The quantitative (quant) level of a positive drug screen specifically indicates whether a drug or a drug indicator was detected in the donor’s system at the time of collection.
The Question of Quantitative Levels A drug can be detected in a donor’s sample and still be reported as negative. A laboratory has what is called, “cutoff levels”. These levels are designed to screen out some over‐the‐ counter pharmaceuticals or vitamins, certain foods that may show as drug indicators, as well as ambient absorption, such as walking past a smoke‐filled room.
Many factors influence the level of a drug in a donor’s system. Metabolism, physical condition, fluid balance, frequency of drug ingestion and the last time the drug was consumed are all contributing factors to quantitative levels. The ‘number’ you may see does not provide valid information outside the entire review process conducted by a licensed Medical Review Officer.
The Department of Transportation (DOT) 49 CFR Part 40.163(f) says the MRO cannot provide quantitative levels to Employer or other drug screening company. “You must not provide quantitative values to the DER or C/TPA for drug or validity test results. However, you must provide the test information in your possession to a SAP… [Substance Abuse Professional]…who consults with you (see Sec. 40.293(g)).”
Why does the DOT discourage quantitative level reporting and what does that have to do with Non DOT drug screening?
- The ‘numbers’ associated with quant levels require interpretation and context. This process should be handled by a medical doctor.
- There can be liability issues with the pre‐judgment that may occur if a quant level is available.
- The DOT is the single standard for drug screening. A regulation within this standard is always a consideration for non DOT drug screening. A non DOT quant level has the same repercussions a DOT quant level has – misinterpretation and liability.
What about quantitative (‘quant’) level of a positive drug screen for non DOT drug testing?
While it may seem that providing quant levels for a drug screen is a good idea, the opposite is true. Providing unambiguous and comprehensible information is helpful to our clients; providing confusing or potentially misinterpreted information is not so helpful. As a DER or C/TPA, we must consider the ramifications of the information we provide: for ourselves, a client, and for a donor (or an employee). Quantitative levels are just a part of the medical professional’s resources for interpreting a drug screening result. In a medical or SAP context, these levels assist with the overall interpretation of a positive drug screen. Outside of that context, quantitative levels provoke far more misinterpretation rather then providing any meaningful information.