DRUG TESTING AND ANALYSIS INFO
What does "Preliminary Positive" mean?
Using a urine drug test cup or saliva drug test device is only the first step in the drug testing process. These drug tests screen for the presence of drugs; however, they do not provide laboratory-confirmed results unless required. In rare circumstances, it is possible to obtain false positive drug test results despite a donor’s proclaimed sobriety. Some over the counter medications, e.g. Ibuprofen, and even some foods, e.g. poppy seeds, may trigger specific drug test panels to yield positive findings. All preliminary positive drug test results can go through a certified Medical Review Officer (MRO) for analysis under a CLIA-Waived laboratory setting. The MRO will be able to provide an explanation for a person’s legitimate drug use or possible contraindicating food intake.
What does "FDA Approved" mean?
The United States’ Food and Drug Administration (FDA) is a federal agency designated to protect the health and welfare of American consumers of food, drugs and medical devices. FDA regulations and inspections are strict in order to prevent the risk of disease and widespread illness across the country. FDA Approved drug testing kits meet the highest standard of drug testing. In order to receive FDA accreditation, every component of the drug test mechanism, including written packaging claims and instructions must be clinically tried for validity, safety and effectiveness. The FDA is also responsible for inspecting their own procedures and equipment used to conduct trials, including their laboratories and computer systems. It is illegal for manufacturers to advertise FDA Approval on products that haven’t been FDA Approved. If a product isn't FDA Approved, no scientific data exists to back any of the product’s claims.
What does it mean if a medicated drug receives FDA Approval?
Prescription drugs and biochemical compounds must undergo rigorous clinical testing before they can be sold in the United States. The Food and Drug Administration (FDA) reviews these findings to verify identity, potency, purity and stability of the drug’s ingredients.
What Does "NIDA" stand for?
The National Institute on Drug Abuse (NIDA), was formed to curb rising drug abuse rates in the country by promoting technological advancements in drug testing and other drug prevention strategies.
"NIDA 5" is sometimes used interchangeably with "SAMHSA 5". The NIDA 5 and SAMHSA 5 top drugs of abuse are:
- Amphetamines (AMP)
- Cocaine (COC)
- Opiates (OPI)
- Marijuana (THC)
- Phencyclidine (PCP)
NIDA 5 panel drug tests come in a variety of forms, including urine collection cups such as our DrugConfirm Advanced Urine Drug Test Cup; saliva drug tests, like our Oratect Oral Fluid Device, and hair follicle tests, i.e. HairConfirm Regular.
What does “CLIA" stand for and what is a CLIA Waived test?
Clinical Laboratory Improvement Amendments (CLIA) were implemented by U.S. Congress in 1988 to regulate timeliness, accuracy and dependability of clinical laboratory testing procedures. CLIA Waived tests are simple to conduct and use standardized equipment which prevents inaccuracy and encourages repeatability.
Certain laboratory tests, including drug confirmation testing, may be highly complex and require the use of special equipment. If these tests satisfy certain conditions, they can be exempt or waived from regulatory protocol. In other words, CLIA Waived tests, which are automatically FDA Approved, can be performed at home or in the workplace.
Drug screens including Alcohol (ALC), Fentanyl (FEN), Synthetic Marijuana (K2), Lysergic Acid (LSD) panels are used for forensic purposes only and cannot receive a CLIA Waiver.
How sensitive are drug testing kits and what are the concentration cutoff levels of drugs?
Drug test kits differ in their sensitivity levels for drug detection. The Substance Abuse and Mental Health Services Association (SAMHSA) provides guidelines for what constitutes a positive drug test result. If the drug concentration of a specimen falls below SAMHSA cutoff levels, the specimen will not yield a positive test result. If an immunoassay drug screen delivers positive results, Gas Chromatography/Mass Spectrometry (GC/MS) must be conducted in a laboratory setting to confirm preliminary findings. As per SAMHSA.gov, “the initial drug test shall use an immunoassay which meets the requirements of the Food and Drug Administration for commercial distribution. The following initial cutoff levels shall be used when screening specimens to determine whether they are negative for these five drugs or classes of drugs:
Initial SAMHSA Drug Test Concentration Cutoff Levels:
- Amphetamines: 1,000 ng/mL
- Cocaine metabolites: 300 ng/mL
- Marijuana metabolites: 50 ng/mL
- Opiate metabolites: 2,000 ng/mL
- Phencyclidine: 25 ng/mL
SAMHSA also proposes guidelines for proper confirmatory testing conduct: “a specimen identified as positive on an initial drug test shall be confirmed for the class(es) of drugs screened positive on the initial drug test using Gas Chromatography/Mass Spectrometry (GC/MS) at the cutoff values listed in this paragraph. Each confirmatory drug test shall provide a quantitative result. When the concentration of a drug or metabolite exceeds the linear range of the standard curve, the certified laboratory may record the result as ‘exceeds the linear range of the test’ or as ‘greater than or equal to (insert the value for the upper limit of the linear range)’, or may dilute an aliquot of the specimen to obtain an accurate quantitative result when the concentration is above the upper limit of the linear range.
Confirmatory Drug Test Concentration Cutoff Levels:
- 6-Acetylmorphine: 10 ng/mL
- Amphetamine: 500 ng/mL
- Cocaine: 150 ng/mL
- Codeine: 2,000 ng/mL
- Marijuana: 15 ng/mL
- Methamphetamine: 500 ng/mL
- Opiates/Morphine: 2,000 ng/mL
- Phencyclidine: 25 ng/mL
What are the drug test detection time cutoff periods per drug and drug testing method?
The detection period of any drug (illegal or prescribed) will vary from person to person based on individual factors including:
- Weight and Body Fat Percentage
- Underlying Health Problems
- Frequency of Drug Abuse
- Drug Potency
Detection cutoff timeframes vary by drug and test type:
||up to 90 days
||up to 90 days
||up to 90 days
||up to 90 days
||up to 90 days
||up to 90 days
||up to 90 days
||up to 90 days
||up to 90 days
What is the difference between narcotics and stimulants?
Narcotic drugs are substances that induce sleep or drowsiness, similar to depressants. Legally, a narcotic substance may refer to opium and its derivatives, such as cocaine, heroin and prescription medications. Narcotics use can be easily detected by any instant drug testing method. The most commonly abused narcotic substances include:
Do any of your drug test kits test for LSD or other Hallucinogens?
The most commonly abused hallucinogens include:
- Ecstasy (MDMA)
- Phencyclidine (PCP)
- Lysergic Acid Diethylamide (LSD)
There are a variety of instant drug testing kits available to test for these commonly abused hallucinogens, including our One Step LSD Urine Drug Test Dip Card and our SalivaConfirm Oral Fluid Drug Test Device. It's possible to identify some or all of these hallucinogenic drugs at once depending on the needs of your practice.
How can drugs affect an unborn baby?
Drug use during pregnancy can affect both a mother and her fetus. Drug metabolites can cross the placenta, which provides nourishment and protection for the fetus. A mother’s drug abuse can result in organ toxicity and drug dependency even before the baby is born. It is also possible for drug metabolites to be passed onto the newborn through breast milk. A fetus’ major organs develop approximately 2-3 weeks after conception until the second trimester. Exposure to drugs during this period can cause serious birth defects or miscarriage. Some drugs can interfere with the functional development of the Central Nervous System in the second and third trimesters as well. Drug use during the third trimester poses the greatest risk of stunted fetal growth or premature birth.
How do you use a urine drug test strip to test for nicotine and tobacco use?
Gold particles coated with selective cotinine antibodies are contained at the end of a urine drug test strip. This antibody binds to cotinine, a nicotine metabolite, in urine specimens. Once the end of the drug test strip is dipped in the urine sample, the gold particles migrate through the strip to produce clearly defined red bands to suggest nicotine use. Urine drug test strips designed to screen for cotinine use can sensitively measure cotinine levels as low as 6 ng/mL of urine.
What is meant by “cutoff level”?
The cutoff level of a specific drug is the minimum concentration of a drug in a urine sample to yield a positive drug test result. If the concentration of drug in urine is below the designated concentration cutoff level, the drug test will present a negative finding. Cutoff levels can be imagined as the differentiating line between positive and negative drug test results. A cutoff level is established based on the average ratio of intentional and incidental drug use.
What is the difference between on-site drug testing and laboratory drug testing?
On-site drug testing is common throughout clinical organizations, addiction rehabilitation centers and hazardous workplace settings. On-site drug tests such as urine drug test cups and oral fluid devices are easy to use and test different drugs of abuse within minutes. For best results, on-site drug testing should be performed by a nonbiased third party. Positive results must undergo confirmatory lab testing, especially if employers intend to act against an employee. The most popular confirmatory lab tests used today is Gas Chromatography/ Mass Spectrometry testing (GC/MS). Collected urine, saliva, or hair samples are analyzed by an accredited CLIA Waived laboratory. Confirmation testing requires an average of 3-7 business days for completion. Lab-based drug testing provides utmost accuracy and legal defensibility.
What exactly is drug detox?
The goal of drug detox is to eliminate toxins which have accumulated in the body through continued drug use. Withdrawal symptoms are often the first indicator of successful drug detoxification. Withdrawal refers to a generally uncomfortable physical and mental transitional period that results from discontinued drug use.
How is detoxification performed?
Detoxing from any drug can be an arduous process. The goal of detoxification is to remove drug metabolites from all areas of the body to prevent future cravings and abuse. A certified detox facility should combine counseling with medication to help with possible psychological distress and withdrawal symptoms.
Is it safe to use central nervous system (CNS) depressants with other medications?
CNS depressants should not be combined with other forms of mediation, such as prescription opioids or over the counter cold and allergy medications. Alcohol consumption should be especially avoided if taking CNS depressants, as the combination of these drugs can lead to lethal cardiac or respiratory side effects.
What are stimulants?
Stimulants refer to a category of substances designed to increase alertness, attention span and energy levels. Physical side effects of stimulant use include elevated blood pressure and increased heart and respiration rate. Medical use of stimulants is beginning to wane as a result of the likelihood of developing an addiction.
What are the consequences of abusing stimulants?
Prolonged use of stimulants such as ecstasy or cocaine can lead to dependency and addiction. Short-term side effects of stimulant use are not limited to:
- Feelings of Hostility
- High Body Temperature
- Irregular Heartbeat
Long-term side effects of stimulant abuse include:
- Heart Palpitations
- Anxiety and Mental Disturbances
- Loss of Appetite
How do stimulants affect the brain and body?
Stimulant drugs have chemical structures similar to a family of neurotransmitters called monoamines. Norepinephrine and dopamine are naturally occurring monoamines that increase blood pressure, heart rate and blood glucose levels while opening up the pathways of the respiratory system. Stimulants such as cocaine mimic the effects of monoamines, which can be pleasurable to some users, consequently leading to addiction.
What is the purpose of workplace drug testing?
The US Department of Labor estimates employee drug use costs 75 to 100 billion dollars annually in lost labor, accident coverage, benefits and Workers Compensation expenses. Drug testing in the workplace statistically reduces rates of tardiness, absenteeism and turnover. Implementing a drug testing program also helps to keep theft, crime and violence out of the workplace. It is possible to request pre-employment, periodic or random drug testing as long as employers clearly document their drug testing policy.
What is meant by prescription drug abuse?
Prescription drug abuse refers to the non-medical use of a controlled psychotropic pharmaceutical drug. The officially declared opioid epidemic claims tens of thousands of lives annually in the United States. Prescription drug abuse, especially if prolonged, can lead to health problems, criminal behavior and compromised lifestyle.
What is the appropriate way to treat a dual diagnosis which includes addiction?
The recommended method of treating a dual diagnosis is to first handle the symptomatic drug abuse, and subsequently treat the accompanying emotional or psychiatric disorder. Once addiction is under control, psychological treatment can be prioritized.
How do I select the most appropriate rehab treatment?
Choosing the correct treatment approach is an important, albeit confusing decision. If opting to enroll in an addictions treatment center, many programs are available to suit your individual goals:
- Outpatient therapy, which involves periodic visits to a selected treatment facility
- Inpatient therapy, where care is administered to patients who reside onsite
- 12-Step program, which helps addictions sufferers recognize trends in their behavior
- Group therapy, where sufferers gather to express concerns, experiences and learn
What is a false positive result?
It is possible for an immunoassay screen to yield a positive drug test result despite there being no drugs of abuse in the donor’s system. Many safe substances and foods such as OTC cough medicine, tonic water, etc. may trigger panels on a drug test to read positive. False or preliminary positives can be sent to a laboratory for confirmation testing.
What is the most common drug prescribed for ADHD?
Methylphenidate, typically referred to as Ritalin, is frequently recommended for the treatment of ADHD symptoms. Ritalin is a Central Nervous System (CNS) stimulant that behaves similar to Amphetamines by encouraging focus and increasing cardiac and respiratory action. Ritalin promotes the release of dopamine, a neurotransmitter responsible for feel-good sensations. Triggering the brain’s reward system by activating dopamine can create a high potential for Ritalin abuse.
What are the neurological effects of abusing ADHD medication?
ADHD prescription drug abuse can lead to myriad detrimental side effects:
- Impaired Memory
- Slowed Learning Ability
- Poor Concentration
- Panic Attacks
- Impaired Motor Function
Why do many people prefer behavioral therapy over prescription ADHD medication?
Prolonged administration of ADHD medicine i.e. Ritalin can lead to addiction. It is possible to become tolerant of ADHD medication, which means larger doses are required to produce desired effects. Ritalin addictions often occur because the drug increases dopamine release from the brain. Cognitive behavioral therapy, emotional counseling and psychological support must be provided to ADHD sufferers so they can learn to cope with life without resorting to drug abuse.
What are the consequences of intravenous drug administration, or injecting drugs?
Drugs prepared for injection outside of a sterile site are susceptible to contamination by bacteria, dust, dirt, etc., which can lead to serious infections. Injecting drugs into veins with hypodermic syringes bypasses the body's natural defense mechanisms, i.e. skin, respiratory cilia and digestive enzymes. Intravenous administration makes it difficult for the user to control the intensity of the drug’s effects, increasing the likelihood of toxic overdose.
What are the consequences of intranasal insufflation, or snorting drugs?
The delicate epithelial tissues lining the nasal cavity can become permanently damaged through direct drug contact. The harsh chemical compounds found in most drugs can cause:
- Open Sores
- Nose Bleeds
- Deterioration of Nasal Cartilage
If drug test results are negative, does this mean the donor did not use drugs?
No. Several factors may yield false negative drug test results even if someone is an active user:
- Incorrect drug test performed
- Elapsed drug detection window
- Specimen adulteration
- Using an expired or damaged drug test
- Specimen drug concentration is below minimum cutoff level
If you still suspect drug abuse after a negative drug test result is obtained, it is recommended to conduct the drug test again at a later date.
Why did I receive an instant test positive result, but a GC/MS confirmation test negative result?
Many factors affect the results obtained from a drug test. Although instant drug screens are still highly accurate, false positive and false negative drug test results are possible in rare circumstances. Laboratory testing is the last line of defense against invalid drug test findings, as results are virtually guaranteed to be error-free.
What precautions should be taken for drug abusers who have heart conditions?
Precautionary measures must be taken for heart patients with a known drug abuse history. Beta blockers should not be prescribed to patients who have used Dexedrine, as these agents may increase the risk of high blood pressure and irregular heartbeat. Many drugs interact negatively with heart medicine which could lead to fatality.