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Instant Drug Testing or POCT

Instant Drug Testing or POCT

Last updated on October 2nd, 2020 at 10:01 am

>>>The Ins and Outs of Instant Testing | By Andrew Current

> Introduction

> It goes by many names: instant testing, point of collection testing, rapid results testing, on-site testing, etc. Instant testing is growing in popularity every year. It offers a distinctly unique drug testing solution compared to lab-based drug testing. Instead of having to send employees and applicants to a collection facility, ship specimens to a lab, and wait several days to receive test results, instant testing occurs in the workplace and provides an immediate screening result. It is available for urine drug testing, oral fluid drug testing, and breath alcohol testing. Covering those specimen types, instant drug testing can provide solutions for all the most commonly requested drug testing methods. We are going to examine the advantages of instant testing, along with its limitations to determine how it can best fit into new and existing drug testing programs.

The Advantages of Instant Testing

Speed to result – The first and most obvious advantage to instant testing is the time it takes to get a drug test result. With traditional lab-based urine drug testing, it looks something like this:

  • Collect a urine specimenat an off-site collection facility.
  • Transport the sample to a lab.
  • The lab conducts a preliminary screen of the sample.
  • If the result is non-negative the lab conducts a confirmation testusing gas chromatography/mass spectrometry (GC/MS) or an equivalent technology if permitted by applicable state law.
  • If the result is confirmed positive a medical review officer (MRO) attempts to verify the result by contacting the donor.
  • Once the result is verified one way or the other it is reported to the employer according to applicable state lawrequirements.

While drug testing providers have made this process as efficient as possible, there is no getting around the fact that the average turnaround time from collection to laboratory is 24-48 hours for negative samples and 72+ hours for non-negative samples. And of course, these are just the averages in business hours. Once weekends, holidays and after-hours collections are factored in, the time can be longer. Here is how instant testing eliminates steps and makes the process faster:

  • Collect and test a urine sample at the workplace with a supervisor or manager trained by the testing device manufacturer.
  • If the result is negative, send the employee back to work.
  • If the result is non-negative, overnight the sample to a laboratory for confirmation testing and MRO review. 

Whether an employee tests negative or non-negative (meaning a lab confirmation is required before making an employment decision), the collection process has been cut down from half a day to send an employee back and forth to just a few minutes to walk in and out of the HR office. If the employee tests negative, then all that is required is simply recording the test result. For those employees who initially test non-negative, you will have to wait for lab-verified results; however, you have still eliminated collection time and, depending on your individual results, approximately 90% or more of those who take the test can start work or return to work immediately.

Cost savings – The second advantage of instant testing comes in money spent and money saved. Here are the people involved in the drug testing process when conducting a traditional lab-based urine drug test:

  • Employee
  • Collection technician
  • Laboratory
  • Medical review officer

Unless you own the collection facility or laboratory, you have to pay each person involved with the process. As well, most state drug testing laws mandate that employers pay employees during collection time. So, you are paying your employee to take several hours off to travel to and from the collection site or inconveniencing the candidate you are trying to hire.

Here are the people involved in an instant drug test:

  • Employee
  • Supervisor
  • If the test result is negative, the chain stops there.
  • If the result is positive, then add in the shipping company, laboratory and MRO.

The amount of time paid to employees during collection goes down from hours per individual to minutes. Instead of paying supervisors for hours of follow-up and paper work, you are paying them their regular salary to conduct most tests on-site. Even when you consider the added cost of conducting the initial instant test and follow-up lab test for results that come up non-negative, the average cost of both negative and non-negative instant tests is lower than the average lab test.

Control the experience – Finally, one advantage of instant testing that may be less obvious than time and money is that employers maintain control of the drug testing experience. Take applicant test for example. With instant testing, you can inform the job applicant of the test and conduct the test at the same time. Instead of giving drug using applicants the time to go home, abstain for a few days, pass the test, and get hired, an employer can get an initial result in less than an hour and know whether he or she is about to employ a drug user. The same is true of random drug testing. With lab-based testing, an employer needs to coordinate with supervisors, managers, HR, collection facilities, laboratories, and MROs all before setting a date to conduct testing. With instant drug testing, an employer can cut out the second half of the equation and simply tell supervisors, managers, or HR the day of that random drug testing will occur. He or she has complete control over when and where testing occurs.

The Limitations of Instant Testing

Given what we’ve just gone over, it seems like instant testing should be a no-brainer. So then why isn’t every employer using it? Well, the first and simplest reason is that not every state’s drug testing law allows it. However, the list of states that prohibit instant testing is relatively short:

Alabama – Voluntary Law

Arkansas – Voluntary Law

California – Lab Licensing Law

Kansas – Lab Licensing Law

Kentucky – Voluntary Law

Minnesota – Mandatory Law

New York – Lab Licensing Law

Ohio – Voluntary Law

Puerto Rico – Mandatory Law

Tennessee – Voluntary Law

Vermont – Mandatory Law

What is the difference between all those law types listed next to each state? When it comes to drug testing, not all laws are created equal. Some states have voluntary drug testing laws, which only apply if an employer decides to participate in the drug testing incentives program created by the law. Other states have mandatory drug testing laws that apply any time an employer wants to conduct drug testing. Finally, some states that do not have drug testing laws have laboratory licensing laws that require all testing take place in a lab, which indirectly prohibits instant testing. Navigating these different law types is important because while Alabama, Arkansas, Kentucky, Ohio, and Tennessee all prohibit instant testing, they only do so under voluntary law. So, if an employer values instant testing above whatever incentive may be offered by the voluntary program, then he or she is free to use instant testing in these states.

Other limitations hit closer to home.  First, using instant testing often requires non-medical staff to be comfortable and trained in collecting specimens.  The “yuck” factor is often cited as the single reason that an employer will not use instant tests.  Also of concern is truthfulness of the supervisor when there is a “local” connection between the supervisor and the donor. “Are we sure he or she really collected a specimen from that donor?”  With that comes the necessity to record a specimen so an employer can prove that each candidate was screened using the same procedure and the same test method. Finally, some employers do not have the facilities to accommodate instant testing, such as a private bathroom with no access to water for a proper urine collection.

There are limitations to the technology as well.  Instant urine does not provide as many panel options as lab-based urine and instant oral fluid is often challenged in its sensitivity to detect drugs compared to its lab-based counterpart.  Alcohol screening devices are just that – screening devices. And because of the rapid metabolism of alcohol in a person, a confirmation test needs to occur within 20 minutes for an employer to act on the result.  Oftentimes the coordination of an EBT in 20 minutes proves too challenging for employers.  

Conclusion

When done right, instant drug testing programs can help companies achieve their drug testing objectives in a fast and cost-effective manner. The legal viability of instant testing depends on compliance with all applicable state laws and following best practices that can ensure the accuracy and integrity of a drug testing program. However, it isn’t always a given that instant testing will fit into every employer’s drug testing program. A thoughtful review of your testing program along with the pros and cons of instant testing will help you determine just how practical it will really be for your workplace.


Andrew Current of the Current Consulting Group