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What is a Urine Drug Test?

A urine drug screening looks for for the metabolites of drugs in urine. A metabolite is not the native drug. It is what your body produces when a drug is ingested. A urine drug test can screens for many commonly abused illegal and prescription drugs. Examples include cocaine, methamphetamines, amphetamines, barbiturates, benzodiazepines, marijuana, PCP, opiates and methadone.

Why it’s done?

  1. Urine drug testing is used by employers to help determine whether an individual will be a safe, productive employee.
  2. Some employees are required by law to pass a urine drug test in order to perform safety-sensitive work. Most of those are in transportation and fall under the regulations of the U.S. Department of Transportation.

Screening Test

The first test in a urine drug screening is called the immunoassay, or screening test. A screening test is cheap and fast, and the vast majority of them are negative and are released without further testing. If something is detected in an immunoassay test, it goes through further testing. A non-negative screening tests never referred to as “positive,” as there are a number of substances that can trigger a non-negative result. But a negative is considered conclusive. This method does not quantify the levels of drug in the urine, but only whether it is above or below the cutoff (explained below).

Confirmation Test

If the immunoassay, or screening test, is non-negative, a more specific test is performed to confirm the presence of the drug. Called gas chromatography/mass spectrometry (GC/MS), the sample is tested only for the specific drug or drugs that were non-negative on the screening test. There is no possibility of a false positive here.

What is a False Positive Result?

A false positive results only when a confirmation test is not performed, and there is no medical review. A GC/MS is definitive and defensible., Some irresponsible employers and drug testing providers do not confirm non-negative screening tests and subject themselves to major legal liability.

At InOut Labs, ALL non-negative screening tests undergo confirmation testing and medical review. Every single one.

How a Urine Drug Test is Conducted ?

Urine drug test collection procedures are described by the Department of Health and Human Services in 49 CFR Part 40, and are generally the same for regulated testing and non-regulated. Most regulated testing is for employees regulated by the US Department of Transportation and often referred to as DOT drug testing.

The step-by-step urine specimen collection protocol includes verifying the donor’s identity, securing the collection area to reduce opportunities to cheat, and completing paperwork that establishes a chain of custody. There is zero opportunity for an individual’s specimen to be mixed up with someone else’s specimen.

What About Prescriptions?

Some prescribed medications will be detected in a urine drug test. For this reason it’s important the a Medical Review Officer (MRO) be involved. An MRO reviews all positive drug test results and will verify all prescriptions. If a positive result is due to a valid prescription, the result is reported as a negative. This protects both the employer and the donor. For more on the MRO, see here.

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