Drug & Alcohol Testing

A Drug Tests is a technical analysis performed to determine the presence of one or more prescription or illegal drugs in your system. Drug tests are typically used in pre-employment screening, DOT drug testing, legal or forensic investigations, random, post accident, suspicious, probation, court ordered, personal and sports screening.

Currently there are two main options for drug testing: Instant and Lab Based
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Instant Drug Tests
An instant drug test is exactly as its name implies—you get the results right away, at the point where it's collected, usually within a few minutes. It's what we call an immunoassay screening; its purpose is to detect any presence of that category of drugs in the specimen. The result is either negative (it's not present) or non-negative (it is present). An instant drug test can't officially give a "positive" result.

Other names for instant testing are "point of care testing" (POCT) and rapid tests. An instant drug test typically uses urine or oral fluid (saliva) for the test specimen.

Lab Based Drug Tests
Lab-based drug tests are more accurate. We like to say they are more rigorous, more involved, and more defensible in a court of law, all of which are elements certain organizations must consider, particularly heavily regulated industries, like the DOT.

When we say lab-based testing is "more involved," here's what we mean:
The lab will conduct an initial screening to determine if the specimen is clean of any drugs or if it has some type of drug metabolite in it. If the answer is yes to the drug metabolite, then the lab runs it through a more advanced process to confirm what the drug is, it will specifically identify the chemical makeup and the quantity.

Another layer of rigor comes with the Medical Review Officer (MRO). The DOT defines an MRO as a person who is a licensed physician and who is responsible for receiving and reviewing laboratory results generated by an employer's drug testing program and evaluating medical explanations for certain drug test results.

Certain industries, like the DOT, require an MRO to review lab results. But even if an employer isn't legally required to use an MRO, it can still choose to enlist an MRO's services for its employee drug-testing program. Again, this helps ensure the integrity of the results and the program itself. It's a smart thing to consider implementing for any job that has a safety sensitive element to it (for example, anyone operating some sort of machinery).

Rapid testing doesn't have all these protocols. Its main purpose is speed and to simply report either a "negative" or "non-negative" result.

Window of Detection & Adulteration Level

When choosing a test that's right for you, consider these 4 factors:

Urine Drug Test

A blood test is usually performed during emergencies but can also be used to detect drug compounds for pre-employment tests. Blood tests are usually an integral part of annual physicals.

Compared to other testing methods, collecting the specimen is more invasive, since it requires drawing a small amount of blood from the vein. It is also limited to recent substance use, within 2 to 12 hours prior to the test.

Adulteration level: Difficult

Hair & Fingernails Drug Test

A hair or follicle test needs a strand of your hair from your face, head, or armpit. It’s useful in providing information on a person’s cumulative substance use.

Of all testing methods, a hair & fingernails test offers the longest window of detection.

Hair from your scalp has a detection window of three months, while body hair has a window of up to 12 months. This long detection window is attributable to the tendency of drug metabolites to remain in the hair from one week after drug use up until the hair grows. As such, a hair test can offer a timeline into how long a person has been using an illicit substance.

Fingernails offer a window of detection of up to 6 months, while toenails has a window of up to 12 months. Fingernails are made up of keratin, the same material that hair is made of. As the nail grows, substances can pass from the blood vessels below the nail into the keratin fibers, where they become trapped. Fingernails are four times thicker than the typical strand of hair and often capture more of a substance than hair can. Biomarkers become locked in keratin fibers along the entire length of the nail and can be detected up to 3-6 months after drug or alcohol abuse.

However, it is not without limitations. A hair test may not be highly capable of detecting low-level or single-use cases.

Adulteration Level: Moderate

Oral Fluid Drug Test

During an oral fluid test, your mouth is swabbed to collect saliva, which is then analyzed to detect the concentration of orally consumed substances. In some cases, it can catch same-day use or residual drugs in the mouth.

However, a saliva test is not without disadvantages. Saliva production may be limited due to drug use. It also has a short window of detection of approximately 24 to 48 hours after last use.

Adulteration Level: Difficult

Sweat Drug Test

During this test, you may be required to have either an absorbent pad placed on your skin for less than 24 hours or wear a sweat patch for seven to 14 days. Like a hair test, a sweat test gives an insight into a person’s cumulative substance use. Compared to urine samples, sweat specimens are difficult to tamper with and possibly more affordable.

Adulteration Level: Difficult