Helping Employees Understand Worplace Drug Testing

Much of what we post and write about concerning drug testing or drug screening is designed for employers to help their employees better understand the processes. If you have worked for a DOT-regulated company or if you have started a new job recently, you have probably had a drug test. For those who have never had a drug test, this information will be very beneficial. It is about helping applicants and employees to understand the drug testing process.

Many employers today require a pre-employment drug test. They want to make sure at the time of hire that the person coming on board is free of illicit or illegal drugs. The drug test is typically done post-offer, and the job offer is conditional upon successfully passing the drug test. In almost all cases, you will not get the job if you test positive on a pre-employment drug screen.

The majority of employers today utilize a urine drug test for pre-employment purposes. Hair testing and oral fluid testing are also options. The two most common types of drug tests are the 5-panel drug test and the 10-panel drug test.

5 Panel Drug Test: Marijuana (THC), Cocaine, Phencyclidine (PCP), Amphetamines (ecstasy, methamphetamine), Opiates (heroin, codeine, morphine)

10 Panel Drug Test: Marijuana (THC), Cocaine, Phencyclidine (PCP), Amphetamines (ecstasy, methamphetamine), Opiates (heroin, codeine, morphine), Barbiturates (BAR), Benzodiazepines (BZO), Methadone (MTD), Propoxyphene (PPX), Methaqualone (MTQ)

Synthetic narcotics such as Oxycodone (OxyContin), Oxymorphone (Opana), Hydrocodone (Vicodin) and Hydromorphone (Dilaudid) are often added to either the 5 or 10 panel drug tests.

employees in a meeting to discuss workplace drug testing

Specimen Collection

For a urine drug test, your urine specimen is collected in the privacy of a rest room. You will be asked to remove your coat, jacket, sweater or other outer garments. You will also be asked to remove the contents of your pockets and leave all personal belongings outside of the collection area in locked storage. Prior to going to the restroom, you will have an opportunity to wash and dry your hands. You will not be allowed to wash your hands again until your urine is sealed for custody and control to be shipped to the laboratory. The toilet water will often be blue, and you will be asked not to flush the toilet after you urinate. This is all part of the process to protect the integrity of your urine specimen and to ensure there is no specimen tampering or potential cheating on the test.

The specimen collector will begin the process with the initial paperwork. The collector will then finish the process once you provide the urine specimen by sealing your specimen and completing the final paperwork. You will receive a copy of the completed custody and control form (CCF) when the process is completed. You can then wash your hands and collect your belongings. You will be asked to record any medications you are taking on the back of the CCF form (your copy) for your own use in the event you are called by the Medical Review Officer (MRO) to discuss your laboratory test result.

Laboratory Testing

Your urine specimen collection is done at what is commonly called a collection site. Specimens are then shipped to our Substance Abuse and Mental Health Services Administration (SAMHSA) certified laboratories where an initial screen is performed. Ninety percent of specimen’s test negative on the screening test and are reported immediately to the MRO, who in turn immediately reports the results to the employer. The labs we utilize most often are Quest Diagnostics and LabCorp. Both are SAMHSA certified.

Specimens that test positive on the initial screen at the laboratory are retested with confirmation testing called gas chromatography-mass spectrometry, or GC/MS. This testing provides two results: a definitive molecular fingerprint of the drugs that are present in the sample, and the corresponding measured drug concentrations. This testing rules out false positives, like claims of poppy seed bagels causing your positive test for opiates.

Sometimes the initial screening is performed at the collection site or at the employer’s place of business. These are called instant or Point of Collection Tests (POCT). These tests can produce a negative result in about five minutes. In all cases, if the instant test result is not negative, the specimen should be sent to the lab for confirmation testing and the result reviewed by the Medical Review Officer.

MRO Review and Verification

The Medical Review Officer reviews the drug test results before your employer receives them. If the lab reports a result to the MRO as a positive, you will receive a phone call from the MRO. As a licensed physician, the MRO will have a confidential conversation with you. If you believe your prescribed medications caused the laboratory positive test, the MRO will verify your prescriptions with your pharmacy and, if validated, your result will then go to the employer as a negative. You can be confident there are no false positives; if you are on medications, these will be accounted for with the medical review process. There is no need to discuss your medications with your employer or the specimen collector, only with the MRO.

employee reading a workplace policy manual

The MRO also is responsible for assisting you if you want to challenge the result of a positive test. There is only one option to challenge. A portion of the original specimen that was collected remains available at the lab for retesting at another lab. So, the original lab pulls your specimen and ships it to a second lab for retesting. This is an expensive process, and it will be your responsibility to pay the fee for this retest process.

Turnaround Time

It typically takes a good drug testing provider one to two business days to get about 90 percent of the drug test results back to the employer. The remaining tests can take up to seven business days due to confirmation testing at the laboratory, MRO reviews, verifications or delays due to you contacting the MRO to discuss medical explanations for your positive result.


Drug testing is an accurate process. If you are not taking illegal or illicit drugs, you have nothing to worry about. Peeing in a cup is not anyone’s favorite activity, but get it done and then get the job. Unfortunately, there are more than 30 million drug users in the United States. For that reason, employers have to be very meticulous when they hire someone. Safety is always a concern. Every employer and all employees want a drug-free workplace.

Immediate service for drug testing is always available from National Drug Screening.