A drug test is an analysis of a biological sample used to determine the presence of specific substances. These tests do not usually indicate whether or not the subject is impaired at the time they are administered, just if the person has used any of the substances being tested for in a set period of time. Drug tests are administered for a variety of reasons in several different ways. Drug tests are a way to determine if a person is using illicit drugs, which may indicated a problem with substance abuse.
The National Institute of Drug Abuse (NIDA) estimates that drug abuse and addiction cost society around $524 billion a year in lost workplace efficiency, health care costs, crime, and legal troubles. Employers may test their employees in order to ensure a drug-free workplace and protect their investment.
An estimated 67.9 percent of adult illegal drug abusers are employed at least part-time and many of them full-time, according to NIDA. Drug testing may reduce or deter substance abuse at places of employment that drug test their employees as a condition of employment. Many athletic programs, including schools and professional sports organizations, test for the presence of ability-enhancing or illegal drugs. Schools that administer random drug tests are only allowed to do so legally for students who participate in extracurricular competitive activities that may include sports or student clubs, or for students who demonstrate just cause or suspicion of drug abuse.
Home tests are also available, and some parents may choose to test their teenagers for the presence of illicit drugs. Drug tests may also be court-ordered as a condition of parole or as part of a substance abuse treatment program.
Drugs Test Methods
There is a certain amount of flexibility in drug testing, and some tests are more accurate than others. There is not a standard for all drug testing, although the Substance Abuse and Mental Health Services Administration, SAMHSA, along with the U.S. Department of Health and Human Services (DHHS) have a standardized procedure that federal agencies must follow. Private employers who drug test are not usually required to follow federal guidelines, although many do so for legal reasons.
Drug tests can be administered at the workplace, at a health clinic or medical office, or at a laboratory, as well as at home via drug-testing kits. Drug testing accuracy depends in part on the type of test used and standards observed. Drug tests use biological samples from the body in order to check for the presence of drugs and sometimes alcohol. Drug tests may test one’s:
- Saliva or oral fluids
Likely, the most common and least expensive drug tests involve urinalysis. For these tests, you collect a urine sample by urinating into a specimen cup and levels of antigen-antibody complexes that your body produces when drugs are present are counted in nanograms per milliliter, ng/mL. Drugs can be detected through a urine drug test for anywhere from one day to one month after use, depending on the type of drug abused, duration of abuse, and amount of drug abused. They are detectable longest for chronic abusers, as published by Yale University.
There are two levels of urinalysis drug tests: immunoassay and gas chromatography or mass spectrometry. The first is the most cost-effective, produces immediate results, and generally is used as an initial test, although it may not be as accurate as other methods. False positives are possible, and certain types of drugs may be missed. Often, a secondary gas chromatography or mass spectrometer test is ordered that also tests urine. It is more accurate, but also more expensive, and it takes longer to complete.
Federal drug tests use a split sample, meaning they take the urine sample, split it in two and first test with immunoassay methods and then gas chromatography or mass spectrometer methods if the first test was positive. This is called a confirmation test after the initial screening test. All federal drug tests are required to be performed at SAMHSA-certified labs and follow strict guidelines and chain of custody procedures, ensuring the samples are handled correctly, thus reducing the margin for error.
At-home, or portable, drug test kits can be purchased online and over the counter for as little as $10-$20 apiece. These kits are typically urine tests that check for the presence of illegal or prescription drugs. Depending on the kit, the presence of different drugs may be tested. If you are administering the test to check for specific drugs, be sure to read the label to ensure that your test will detect the drug you are interested in.
The U.S. Food and Drug Administration (FDA) reports that these tests are fairly accurate in determining a preliminary presence of illicit drugs if used correctly. If you get an initial positive result, you are supposed to then send the sample to a laboratory for further testing, which will cost you more money but provide you with more accurate and detailed results. If you get a negative result, but still suspect drug abuse, check to ensure your test detects the correct drugs, wait a bit, and administer the test again. Drugs may take a few hours to reach the urine and show up on a drug test.
Drug Detection Window
Blood tests are generally considered more accurate than urinalysis and detect drugs currently in the system. The U.S. Department of Labor, DOL, estimates that drugs stay in the system and are therefore detectable by drug tests for the following amounts of time:
- Alcohol: 1.5 hours for one ounce
- LSD: 8 hours
- Heroin metabolite: less than 24 hours
- Amphetamines: 48 hours
- Methamphetamine: 2-3 days
- Methadone: 2-3 days
- Morphine: 2-3 days
- Marijuana: 3-4 days for casual users; several weeks for chronic users
- Cocaine: 2-10 days
- Barbiturates: 2- 10 days
- PCP: 1 week
- Benzodiazepines: 2-3 weeks
Alcohol generally leaves the bloodstream quickly, and it is difficult to detect in urinalysis. Therefore, a breath test can be administered to determine the amounts of alcohol in the blood, or blood alcohol concentration (BAC). This is one of the only types of test that measures if someone is currently impaired, and it is only effective while alcohol is currently in the bloodstream.
Oral fluid testing is done via a swab of the mouth, is easy to administer, harder to fake or beat, and shows promise at the possibility of detecting current levels of impairment for certain drugs, such as marijuana, cocaine and amphetamines or methamphetamines. Drugs remain present in oral fluids for an even shorter window than they do in urine, around 5- 48 hours, according to Yale University.
Sweat tests are also easy to administer and done by placing a large adhesive bandage on an area of skin that is worn for a length of time. This method may be more widely used to maintain compliance during probation and parole rather than in the workplace.
Hair testing provides the longest window for detecting prior drug use and may be able to detail drug use history for as long as 90 days. Like the urine test, hair testing does not indicate current levels of impairment, although it may paint a more complete picture of drug abuse or use. While hair testing does not provide any information on alcohol use or history of use, it is the least invasive type of drug test.
Drugs Tested For
The federal drug panel tests for the five most commonly abused types of drugs:
- Amphetamines: speed, ecstasy, meth, crank
- Cocaine: crack, coke
- Opiates: heroin, codeine, morphine, opioid narcotics
- Phencyclidine: PCP, angel dust
- THC: marijuana, hash, cannabinoids
Sometimes, alcohol, in the form of ethyl alcohol or ethanol, is added to this panel. The National Survey on Drug Use and Health (NSDUH) reported that 24.6 American adults over the age of 12 had abused illicit drugs in the month prior to the survey in 2013. Marijuana was the most commonly abused drug with 19.8 million people using it, psychotherapeutic drugs were abused by 6.5 million people, cocaine was abused by 1.5 million people, 1.3 million people abused hallucinogens, and 0.3 million people had abused heroin in the previous month.
Depending on the reason for the drug test or suspicion of drug abuse, additional drugs may be added to the five-drug panel. For instance, if a sports organization wishes to test for the presence of performance enhancers, it may add them to the original panel. Private employers may wish to check for prescription drug misuse by adding sedatives or tranquilizers to the panel. A traditional eight-panel test will add barbiturates, benzodiazepines, and methaqualone to the panel while a 10-panel test adds methadone and propoxyphene. Hallucinogens, anabolic steroids, MDMA, hydrocodone, and inhalants may also be added to drug-testing panels.
History of Drug Testing
Drug and substance abuse continues to drain society and impact communities and families all over the world as well as closer to home. The NSDUH reported that 22.7 million adults over the age of 12 in the United States needed treatment for a substance abuse problem at a specialized facility in 2013. Only 2.5 million, or 10.9 percent of those needing treatment, actually received it that year.Denial is one of the most common reasons people do not enter into drug or alcohol treatment programs. While drug testing does not force someone to enter into treatment, it may act as an indicator that a problem exists. Continual drug testing after treatment may also help addicts maintain sobriety in order to avoid negative consequences. Workplaces, schools, and professional sports organizations are taking anti-drug stances as well and stating that drug abuse is not socially acceptable in an effort to deter substance abuse.
The American military was the first to adopt drug-testing policies in this country, due to drug and alcohol abuse within its ranks.
Within eight years after initiating mandatory drug testing, military drug abuse dropped 80 percent, as published by the Journal of Global Drug Policy and Practice. Federal employers and workplaces were quick to pick up drug testing in 1986 under the direction of President Ronald Reagan as a result. Federal guidelines were written and mandated for drug testing in 1987 and continue to be updated and modified today. The United States Department of Transportation (DOT) followed suit and issued a set of rules for its subsidiaries and employees in 1988.The private sector, particularly employers engaging in dangerous work, was close behind in asking their employees to submit to drug testing. State agencies were then forced to enact legislation regulating drug testing, establish set guidelines to protect employees, and ensure that they would be directed to the proper level of care required if a drug test was failed. While private employers are not required to drug test, many states give workers compensation discounts to workplaces that do comply with drug testing.
Controversies Surrounding Drug Testing
Required and random drug testing evokes a moral dilemma as more and more companies across the country are adopting drug-testing policies and requirements. Some argue that random drug testing is an invasion of privacy, that drug testing may lower company morale and give the impression that employers do not trust their employees, and that drug tests do not always directly correlate with workplace performance either. Critics argue that drug testing does not account for workplace accidents that are related to other factors such as fatigue and even alcohol abuse, and that impairment testing may be more beneficial and less invasive.
Many drug panels also test for the presence of legal, prescription drugs including painkillers. While these can impair users and be misused, this is not always the case, and employees using prescription drugs correctly may be unjustly terminated due to a positive drug test. The New York Times published that one doctor estimated that 15 percent of his patients misused painkillers, giving validity to including these substances in the drug test panels.
Drug testing is also not always accurate, and false positives are common. Drug tests may also be expensive to follow up on if you have gotten a false positive and require a confirmation test. Non-standardized procedures and regulations may lead to improper testing techniques and reliability issues. Not to mention drug tests can be beaten, and many methods are used in order to obtain false negative results.
It is imperative that drug-testing procedures be followed up with correctly. If a positive result is obtained, for example, there needs to be a policy in place that permits necessary treatment plans. Substance abuse may indicate a larger problem, including mental health issues or addiction, which is a treatable chronic brain disease.
Here at Orlando Recovery Center, we provide comprehensive and compassionate treatment that includes behavioral therapies, counseling, educational opportunities, attention to physical and emotional well-being and health, as well as family and peer support groups. A professional can help you better understand the results of a drug test and the subsequent required steps you should take. Contact us today.
The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.