Drug Screening: The pros and cons of each method


According to the Substance Abuse and Mental Health Services Administration, the organization that certifies drug screening laboratories, 28.6 million people aged 12 or older reported that they had used an illicit drug in the past 30 days. That corresponds to roughly one in 10 Americans.

The use of illegal substances in the work place is an ever present threat against safety and productivity. It is important to understand what resources are available to help you screen for any potential risks your company may have and which methods best fit your current need.

Here is a brief summary of four of the most common screening options:


A common misconception is that a urine drug screen tests for traces of the drug itself inside of the urine, when in actuality, it is testing for the metabolites that the body produces while processing the substance, which remain in an individual’s system much longer that the drug itself.

Consequently, urine drug screens offer a much longer window of detection than other methods of screening. This window is what has caused urinalysis to become the primary method of occupational drug screening and the industry standard for detecting recent drug use, typically one to five days.

Urine drug screens are also currently the only method that is allowed for federally mandated testing, such as Department of Transportation regulated employees.

One of the downsides to urine testing is the potential for adulteration for non-observed tests. While there is no way to guarantee that a test has not been tampered with, there are options available to test the integrity of the samples that are provided. Creatinine and pH values are two of the common measurements used for ensuring the integrity of a urine specimen and are available at most major testing laboratories.


Oral fluid’s strength is its accuracy detecting drug use within 36 hours of initial use. If an employee is suspected to have been under the influence in the past couple of days, an oral fluid test is the best option for confirming substance abuse in that time frame. As a result, oral fluid testing is a popular option for reasonable suspicion and post-accident screening scenarios. Unfortunately, this also makes it a poor choice for any kind of drug screen that an employee or applicant has had time to prepare for.

Unlike most urine drug screens, an oral fluid test is completely observed, which makes adulteration much more difficult for an employee who is being testing. Most oral fluid tests can be performed onsite at the place of employment, which reduces collection fees and productivity loss during the time of collection.


According to Quest Diagnostics, hair testing detects twice the number of positives as urine tests. This could be attributed to the much longer window of detection that hair screening offers. Unlike urine and saliva testing, which can be used effectively between one to five days, hair testing can detect drug use and patterns of drug use for up to three months.

This extended period of detection makes hair testing ideal for random program and pre-employment testing scenarios, where an employer may want a better idea of an employee or applicant’s long-term drug use patterns.

Hair testing would not be ideal in situation where recent drug use needs to be evaluated, since it takes roughly two to three weeks for the hair to grow in and show any kind of drug use. Since 100-120 strands of hair are needed to properly complete the hair testing, issues may also arise in applicants or employees who have little or no hair on their bodies or heads.


There is no better option for testing active drug use in an employee’s system than a blood screen, which can tell exactly what is currently in an individual’s system at the time of testing. Drugs and alcohol are rapidly metabolized in the body, which allows substance abuse to be detected within minutes of entering an individual’s system. The downside to this procedure, is that metabolization also quickly eliminates drugs from the body, allowing substance abuse to be test for only a few hours.

Due to the invasive nature of a blood test and the very brief detection window, blood testing is usually reserved for reasonable suspicion and post-accident screening where active drug or alcohol use is likely.

If you have questions about your current screening program, please don’t hesitate to reach out to us. A-Check Global’s team of dedicated professionals is available to help and provide friendly, accurate guidance. Give us a call today at 877-345-2021, or email support@acheckglobal.com.

Drug Urine Saliva Hair Blood
Amphetamines 24-72 hrs 24-36 hrs 1-3 months 24 hrs
Cocaine 24-72 hrs 24-36 hrs 1-3 months 1-3 days
Opiates 24-72 hrs 24-36 hrs 1-3 months 1-3 days
PCP (occasional use) 1-5 days 24-36 hrs 1-3 months 1-3 days
PCP (chronic use) up to 30 days 24-36 hrs 1-3 months 1-3 days
THC (occasional use) 1-5 days <24 hrs 1-3 months 12-24 hrs
THC (chronic use) up to 30 days <24 hrs 1-3 months 2-7 days

Effective January 1, 2018: DOT Drug Screening Expands to Include Semi-Synthetic Opioids

Drug screen

The Department of Transportation (DOT) has ruled to adopt drug screening panels set by the Department of Health and Human Services earlier this year, with changes in effect January 1, 2018.

What changes are being made to the panel?

The DOT has opted to expand the required panel to include the following Schedule II semi-synthetic opioids: hydrocodone, hydromorphone, oxycodone, and oxymorphone. Technically, the DOT panel is still considered a 5-panel drug screen. The difference is in the expanded opioid coverage that will now be part of federal drug screening programs for urine testing. Many might be more familiar with these opioids from their pharmaceutical brand names: OxyContin®, Percodan®, Percocet®, Vicodin®, Lortab®, Norco®, Dilaudid®, and Exalgo®.

Additionally, Methylenedioxyamphetamine (MDA) has been added as an initial test analyte, replacing methylenedioxy-N-ethylamphetamine (MDEA).

Why were these changes made?

Prescription drugs have become one of the most widely used, misused, and abused drugs in history. They are highly addictive and often prescribed as pain management for everything from minor procedures and broken bones to chronic conditions. In 2015, opioid misuse and overdose culminated in over 33,000 deaths for the year. In 2017, the current administration declared the opioid epidemic a public health emergency.

The inclusion of these semi-synthetic opioids is the DOT’s response to this epidemic and an attempt to remove these drugs from the federal workplace environment.

What does this mean for employers? What is the impact to existing screening programs?

While employers are assured their employee pools are being tested for a commonly abused class of drugs not previously tested under the DOT panel, these changes will have some impact:

  1. There may be instances where employees who have not previously tested positive on their drug screens will now be showing positive on their results.
  2. Diligent reporting by the Medical Review Officer (MRO) may increasingly raise safety concerns or report an employee unqualified as part of a reasonable medical judgement.
  3. And, finally, a potential increase in drug screening price.

A little more about safety concerns raised by the MRO.

If the MRO believes there is a significant safety risk with the employee’s continued use of an opioid drug, then the MRO will now instruct the employee to have his/her prescribing health care provider (HCP) contact the MRO to discuss possible changes or discontinuance of the medication.

There are three outcomes for this process:

  1. If the prescribing HCP does not contact MRO within 5 days, the MRO will report a safety concern to the employer.
  2. If the prescribing HCP discontinues the medication or changes the medication to one that does not present a significant safety risk, the MRO will not report a safety concern to the employer.
  3. If the prescribing HCP contacts the MRO and states that the medication is not being changed or discontinued, the MRO will report a safety concern and recommend a fitness for duty evaluation of the employee.

The usual Federal Chain of Custody and Control forms (CCF) that we have now can still be utilized after Jan. 1, 2018 without issue until June 30, 2018 at all laboratories. After that, we will be required to use the newly updated CCFs for any federal drug screening.

How can I make sure that I am ready for the upcoming changes?

A-Check Global is your trusted partner during this change. If you have any questions surrounding your federal workplace program or changes to the DOT protocol, A-Check Global’s team of dedicated professionals are available to help, and can provide friendly, accurate guidance.

Give us a call today at 877-345-2021, or email support@acheckglobal.com.


DOT Use of Paperless Chain of Custody and Control Forms


In 2015, the Department of Transportation (DOT) approved the use of Electronic Federal Chain of Custody and Control Forms, sometimes referred to as eCOCs or eCCFs.

In simple terms, it represents a virtual paper trail from here to there.

Think of it as a digital version—an “electronic paper trail”—of a traditional paper form, detailing every step on the journey taken during a human specimen test. This includes everything from collection to transfer, analysis, and reporting—all linked to a specific screening laboratory. Employers are required to provide this level of control documentation to every candidate undergoing a drug screen.

For DOT testing programs, the eCCF is also used to document final results reported to a Medical Review Officer (MRO).

The introduction of these electronic forms into the DOT testing environment has streamlined the drug screening process, reducing turnaround times by preventing delays in the transfer of documents and eliminating the need for employers, Medical Review Officers, and Third-Party Administrators to track down CCFs.

Errors are minimized and deadlines are easily met.

Short deadlines in the electronic Chain of Custody process, such as the collection facility’s responsibility to send the CCF to a Medical Review Officer (MRO) within 24-hours, are met more reliably than with the paper process. There are also many other important benefits:

  • The potential for data entry errors is reduced; information is entered into the system once, and the need to decipher handwritten information is eliminated.
  • Barcodes attached to every specimen accurately detail donor demographics.
  • Through approved locations with proper technology, donors can now provide an electronic signature.
  • Fatal flaws (fairly common problems that can jeopardize drug screen integrity) are minimized: missing signatures, inaccurate donor, employer, or collection facility information, etc.

Additionally, since drug tests can now be processed online, employers no longer need to order, store, or mail physical forms and no longer need to worry about using the correct federal or forensic form. Tracking a drug screen and staying up to date on its progress is now completed electronically.

If you have questions about your current screening program, please don’t hesitate to reach out to us. A-Check Global’s team of dedicated professionals is available to help and provide friendly, accurate guidance. Give us a call today at 877-345-2021, or email support@acheckglobal.com.


The Impact of Marijuana Legalization


The growing number of legalized marijuana states indicates a public perception shift of marijuana’s role in their communities. Many states have legalized the use of medical marijuana for patients with chronic or severe medical diagnoses, but many states are also starting to legalize the use of recreational marijuana, creating an issue for employers who are now unsure whether they are legally allowed to continue screening applicants and employees for marijuana use.

Does marijuana legislation protect employers?

More than half of the drug testing laws passed in 2016 were directly related to marijuana regulation, and a large percentage of the current regulation revolving around marijuana is heavily favored toward employer and business protection.

Currently, California regulation (Health and Safety Code – HSC, 11362.45) states, “Nothing in section 11362.1 shall be construed or interpreted to amend, repeal, affect, restrict, or preempt: … (f) The rights and obligations of public and private employers to maintain a drug and alcohol free workplace … or affect the ability of employers to have policies prohibiting the use of marijuana by employees and prospective employees, or prevent employers from complying with state of federal law.” This allows employers in California to continue drug screening their employees and applicants in order to maintain their zero-tolerance marijuana policies.

Additionally, Florida’s regulations (Chapter 381, Public Health – General Provisions) also protect employers from many of the issues surrounding marijuana legalization: “Nothing in this section shall require any accommodation of any on-site medical use of marijuana in any… place… of employment…”

The debate over consumption, safety, and workplace issues.

Some believe since recreational marijuana is now legal in a growing number of states, businesses should no longer be able to screen or reprimand employees for drug use, often drawing parallels between marijuana and alcohol effects. In business practice this does raise questions, as a substantial amount of research currently supports risk associated with marijuana consumption.

According to the National Institute on Drug Abuse (NIDA), the potency of marijuana has risen by a factor of three in the last 30 years. This increase, coupled with the recent legalization movements, has caused numerous agencies from marijuana-legal states to report severe increases in public safety hazards.

Following the legalization of medical and recreational marijuana in Colorado, the Rocky Mountain High Intensity Drug Trafficking Area; an organization governed by the Office of National Drug Control Policy; whose goal is to facilitate cooperation and coordination against drug trafficking in areas surrounding Colorado, Utah, and Wyoming; have reported the following conclusions:

  • Traffic fatalities involving operators testing positive for marijuana have increased 100 percent from 2007 to 2012
  • The majority of driving-under-the-influence arrests involve marijuana and 25 to 40 percent were marijuana alone
  • There has been a 16 percent increase in toxicology reports showing positive marijuana driving-under-the-influence results
  • 57 percent increase in marijuana-related emergency room visits from 2011 through 2013
  • 82 percent hospitalization increase from 2008 to 2013

This evidence strongly supports the hazards irresponsible marijuana use can cause. The cognitive impairment that marijuana imposes on the user produces a substantial risk for any employee operating or working near heavy machinery.

It also has a significant impact on a person’s ability to perform basic work functions. In a recent study, the National Academy of Sciences (NAS) stated that “recent cannabis use impairs the performance in cognitive domains of learning, memory, and attention” with “recent use” being defined as a 24-hour period.

There are also other major costs that employers may incur from employees who are regularly using marijuana that are related to insurance and healthcare expenses. NAS has also found that smoking marijuana on a regular basis is associated with chronic cough and may be linked to greater mental health symptoms for people suffering from bipolar disorders.

Legislation is evolving and ongoing.

There have already been more than 20 bills introduced in the post-2016 election regarding the regulation and legalization of marijuana. The landscape of marijuana legislation is likely to continue to push in favor of legalization, making the importance of developing an effective drug-free workplace policy and having an effective drug screening program a critical business decision for your organization.

If you have questions about developing a drug-free policy, or about your current screening program, please don’t hesitate to reach out to us. A-Check Global’s team of dedicated professionals are available to help, and can provide friendly, accurate guidance. Give us a call today at 877-345-2021, or email support@acheckglobal.com.


Understanding Drug Screen Reports

drug_test_92572931-56b08ae65f9b58b7d023ef47When speaking with our clients who routinely drug screen even high volumes of employees, we’re often asked questions about reading or deciphering drug screen results. That’s a good thing, because it shows our clients are as committed to making informed employment decisions as we are about providing accurate and compliant information.

Even experienced employers can benefit from some good advice

We’ve seen it all, but one of the more common areas to pay attention to within the Chain of Custody and Control Form (CCF) is the “Reason for Testing.” Employers might incorrectly mark this area, so it’s important to accurately choose one of the major reasons for testing to help minimize and overcome any recurring compliance risks. The reasons for testing listed on most non-federally regulated CCFs are:

  • pre-employment
  • random
  • reasonable suspicion
  • return-to-duty
  • promotion
  • follow-up testing

On every CCF document, a Specimen ID number will also be assigned. The location of the ID can vary from form to form, but can usually be located in the upper margins of the document. The Specimen ID is one of the most important parts of the drug screening process, as it ensures the integrity of the result remains true as it travels between locations.

Location, location, location

Location identification is often another area of confusion, since the complete process of a drug screen is not usually completed in one place.

The first step in the specimen testing process is the collection facility. This step is where the donor provides the initial sample to be shipped to and evaluated at the testing laboratory. The testing laboratory is where the initial positive or negative determination will be made. Once official results have been determined, the testing laboratory will then send non-negative – and all federally regulated – results to the Medical Review Officer (MRO). The MRO is responsible for evaluating medical health and prescriptions to determine any medically valid reasons for any non-negative results.

Understanding the results

After the MRO process, verified results are then made available to the employer. There are four sections that are typically outlined on a drug screen report:

  • substance abuse panel
  • initial test level
  • GC/MS confirmation test level
  • Determined result.

The “substance abuse panel” is the list of drugs that an applicant or employee was screened for. Understanding the “initial test” and “GC/MS” (Gas chromatography-mass spectrometry) confirmation levels is where the process can get a little complicated.

Contrary to popular belief, these numbers do not indicate the level that the donor tested at. The initial test level is the threshold that the lab uses to determine negative or positive results. Any results that exceed the initial test level threshold are flagged as positive results.

Once a specimen has been flagged, a GC/MS confirmation test is performed to verify the positive reading. If the confirmation results meet or exceed the GC/MS confirmation levels that are outlined in this field, then the result is reported out to the MRO as a positive.

It is in this field that sub-testing will also be reported. Sub-testing is the practice of testing for different types of a drug category. The most common type of sub-testing is screening for methamphetamine inside the amphetamine category, but sub-testing can also occur for opiates, barbiturates, alcohol, and other drug categories.

While it can be complicated, we’re here as your trusted partner, and available to talk with you about your drug screening program and applicant/employee drug reports. Contact A-Check Global today.