Today, drug testing has become one of the most common ways used to screen potential employees, affirm insurance claims, and more. Simply put, it’s a part of life for millions of people and organizations.
But not all drug tests are created equally. Two options are lab based or instant drug tests, and while they can look for similar substances in one’s body there are some significant differences between the two. Taking a closer look at them will help you figure out which is right for your situation.
Let’s look at the comparison between Lab Based Testing and Rapid Screening sometimes called instant drug testing or point of collection testing (POCT).
Lab Based Testing
- Oral fluid or urine specimen collected locally and shipped to lab
- Employers do have option of collecting specimens and shipping to lab
- Lab performs initial screening and if not negative then confirmation testing
- Negative initial screening are reported immediately by Lab to MRO
- Medical Review Officer (MRO) received reviews and reports all result
- Overall cost of testing might be slightly higher then rapid screening
- Lab Based Testing required for DOT drug testing programs
- Standard drug testing panels like 5 and 10 pane are available with other options
Rapid Screening – Instant Drug Testing or POCT
- Oral fluid or urine specimen collected locally or in house by employer
- Initial screening is done instantly with this testing administered by the specimen collector
- Negative results are available immediately
- Non-Negative specimens are shipped to lab for confirmation testing
- Results of tests that went out to lab are reviewed and reported by the MRO
- Overall cost of testing might be slightly lower then Lab Based Testing
- Instant testing prohibited for DOT drug testing programs
- Standard drug testing panels like 5 and 10 pane are available with other options
Instant Drug Testing - Urine Specimens or Oral Fluid Specimens
Both urine and oral fluid specimens can be used with instant drug testing. Oral fluid will detect more recent use of drugs as compared to urine. The collection is always observed with oral fluid, so cheating is limited. Many of our networked collection sites are not offering in addition to urine instant drug testing the option of instant oral fluid drug testing.
Proctored instant oral fluid testing is also available with testing completed at home or in the office. Virtual proctoring via webcam eliminates the need for an employer representative to administer the testing process.
Common questions on instant drug testing?
What is considered an instant drug test?
These are drug tests where you can get same day negative results. Our instant or rapid drug testing centers include Quest Diagnostics facilities, LabCorp facilities, e-Screen facilities and other drug testing centers and clinics through the United States. Orders must be place in advance, please Order Now or call 866-843-4545. Employers can also administer instant or rapid drug testing at their company facilities. Please complete a Contact Form for this option.
What is the fastest type of drug test?
An instant drug test will get you the fastest negative drug test results. With instant drug testing with either urine or oral fluid if the test is anything but negative, the specimen must go on for lab based drug testing and it may take a few days longer to get back a lab confirmed result with MRO review.
Can an instant drug test be wrong?
Yes, a result that is not negative could be wrong. We should actually call it inconclusive. The negative result is 100% accurate, anything else should go out to a lab for confirmation testing and results reviewed and reported by the medical review officer (MRO).
Why is it necessary is that instant drug testing results that screen non negative be sent to a lab for confirmation testing?
The primary reason being that all instant non-negative are only 97%-98% accurate which is shown on a package insert for any brand that is FDA Cleared. Negative results are 100% accurate, positive result need lab confirmation testing.
All positive initial screens should be confirmed by GC/MS (Gas Chromatography/Mass Spectrometry) at a DHHS/SAMHSA certified laboratory. This is due to the fact that any laboratory or on-site/instant drug screen, no matter how accurate, is not 100% accurate in identifying drugs of abuse in urine. The initial screens react to multiple drug metabolites, and can under certain non-ideal situations, produce a positive result when the target drug is not present or is present at a level below the GC/MS confirmation cut-off level. GC/MS confirmation is a more specific test that looks for and if present quantifies the target metabolite. It is the GC/MS confirmation through a certified laboratory that will stand up in the court of law if the drug test result is challenged by the donor.
How is it that our instant tests that read positive are sometimes received back from the MRO as negative?
That is exactly why the lab confirmation test is necessary. The instant test is not accurate for negative positive results. It could have been an over the counter medication, it may have been reversed by MRO due to a prescription or perhaps it screened positive but did not confirm positive. That is also why we never say the instant test is positive, if it is not negative – it is always inconclusive until confirmed at the lab
Are instant drug test products accurate for positive results?
Using an instant drug testing product requires confirmation testing at a laboratory when the result is non-negative. This type of testing provides only a qualitative, preliminary analytical result. A secondary analytical method must be used to obtain a confirmed result. Gas chromatography/mass spectrometry (GC/MS) is the preferred confirmatory method and only available at a certified laboratory. These screening products are reliable for negative results but not reliable for positive results. False positives can occur due to over the counter or prescribed medications. The laboratory positive test will be definitive and defensible in a court of law. The Medical Review Officer (MRO) process rules out positives due to legally prescribed medications. The MRO is able to discuss medications with the donor due to the doctor patient confidentiality.
Organizations administrating instant testing products may face significant exposure to liability if not confirming non-negative results at the laboratory by falsely accusing someone of using illicit drugs when this might not be true. Asking the employee or client about their legally prescribed medications can violate confidentiality and HIPAA laws as well as other employee protections.
Is instant drug testing for employees legal?
Generally speaking – Yes instant drug testing of employees is legal. However, the following states ban or have restrictions in place
- Kansas – Prohibited for all employees.
- Maine – Pre-employment only.
- Maryland – Employer must register with the State. Pre-employment only.
- Minnesota – Prohibited for all employees.
- Nevada – Must be performed in a licensed facility.
- New York – Must be performed in a licensed facility.
- North Caroline – Pre-employment only.
- Oklahoma – Must be performed at a certified collection site.
- Oregon – Sites must become POCT registered.
- Puerto Rico – Prohibited for all employees.
- Vermont – Prohibited for all employees.
Also, instant drug testing is not allowed for United States Department of Transportation (DOT) drug testing programs or testing of Federal employees.
Always check state laws for any employment drug testing program.
How You Can Speed Up The Hiring Process With Instant Drug Testing?
With the tough labor market, employers are constantly seeking ways to speed up the hiring process, so they do not lose quality candidates. We are seeing many businesses looking to hire and fill vacant positions but are finding it difficult to find qualified people. One challenge businesses face is completing the hiring process quickly once they do find the right candidate. Having to wait 2-5 days for a drug screen result can lead to a prospective employee taking another position leaving the business to start the hiring process all over again.
One way businesses can speed up the process is to use instant testing in the states that do not prohibit instant testing. It is important to note that instant testing is NEVER allowed for the Department of Transportation Testing (DOT). For employment screening, instant testing may be used but an employer should follow best practices when utilizing instant testing.
Instant testing can be scheduled electronically in most areas across the country, further speeding up the process. In states where instant testing is not available, lab-based testing should be utilized. Most lab based results should be available within 24-48 hours from receipt at the testing laboratory which is usually the next day after the collection at the collection site location.
Employers can also decide to collect specimens and administer instant drug testing in house thus saving a few more dollars with this in house process.
Is Instant Drug Testing Right for Your Company?
With these two options available, it’s important to make a decision based on what fits your specific needs the most. While instant testing is commonly used by employers for a pre-employment drug test or random drug testing in the workplace, lab based testing is still the only type of testing allowed by various government agencies.
The biggest factor that helps most decide between the two is often time. Instant drug tests obviously provide increased convenience and faster turnaround times. However, lab-based testing has come a long way over the last few years and today results are faster than ever. Lab-based drug testing is required for DOT drug testing programs. Let’s ask some questions to help you decide.
- How many substances do you want the drug screening test to check for? Often, instant tests will only provide a few simple tests and won’t cover all of the substances that can potentially be abused. Lab-based tests can check for almost any substance.
- How far back in the subject’s history do you intend to check? Using a hair based drug screening test will let you look further back, but it can only be processed by a lab. The urine instant tests usually only go back about five days.
- Accuracy is probably the biggest consideration to take into account. Without lab confirmation of instant drug test non-negative results, the rapid screen is not accurate. The process of sending in the non-negative specimens to the lab for confirmation testing and MRO review might be cumbersome for some employers.
- What about cost? The instant drug testing is generally just slightly less expense then lab based drug testing. This cost savings increases when the employer is collecting specimens and administrating the testing in house.
- Finally, it’s worth considering whether or not a company’s employees are capable of handling test results. With instant tests an organization is responsible for collecting samples, running tests, and reading results. This is an important responsibility that someone on the team must take on and it required training.
The decision to use instant drug testing or lab based drug testing or a combination of both is up to each individual employers. A big decision and experts at National Drug Screening are available to assist.
