplace.

Furthermore, this measurement is essential for law enforcement agencies during investigations involving cannabis-related offenses. Detecting the presence of THC in urine can be used as evidence in court, supporting charges against individuals suspected of driving under the influence of marijuana or other related offenses.

Duration of Marijuana Use Detection

The presence of THC metabolites in urine provides an indication of the recent use of marijuana. However, it is important to note that the detection time frame may vary depending on several factors, including the individual’s metabolism, frequency of drug use, and potency of the marijuana consumed.

Typically, THC metabolites can be detected in urine within 2-5 hours after consumption and remain detectable for up to 3-30 days after usage. Chronic marijuana users may exhibit traces of THC in their urine for an extended period compared to sporadic or first-time users.

Urine Testing Methods

Various methods are available for accurately measuring THC levels in urine:

1.Point of Care Drug Testing- Point of care drug testing only provides a pass or fail result. It let’s you know if the concentration of THC is more or less than 50ng/ml.

2. Gas Chromatography-Mass Spectrometry (GC-MS): Considered the gold standard for THC detection, this technique provides precise and reliable results. GC-MS separates and analyzes the compounds present in urine samples. It can detect even minimal amounts of THC and its metabolites, ensuring accurate measurements.

3. Immunoassay Screening: Immunoassay tests are widely used due to their convenience and cost-effectiveness. These tests provide rapid results and are suitable for initial screenings. However, they may have a higher chance of false positives, and further confirmation through GC-MS testing is often required for accurate measurements.

Factors Affecting THC Levels in Urine

Several factors can influence THC levels in urine, leading to variations in test results:

1. Frequency of Use: Individuals who use marijuana regularly or daily are more likely to have higher THC levels in their urine compared to occasional users.

2. Body Fat Percentage: THC is highly lipophilic, meaning it binds to fat cells in the body. Consequently, individuals with a higher body fat percentage may retain THC metabolites in their system for a longer duration than those with lower body fat.

3. Hydration Levels: Dilution of urine through high water intake can potentially reduce THC metabolite concentrations. However, laboratories often check for urine dilution and may request an additional sample if suspicions arise.

4. Metabolism: A faster metabolic rate can aid in the faster elimination of THC metabolites from the body, leading to lower detection times in urine.

The Importance of Accurate Measurements

Accurate measurement of THC levels is critical to ensure reliable results. Inaccurate measurements can lead to false positives or false negatives, which can have significant repercussions.

For instance, false positives may unfairly incriminate individuals who have not consumed marijuana, potentially damaging their job prospects or reputation. On the other hand, false negatives may dismiss individuals who have, in fact, used marijuana, leading to safety concerns or ineffective medical treatments.

Conclusion

The measurement of THC levels in urine plays a crucial role in various fields, including medicine, law enforcement, and workplace regulations. It provides valuable information about an individual’s marijuana usage, helping medical professionals assess treatments, employers maintain a safe work environment, and legal authorities enforce drug-related laws.

Understanding the factors influencing THC levels in urine and utilizing accurate measurement methods ensures reliable results, preventing potential errors and ensuring fair outcomes.

Drug testing can be completed in house cheaply with a high rate of accuracy. A 12 panel drug test is comprehensive and can be purchased for as little as $2.70 per test.

There are many types of drug tests available. Different industries and use cases call for different tests and sometimes different procedures.

For instance a highly competitive job search in a large public corporation will often require a 3rd party testing firm because it is worth the extra cost to avoid liability or claims of unscrupulous behavior. A pain management doctor will often use instant urine screens because they have trained staff on site and it is important that they get the results as soon as possible to direct patient care.

Different procedures, policies and specimens can have significantly different costs. In a hypothetical costing exercise outlined later in this article I estimate that a small business with approximately 250 employees can maintain a robust drug testing policy for $781.20 per year (based on 10% turnover and 5 confirmations).

Cost of Rapid Point of Care Drug Screens

Instant urine drug screens are the most cost effective drug tests available. They offer accurate results quickly, but require competent staff to administer. If a facility has a CLIA certificate they can administer CLIA waived tests and the results will meet the criteria set forth by the FDA for drug testing. a comprehensive urine drug screen costs $2.70 when ordered in bulk.

Instant saliva tests have become popular in recent years because people believe it is more sanitary than urine. They are not CLIA waived and carry a higher cost, approximately twice as much as a urine drug screen. Expect to pay $5-$6 for a comprehensive test even if you purchase in bulk.

 

 

Instant hair drug tests are now available, but they are prohibitively expensive. A cursory search for instant hair drug tests comes back with offers in the $50 range.

Purchasing the tests is only part of an overall drug free workplace program. You will also have to pay for the time it takes to train staff to administer drug tests and the time they spend drug testing people.

It is recommended that all positive tests be sent to a laboratory for confirmation. A confirmatory test is much cheaper than a full spectrum analysis, but will still cost XXXXX

Cost of Laboratory Drug Screens

Laboratories have many capabilities and the cost of drug testing is dependent on which equipment is used. The truth is that using lab equipment is prohibitively expensive. Usually when a lab conducts employment testing they will use immunoassay strips, the same kind found in rapid test cups, to run the test. The difference is that since their staff and facility meets the requirements for high complexity testing they do not need a CLIA waived product. They can also confirm results on site.

After running the test they will use gas chromatography and mass spectrometry to confirm positive results. It only costs about $40 for a confirmation, but if the same equipment and staff has to do analysis on 12 drugs the cost will be closer to $200.

 

 

When an on site drug testing company sends a sample in for a confirmation that’s exactly what they’re purchasing; the use of a gas chromatography and mass spectrometry device to confirm a single finding. One of my newest clients just switched to our 12 panel cups because the 5 panel tests he was using did not include oxycodone. One of his patients failed the 5 panel test for cocaine and when he sent it in for a confirmation it came back negative for cocaine.

Upon reviewing the results one of his nurses noticed that there was a substance that registered on the lab test so they called the lab. It turned out that the patient was positive for oxycodone and the lab workers could easily see that, but the client had paid for a confirmation for cocaine so the official documentation that was provided only indicated that the patient was negative for cocaine.

So why don’t labs always run a full spectrum analysis that identifies all substances? Because a lab can perform a legal 12 panel drug test the same way you would at your business for less than $10 and they can charge you $55 for the work. Each drug confirmation with their expensive equipment costs $30-$50, and a comprehensive test checking for the presence of all drugs would be approximately $200.

Cost of Outsourcing vs. In House Drug Testing

There are several options available for drug testing. You can hire a lab, and there are companies that provide drug testing using rapid tests and also take care of all the details such as policy, paperwork and handling legal aspects.

Most drug testing companies will charge between $20 and $100 depending on the types of drugs you test for, the type of drug testing you need performed, the number of tests performed, and the labor involved.

Most small businesses can complete a single drug test for the cost of the test ($2.70 for a 12 panel cup) and the cost of labor for an employee to observe the drug screen and interpret the results. It takes about 10 minutes to perform a rapid screen in most cases.

Let us look at a hypothetical home healthcare company. In 1 year they may need 20 pre employment tests, 80 random tests and 6 post incident tests.

In House Drug Testing

Cost of Tests: $286.20

Cost of Labor: 15 hours at $18 = $270

5 Lab Confirmations at $45 =  $225

Total: $781.20

 

Outsourced Drug Testing

Cost of Tests = 106 x $40

Total: $4,240

 

Comprehensive Laboratory Testing

Cost of Tests = 106 x $215

Total: $22,790

 

As you can see having a laboratory doing comprehensive GC/MS testing on 106 samples is extremely expensive. Even outsourcing your drug testing to a drug testing company is 542% more expensive than doing comprehensive drug testing in house with a competent employee and lab confirmations.

Laboratories know that the cost of testing is prohibitive so they will often substitute cheaper methods. In some cases a lab will use the same cup your can purchase online very cheaply and mark up the cost several orders of magnitude. A lab would call it rapid test or immunoassay so always ask questions about how the tests are performed and the level of accuracy.

When you use CLIA waived test cups, thoroughly train your staff and follow strict chain of custody procedures the tests you can administer in house are considered extremely accurate and meet government standards for improved laboratory testing.

This hypothetical cost analysis reflects a company that has about 200-300 employees and a robust drug testing policy. Small companies can complete drug testing for as little as the cost of a box of tests ($75 on our website). The overall cost of  a rapid testing program is influenced heavily by employee turnover and the size of the business.

Questions to Help Decide Which Is Best For You

• How often do you drug test?
• How many drug tests does your company need per month?
• How high is your turnover rate?
• What are the legal requirements for employment in your industry?
• What are common guidelines other companies in your industry use?
• Does your state have any special requirements for drug testing?
• What is your budget for your drug testing program?

For most companies an in house testing program is going to save money and allow you to have more control over the process and the regularity of testing. Some small companies may only need to do 1-5 tests per year and they don’t believe the savings is worth training staff.

 

 

How you go about doing drug tests is up to you, but you can drug test staff very cheaply and evidence shows that it probably costs your company more not to drug test employees than it costs to purchase the tests.

It may surprise you to know that even though humans have been using drugs for 6,000 years drug testing is a relatively new invention. Our history of drug testing really didn’t start until the 1980s when a handful of workplace accidents spurred the federal government to take a closer look.

The earliest recorded use of drugs was by the early Egyptian dynasties. The medical and religious use of marijuana can be traced back nearly 5,000 years in China.

The Rigveda (ancient canonical text of Hindu) mentions Soma more than 3500 years ago, a drink that was extracted from a plant that was said to produce immortality. Historians and researchers believe it was a plant extract that resembled ephedrine or other stimulants.

It wasn’t until the 19th century when cultures started purifying, synthesizing and altering organic substances that drugs became more powerful and the negative effects of drug use started to become apparent.

Earliest Drug Testing in the Equine Industry

The first drug testing was used in horse racing. European horse trainers brought the techniques of doping horses with them to America which was soon adopted by many American horse trainers in the early 1910s. The first horseman that was suspected publicly of doping horses was John Oliver Keene, better known as Jack Keene, the developer of Keeneland.

While racing in Russia he began dominating the circuit. Russian trainers became suspect and devised a plan to test the horse’s saliva after they suspected Keene had fed drugs to the horses by force feeding the horse saliva to frogs. The frogs began acting erratically and soon Jack Keene was banned from horse racing in Russia.

Once back in America where he founded Raceland park and eventually Keeneland.

 

 

From 1930-1950 several drug testing labs for the equine industry were set up across the country. They mostly tested the saliva of horses using microcrystalline testing.

Saliva samples were mixed  solvents and then combined with reagents. Once the solvents evaporated the crystalline residues that were left were examined under a microscope and compared with crystals produced by known drugs used by equestrians.

In the 1950s chromatography was substantially improved by Archer John Porter Martin and Richard Laurence Millington Synge who both won the Nobel prize in chemistry for their work. Chromatography quickly became the primary technique for drug testing over the next decade.

 

 

 

Early practitioners used thin film chromatography which was soon replaced by gas chromatography.

History of Drug Testing in the Workforce: Ford Sociological Department

It is now widely accepted that drug testing employees increases productivity and safety and reduces employee turnover, but management noticed this trend long before data was collected or published about it.

In the 1910s Henry Ford’s automobile business was booming. The increase in sales meant that he needed to keep approximately 15,000 workers manning his assembly lines.

At the time auto work was a dangerous, tedious and low paying job that had a high turnover rate. In 1913 Ford had hired a total of 52,000 workers even though there were never more than 15,000 on the payroll at one time.

 

 

In 1914 Henry Ford doubled the hourly rate for his employees from $2.34 to $5. The increased salary came with strings attached. Employees had to be continually employed by Ford for 6 months before receiving their raise, and they also had to submit to the Ford Sociological Department.

Ford wanted his employees to become model citizens. Shift leaders had long suspected that employees that drank and gambled were not as productive, and such a large increase if pay afforded the company the opportunity to intrusively monitor their employees for degenerate behavior.

Besides the increase in pay Ford offered workers that signed up for the Sociological department many other incentives. These included:

• An English School for immigrants
• Assistance with transitioning from rentals to home ownership
• Low cost loans for housing and furniture
• Access to lawyers on staff
• Free access to medical care for employees and their family

The program was paternalistic, intrusive and expensive. Most workers whole heartedly bought in however because the benefits were so great that the invasion of their privacy seemed minimal.

 

 

The program was also successful. Turnover fell from 370% in 1913 to just 16% in 1915. Due to controversy, economic cost and a reorganization of the company Ford’s Sociological Department ended in 1920. Even Henry Ford himself disagreed with many of the intrusions the department brought with it. In Ford’s 1922 autobiography he said so himself.

“paternalism has no place in industry. Welfare work that consists in prying into employees’ private concerns is out of date. Men need counsel and men need help, often special help; and all this ought to be rendered for decency’s sake. But the broad workable plan of investment and participation will do more to solidify industry and strengthen organization than will any social work on the outside.” – Henry Ford , My Life and Work-An Autobiography of Henry Ford

Even though drug testing itself wasn’t a part of Ford’s sociology experiment, the whole program was an early 20th century equivalent to drug testing which has been distilled down to a single scientific test that lacks the controversy of an intrusive spy ring. The results were similar and were in line with the drive to increase productivity and worker efficiency by auto manufacturers of the day.

History of Drug Testing in the 1980s: Employment

Beginning in 1980 there were several high profile workplace accidents that were linked to on the job drug use.

In 1981 an accident aboard the USS Nimitz left 14 sailors dead and 48 injured. Property damage was estimated at $150 million and when autopsies were performed it was found that six sailors tested positive for marijuana.

The Department of Defense acted quickly adopting several new policies for drug testing and drug use in the military.

In 1987 a Conrail train crashed into an Amtrak passenger train north of Baltimore after running a warning signal. During the NTSB investigation that followed it was found that engineer Ricky Gates tested positive for marijuana and PCP. The brakeman Eddie Cromwell also tested positive for PCP but was given immunity for testifying that the crew was smoking marijuana just before the accident.

Sixteen people died in the Conrail crash and 174 were injured. The NTSB ruled that drug impairment was the root cause of the disaster.

 

 

Ricky Gates was charged with manslaughter and was released after spending 4 years in prison. During a subsequent interview with the Baltimore Sun Gates said that the accident would not have happened if he hadn’t been smoking marijuana. He said the drug threw his perception of speed and time off and that he had skipped critical safety measures in his rush to get back to Baltimore and get high.

Drug Free Workplace and Omnibus Acts

As drug use and on the job accidents attributed to drugs continued to rise it became a common story in news media.

In 1986 Ronald Reagan used his executive powers as President to issue Executive Order 12564 which required mandatory drug testing for federal employees.

In response Congress passed the Drug Free Workplace Act of 1988 which outlined drug testing regulations for businesses that received federal contracts, but also informed the drug policy of businesses across the country.

Discounts to workers compensation plans and corporate insurance lead many companies to institute their own drug free workplace policies even though they were not subject to the same federal oversight.

It became clear that the biggest dangers of workplace drug use was in the transportation industry. In 1991 Congress passed the Omnibus Transportation Employee Testing Act which requires drug testing for all safety sensitive employees in the transportation industry. The Department of Transportation oversees mandatory random drug testing and pre-screening for employees in trucking, railroads, aviation, pipeline, public transit and other transportation related industries.

Widespread Adoption and Drug Testing Advancements

During the 1980s immunoassays were developed with increased sensitivity that were necessary to detect highly potent drugs. The pinnacle of early immunoassay testing was enzyme linked immunosorbent assays (ELISA).

In 1988 with the expanding role of independent labs in testing employees subject to the drug free workplace policy the government standardized laboratory oversight with the CLIA amendment. Laboratories were subject to CLIA since the initial law was passed in 1967, but the new amendments helped clarify the regulations and policies regarding the different complexities.

In the early 1990s laboratories started using gas chromatography with mass spectroscopy (GC/MS) to confirm drug test results. This new technology brought sensitivity and accuracy to new levels.

Since more and more businesses were integrating drug free workplace policies and drug testing employees scientists developed rapid drug tests that could be used on site and give near instant results for employers.

A laboratory will now have multiple methods for testing samples for drug use and the sensitivity is many orders of magnitude smaller than isolating crystals from horse saliva. Labs can also test several different samples including blood, urine, saliva and hair.

Rapid testing has improved to the point many companies administer their own drug testing on site and only involve a lab when there is a positive or inconclusive result.

Since the 2000s new equipment that utilizes liquid chromatography with mass spectrometry (LC/MS) and triple stage mass spectrometry (LC/MS/MS). The latest advancements use what is called ultra high performance liquid chromatography with high resolution mass spectrometry (UHLC/HRMS).

While even the best LC/MS equipment was mostly used for confirmations because the number of molecules that could be tested was small and once data is collected the test could not be replayed to seek out other molecules. The new UHLC/HRMS equipment scans over a much larger range and can identify hundreds of molecules. Once the test is run the collected data can be analyzed afterward to screen for additional compounds.

 

 

Dealing With COVID and Rising Drug Use

As 2020 began COVID 19 caused many businesses to implement work from home programs and suspend random drug testing for employees to limit contact. Many researchers theorized that drug abuse would increase and as inflated numbers of overdose deaths started to come in across the country it seemed their prediction was accurate.

It came as a shock when it was reported that positive employment drug tests were at their highest levels since 2003, and that the data for that statement was from 2019 and not during the pandemic.

 

 

As the pandemic winds down and employees return to their offices it’s likely we will see another increase in positive drug test results.

If the history of drug testing has taught us anything it’s that when employees use drugs productivity and workplace safety suffers while turnover and liability increases. The National Council on Alcoholism and Drug Dependence (NCADD) estimated that 70%, or over 10 million of Americans who use drugs are employed and cost employers a total of $81 billion annually. It has never been more important for employers to adhere to a drug free workplace program.

FYL on a drug test stands for Fentanyl. Fentanyl is a commonly abused opiate, recently replacing heroin as the primary drug of choice for opiate addicts. 

What is FYL On a Drug Test?

FYL stands for Fentanyl. Fentanyl is a powerful opioid that is used in the treatment for severe pain but is also becoming widely abused. It is often mixed with Heroin to increase potency and lower cost for drug dealers. This trend has caused a dramatic rise in Fentanyl related overdose deaths. Fentanyl is 100 times stronger than morphine.

Fentanyl has a rapid onset and short duration. Withdrawl effects are more severe than heroin. Fentanyl use can be detected for up to 3 days with a fentanyl drug test.

For pain management cancer patients are often prescribed transdermal Fentanyl patches that extend the release of the drug to the blood stream. The dosage of a fentanyl patch is 25-100 micrograms per hour. Common brands are Duragesic, Abstral and Subsys.

Drug addicts defeat the extended release by cutting the patches open, mixing the contents with water and injecting the solution.

Fentanyl is also available in buccal tablets, sublingual tablets and lozenges. Besides cancer patients it is sometimes used as a treatment for breakthrough pain for patients that have a high opiate tolerance.

In street form fentanyl is a gray/white powder that is often mixed with doses of heroin. In 2017 the number of heroin overdose deaths that contained fentanyl and other synthetic opioids surpassed the number of overdose deaths from heroin alone.

Patients that have a positive drug test for fentanyl may be using diverted pharmaceuticals, but it’s more likely they are using heroin that has fentanyl or one of its analogues mixed in.

Dangers of Fentanyl

A therapeutic level of fentanyl and a dangerous amount is very small which makes using fentanyl as a recreational drug very dangerous. Naloxone injections used by EMTs are effective in combating fentanyl overdose, but recently EMTs have reported using 3 or 4 injections to revive patients because the amount of fentanyl or the strength of the analogues were so great a normal dose had no effect.

Besides being mixed with heroin and sold in powder form fentanyl is also pressed into counterfeit pharmaceuticals that resemble popular street opiates. The most common form is counterfeit 30mg oxycodone pills, but drug dealers also have been busted with counterfeit xanax, counterfeit OxyContin and several other types of pills that are pressed with molds.

Drug dealers aim to include enough fentanyl to mimic the high that the user would feel from taking the pill they are counterfeiting, but due to the potency of fentanyl the result is usually much weaker or much stronger than the pill it is based on.

Fentanyl and its analogues are being studied and sometimes deployed tactically by military and law enforcement. On October 23, 2002 during the Moscow Hostage crisis Russian authorities used a fentanyl analogue gas to subdue Chechan terrorists and resolve the incident. The gas ended up kiling approximately 137 of the more than 800 hostages that were being held.

Xylazine Used as a Cutting Agent

Manufacturers and drug dealers are increasingly turning to the drug xylazine to increase the effects of fentanyl for the end user. Unlike fentanyl, xylazine is not an opiate and doesn’t react to Narcan during an overdose. 

In 2022 the DEA found that in 2022 23% of fentanyl powder and 7% of fentanyl pills contained xylazine.  

Side Effects of Fentanyl

Fentanyl’s side effects are much like the side effects of other powerful opioids.

• abdominal or stomach pain
• blurred vision
• chest pain
• clumsiness or unsteadiness
• confusion
• constipation
• decreased urine
• dizziness
• drowsiness
• dry mouth
• headache
• increased thirst
• irregular heartbeat
• lightheadedness
• loss of appetite
• mood changes
• muscle twitching or jerking
• nausea
• numbness or tingling in the hands, feet, or lips
• pale skin
• rapid breathing
• respiratory depression
• sneezing
• sunken eyes
• swelling
• tightness in the chest
• unusual tiredness or weakness

With many companies electing to allow employees to work remotely during the pandemic, businesses are interested in the best methods of drug testing remote employees. Fortunately there are several options available for drug testing remote employees depending on your company’s specific situation.

Have Remote Employees Report to The Office for Drug Testing

The easiest method of drug testing remote employees is to have those employees come in for staff meetings or performance reviews on a regular basis. You can select employees to be randomly tested at their next meeting or call employees at random.

The primary benefit of having your employees report the office is that you do not have to change your drug testing regimen if you were drug testing on site before the pandemic.

One drawback is that once an employee has been made aware of their next appointment they can prepare to possibly be drug tested. Most people that use drugs are aware of drug testing procedures and they will be suspicious about any request to report to the office whether you mention a drug test or not.

If a company’s workforce is local to the business location and there is a skeleton staff still at the office this is by far the easiest, cheapest and most convenient option.

Since multiple employees will be entering your building you will need to escalate sterilization practices and institute procedures to safeguard everyone from viral infections.

 

 

This will include measures like taking everyone’s temperature, mandating protective equipment, having everyone use hand sanitizer, keeping an appropriate distance between employees and possibly installing sneeze guards in rooms where an employee reporting for drug testing will interact with the employee administering the test.

Keep employees exposure limited with an efficient process and sterilizing areas that could possibly be infected between appointments.

Outsource Drug Testing to a Local Laboratory or Drug Testing Company

Another option that could work well if to temporarily outsource drug testing to a third party. Employees could be notified by phone and given a set time limit to report to the lab for testing.

Some benefits of outsourcing is that a company specializing in drug testing will have more experience administering drug tests. They may catch more people trying to cheat, they will be liable for any legal issues and it removes any question of an employee of your company showing favoritism to others.

The primary drawback of outsourcing your drug testing is the cost. It can cost 10x-100x more per employee for a drug testing company or lab to administer testing. In addition to the cost drug testing facilities are prone to corruption.

In March of this year a supervisor at a drug testing facility in Las Vegas was charged with accepting bribes from federal probationers in exchange for concealing their positive and missed drug tests. The employee, Billy Joe West, plead guilty in June. In December of 2018 a drug tester in Waldorf Maryland was charged with similar crimes after accepting a bribe during an undercover sting.

Corruption in drug testing companies is rarely investigated and employees are often paid low wages. If employees that have the responsibility of testing federal parolees are so easily coerced, how easy would it be to bribe an employee that is handling employment tests?

You can always switch back in an in house drug testing program after the pandemic subsides and it could be helpful to have this option as a backup for any future issues.

Test Patients During Telehealth Screenings

One of the more adaptive clinicians we have spoken with, George L. Swanberg, a Licensed Clinical Social Worker and Licensed Substance Abuse Treatment Practitioner, and the Executive Director of Life Line Counseling Center in Warrenton Virginia, has developed a procedure for alcohol testing through Zoom meetings.

Using Alco-Screen strips and observing the patient closely he has them follow these instructions:

1. In view of the camera the client rips open the packet, removes the strip, and shows me the beige end.
2. Then, I watch him/her put it on the saliva laden tongue for about 30 sec. 
3. Then they remove it and show it to the camera for about 30+ seconds. 

Very important: I then have them place a drop of alcohol hand sanitizer on the pad and show it to me. 

If it turns green I’ve not only tested the client but tested the veracity of the test so I know they did not defeat the enzyme process by sticking it in the microwave or through another method first. 

COVID restrictions have allowed practitioners leeway in how they handle screening. It is better to develop some sort of testing guidelines than to suspend testing entirely. It is up to clinicians to set their own precedents and develop their own procedures when operating under undocumented circumstances.

DNA Verified Samples

A technology that isn’t well known in the drug testing industry is using DNA verification for laboratory samples. This would be an interesting option for companies that have remote employees scattered across the country.

The company mails the employee their urine screen with directions and the employee provides the sample at their convenience and ships it to the laboratory. An express shipping option with signature confirmation is used to strengthen the chain of custody.

The laboratory uses a one time mouth swab in combination with a sealed urine cup and can match the urine sample to the employee that is supposed to be the donor. The gas chromatography confirmation techniques used would be adjusted to specifically look for any type of adulteration as well.

Gentox lab’s NextGenUDT product is one of many DNA confirmation products available in the United States. Gentox’s CEO claims that their DNA verification definitively authenticates samples, reveals mislabeling errors, and detects urine sample substitutions.

 

 

The major drawback to this type of testing is the cost. DNA verification in addition to even the most basic laboratory test drug test would be much more expensive than an internal drug testing program. However this is an elegant solution and for some companies the benefit will justify the cost.

The benefits are that a licensed lab will be conducting the most thorough lab testing available, it would be very convenient for your employees and it reduces the risk of adulteration through substitution.

Suspend Your Drug Testing Program for a Short Time

Federal regulatory agencies have given businesses more leeway with meeting their guidelines due to the unprecedented nature of the pandemic. Many doctors offices have been allowed to schedule patients for telemedicine appointments and courts have even postponed trials.

You could contact your lawyer and ask about how a temporary suspension of your drug testing policy would affect your legal responsibilities. The American Society of Addiction Medicine has published guidelines for the unique considerations medical professionals are facing during this time.

Always consult a legal professional before taking any action that could affect your business’s adherence to your drug free workplace policy. You could be held liable down the road and even an act of God like a pandemic may not be a good enough excuse.