Drug Testing: What Test is Right for You?

By Accutrace, Inc.

In a recent report Quest Diagnostics looked at drug use in the U.S. workforce between 2013 to 2017 and compiled the following key insights:

  • Cocaine positivity rates increased for the fifth consecutive year in the general U.S. workforce across every specimen type
  • Marijuana positivity continued its five-year upward trajectory
  • Increases in marijuana positivity rates were most striking in states that have enacted new recreational use statues
  • Methamphetamine positivity skyrocketed in the Midwest and Southern states
  • Prescription opiates continue to decline in workforce testing data

Quest research, 2018

Now, I’m no math wiz, but when you look at the frequency and increases of positive results in the workplace, well – that highlights the importance of not only new hire drug testing but also random testing for active employees. Your drug screening vendor’s ability to provide ongoing support beyond your new hire’s first day is just as important as their ability to provide the right drug test during your hiring process.

At Accutrace/link, we develop drug testing solutions for our clients based on your needs, customizing our approach to accommodate a client who wants to create a custom test package for new hires in a particular industry or job position. Accutrace also provides random drug testing through our Medical Review Officer to ensure your active employees’ safety. Accutrace can provide random drug testing on a quarterly bases to as frequently as a daily bases if required.

Drug Tests by Industry

So you know the importance of drug testing in your hiring process? – Check.

Next, we want to run through a few industries specific drug tests that you should be aware of when considering which test is right for you. The truth is, most people may not think about whether their drug test is industry appropriate until they’re suddenly asked to provide a record of it because of an incident or reasonable suspicion of an employee. That’s when we scramble, and it’s too late.

Transportation & Logistics

In 1991, the U.S. Congress passed the Monibus Transportation Employee Testing Act when they recognized the need for a drug and alcohol-free transportation industry. That act required DOT agencies to implement drug and alcohol testing and safety-sensitive employees to maintain the safety of the traveling public and workers.

Some DOT departments with safety-sensitive employees include:

  • Federal Aviation Administration
  • Federal Motor Carrier Safety Administration
  • U.S. Coast Guard
  • Pipeline and Hazardous Materials Safety Administration
  • Federal Railroad Administration
  • Federal Transit Administration

Now that we know the why and who of DOT drug testing, let’s take a look at the what. For starters, all DOT drug tests must use urine samples and all DOT drug tests use the same 5-panel test including:

  • Marijuana metabolites/THC
  • Cocaine metabolites
  • Amphetamines (including methamphetamines, MDMA)
  • Opioids (including codeine, heroin (6-AM), morphine, hydrocodone, oxycodone, hydromorphone, and oxymorphone)
  • Phencyclidine (PCP)

Accutrace supports DOT drug testing with many of our partners and allows you to complete testing in a number of situations. The most common is on a Pre-Employment basis. But you will also need to conduct testing for reasonable suspicion/cause, random testing, return-to-duty, and post-accident testing. The Accutrace platform allows you to track all testing and reasons for complete HR record keeping, initiated and completed via an electronic chain of custody and our nationwide network of testing locations.

Healthcare Professional Drug Tests 

When we go to the doctor or are admitted to the hospital, we rely on our medical professionals to make decisions that impact our health and our life. With so much at stake, it goes without saying we need our medical professionals to be of a clear mind to provide the best outcomes. Despite their knowledge and extensive training, they are just as at risk for substance abuse as the general public. This is why Accutrace provides a specialty panel that test for both illicit drugs, and other drugs that are readily available in hospitals and medical centers by medical professionals.

The Accutrace medical professional drug test begins with a base panel including:

  • Amphetamines
  • MDA Analogues
  • Barbiturates
  • Benzodiazepines
  • Narcotics
  • Cannabinoids
  • Cocaine Metabolites
  • Phencyclidine

Accutrace also allows panels to be customized by adding additional drugs including:

  • Narcotics
  • Antidepressants
  • Antihistamines
  • Simulants

Our comprehensive and highly customizable mix of drug and cutoff-level panels enables our healthcare partners to target illegal drugs and the areas of specific risk based on access to prescription drugs.

OSHA Drug Testing 

OSHA drug testing is designed to identify possible employee exposures to contaminants in the work environment to reduce employee attrition, increase job satisfaction, improve overall morale, as well as protect your company by reducing your exposure to risk.

Accutrace offers a full line of testing services that can assess exposure to harmful or hazardous substances in accordance with the U.S. Occupational Safety and Health Administration (ASHA) regulations.

By utilizing the OSHA specific drug testing you’ll be afforded the following benefits:

  • Conduct ongoing safety reviews by tracking exposure levels.
  • Accutrace offers consistent, accurate, standardized testing procedures and data.
  • Employees have convenient access to high-quality testing through employer-owned, on-site clinical occupational health centers.
  • Accutrace works with you to establish specific risk factors inherent to your workforce environment, then determine the appropriate safety testing specific to your needs.

How Does the Screening Process Work? 

After you make an offer to your new hire, you will order a drug test to be taken before they can start work.  When Accutrace receives your order, we will send your new hire a Chain of Custody form (CCF).  The new hire takes the form to the collection point, submits their sample at which point the sample goes to the lab.  Next, an Accutrace Medical Review Officer (MRO) reads the results and determines whether the tests are positive or negative, and returns the results.  If the results are positive, the MRO will order the confirmation test to eliminate a false positive.  Once the MRO is sure of the results, the MRO will send the confirmed results back to Accutrace for inclusion in our complete screening report and our customer is notified of the results. 

Below you can see a graphic of how this process works: 

Drug Test Administration Methods

I mean, who cares how the drug test is administered, anyway?

The answer: A lot of people. More importantly, though, you should and whether yours is an oral test or a blood test can make a big difference. To be fair, I know you might be suffering from information overload at this point. But what guide to drug testing would be complete if we didn’t review the different methods available for drug test administration?

Below, we’ve outlined each method for drug testing and the differences you can expect between each, from how far back you’ll be able to test for drugs, to how easy it is to administer.

Oral Testing

Also called saliva testing, is very easy to do and super effective.  This type of testing involves simply swabbing the inside of a donor’s mouth and sealing the swab in a tamper-proof tube.  This is tamper proof because the sample never leaves the collector’s hand and it is sealed in front of the donor.  Then the tube is sent to the lab for analysis.  Oral testing can detect the presence of drugs in the donor’s body up to three days after ingestion.

Urine Testing

This type of screening is the standard test for the workplace and required for DOT drug testing.  The new hire donor goes to the collection point and provides a urine sample in the collector’s restroom in the testing area.  No personal items are permitted in the restroom with the donor so as to keep the sample free of contamination or tampering by the donor.  The collector instructs the donor how to collect their sample and return it to the collector who seals the container with tamper proof tape in front of the donor.  Urine testing also detects the presence of drugs up to three days after use.

Hair Testing

This method involves taking a small sample of hair from an inconspicuous place, such as the back of the head below the crown, and testing it in the lab.  This is a highly effective test because this test can detect the presence of drugs up to 90 days prior to the day of the test.  Drugs reside in the shaft of the hair, with recent usage appearing near the scalp and past use further out on the hair sample. 

If a donor does not have head hair, body hair can be substituted.  Body hair can even be collected from multiple locations on the body to get the amount needed for the test.  

Blood Testing

Also, an option for some industries, especially if your company wants to detect illicit drugs.  Marijuana remains in the body for up to 24 hours after a single use, but up to seven days for regular use.  Cocaine and amphetamines are detected up to three days after use.

Beware of False Positive Results

There are times when your new hire is legitimately taking prescription or over the counter medications that show up in drug testing.  When this happens, it is called a “false positive” result.  Some of the common drug classes that may produce a false positive are:

  • Antihistamines
  • Antidepressants
  • Antibiotics
  • Analgesics
  • Decongestants
  • Some OTC medications

At the lab, when a positive result is returned, the lab will retest the unused portion of the donor’s sample and do a more sensitive test to determine the concentration level of the drug found.

Each test has a cutoff level where concentrations that fall below the test concentration are negative and those that are above the cutoff level are positive.  Even ibuprofen (Bufferin) and NSAIDs (Advil) can cause a false positive for barbiturates! Any positive drug test can result in negative consequences for the new hire that is not warranted so accurate, reliable drug testing is extremely important. 

When a false positive is returned, a second confirmatory test is performed to ensure that the results are correct.  The confirmatory test uses a different, more sensitive test (Gas Chromatography-Mass Spectrometry) to greatly reduce the chance of a false positive result.  A company’s human resource department should develop a policy on what actions should be taken when they receive a positive result.  New hires should be able to report the medications they are currently taking so that can be considered before the tests are done.

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