Drug Testing Overview
Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Feb 14, 2019
Last Modified Date: Feb 14, 2019
Published Date: Dec 10, 2018
What is drug abuse?
It is a condition characterized by a destructive pattern of drug use that leads to significant problems or distress for drug users and those around them. Whether it is alcohol, prescription, or illicit drugs that are abused, it generally begins with casual experimentation, spurred by curiosity or the urging of friends who are using drugs. While many people experiment without developing a drug abuse problem, others find drug use more difficult to control, becoming regular drug abusers. Left unchecked, drug abuse can progress to drug addiction.
How to Identify a Drug Abuse Problem
Knowing the signs of drug abuse can help you spot a problem in a friend or family member and intervene before it develops into an addiction – a serious chemical dependency that causes changes in the brain that lead to withdrawal symptoms when drugs are not used. Five of the most common signs of drug abuse are:
1. Changes in Interests, Friends – Individuals who have developed a drug abuse problem may lose interest in activities that they typically enjoy as their lives become consumed with drug use. They may also spend less time with family and long-time friends, either spending that time with a new, drug-using crowd or becoming isolated, spending most of their time alone. These changes may be accompanied by the individual becoming secretive about his or her daily life and defensive, argumentative or hostile when questioned closely about it.
2. Changes in Sleeping and/or Eating Habits – Drug abuse typically leads to erratic sleeping habits, so if your friend or loved one is suddenly keeping odd hours, staying awake for lengthy stretches of time or sleeping more than usual, these changes can be an indication of drug abuse. Erratic eating habits are also common, and may include long stretches without food and/or binging at odd hours.
3. Appearance Changes – You may notice rapid weight gain or weight loss, blood shot eyes, dilated pupils, sniffling, itching, injection marks, dark under-eye circles facial puffiness or pallor. A person who is abusing drugs may become complacent about personal hygiene, so you may notice that he or she isn't brushing teeth, showering or changing clothes as often as usual.
4. Erratic Behaviors, Moods – Drug abuse often causes erratic moods and behavior. If your friend or family member seems down in the dumps one minute, then super-charged the next, such rapid mood swings can indicate drug abuse. Other behavioral signs to watch for include evasiveness or dishonesty, depression and uncharacteristic excitability, violence or destructiveness.
5. Work, School, Financial Problems – If a typically responsible friend or family member begins having trouble keeping up with daily obligations, drug abuse may be an issue. Perhaps he or she has missed more work or school than usual or is performing poorly in the workplace or classes. Maybe they are letting responsibilities at home slide, such as daily chores or errands. Perhaps there are financial problems, bills not getting paid as usual, for instance, or a lot of borrowing.
If you notice any of these signs and suspect drug abuse, further investigation to confirm your suspicions is warranted. If possible, look for drug paraphernalia among your friend or family member's belongings, such as cigarette rolling papers, marijuana smoking pipes, burnt spoons, lighters, syringes, or razor blades and cutting surfaces, like mirrors or glass. Additionally, large amounts of eye drops meant to reduce redness may be an indication of frequent drug use.
Now that you know the answer to the question “what is drug abuse” and have recognized the signs in your friend or family member, taking action is the next step. That means helping that person get the support and treatment they need to stop abusing drugs.
Start by gathering information on the long and short term effects of drug abuse, as well as treatment programs and facilities in your area. Then, talk to that person calmly – when he or she is sober – letting him or her know your concerns about how drug use is affecting them, both mentally and physically. Point out the damage drug abuse is doing to relationships with friends and family, and how it is affecting work and/or school performance. Offer to help your loved one get counseling or drug treatment as necessary, presenting them with your list of local resources.
Individuals who are abusing drugs may not be forthcoming about their habits. Drug testing is the most effective means of finding out exactly which drugs are an issue, detecting the presence of marijuana, opiates, cocaine, amphetamines, barbiturates, pain-killers, muscle relaxers and anti-anxiety medications, among many others. Above all, do not speak or behave as if a drug abuse problem is something to be ashamed of. Rather, treat it as what it is – an illness that needs management and/or medical treatment.
Common Pre and Post Employment Drug Screenings
Employment drug testing has become commonplace today. While it is legally required in some industries – particularly the transportation industry – many employers establish drug testing programs on their own. The reason for this is that substance abuse has a big impact on worker safety and productivity. According to U.S. Department of Labor estimates, drug use in the workplace costs employers between $75 and $100 billion every year in lost time, accidents, healthcare expenses and workers compensation costs. Substance abusers incur 300 percent more health care expenses than the average worker and are five times more likely to file workers compensation claims. Additionally, 65 percent of on-the-job accidents related to drug or alcohol use. This problem is not likely to go away soon. The National Survey on Drug Use and Health shows that the use of illicit drugs – particularly marijuana and heroin - has increased over the last five years.
About Employment Drug Testing
The most common type of employment drug testing done today is pre-employment testing, which screens potential new employees for substance abuse before they are hired. A growing number of employers also screen existing employees. This may include random drug testing for safety-sensitive positions, individualized testing of employees suspected of drug use, post-accident drug tests, and testing required by law in certain industries, such as testing of truck drivers mandated by the U.S. Department of Transportation.
Mandated Employment Drug Testing
Employers who are mandated by federal law to drug test employees, including government agencies, are required to follow guidelines provided by the Substance Abuse and Mental Health Services Administration (SAMHSA), a branch of the U.S. Department of Health and Human Services. Those guidelines require that employees be tested for five illicit drugs, which is typically done with a standard 5 panel drug test that detects the following:
Amphetamines, or stimulants, including methamphetamines and speed THC, from marijuana or derivative drugs, such as hashish Cocaine Opiates, including heroin, codeine, morphine and opium Phencyclidine, commonly called PCP or angel dust
Companies that must follow U.S. Department of Transportation drug testing mandates are required to use a variant of the 5 panel urine test that detects a wider range of amphetamine drugs. As of 2010, the D.O.T. added initial testing for MDMA and confirmatory testing for MDMA, MDA and MDEA, which are ecstasy-type drugs, to their amphetamine testing requirements.
In both cases, testing must be completed through a certified laboratory that adheres to standardized testing procedures and guidelines established by SAMHSA.
Voluntary Employment Drug Testing
Private employers who do not fall under federal drug testing mandates have greater latitude in their drug testing programs. While some of those employers use that minimal 5 panel drug test, many others opt to do more thorough testing to better ensure workplace safety and productiveness. Among the more popular options in expanded drug testing include:
9 Panel Drug Testing – A standard in the industry – it tests for a number of recreational drugs including THC, cocaine, methamphetamines, and PCP. It also looks for commonly abused prescription drugs like morphine, barbiturates, amphetamines and benzodiazepines.
9 Panel Drug Test + Alc-Scr – This urine test combines the tests in the previous panel with a standard alcohol screening test.
9 Panel Drug Test + Oxy + Crt – This panel adds tests for Oxycodone (also known as Oxycontin) and Creatinine. The Creatinine test measures the level of creatinine in the blood. High levels of creatinine in the blood can indicate kidney problems. Low levels may indicate that the person being tested attempted to ‘trick’ the test by drinking large amounts of water to flush signs of drug use out of their system.
10 Panel Drug Tests – These test for the standard 5 substances, along with a variable selection of prescription and/or illicit drugs according to an employer's preferences.
Nicotine and Metabolite Quant Test – This is a blood test that measures for the presence of nicotine and its metabolites in the blood. Some employers may test employees’ nicotine levels for reasons pertaining to health care benefits or as a means of ensuring a tobacco-free workplace.
How Employment Drug Testing Is Done
While some employers have facilities for drug testing on-site, most send potential hires or employees to local laboratories for testing. As a rule, urine samples are put through an initial screening. Then, if results are positive for any substance, a second test is done for confirmation of those results. If that second test confirms a positive result, most employment drug testing programs will have the results reviewed by a Medical Review Officer (MRO), an independent physician who will determine whether there may be a medical explanation for that positive result via additional testing and/or contact with the test subject. Drug testing programs that utilize these standard procedures are quite dependable, producing accurate results for employers who are striving to create a safe, drug-free environment for their employees.
Which is the Best Drug Testing Method
Drug testing has become a commonplace precaution in today's world, used by employers to ensure safer workplaces and in some industries, to meet legal drug testing requirements (PDF). Testing is also commonly used to monitor patient progress in drug treatment programs, by drug courts, and by concerned parents who wish to detect drug use in their children or teens. A variety of testing methods are used today, with the urine test and saliva drug test among the more popular options. Which, of the two, is the best? Each has pros and cons, which we'll outline here.
How Urine Drug Testing Works
For urine tests, also known as urinalysis, the test subject provides a sample of urine, which is then tested for indications of drug use in one of two ways. In on-site drug testing, a test card is used for immediate screening results. The accuracy of instant urinalysis varies to some degree according to the particular test kit used. Traditional urinalysis, in which the urine sample is sent to a lab for more stringent analysis, is generally considered more reliable than instant testing. Typically, this is done via an initial screening, called an immunoassay, with any positive findings confirmed with gas chromatography – mass spectrometry, a test that provides a more in-depth analysis.
Urine Drug Testing: The Pros and Cons
The pros of urine tests for drug screening include reliable, accurate results. Urine tests have long been the standard for drug screening, their technology tried and true in terms of reliability and accuracy, with extensive study and use providing a solid body of scientific evidence of their efficacy. For that reason, results of urine tests are more likely to be accepted as evidence in legal actions related to drug testing or drug use. Other advantages include a wider detection window for many common substances than saliva tests, which can aid in identifying chronic drug use.
The chief disadvantages of urine tests is the potential for sample adulteration by test subjects, and privacy issues due to that potential, since the surest means of protecting against that possibility is observation as samples are produced. Numerous testing methods have been developed to detect adulterations accurately, but these extra steps do increase the expense of urine drug testing.
How Saliva Drug Testing Works
Saliva, or oral fluid, drug tests analyze a sample of saliva collected from a test subject for indications of drug use. Sample collection is done via a swab, which is placed in the subject's mouth, between the cheek and lower gum, for about two minutes to absorb saliva. Some saliva drug test kits provide instant, on-site results, while others require swabs to be sent to laboratories for analysis.
Pros and Cons of Saliva Drug Testing
Pros of saliva tests include less invasive sample collection and a greater ability to detect current intoxication as compared to urine tests, making it very popular for post-accident testing in the workplace. Additionally, since the collection process is less invasive, it allows easy observation throughout the testing process, greatly reducing the potential for sample adulteration.
Cons of saliva testing include a smaller window of detection, with these tests most reliable in detecting very recent drug use, occurring within 24 to 48 hours. While saliva testing is largely considered reliable and accurate, it is a fairly new technology as compared to urine testing and is not as well accepted. Additionally, saliva drug testing may not be considered acceptable under the guidelines of federally-mandated drug testing programs that certain industries are required to follow.
When it comes to the question of saliva test versus urine test, the answer depends largely upon the individual goals and circumstances of the person or organization performing the tests. For instance, the employer looking for a quick, convenient means of on-site screening in the workplace may find saliva tests the best drug testing method, while those who wish to cover all the bases in case of legal challenges to the results may choose to go with urine tests.
Additionally, the longer detection window of urine testing may make it the best testing method for the employer, parent or drug counselor who is interested in establishing an overview of a person's pattern of drug use. On the other hand, the narrower detection window of saliva testing makes it more useful for detecting current impairment or very recent drug use, a plus in post-accident testing and for parents or counselors who need to know whether test subjects have used drugs today. So, the bottom line is that the best testing method depends on what you're hoping to accomplish through the testing process.
Lab Tests (A-Z)
This test measures the level of Carbohydrate-deficient Transferrin (CDT) in the blood.
The 9 Panel Drug Test offered by Health Testing Centers is the industry standard screening test for the detection of common drugs. TEST AVAILABLE AT LABCORP ONLY
The 9 Panel Drug Test plus alcohol screening offered by Health Testing Centers is the industry standard screening test for the detection of alcohol and common drugs. TEST AVAILABLE AT LABCORP ONLY
The 9 Panel Drug Test plus Oxycodone offered by Health Testing Centers provides additional detail regarding specific opiate types in a person's system. TEST AVAILABLE AT LABCORP ONLY
The Lithium test is used to measure lithium levels in the blood. AVAILABLE AT LABCORP ONLY.
This blood test is used to measure nicotine and it's metabolites in the body.
The Valproic Acid test is used to measure and monitor the level of valproic acid in the blood. AVAILABLE AT LABCORP ONLY.