Most of us are aware that many employers have mandatory drug testing, but what other situations is testing implemented in? How did mandatory drug testing come to pass? Who makes drug tests? What types of drug tests are there, and how do they work?
Lab Drug Screening History
In 1971, President Richard Nixon instructed the military to implement a drug testing program, which showed a high positivity rate among personnel returning from Vietnam. In 1982, the U.S. Department of Defense formulated drug testing requirements and procedures which formed the foundation of lab drug testing as we know it today.
Since then, Quest Diagnostics released the first drug testing index (DTI) to analyze drug use trends, and Congress passed the Drug-Free Workplace Act and the Anti-Drug Abuse Act. Later, in 1991, the Omnibus Transportation Employee Drug Testing Act was passed, which required drug testing of departmental employees and applicants.
After drug screening became prevalent, positivity rates declined consistently, suggesting that testing discourages drug use among employees, participants, and applicants. There are several medical and legal reasons for drug testing. A healthcare provider may, for example, test a patient that suffers from acute illness to help them make a diagnosis and to guide treatment.
Drug screening can be a valuable aid in a chronic setting. If a person undergoes severe changes in mood and behavior, a drug test can confirm a suspicion of abuse or accidental intake. Rehabilitation facilities may also use drug tests to determine if known drug abusers are throwing their treatment to the wind.
The results of a drug test can have legal implications as well, as narcotics can influence a person’s behavior and their ability to conduct themselves safely. Legal drug testing is typically carried out after a crime or road accident.
Lab drug screening can also be a requirement in terms of workplace or sports committee policy.
Big Three Names in Urine Testing
Quest Diagnostics is an American clinical laboratory and Fortune 500 company that was founded in 1967. The company offers high-end urine employee drug screening and is considered to be a national leader in workplace drug testing. In combination with drug testing, Quest Diagnostics also provides an extensive national collection site network and personal service.
Laboratory Corporation of America Holding or LabCorp is an American S&P 500 company and an industry leader when it comes to urine drug testing services. Quest Diagnostics and LabCorp conduct 15 percent of all testing in the United States alone, which is a relatively large percentage, especially if one takes into account that hospitals conduct the vast majority of drug testing in the country.
LabCorp offers a wide range of testing services. Their laboratories are also strategically located, and their processes are streamlined to ensure quick turnaround times.
MedTox Labs offers several employment testing options and high-end service. This company employs the latest technology to provide companies with lab urine screening services that are compliant with Federal Workplace Drug Testing Guidelines.
Different Types of Testing Procedures
Urine Drug Testing
Urine drug tests analyze urine for the presence of illegal and prescription drugs including, among others, amphetamines, methamphetamines, benzodiazepines, marijuana, and cocaine. Urine tests are widely considered to be the most reliable, as the body releases waste products from drugs or alcohol in urine.
There are two types of urine tests, namely immunoassay and gas chromatography/mass spectrometry (GC/MS). In many cases, GC/MS is carried out to confirm the results of the immunoassay. More on this later.
Saliva is becoming increasingly popular as a method to test for prescription medication and illegal drugs. Saliva testing is considered to be less invasive than urine testing, and several drug metabolites, including 6-monoacetylmorphine, amphetamine, and methamphetamine are more readily detectable in saliva than in urine.
Metabolites such as morphine, benzodiazepine, cannabis, and cocaine are not as easily detectable in saliva as they are in urine, however.
Blood testing is widely considered to be the most accurate drug testing method. This method involves the analysis of a blood sample that is extracted from a vein to detect the presence of prescription medication or illegal drugs. Blood drug tests are reliable and difficult to beat. However, it is also the most expensive and invasive of all available tests.
Hair testing is not widely used as a drug testing method, mainly because it doesn’t measure current drug use. If, for example, a person used cannabis once a few months ago, they may test positive because the residue for cannabis can remain in the hair for months.
Perspiration testing involves wearing a sweat patch on the skin for two weeks. The patch then detects the presence of metabolites in the person’s perspiration. This form of drug testing applies to situations where people have to be monitored, for example, in parole cases.
What are the Most Common Methods?
Each testing method is unique and differs in terms of costs, reliability, and suitability to the situation.
The cost of lab drug screening varies according to the method and the drugs in question. Generally speaking, a drug test can cost anything from $10 to $30 per test with the costs of hair and blood testing being on the higher end. The cost of onsite alcohol testing is the lowest and typically ranges from $1 to $10. Urine and saliva drug tests are also relatively inexpensive.
The less invasive a test is, the better, especially in a professional setting. When testing employees or applicants for prescription medication or illegal drugs, many companies will prefer saliva tests as it only requires a swab of the inner cheek instead of a urine sample.
Most of the testing methods listed above are, on the whole, accurate. Blood tests are more accurate followed by urine, saliva, and perspiration testing. Although hair testing is also a valid method to determine previous drug use, it is not a reliable indication of recent use.
Another factor that has to be taken into account is the surrounding circumstances. If, for example, one-time usage of medication drugs has to be determined, a perspiration drug test will not be suitable.
On the other hand, if a court of law wants to determine whether a person is a habitual substance abuser during, say, a child custody case, a perspiration test may be a more suitable alternative to a urine or saliva drug test.
The Most Common Methods
When taking the above factors into account, it becomes clear why urine and saliva drug testing are the most common methods, especially in employment or legal settings. Although these methods are not as accurate as blood testing, they are affordable, easy to administer, and relatively unobtrusive.
Urine Drug Testing Procedure
Before the lab drug test, the employee or applicant may not provide the employee or laboratory with information about prescription or over-the-counter medication. If the test turns out to be positive, the Medical Review Officer (MRO) will contact the employee or applicant about any medications that are present.
Specimen Collection Procedure
The specimen should be collected in a secure area by the collection site person from the employee in accordance with the required procedures. The specimen collection procedure should allow for individual privacy unless there is a reasonable suspicion that the person may substitute the specimen.
A non-medical person that oversees the collection directly should be the same gender as the person giving the specimen.
To carry out a urine drug test, at least 45 ml of urine is required. If the person giving the specimen fails to provide this amount, the collection site should provide the person 24 ounces of liquid and have them provide the sample in two hours.
Laboratory Analysis Procedure
The first urine drug test is an immunoassay test. If this test is positive, a confirmation test (GC/MS) is performed. After receiving notification of a positive test, the employee has 72 hours to request from the MRO to test the specimen in a different certified laboratory.
Reporting and Review
Upon completion of the urine drug test, an MRO examines the positive results to determine whether there is an alternative cause for the result. The MRO may also invite the employee to discuss the results. If there is a satisfactory explanation, the MRO will report to the employer that the results are negative.
Habitual use of prescription medication and illegal drugs can have a detrimental effect on an employee or applicant’s performance in the professional environment. The use of performance-enhancing drugs in competitive sports tips the scales of fairness and can cause health problems for the athlete over the long haul.
By employing drug testing methods, organizations and companies can safeguard themselves against the adverse effects that these substances have on users.
When testing someone for drugs, there has to be defined indication in mind. If this is not the case, the result will not provide the required information. The tester should know why they are doing the test, what drug they are testing for, and if they want the result to be merely positive or negative or if they want a specific drug concentration.
Urine is the sample of choice for regular clinical testing as it is easy to obtain and analyze, and because the collection of a urine sample requires no specialized training.