Drug Tests – What Do They Test For and What are the Methods of Testing?

What drugs to tests detect?

Testing conducted according to SAMHSA’s guidelines checks for  five illicit drugs plus, in some cases, alcohol (ethanol, ethyl alcohol,  booze). These five illicit drugs are:

Amphetamines (meth, speed, crank, ecstasy)
THC (cannabinoids, marijuana, hash)
Cocaine (coke, crack)
Opiates (heroin, opium, codeine, morphine)
Phencyclidine (PCP, angel dust)

However, most private employers are not limited in the number  of substances they can test for and may include drugs that individuals  legitimately and/or therapeutically take based on a physician’s prescription.  Although most private employers can test for any combination of drugs, there  are commonly selected “panels.”

The typical 8-Panel Test includes the above-mentioned  substances plus:

Barbiturates (phenobarbital, butalbital, secobarbital,  downers)
Benzodiazepines (tranquilizers like Valium, Librium, Xanax)
Methaqualone (Quaaludes)

The typical 10-Panel Test includes the 8-Panel Test plus:

Methadone (often used to treat heroin addiction)
Propoxyphene (Darvon compounds)

Testing can also be done for:

Hallucinogens (LSD, mushrooms, mescaline, peyote)
Inhalants (paint, glue, hairspray)
Anabolic steroids (synthesized, muscle-building hormones)
Hydrocodone (prescription medication known as Lortab,  Vicodin, Oxycodone)
MDMA (commonly known as Ecstasy)

Methods of testing:

There are a number of different bodily specimens that can be  chemically tested to detect evidence of recent drug use. Although some state  laws dictate which types of tests can be used, a number of options are  technologically feasible. Urine is the most commonly used specimen for illicit  drugs, reflecting SAMHSA’s guidelines, and breath is the most common for  alcohol, reflecting DOT’s guidelines.

Urine: Results of a urine test show the presence or absence of  drug metabolites in a person’s urine. Metabolites are drug residues that remain  in the body for some time after the effects of a drug have worn off. It is  important to note that a positive urine test does not necessarily mean a person  was under the influence of drugs at the time of the test. Rather, it detects  and measures use of a particular drug within the previous few days and has  become the defacto evidence of current use. Because alcohol passes rapidly  through the system, urine tests must be conducted very quickly after alcohol consumption  in order to ensure any degree of accuracy. For this reason, urine tests are  generally not helpful in detecting alcohol use as opposed to illicit and  prescription drug use, which is more easily traced in urine.

Breath: A breath-alcohol test is the most common test for  finding out how much alcohol is currently in the blood. The person being tested  blows into a breath-alcohol device, and the results are given as a number,  known as the Blood Alcohol Concentration (BAC), which shows the level of  alcohol in the blood at the time the test was taken. BAC levels have been correlated  with impairment, and the legal limit of 0.08 for driving has been set in all  states. Under DOT regulations, a BAC of 0.02 is high enough to stop someone  from performing a safety-sensitive task for a specific amount of time (usually  between 8 and 24 hours) and a BAC reading of 0.04 or higher is considered to be  a positive drug test and requires immediate removal from safety-sensitive  functions. Under DOT regulations, a person who tests at the 0.04 BAC level may  not resume job duties until a specific return-to-duty process has been  successfully completed.

Other alternative specimens that can be used for detecting the  use of selected drugs of abuse include blood, hair, oral fluids and sweat.

Blood: A blood test measures the actual amount of alcohol or  other drugs in the blood at the time of the test. Blood samples provide an  accurate measure of the physiologically active drug present in a person at the  time the sample is drawn. Although blood samples are a better indicator of  recent consumption than urine samples, there is a lack of published data  correlating blood levels for drugs and impairment with the same degree of  certainty that has been established for alcohol. In cases of serious injury or  death as the result of an accident, the only way to determine legal  intoxication is through a blood specimen. There is also a very short detection  period, as most drugs are quickly cleared from the blood and deposited into the  urine.

Hair: Analysis of hair provides a much longer “testing  window,” giving a more complete drug-use history going back as far as 90 days.  Like urine testing, hair testing does not provide evidence of current  impairment, but rather only past use of a specific drug. Hair testing cannot be  used to detect for alcohol use. Hair testing is the least invasive form of drug  testing, therefore privacy issues are decreased.

Oral Fluids: Saliva, or oral fluids, collected from the mouth  also can be used to detect traces of drugs and alcohol. Oral fluids are easy to  collect (a swab of the inner cheek is the most common collection method),  harder to adulterate or substitute, and may be better at detecting specific  substances, including marijuana, cocaine and amphetamines/methamphetamines.  Because drugs do not remain in oral fluids as long as they do in urine, this  method shows promise in determining current use and impairment.

Sweat: Another type of drug test consists of a skin patch that  measures drugs in sweat. The patch, which looks like a large adhesive bandage,  is applied to the skin and worn for some length of time. A gas-permeable  membrane on the patch protects the tested area from dirt and other  contaminants. Although relatively easy to administer, this method has not been  widely used in workplaces and is more often used to maintain compliance with  probation and parole.

When drug testing is conducted?

There are a variety of circumstances under which an  organization may require a drug test. Following are the most common or  widespread:

Pre-Employment: Pre-employment testing is conducted to prevent  hiring individuals who illegally use drugs. It typically takes place after a  conditional offer of employment has been made. Applicants agree to be tested as  a condition of employment and are not hired if they fail to produce a negative  test. However, it is possible for employees to prepare for a pre-employment  test by stopping their drug use several days before they anticipate being  tested. Therefore, some employers test probationary employees on an unannounced  basis. Some states however, restrict this process. Furthermore, the Americans  with Disabilities Act (ADA) of 1990 prohibits the use of pre-employment testing for alcohol use.

Reasonable Suspicion: Reasonable suspicion testing is similar  to, and sometimes referred to, as “probable-cause” or “for-cause” testing and  is conducted when supervisors document observable signs and symptoms that lead  them to suspect drug use or a drug-free workplace policy violation. It is  extremely important to have clear, consistent definitions of what behavior  justifies drug and alcohol testing and any suspicion should be corroborated by  another supervisor or manager. Since this type of testing is at the discretion  of management, it requires careful, comprehensive supervisor training. In  addition, it is advised that employees who are suspected of drug use or a  policy violation not return to work while awaiting the results of reasonable  suspicion testing.

Post-Accident: Since property damage or personal injury may  result from accidents, testing following an accident can help determine whether  drugs and/or alcohol were a factor. It is important to establish objective  criteria that will trigger a post-accident test and how and by whom they will  be determined and documented. Examples of criteria used by employers include:  fatalities; injuries that require anyone to be removed from the scene for  medical care; damage to vehicles or property above a specified monetary amount;  and citations issued by the police. Although the results of a post-accident  test determine drug use, a positive test result in and of itself cannot prove  that drug use caused an accident. When post-accident testing is conducted, it  is a good idea for employers not to allow employees involved in any accident to  return to work prior to or following the testing. Employers also need to have  guidelines to specify how soon following an accident testing must occur so  results are relevant. Substances remain in a person’s system for various  amounts of time, and it is usually recommended that post-accident testing be  done within 12 hours.

Random: Random testing is performed on an unannounced,  unpredictable basis on employees whose identifying information (e.g., social  security number or employee number) has been placed in a testing pool from  which a scientifically arbitrary selection is made. This selection is usually  computer generated to ensure that it is indeed random and that each person of  the workforce population has an equal chance of being selected for testing,  regardless of whether that person was recently tested or not. Because this type  of testing has no advance notice, it serves as a deterrent.

Periodic: Periodic testing is usually scheduled in advance and  uniformly administered. Some employers use it on an annual basis, especially if  physicals are required for the job. Such tests generally are more accepted by  employees than unannounced tests, but employees can prepare them by stopping  their drug use several days beforehand.

Return-to-Duty: Return-to-duty testing involves a one-time,  announced test when an employee who has tested positive has completed the  required treatment for substance abuse and is ready to return to the workplace.  Some employers also use this type of testing for any employee who has been  absent for an extended period of time.

Other: Other types of tests are also used by some employers.  For example, follow-up testing or post-rehabilitation testing is conducted  periodically after an employee returns to the workplace upon completing  rehabilitation for a drug or alcohol problem. It is administered on an  unannounced, unpredictable basis for a period of time specified in the  drug-free workplace policy. Another type of testing, blanket testing, is  similar to random testing in that it is unannounced and not based on individual  suspicion; however, everyone at a worksite is tested rather than a randomly  selected percentage. Other types of testing include voluntary, probationary, pre-promotion  and return-after-illness testing.

Department of Transportation

Anyone designated in DOT regulations as a safety-sensitive employee is subject to DOT drug and alcohol testing.

DOT Modes

FAA (Federal Aviation Administration)
FMCSA (Federal Motor Carrier)
FRA (Federal Railroad Administration)
FTA (Federal Transit Administration)
PHMSA (Pipeline & Hazardous Materials Safety  Administration)
USCG (United States Coast Guard


DOT Mandated Testing



Reasonable Suspicion / Reasonable Cause

Post – Accident




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