How Does Employment Drug and Alcohol Testing Work?

According to the Department of Labor, workplace drug use costs US employers $75 to $100 billion in lost revenue each year, which accounts for lost time, accidents, healthcare, and workers’ compensation costs. While drug screening practices are currently in flux in locations where marijuana has been legalized, most Fortune 500 companies still require their employee screening processes to include drug testing to look for cocaine, PCP, opiates, amphetamines, and marijuana (in some states), which could disqualify an applicant.

Drug testing in the workplace is a standard practice that virtually all applicants should expect to find in the hiring process of a company, so it’s important to have a clear understanding workplace drug testing to create company test policies that are comprehensive, effective, and compliant with federal and state laws and regulations.

Reasons for Workplace Drug Testing

So why do employers choose to perform drug and alcohol tests on prospective and current employees? The most common reasons for workplace drug testing are:

  1. To foster a safe and healthy work environment for employees and customers.
  2. To help the company benefit from Workers’ Compensation Premium Discount programs.
  3. To identify and disqualify candidates who use illegal drugs.
  4. To deter drug and/or alcohol abuse among the company’s current employees.
  5. To identify and appropriately refer current employees who have problems with drug and/or alcohol abuse.
  6. To comply with state and federal laws and regulations (i.e. the U.S. Department of Transportation’s rules for drug testing employees who fill certain safety-sensitive positions.)
  7. To promote employee and customer confidence in the company’s commitment to quality and safety

How the Drug Testing Process Works

Employers are generally required to obtain written consent from applicants before conducting a drug test. They should understand that their eligibility is contingent on the results of the test. Employers outsource the drug screening portion of the hiring process to specimen collection sites or drug testing vendors. Typically, the applicant is required to perform the testing within a couple of days of their application to narrow the window of time they can “get clean.”

Not long after the specimen (typically urine) is sent to the lab, the results become available. It takes even less time if the applicant is found to be drug-free. A positive test takes longer, because it must be re-verified before the employer and applicant are notified. The lab will keep samples of the positive test in case the findings are challenged.

How Drug Users Circumvent Drug Screenings

The process of background checks for most entry-level positions is a familiar process for those entering the job market, and drug users have found ways to get around the hurdle of requisite drug screenings. Periodic cocaine users can still pass a drug test 24 hours after using the illegal substance, and even chronic users only need a few days to test clean. A similar time frame holds true for heroin and PCP users. Marijuana, on the other hand, requires a longer detoxification period. These users often find alternative methods to giving up the substance.

In terms of urine samples, marijuana users sometimes attempt to alter their own sample by adding agents such as dish soap or bleach or submitting a synthetic sample. Drug users can also find legal substances at local general nutrition centers to flush their systems. Some users even go as far as borrowing urine from a clean person to pass off as their own. 

Most drug users find their way around screenings, whether they choose to detox or cheat the system. Therefore, as methods for beating drug screenings are growing, the need for firms like Victig that provide holistic options to job candidate dishonesty becomes crucial.

Circumstances That Merit a Drug Test

There are many occasions that could be written into an organization’s drug testing policies, which are listed below.

Pre-Employment Testing

Following an offer of employment, the applicant agrees to be tested, understanding that the offer will be withdrawn if the test proves positive. Because applicants can prepare for pre-employment testing by abstaining from drug use for several days, some employers perform additional unannounced tests on probationary employees, but some states restrict this practice.

Per the Americans with Disabilities Act (ADA), employers across the board are prohibited from performing pre-employment testing for alcohol use. With pre-employment testing, employers cannot be selective about the applicants they choose to test at this stage.

There are four types of pre-employment drug screening: 

  1. Urine test

The most traditional type of drug test uses the potential employee’s urine to screen for drugs and alcohol. Five-panel drug tests screen for: 

  • Marijuana
  • PCP
  • Cocaine
  • Opiates
  • Amphetamine

If an employer wants a more complete view of an individual’s drug usage, an in-depth 10-panel test can be performed. Alcohol passes through the system very quickly, which makes urine tests more effective for detecting drugs than alcohol.

  1. Blood test

A blood test is used primarily to check alcohol and drug levels at the time the test is completed. It is not as reliable as urine tests for long-term detection but is more effective in determining current levels of alcohol and drugs in the system.

  1. Hair follicle test

Hair testing is effective in detecting months worth of illicit drug use, such as marijuana, amphetamines, cocaine, heroin, and PCP.  When an employer needs a complete long-term picture of a potential employee’s drug use, a hair test may be justified. 

  1. Saliva test

Some employers may choose to perform a saliva test because it’s quick, easy, and provides deep insights. Saliva testing is mainly used to check for recent usage and pinpoint a specific substance. It is more effective in detecting specific drugs than urine, but drugs and alcohol do not remain in saliva as long as they do in urine. 

Testing Based on Reasonable Suspicion

Reasonable suspicion testing is performed when a supervisor has observed and documented the signs and symptoms of drug use in an employee. This type of testing is discretionary, so it’s crucial that the organization’s supervisor training program include clear and consistent definitions of the “signs and symptoms of drug use” to look out for and that their suspicions be corroborated by someone else in management. 

Post-Accident Testing

Objective criteria that are often used to justify a post-accident test on an employee include an incident that results in:

  • Fatalities
  • Injuries requiring off-site medical care
  • Property damage exceeding a specified dollar amount
  • Police citation

However, some employers choose to label this type of testing as “post-incident” to cover any event in which accident or injury could have occurred but was fortunately averted in order to rule out the presence of drugs and/or alcohol as a factor in the incident.

Random

This type of testing has no advance notice and is used as a deterrent for drug use. Subjects are drawn at random from an employee pool on a scientifically arbitrary basis to assure an equal chance for selection among all employees. 

Periodic

These tests occur uniformly across the employee base, usually on an annual basis and especially for positions that require regular physicals. Periodic tests can be planned for by abstaining from drug use for several days before the scheduled testing.

Return to Duty

Return-to-duty testing is for employees returning to work after an extended absence, usually because they tested positive in a previous drug test and have undergone the required treatment and rehabilitation process for substance abuse. Post-rehabilitation testing can also be periodic and unpredictable.

Blanket

Blanket testing is similar to random testing in that it is unannounced, and participants cannot prepare for passing a drug test by abstaining beforehand. However, instead of testing a random employee or selection of employees, all personnel are tested.

Other

Other types of drug testing that can be included in your drug-free workplace policy are voluntary, probationary, pre-promotion, and return-after-illness testing. These are all generally announced, allowing employees to anticipate and prepare for testing.

What Are the Federal Guidelines for Drug Testing and Who Must Follow Them?

Some federal agencies are overseen by the Substance Abuse and Mental Health Services Administration (SAMHSA) (which is part of the Department of Health and Human Services (DHHS)) and are subject to their guidelines. But because SAMHSA’s mandatory guidelines have been supported by court decisions even in the private sector, many private employers choose to follow them as a precautionary measure even though they are granted some latitude to implement policies of their own design. 

These federal guidelines include:

  • Having test results evaluated by a qualified Medical Review Officer (MRO)
  • Requiring the use of only SAMHSA-certified drug labs
  • Provisions for the five substances (or six, including alcohol) tested for in federal drug testing programs: Amphetamines (meth, speed, crank, ecstasy), THC (cannabinoids, marijuana, hash), cocaine (coke, crack), opiates (heroin, opium, codeine, morphine), phencyclidine (PCP, angel dust), and in some cases, alcohol (ethanol, ethyl alcohol, booze)
  • Following procedures to assure accuracy and validity in the testing process: chain of custody, initial screen, confirmation test, split sample

SAMHSA’s Testing Process Procedures and Visibility of Results

Observing the four procedures outlined by the SAMHSA will provide the necessary quality control measures to conduct drug testing within your organization with confidence.

  • Chain of Custody: This is a form that follows and documents the lifecycle of the sample from collection to disposal. This provides an unbroken link, in writing, between the specimen and the employee or applicant while the sample is being handled and stored at the collection site and the laboratory.
  • Initial Screen: This covers the sample’s first analysis, which cannot be considered wholly accurate or reliable on its own, since it’s possible for an initial screen to result in a false positive. A second confirmation test is always conducted on a positive result at this stage.
  • Confirmation Test: This second test is performed a little differently to provide added specificity and is considered highly accurate. Its intention is to rule out any false positives from the initial screen and is performed by gas chromatography/mass spectrometry (GC/MS). The confirmation test and the initial screen must agree in order for the test results as a whole to be considered positive.
  • Split Sample: At the time the sample is collected, it is split in two — one half for the initial screen, and the other for the confirmation test if the first returns positive.
  • MRO: Before the test results can be reported to the employer as positive, they must be reviewed by an MRO, or a licensed medical doctor with training in substance abuse. The MRO makes sure of the correct application of chain-of-custody and crosschecks with the employee or applicant to rule out the interference of certain doctor-prescribed medications, which can cause a positive result.
  • Restricted Access to Results: Employees and applicants generally must sign a release that allows the results of the drug and alcohol test to be viewed by the employer. Otherwise, the result of a drug test can be considered personal health information and protected under the Health Insurance Portability and Accountability Act (HIPAA). That being said, employers must handle such information with discretion, as with all sensitive materials, regardless of whether the employee or applicant has signed a release

Drug Testing Methods

The most common method of drug testing for the five illicit drugs listed in the SAMHSA guidelines is urinalysis, while breath testing is the most common for alcohol. Other types of bodily specimens can be collected for detecting specific types of drugs and usage, such as blood, hair, oral fluids, and sweat.

  • Urine: Shows the presence or absence of drug metabolites in urine. 
  • Breath: Measures how much alcohol is in the bloodstream (blood alcohol concentration or BAC).
  • Blood: Provides a more accurate measure of how much alcohol or drugs are actively present at the time the sample is collected. 
  • Hair: Provides evidence of usage history of a specific drug, not current impairment.
  • Oral fluids: Detects current use by collecting traces of drugs or alcohol in the mouth.
  • Sweat: Used mainly to maintain probation or parole compliance; signs of usage are collected with a skin patch and worn for a length of time

Drug Test FAQ

  • What other drugs can private employers test for apart from those listed by the SAMHSA?

There is an 8-panel test that includes SAMHSA’s listed substances plus Barbiturates (phenobarbital, butalbital, secobarbital, downers), Benzodiazepines (tranquilizers such as Valium, Librium, and Xanax), and Methaqualone (Quaaludes.) A 10-panel test includes all the above plus Methadone, used to treat heroin addiction, and Propoxyphene (Darvon compounds). Other substances that can be included in drug screening for employers are Hallucinogens, Inhalants, Anabolic steroids, Hydrocodone, and MDMA.

  • How long are certain substances detectable?
    • Alcohol: 1 oz. for 1.5 hours
    • Amphetamines: 48 hours
    • Barbiturates: 2–10 days
    • Benzodiazepines: 2–3 weeks
    • Cocaine: 2–10 days
    • Heroin Metabolite: less than 1 day
    • Morphine: 2–3 days
    • LSD: 8 hours
    • Marijuana: casual use, 3–4 days; chronic use, several weeks
    • Methamphetamine: 2–3 days
    • Methadone: 2–3 days
    • Phencyclidine (PCP): 1 week
  • Who pays for drug tests?

The employer. Additionally, under the Fair Labor Standards Act (FLSA), employees are generally paid for time spent undergoing required testing.

Starting a Drug-Testing Program

Though employers are not prohibited by any federal laws from testing employees and applicants for drug use, it is important to become familiar with state laws that prohibit or restrict random drug testing on employees who aren’t in safety-sensitive positions. The Americans with Disabilities Act (ADA) also has protections—in certain situations—for individuals with a history of substance abuse who are considered qualified with a disability.

While drug testing is an important component of a drug-free workplace program, it’s also important to have provisions for clearly outlining your expectations regarding drug use and for uniform supervisor training on detecting signs of use and enforcing policies. It is also advisable to seek legal consultation for an existing program or before starting a new one, which will help you confidently create a comprehensive drug-free workplace program to protect your company, your employees, the people you serve, and ultimately, your community.