Drug Testing vs Laboratory Testing: Complete Guide

Table Of Contents:

• Why should I be concerned about the drug test?
• What is a drug?
• Why do people use drugs?
• How are drugs obtained?
• Broadly speaking, drugs can be classified into two categories:
• How are drugs consumed?
• Why drug testing?
• Drug Test Vs Drug Screening
• What does the law say about the Instant Drug Testing and Lab-Based Testing?
• How is the instant drug test result treated by FDA and DOT?
• What procedure is adopted for Lab Drug Test?
• Factors that govern instant drug testing and lab-based drug testing
• What are the advantages of lab-based drug testing over instant drug testing?
• What if someone was exposed to the drug inadvertently and tested positive or used the drug for a valid reason?
• What are the types of drug testing?
• Urine Drug Testing
• Urine Drug Testing – Fact Sheet
• Drug Fact Sheet References:
• Oral Fluid or Saliva Drug Testing
• Hair Drug Testing
• Blood Drug Test
• Pros and Cons Lab-Based Test
• Pros and Cons of Instant Drug Test
• CONCLUSION

Why should I be concerned about the drug test?

The world of recreational drugs is dynamic, innovative and costs whooping 750 billion dollar loss to the US economy every year.

Every year, drug traffickers develop innovative drugs that are high in Psychotropic and addictive ingredients.  The traffickers have enormous resources and infrastructure at their disposal to perpetuate the heinous crimes.

The other group is busy diverting prescription drugs from the legal medical supplies network to the illegal drug marketing network and selling them as recreational drugs.

As the drug screening companies spend billions on research for smart drug testing, the traffickers are busy in developing super-smart drugs.

What is a drug?

The drug is a chemical that triggers physiological and psychological changes in humans and other organisms when consumed.

Example of Physiological Change:  Maintaining the body temperature at a constant level despite varying environmental conditions outside.

Example of Psychological Change:  Feeling composed or feeling like hanging up high in the air.  Please do remember, a drug is nothing to do either with nutrients or nutrients supplements.

Source: Wiki Pedia

Contents

• Why Should I be concerned about the drug test?
• Why drug testing?
• Drug test Vs drug screening.
• How does the law says about the instant drug testing and lab-based testing?
• How is the instant drug test result treated by FDA and DOT?
• What procedure is adopted for Lab drug test?
• Factors that govern instant drug testing and lab-based drug testing
• What are the Advantages of lab-based drug testing over instant drug testing?
• What are the types of drug testing?
• Pros and Cons Lab-based test
• Pros and Cons of Instant test
• The Final Word

Why do people use drugs?

People use drugs mainly for two purposes:

1. For the treatment of certain ailments and cures
2. For recreation and pleasure

How are drugs obtained?

Drugs are obtained from medicinal plants.  In recent times, these drugs are also produced by organic synthesis.

Broadly speaking, drugs can be classified into two categories:

• Pharmacology drugs
• Psychoactive drugs

Pharmacology drugs are the chemicals that produce biological changes in organisms.  They are used by physicians to treat certain ailments and cure diseases.  The other name of pharmacology drug is medicine.

Pharmacology drugs are scientifically studied, evaluated, and administrated.  Their action is the same on the organism and they produce the same effect under the same conditions.  Each pharmacology drug has a unique ATC code.  Pharmacology drug abuse is a serious problem in the US today.

A person who consumes pharmacology drugs is said to be under medication.  Often these drugs are used for a specified period and are consumed periodically, except in chronic ailments.

Sometimes, pharmacology drugs are abused for recreation and fun.  Addiction to these drugs leads to severe health problems and other issues at home and workplace.

Psychoactive drugs are the chemicals that affect the central nervous system (CNS) and also affect perception and consciousness.  These drugs are classified as follows:

• Depressants
• Antidepressants
• Stimulants
• Anxiolytics
• Antipsychotics
• Hallucinogens

These drugs are used all over the world to treat a variety of health conditions including mental disorders.  The most commonly used drugs are alcohol, caffeine and nicotine.  These commonly used drugs also fall into the category of recreational drugs, as they are used solely recreationally and not medication purposes.  Misuse of pharmacological drugs affects physical or psychological conditions, and cause side effects too.  A wide range of recreational drugs are illicit and their consumption is prohibited under the Single Convention on Narcotic Drugs

How are drugs consumed?

Drugs are consumed by one of the following ways:

• Inhalation
• Dissolving drugs under the tongue
• Through smoking
• By ingestion
• By injection
• Using drug patches (drugs get absorbed through the skin)

Source: https://en.wikipedia.org/wiki/Drug

Why drug testing?

Drug testing is the examination of urine, blood or another type of biological sample to ascertain if the person in question has been using the specific drug or drugs.  Many instances may require drug testing:

• Pre-employment drug screening test – Drug testing is often administrated before one joins the workplace, especially for positions that may involve transportation, airline industries, and other workplaces where public safety is the utmost priority.
• Drug testing on the reasonable suspicion – This type of drug test is solely done on serious observation of behaviors by the supervisor or coworkers.
• College or professional athletic drug testing.
• Random drug testing - to identify on-the-job drug abuse.
• Routine or scheduled drug test – Drug test that is done on employees periodically or as per the company’s schedule.
• Post-accident drug testing – A vehicular or on-the-job accident that may have involved human error and resulted in casualties or property damage.
• Return to work drug testing – If an employee’s job could lead to safety issues if the judgment or physical ability were impaired.

Many US employers do drug testing to ensure safety and security at the workplace and to keep the workforce healthy and productive.

Drug Test Vs Drug Screening

Though drug testing and drug screening detect drugs in the human system, there lies a vast difference between them.  The procedure adopted in each test is different, but the aim of both the procedures is to determine the traces of the drug in the samples taken from an individual, who is supposed to be on high on drug abuse.

The main differences are given below:

What does the law say about the Instant Drug Testing and Lab-Based Testing?

Federal authorities have certain designated drug testing labs to carry out the instant and lab-based drug tests. Testing labs that are not approved by the federal authorities follow the respective state laws.

Some states don’t allow instant drug tests while some states have some relaxation for recreational drugs.  Some states require the drug testing labs to go for confirmatory test if the sample tests for non-negative.

As the states have their laws to regulate the rapid and lab-based drug test, it is prudent to work with drug testing laboratories that comply with all the states’ laws and having presence all over the United States.

How is the instant drug test result treated by FDA and DOT?

An instant or rapid drug test refers to the drug test that gives the result instantly, at the very point of drug testing.  This type of drug test is also known as street drug testing.  It takes just a few minutes to get the result.  Technically, it’s called immunoassay screening.  The blood sample is declared as either negative or non-negative.  Instant or rapid drug test doesn’t categorically declare the blood sample as positive.

Though instant drug test detects limited drugs in urine, saliva or blood, this test is still considered vital at some places like transport, heavy machinery sites, chemical plant sites, etc., where random checks, reasonable-suspicion checks are routinely carried out.

FDA has permitted rapid test options for a limited number of drugs, but a Lab-based confirmatory test is mandatory for non-negative screening tests.

In US Department of Transport regulation, an instant urine test is not permitted by the DOT, but this test is allowed at the workplace under Non-DOT testing of drugs.

The term instant drug test is also known as a rapid drug test.  In instant drug test, urine or oral fluid (saliva) is used as a test sample.  The substances associated with the following drugs are detected:

• Amphetamine
• Barbiturates
• Benzodiazepines
• Cocaine
• THC
• TCA
• Methadone
• Methamphetamine
• Opiates
• Oxycodone
• PCP
• Propoxyphene

What procedure is adopted for Lab Drug Test?

In a Lab Drug Testing, the workplace managers would decide what drug panel test they would like to administer.  Then samples like urine, blood, hair or saliva is collected by trained drug testing personnel at a designated and sterilized room and sent to the lab for exhaustive testing procedure.  Normally, these procedures take up to three days.

Employers are required to hire the services of a certified and competent Laboratory for the drug screening program.  The drug testing is done in two steps

Immunoassay (screening method) and confirmatory tests are the most commonly used drug testing methods.  There is the least chance of inaccuracy in this procedure.  If the screening method shows a negative result, no further test is done.  Else, confirmatory test is administrated to identify the drug, its metabolites, amount of the drug, and the duration of intake of the drug.

Factors that govern instant drug testing and lab-based drug testing

• Cost Factor:  Instant drug testing is cheaper compared to a lab-based drug test (if it's done in the workplace).  Instant drug tests cost around $10 (minimum) while lab-based drug test costs can go up to $200 per person.
• Safety Factor:  Workplaces that are concerned about a high level of safety and sensitivity should opt for a lab-based drug test.  This will enable them to defend in the court of law.  Lab-based drug test can be used across the board.  There are some places (like staffing agency or a street drug checks) where instant drug testing is highly essential to get people and vehicles moving faster.
• Time Factor:  Employers mostly prefer instant drug test in instances like random checks and suspicious checks because some drugs have low detection window.  Saliva or swab testing may detect drug use as quickly as 1 to 2 hours after ingestion/use, while urine testing usually requires 2 to 6 hours to detect use after ingestion/use.

What are the advantages of lab-based drug testing over instant drug testing?

Labs take the drug test seriously and employ all the devices, specialists, and techniques at their disposal and they will not rest until the goal of detecting the drug or combination of drugs is achieved.  The test results of federally approved labs stand the scrutiny of the law enforcement agencies.

Organizations like the Department of Transportation accept only the lab-based drug test.  The sample obtained for the drug test undergoes rigorous testing procedure and standard protocol.  In case of any discrepancy in the result, the labs might consider subjecting the sample to more advanced test procedures to detect the drug, its family, and quantity.  In the screening procedure, such a lengthy procedure is ruled out.

What if someone was exposed to the drug inadvertently and tested positive or used the drug for a valid reason?

Before going to the main issue, let me tell you the instances where certain type of drug usage is legal.  For example, poppy seeds are taken orally for constipation, cough, asthma, etc.  Cannabis derivates are allowed to be sold as prescription drugs across the US and approved by the Food and Drug Administration.  Apart from these instances, there is a possibility of passive inhalation of marijuana like drugs.

The drug testing labs have cut-offs and thresholds in testing to differentiate people who used drugs intentionally from the ones who were exposed to the drugs inadvertently (for example, secondary inhalation is inadvertent).  A person is tested positive for the drug if the drug quantity exceeds the cut-offs, else the person is deemed negative.

The company can justify the drug abuse in the court only if the test result (positive) value exceeds the quantity threshold.

Industries like Department of Transportation are additionally required to get the review of the Medical Review Officer (MRO).  MROs are the licensed physician authorized to evaluate and review the drug testing report submitted by the employers.

MROs reviewed drug test report carries valid credentials and speaks a lot about the integrity of the drug test result.

Instant drug test reports do not have all these features, and cannot be cited as drug abuse proof in the courts.  Instant or rapid testing requires a lab-based confirmatory test for an authentic result.

What are the types of drug testing?

Urine Drug Testing

Drug testing in urine is the most popular form of drug tests across the United States.  This test is the only test approved for a safety-related workforce by the federal agencies.  The drug effect in urine remains for three days compared to the blood in which the drug effect lasts for a few hours.  The most common drugs detected by urine drug test are listed below.

• Nicotine
• Amphetamines or methamphetamines
• Barbiturates
• Benzodiazepines
• Cocaine
• Hydromorphone
• Hydrocodone
• Oxymorphone (oxycodone)
• Marijuana, MDA-analogues
• MDA or MDMA
• Opiates
• 6-diacetylmorphine (indicative of heroin use)

Urine Drug Testing – Fact Sheet

The drug detection time for these drugs ranges from a minimum of 2-6 hours to a maximum of six weeks (for chronic ailments).  This is a general guidance and reference table.  Range of variables like medication, food, etc., are likely to affect the drug detection results.

Drug Fact Sheet References:

1. LabCorp/Drugs of Abuse Reference Guide.
2. www.confirmbiosciences.com

Oral Fluid or Saliva Drug Testing

Oral fluid or saliva testing is the next reliable option after the urine drug test to test for drug abuse, in the case of Pre-employment testing, Post-accident testing, testing on reasonable suspicion, etc. The donor is required to avoid any drinks, beverages and food 15 minutes before the test.  This test can also be considered as a rapid or instant test.

This drug testing is not useful for detecting the drugs that have been abused for a long time.  The drug testing time in this method ranges from a few hours to two days.

This drug test is reliable in the sense that there is no room for impersonation, deception, or adulteration.  The following drugs can be detected using this method:

• Alcohol
• Barbiturates
• Benzodiazepines
• Cocaine
• MDMA (Ecstasy)
• Marijuana (THC)
• Amphetamines
• Methamphetamines
• Opiates
• Phencyclidine (PCP)

Hair Drug Testing

Hair drug or hair follicle drug test is the most reliable source of drug test when it comes to detecting the drugs.  This drug test looks for habitual and regular consumption.  The detection window for this type of test is approximately 90 days, i.e., has the longest time frame.  It gives a more complete drug use history and least form of invasive testing.  There is no question of tampering with hair samples as the test is done in full view of the testers.  Around 100 to 150 strands of hair cut right from the surface of the scalp to obtain the sample.

Hair drug is administrated to detect the following drugs:

• Cocaine
• Marijuana
• MDMA (Ecstasy)
• MDEA (Eve, Colloquially)
• Opiates
• Cocaine
• Amphetamine
• Methamphetamine
• Phencyclidine (PCP)

Blood Drug Test

A blood drug test is done to detect certain drugs and their quantities in a person's system at that particular instance.  The drugs effect remains in blood from few minutes to hours.  Blood analysis allows a very short period of detection time.  A lot of drugs get metabolized and are eliminated from the human body system.

The blood drug test allows employers and drug prohibition agencies to quickly detect the drugs that are active in blood vessels.

Blood drug testing is done with the help of a needle stick and hence it is an invasive test.  This test totally eliminates the chances of impersonation and adulteration.  The following drugs are detected in this drug testing.

• Alcohol
• Amphetamines
• Cocaine
• Fentanyl
• Marijuana
• Methamphetamines
• Nicotine
• Tramadol
• Opiates
• Phencyclidine

Pros and Cons Lab-Based Test

All the employers would like to keep their workplace safe, secure and healthy.  One thing that has all the employees worried is the question "should I go for a lab drug test or an instant drug test?”

Pros

• The lab drug test is done by experts in the drug testing field and they have in-depth knowledge while delivering the test result.
• Lab drug testing offers their own cut-offs and threshold levels of each drug.  This will enable the employer to defend their argument in the court of law.
• Lab test are highly accurate, but in reality, no test can be 100% accurate.  There is always a possibility of a false positive or false negative result in some cases, as some unknown factors might influence the test result (such as medication drugs, food habits, etc.).
• Court and Law Enforcement agencies accept only Lab Test Results that are approved by the federal agencies and strictly follow SAMHSA guidelines.  Besides, the test result's empirical data is admissible in the court.  Rapid drug test or instant drug test results are not acceptable in the courts unless employers submit the confirmatory test results from the approved labs.
• Despite the inherent drawbacks, the lab test is still considered the best option by the courts, federal agencies, and employers.

Cons

• Certain odd drugs are not included in the drug testing panels.  Employers are to pay extra for detecting these drugs.
• The lab test is not 100% fool-proof.  There is always a possibility of cheating and adulteration during the test.
• The time factor is one of the disadvantages in a lab-based test.  The waiting time ranges from 24 hours to 72 hours and some cases might take longer.

Pros and Cons of Instant Drug Test

Pros

• In this test method, the sample is collected onsite, tested in a few minutes.  For example, onsite urine drug test takes just a few minutes.  No time is lost either for hiring or random check process.  Saving time means saving money.
• The test result gives the type of drug used and the quantity of the drug used.  It is up to the employer to decide the quantitative threshold for considering the result as positive or negative.
• The instant urine drug test is becoming popular these days and many employers prefer instant urine drug tests.
• Most of the instant drug tests are as accurate as the lab-based tests.
• The instant drug test is less expensive.  The cost ranges from $10 (minimum).  The cost varies according to the type of drug and procedure adopted.
• Instant drug kits are available all over the market including Walmart and online.

Cons

Despite all the advantages the instant drug test offers, it does have its own demerits.  The employer needs to keep in mind the following things while going for an instant drug test.

• The workplace should have trained and experienced persons to handle the instant drug test.  The test needs to keep a strict vigil on the cheaters.
• Instant drug test offers a limited choice of drug test panels, so all the drugs and their derivates can't be detected in this test.
• The instant drug test can be justified in the case of potential employees who are going to take up sensitive positions at the workplace.  Such positions or jobs require exclusive lab-based tests.
• Agencies like FDA and DOT prefer lab-based test than instant drug test.
• Instant drug tests can’t disclose the drugs that have been abused for a long time whereas
  lab-based drug tests can detect the duration of drug abuse in the past).

CONCLUSION

Businesses should choose drug tests (Instant or Lab-Based) that meets the best safety and quality standards in the business.  Drugs test in the past has proved to have decreased turnover rates, increased employees' well-being, and productivity.  Many types of research have pointed out that an effective drug testing program has discouraged the workforce from taking drugs.  Further, the drug testing program at workplaces ensures the safety of machinery, hardware, and life.

Employer should decide on:

• What type of drug test would be appropriate for their employees (like a pre-employment test, random test, return-to-work test, post-accident test, follow-up test, and test under reasonable suspicion)?
• What drug test is appropriate for employees and their positions?
• What panel of drug test is the best for workplace?
• Drug testing schedule and the cost analysis.
• Prepare a yearly drug test schedule and the cost involved.

Though the lab-based test is still considered authentic, reliable and accurate, the popularity of instant drug tests is increasing.  Instant drug tests are now compliant with certification too.  Some instant drug tests strictly follow the guidelines mandated by C.L.I.A.