Drug Test Panels And Understanding Drug Testing Beyond The Five Panel

National Drug Screening, Inc (NDS) is excited to sponsor the Inside Drug Screening column in The Background Buzz for 2024. It is our intent to educate the background screening industry on important news, information and trends about drug screening. Our focus will be on workplace drug testing and each month we will feature a specific drug testing topic followed by any recent news, information and trends. These back to the basics drug testing topics will help your teams better understand drug testing and to help grow your drug testing revenue.

“It is critical for a drug testing vender and for an employer to understand exactly what drugs for which they are testing. There are variations of the 5 panel and 10 panel and with anything above a 10 panel there needs to be a complete list of the drugs the client is looking to add.”

Evaluating the Five Panel Urine Drug Test

Since the late 1980’s, the common drug testing panel for workplace drug testing has been the 5 panel drug test. You may or may not be aware that there are multiple versions of a 5 panel drug test for Non-DOT employers. For DOT employers there is only one version of the five panel, but it has changed over the years. We also want to discuss in this article what we call beyond the five panel: 10 panel, additional panels, hair drug test panels and oral fluid drug test panels.

The current DOT panel includes the following:

Opioids Include:

Looking over the above panels, I remember that the DOT 5 panel did not always include Methamphetamine/MDMA/MDS (ecstasy), Heroin, or the expanded opiates of Hydrocodone/Hydromorphone and Oxycodone/Oxymorphone. 49 CFR Part 40 from 2001 included Amphetamine and Opiates. Methamphetamine was only tested in confirmation testing when the specimen must also contain amphetamine at a concentration of greater than or equal to 200 ng/mL. Heroin – 6-Acetylmorphine (6AM) was only tested when the specimen contains morphine at a concentration greater than or equal to 2000 ng/mL.

Now, the previous paragraph might sound confusing, and it is. To explain it more clearly, we see at the labs for Non-DOT testing different versions of a five-panel drug test, and these are listed below. It is very important that you are clear on what you are selling to your client and exactly which version of the Non-DOT 5 panel test you are providing.

Current Versions of 5 Panel Drug Test Available

  1. The DOT Like 5 panel version which would be exactly the same as the chart above.
  2. The October 1, 2010, version of the DOT 5 included Marijuana (THC), Cocaine, Amphetamines, Opiates and Phencyclidine (PCP). The amphetamines group included initial testing for MDMA and confirmatory testing for MDMA, MDA, & MDEA. The expanded opiates are not on this panel, and it is still available from SAMHSA certified labs.
  3. Prior to October of 2010, we had another version of the DOT 5-panel drug test. This 5-panel included Amphetamine with Methamphetamine, Opiates with Codeine & Morphine, Marijuana (THC), Cocaine, and Phencyclidine (PCP). So, note on this version, no metabolite for heroin (6AM), no ecstasy and no expanded opiates – Hydrocodone, Hydromorphone, Oxycodone, and Oxymorphone were included. This 5 panel is still available from SAMHSA certified labs.

Which 5-Panel Drug Test are you Ordering?

So which version of the 5-panel drug test are you using for your non-DOT drug free workplace. As shown above there are at least 3 different versions. Background screening providers and third-party administrators (TPA’s) need to ask questions, which version of the 5-panel test are you getting from your laboratories and selling to your employer customers.

National Drug Screening, Inc recommends to always the use of the newest version of the DOT 5-panel drug test and same drugs for non-regulated or non-DOT situations looking to do a 5 panel. We call this either the 5-Panel DOT Like or the 5-Panel with Expanded Opiates.

Beyond the 5 Panel Drug Test

All of this gets more confusing as we add more drugs to the drug testing panel or eliminate drugs such as excluding marijuana from the panel. Our recommendation is to start with the current DOT 5 panel so for Non-DOT it becomes the 5 panel DOT Like. If we take off marijuana it becomes a 4 panel DOT-Like. So, as we add drugs, we need to be sure we are requesting from the lab the specific drugs we want added.

Most SAMHSA certified labs will offer a standard 10 panel that includes the five we see in the above chart with the additional drugs of: Benzodiazepines (such as Xanax), Barbiturates, Methadone, Propoxyphene, Methaqualone (Quaaludes). Some labs are eliminating the Methaqualone (Quaaludes) synthetic, barbiturate-like drug as it is no longer sold in the United States. This standard 10 panel drug test now becomes a 9 panel.

Additional drugs can be added to urine testing panels, these panels would be custom made by the lab you are using. The additional drugs after the 10 panel could be: Fentanyl, Tramadol, Buprenorphine, Meperidine, Ketamine or others. When requesting anything above a 10 panel you must specify the exact drugs over and above the standard 10 panel. We are not aware of standard configurations for an 11, 12, 13, 14 etc. drug testing panel.

Hair Drug Testing Panels

With hair drug testing panels, it is not as complicated as with urine. The one thing to watch for is the 5 panel drug test that might not include the expanded opiates; we always recommend including the expanded opiates (Oxycodone, Oxymorphone, Hydrocodone, and Hydromorphone). Other drugs that are available for hair beyond the 5 panel include: Fentanyl, Tramadol, Buprenorphine, Meperidine, Ketamine and Zolpidem (Ambien).

Hair Drug Tests Can be Ordered Online with availability of 5 panel, 7 panel, 9 panel, 12 panel, 14 panel and 17 panel.

Oral Fluid Drug Testing Panels

Once available, the DOT oral fluid drug testing panel will be the same as the DOT 5 panel with urine. For Non-DOT various panels are currently available. Wwe see that LabCorp has the most expanded offering with a 5 panel or a 9 panel. Ethanol alcohol and Cotinine Testing – Nicotine can be added to these panels. The 9 panel test includes: Amphetamines – Methamphetamines, Cocaine, Marijuana (THC), Opiates (Codeine, Oxycodone, Hydrocodone, Hydromorphone, 6-MAM – Heroin & Morphine, Phencyclidine (PCP), Benzodiazepines, Barbiturates, Methadone and Propoxyphene.

Summary On Drug Test Panels And Understanding Drug Testing Beyond The Five Panel

As mentioned above it is critical for a drug testing vender and for an employer to understand exactly what drugs for which they are testing. There are variations of the 5 panel and 10 panel and anything above a 10 panel there needs to be a complete list of the drugs the client is looking to add. 

Drug Testing Recent News, Information And Trends

Fentanyl remains a major problem drug in the United States. The DEA has stated that fentanyl is the deadliest drug threat facing our country. This drug is highly addictive, and a very small amount is considered a potentially deadly dose.

A federal drug advisory group has begun the cumbersome process of placing fentanyl on the list of drugs to test federal safety-sensitive employees and truck drivers for drug use after adoption by the Department of Transportation (DOT).

A recent employment drug testing case in Iowa emphasizes the importance of employers following state laws on drug testing and adherence to their own drug free workplace policy. This case also cautions employers in using alternate lists in random testing pools, as the employee in this case was on the alternate list and asked to go for testing. Other employees on the main list were not asked to get tested. There was also an issue of supervisors not trained noting that under the Iowa law there is requirement of initial training and annual training of supervisors. This is an interesting case and you can read more from the Jackson Lewis Drug and Alcohol Testing Law Advisor.

DOT oral fluid testing is still not authorized as no lab has received certification for Federal oral fluid drug testing. We continue to wait on the U.S. Department of Health and Human Services (DHHS), to approve at least one primary test-processing laboratory and one secondary lab to implement oral fluid testing as an alternative to urinalysis. This as stated will be in addition to urine, it will not replace urine drug testing.

About the Author

Joe Reilly entered the world of drug testing in 1993 and over the last 25+ years has become a leading national expert on workplace drug testing, drug free workplace programs and specimen collections for drug tests. Joe is the President of a nationwide drug testing industry consulting firm – Joe Reilly & Associates. He is also President of National Drug Screening and is the Senior Director of Compliance for USA Mobile Drug Testing Inc.

Joe served for twelve years on the board of directors of DATIA the Drug & Alcohol Testing Industry Association (now NDASA) and for four of those years as the Chairman of the Board

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