Workplace Drug and Alcohol Testing

In accordance with the employer’s written substance abuse policy, testing may be performed pre-employment, post-accident, return-to-duty, post-substance abuse treatment monitoring for reasonable suspicion, periodically or for random testing programs (programs in which all employees have an equal chance of being selected for testing). 

Laboratory drug testing

Laboratory testing has the ability to give a defined “positive” or “negative” result. Negative results can normally be expected within 24-48 hours of collection, while positive results typically take 3-5 business days for additional review.

Typical drug screen panels:

• 5-panel screening – Tests for amphetamines, opiates, cannabinoids (marijuana phencyclidine (PCP) and cocaine metabolite.
• 10-panel screening – Tests for the 5-panel substances plus barbiturates, benzodiazepines, methadone, propoxyphene and oxycodone.
• DOT screening (5-panel expanded) – Tests for same substances as a 5-panel test, plus additional semi-synthetic opioids: hydrocodone, oxycodone, hydromorphone, oxymorphone (this is in accordance with the DOT Part 40 Final Rule, effective January 1, 2018).

Testing is also available for alternate panels as specified by the employer’s substance abuse program. 

Types of laboratory testing:

• Urine testing is the most common substance abuse test and can be used to detect a wide variety of drugs. Urine testing also has the benefit of being able to detect drug use shortly after it’s been ingested.
• Hair testing analyzes for drugs within the hair shaft, rather than body fluids. Compared to analysis of body fluids, hair testing is highly resistant to evasion or abstaining from drug use for a few days prior to testing. Drug use can be detected in the hair follicles a week after ingestion and provides a several month window of detection. A hair sample is removed from the subject at the time of the appointment and sent off to the laboratory for analysis, where a 5-panel screening is performed.
• Saliva testing is often referred to as a “swab test”. Testing saliva has the shortest detectable time after use, but also provides the shortest window of detection after ingestion. It involves obtaining a saliva sample from the inside of the subject’s mouth, which is then sealed and sent off for testing, where a 5-panel screening is performed.

Rapid drug testing

Rapid drug testing is performed on a urine specimen. It detects “negative” results within a few minutes and is helpful in returning an injured worker to a safety-sensitive position (non-DOT) or placing a new hire in the workplace quickly. If the rapid screen results are “inconclusive” a laboratory confirmation test and MRO review and certification is required to confirm if it is truly positive. This typically takes 3-5 business days for the verified results. 

Typical random drug screen panels:

• 5-panel substances: Opiates, marijuana (THC), phencyclidine (PCP), cocaine, methamphetamine 
• 10-panel includes 5-panel substances plus: benzodiazepines, amphetamines, methadone, oxycodone, and barbiturates.

Which drug screen works for you?

The chart below shows the two types of drug screens and indicates the various panels that can be chosen and the drugs tested for each of them. (Note: Lab testing also is available for alternate panels as specified by the employer’s substance abuse program.)  

Drug Tests by Type and Tested Substances

Breath alcohol testing (BAT)

Testing for alcohol is performed using an approved evidential breath testing device (EBT). If the initial test result is “positive,” a second (confirmation) test is required. Certified breath alcohol technicians perform evidential breath testing at all LVHN Occupational Medicine locations. 

Random drug testing management 

Under Department of Transportation (DOT) regulations, all employers of CDL/DOT drivers must randomly select 25 percent of their CDL/DOT employees to be drug-tested annually, and 10 percent to be randomly tested for alcohol annually, OR participate in a multi-company consortium following the same specifications. 

Both options are available through LVHN Occupational Medicine for DOT employees as well as non-DOT employees. 

To participate, companies enroll in the annual program either as an individual company, or as part of a multi-company consortium. An administrative fee is charged for each employee entering the pool. Lists are updated throughout the year. 

For more information about LVHN Occupational Medicine services, contact HealthWorks@LVHN.org or call Scott Appnel at 610-969-2972.