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What Can You Expect, What do they Drug Test For, Drug Test Types, Urine Drug Test, Blood Drug Test, Oral Fluids (Swab Drug Test,) Breath Alcohol Drug Test, Drug Test Cutoff's


What Can You Expect?
Drug testing is commonly a four-step process: collection, screening, confirmation, and review. When called in to take a drug test, the individual is met by a trained “collector,” or test administrator, who gives instructions and receives the specimen. It is also the collector’s job to complete the chain-of-custody form, which keeps track of where the specimen has been and who has handled it throughout the process. The form ensures that the specimen was handled properly and in such a way that does not call its source or the test results into question.

If the individual is providing a urine sample, a temperature strip is put on the collection container to guard against a substitute sample. A tamper-evident tape is put over the specimen container, and then the individual is asked to initial it and verify thechain-of-custody form.

Next, the specimen is screened for drugs or drug metabolites. If the screening test is positive, the test will be confirmed by a second, more exacting test. All confirmed positive tests should then be reviewed by a physician or nurse with knowledge of substanceabuse disorders to rule out legitimate prescription drug use.

Some specimens are screened at the collection site, and the initial results are known within minutes; others are screened at a laboratory. All negative screens—those that show no drugs or drug metabolites—are eliminated from further consideration. Specimens that test positive for drugs in the initial screen are examined further in the laboratory through a second analytic technique called gas chromatography/mass spectrometry (GC/MS), which is actually a combination of two specialized techniques. Technicians use gas chromatography to separate the various substances in the specimen, then they make a positive identification through mass spectrometry.

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)

Test Types
There are five primary types of drug tests: urine, blood, hair, saliva, and sweat (patch test). Most common is the urine test which has the benefit of being inexpensive and less intrusive than the blood test. They can also tested for alcohol in the hair now and they have one for the fingernails. Specimen can be adulterated, substituted, or diluted. Limited window of detection. Test sometimes viewed as invasive or embarrassing. Biological hazard for specimen handling and shipping to lab.

Results of a urine test show the presence or absence of specific drugs or drug metabolites in the urine.Metabolites are drug residues that remain in the system for some time after the effects of the drug have worn off. A positive urine test does not necessarily mean the subject 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.

Blood Test
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.

Saliva Drug Tests (Swab Test)
Traces of drugs, drug metabolites, and alcohol can be detected in oral fluids, the generic term for saliva and other material collected from the mouth. Oral fluids are easy to collect—a swab of the inner cheek is the most common way. They are harder to adulterate or substitute, and collection is less invasive than with urine or hair testing. Because drugs and drug metabolites do not remain in oral fluids as long as they do in urine, this method shows more promise in determining current use and impairment.

Sample obtained under direct observation. Minimal risk of tampering. Non-invasive. Samples can be collected easily in virtually any environment. Can detect alcohol use. Reflects recent drug use. Drugs and drug metabolites do not remain in oral fluids as long as they do in urine. Less efficient than other testing methods in detecting marijuana use. Approximately 3 to 10 days.

Hair Drug Test
Analysis of hair may provide a much longer “testing window” for the presence of drugs and drug metabolites, giving a more complete drug-use history that goes back as far as 90 days. Like urinetesting, hair testing does not provide evidence of current impairment, only past use of a specific drug. Hair testing can be usedto detect alcohol.

Sweat Patch
Another type of drug test consists of a skin patch that measures drugs and drug metabolites in perspiration. 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. The sweat patch is sometimes used in the criminal justice system to monitor drug use by parolees and probationers, but so far it has not been widely used in workplaces or schools.

Non-invasive. Variable removal date (generally 1 to 7 days). Quick application and removal. Longer window of detection than urine. No sample substitution possible. Limited number of labs able to process results. People with skin eruptions, excessive hair or cuts and abrasions cannot wear the patch. Passive exposure to drugs may contaminate patch and affect results.Patch retains evidence of drug use for at least 7 days,and can detect even low levels of drugs 2 to 5 hours after last use.

Breath Alcohol
Unlike urine tests, 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.

Drug Test Cutoff's
The Substance Abuse and Mental Health Services Association (SAMHSA) provides guidelines for what qualifies as a positive drug test. If a test does not give results higher than the guidelines, it does not qualify as a "positive" test. If an immunoassay test gives positive results, a second Gas Chromatography test must also give positive results before a result of "positive" is announced. The following chart shows the guidelines by substance.

The following chart from LabCorp gives approximate detection periods for each substance by test type. The ranges depend on amount and frequency of use, metabolic rate, body mass, age, overall health, and urine pH. For ease of use, the detection times of metabolites have been incorporated into each parent drug. For example, heroin and cocaine can only be detected for a few hours after use, but their metabolites can be detected for several days in urine. In this type of situation, we will report the (longer) detection times of the metabolites.

NOTE 1: Oral fluid or saliva testing results for the most part mimic that of blood. The only exceptions are THC and benzodiazepines. Oral fluid will likely detect THC from ingestion up to a maximum period of 18–24 hours. Low saliva: plasma ratio continues to cause difficulty in oral fluid detection of benzodiazepines

NOTE 2: Urine cannot detect current drug use. It takes approximately 6–8 hours or more post-consumption for drug to be metabolized and excreted in urine. Similarly, hair requires two weeks, and sweat, seven days.

Approximate values for detection periods
Substance Urine Hair Blood / Oral Fluid
Alohol 6–24 hours Up to 90 days 12 hours
Amphetamines (except meth) 1 to 3 days up to 90 days 12 hours
Methamphetamine 3 to 5 days up to 90 days 1–3 days
MDMA (Ecstasy) 4 days up to 90 days 25 hours
Barbiturates (except phenobarbital) 2 to 3 days up to 90 days 1 to 2 days
Phenobarbital 2 to 3 weeks up to 90 days 4 to 7 days
Benzodiazepines Therapeutic use: 3 days. Chronic use (over one year): 4 to 6 weeks up to 90 days 6 to 48 hours
Cannabis 3 to 5 days, and sometimes up to 30 days Up to 90 days Up to 24 hours
Cocaine 2 to 5 days with exceptions for certain kidney disorders up to 90 days 2 to 5 days
Codeine 2 to 3 days up to 90 days 2 to 3 days
Cotinine (a break-down product of nicotine) 2 to 4 days up to 90 days 2 to 4 days
Morphine 2 days up to 90 days 1 – 2 days
Heroin 3 to 4 days up to 90 days 1– 2 days
LSD 24 to 72 hours (however tests for LSD are very uncommon) up to 3 days 0 to 3 hours
Methadone 3 days up to 97 days 24 hours
PCP 3 to 7 days for single use; up to 30 days in chronic users up to 90 days 1 to 3 days

Some companies are getting around these guidelines by reporting the levels found without categorizing them as a "positive" or "negative" test. This seems to be a problem primarily with mail-in home tests rather than corporate testing.

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