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Test Was Negative My Positive? Test Home Drug Why was Employer My –



  • Test Was Negative My Positive? Test Home Drug Why was Employer My –
  • Drug Testing FAQs
  • Enjoy this blog? Please spread the word :)
  • What to do if a drug test comes back with a false positive Up to 15% of drug tests will register a false positive, or a false negative. you have taking to the testing facility, you should contact your employer's human resource Industry, Drug Testing, Drug Testing in the Home, Drug Testing in the Workplace. How long does it take to get a negative drug test result? GCMS testing is an extremely accurate test that is completed on non negative results which provides quantitative results for "No thanks, my employer tests at work. . under their regulations to have policies in place that fully explain their drug and alcohol program. I received a positive drug test result, but the employee says it's a mistake is why it's important to understand the measures the DOT has in place to the final result will report out to the employer as a verified negative. . I passed the POCT urine test given by my employer and then failed the lab urine test.

    Test Was Negative My Positive? Test Home Drug Why was Employer My –

    Show your employees that you care, provide them a safety net, and ensure you are making a decision on accurate information in your drug testing program. Let CleanFleet review your drug testing policy to make sure best practices are established.

    Give us a call at There are 0 comment. Currently you have JavaScript disabled. In order to post comments, please make sure JavaScript and Cookies are enabled, and reload the page.

    Click here for instructions on how to enable JavaScript in your browser. The split specimen testing process and expected timeline For all positive results, the MRO reports the initial positive to the employer, because the employer still has to take the driver if FMCSA, for example off the road and wait for the results of split. The laboratory reconfirmed one or more of the primary specimen results.

    In the case of a reconfirmed positive test s for drug s or drug metabolite s , the positive is the final result. In the case of a reconfirmed adulterated or substituted result, the refusal to test is the final result.

    In the case of a combination positive and refusal to test results, the final result is both positive and refusal to test. Although IA has high sensitivity, it has poorer specificity than GC-MS owing to cross-reactivity, whereby compounds in the biologic specimen other than the actual substance or its metabolite bind to the assay and trigger a false-positive result.

    For example, PCP assays can turn positive if an individual consumes dextromethorphan, a common component of cough syrup. Additionally, IA drug tests performed in isolation do not distinguish among drugs within a class i. GC-MS is not performed as a point-of-care test and usually must be sent to a laboratory, resulting in a delay [ 7 ]. Newer but less widely used technologies include liquid chromatography-mass spectrometry and tandem mass-spectrometry, which can be used to bypass the initial screening IA and identify a larger number of substances and metabolites [ 8 ].

    Often, laboratories report the urine creatinine, which helps the clinician correct for the relative concentration or dilution of the urine. Concentration of the urine by the kidneys results in elevated levels of drug metabolites; therefore, urine concentrations of certain drugs and their metabolites are usually divided by the urine creatinine. An example of this is THC, whose excretion in the urine can continue for up to one month after most recent use in heavy users [ 13 ], and urine samples positive for THC must be carefully interpreted to distinguish ongoing excretion from new use.

    Urine THC concentration should be divided by the urine creatinine concentration in order to determine whether the creatinine-normalized THC concentration is increasing or decreasing with consecutive urine samples [ 14 ] and these ratios can then be compared to nomograms of THC excretion in order to make a clinical interpretation [ 15 ].

    Practical issues, such as timing of the urine sample collection, specimen collection techniques, validation of the sample, and result interpretation are covered later in this chapter. Drug testing of blood samples is usually only performed in emergency situations, and due to the invasiveness of obtaining a blood sample, the need for specially trained phlebotomists, and the expense of blood drug testing, it is rarely performed in primary care settings [ 7 , 9 ].

    An additional limitation is that obtaining blood samples requires venipuncture and locating venous access among injection drug users can be very difficult [ 9 ]. Unlike urine samples, blood samples generally detect alcohol and drug compounds themselves rather than their metabolites. Blood testing typically detects substance use that occurred within 2 to 12 hours of the test [ 7 ].

    Oral fluid testing is less commonly used but oral samples represent a convenient, promising matrix for many settings. Unlike urine samples, oral samples are not easily tampered with, and can be collected with minimal invasion of privacy [ 15 , 16 ]. Oral secretions contain either the original drug compound or its metabolite for approximately hours after last use [ 9 , 15 , 16 ].

    Importantly, use of breath sprays, mouthwash or other oral rinses containing alcohol does not affect drug testing result as long as they are not used within 30 minutes of sample collection [ 17 ]. To collect an oral sample, a swab is placed adjacent to the lower gums against the inner cheek and left in place for several minutes before being inserted into a vial for transportation to the laboratory [ 9 ].

    Point-of-care oral testing is also available in some settings [ 18 ]. Hair drug tests have the advantage of detecting substance use days to months, or in some cases, years, later [ 9 , 19 ].

    Drug metabolites are present in hair as early as one week after most recent use, and because metabolites remain trapped in the core of the hair as it grows, hair provides a rough timeline of use over an extended period [ 9 , 20 ]. Hair grows at a rate of approximately one-half inch per month, and so the standard 1.

    Conversely, hair testing is not helpful in detecting sporadic use when weekly or even monthly drug testing is required as part of a drug treatment plan [ 9 ]. Additionally, drug use often must relatively heavy in order for testing to detect levels in hair. Other limitations of hair testing include that individuals can surreptitiously remove the sample through shaving, that sweat production can cause drug metabolites to travel proximally up the hair shaft thus affecting drug test interpretation, and that drugs can be incorporated into hair through simple exposure from second-hand smoke [ 23 , 24 ].

    An additional potential consideration is that drug concentrations can be affected by the melanin content of hair, resulting in potentially higher concentrations of certain drugs in dark hair as compared to blond or red hair [ 15 , 25 ].

    Bleaching or coloring the hair may also alter concentrations of metabolites [ 26 ]. The hair sample is typically cut from the back of the head using scissors, cutting as close to the scalp as possible to estimate most recent drug use [ 9 ].

    For patients who are bald or who have shaved their head, hair can be taken from the armpit, face, or other unshaven part of the body, so long as a sufficiently long enough sample can be taken.

    No point-of-care hair drug testing currently exists. Breath testing provides an accurate measure of the actual blood alcohol content at that moment in time, and is more frequently used in law enforcement or in emergency departments than in primary care.

    The US Department of Transportation maintains an active list of approved breath testing devices for the interested reader https: The US Food and Drug Administration FDA has approved a patch for collection of sweat for drug testing that is placed on the skin for days prior to being sent to a laboratory for interpretation [ 8 , 9 ]. Sweat testing checks for substances and their metabolites in the bloodstream in the hours before and during the time that the patch is applied [ 8 , 9 ].

    Patches that pucker or show other evidence of interference when removed have been designed in attempt to reduce tampering [ 8 ]. Meconium is obtained from newborns and used as a measure of maternal substance use in the third trimester [ 8 , 12 , 28 , 29 ].

    Meconium testing is used as a screen in the newborn nursery or neonatal intensive care unit when maternal substance use during pregnancy is suspected, and can have critical legal consequences for guardianship of the child [ 30 ]. Meconium testing can also inform clinical management of neonatal abstinence syndrome and other newborn withdrawal syndromes. Indications for adolescent drug testing are explored here.

    Drug tests are commonly used in emergent situations, such as when an adolescent presents with altered mental status [ 7 , 8 ]. Some common clinical scenarios include attempted suicide, motor vehicle injury or other injury in which substance use may have been a contributor, unexplained seizures, syncope, arrhythmia, or toxidromal signs that suggest a particular intoxication or withdrawal pattern [ 7 ].

    In such cases, consent for the drug screen is inferred, and its results may be used to guide clinical management. However, drug testing results are generally not available immediately and cannot reliably be used early in emergent management; therefore, initial decisions, such as whether to provide naloxone for suspected opioid overdose should be made by the clinician based on presenting signs and symptoms [ 7 , 8 ].

    Additionally, because highly sensitive drug testing may detect substances at limits far lower than therapeutic doses, drug screens may identify additional substances that are present but not contributing to the acute intoxication or withdrawal picture and may therefore be misleading [ 7 ]. Once the patient is stabilized, however, drug testing results may be helpful in determining subsequent management, particularly once confirmatory testing results are available.

    In primary care or mental health care settings, substance use by an adolescent may be suspected as underlying or complicating symptoms of depression, anxiety, inattention, hyperactivity, or other broader concerns such as a school failure or interpersonal difficulties [ 7 , 9 ].

    In these situations, voluntary drug testing i. A positive drug screen might indicate substance use that an adolescent previously denied, leading to an opportunity for an honest conversation [ 7 ]. However, as highlighted below in the discussion of interpretation of results, there are a number of limitations in drug testing that might result in a negative result despite clinically significant substance use by an adolescent. Drug testing is performed as a routine component of outpatient adolescent substance use treatment [ 7 , 9 ].

    It serves multiple roles, including preventing adverse effects of pharmacotherapy e. In residential substance use treatment, drug testing helps support the drug-free therapeutic environment [ 8 ]. In monitoring for illicit drug use during treatment, testing should be performed at random times, as discussed below, since adolescents are often knowledge of the short window of detection in urine for many substances and might otherwise simply abstain from use for the several days leading up to a scheduled test [ 7 , 9 ].

    Testing should also be performed frequently enough e. A positive drug screen should never serve as grounds for termination from the substance use treatment program, but rather should prompt a careful conversation between the adolescent and clinician to reconsider the current treatment plan [ 7 , 8 ]; multiple positive drug tests may indicate the need for a higher level of care, for example [ 8 ].

    Contingency management, which relies on incentives to encourage ongoing abstinence for adolescents with a substance use disorder, often uses drug testing for monitoring [ 31 ].

    In many settings, the value of prizes increases incrementally with each successive attended visit or negative drug screen, which further improves the efficacy of treatment [ 31 , 33 , 34 ]. A number of other potential settings for adolescent drug testing exist.

    Workplace drug testing is federally mandated by the Department of Transportation DOT for private-sector transportation workers, and many of the current standards for workplace testing have emerged from these regulations [ 9 ].

    Some adolescents and young adults may find themselves seeking or maintaining employment in settings where drug screening is routine [ 7 ]. Drug screens from non-federal employers can and often do expand their drug testing panels to include substances in addition to those on the SAMHSA-5 [ 9 ].

    Many policies regarding when, where and how employers can test their employees are set by states; a full review is beyond the scope of this article but a complete, up-to-date listing of relevant policies is available at a cost from the Drug and Alcohol Testing Industry Association DATIA , an independent industry organization [ 35 ]. Some jurisdictions have proposed drug screening in school. However, this approach is opposed by the AAP due to insufficient evidence that it discourages adolescent drug use, difficulty in correctly interpreting results, and potential adverse consequences such as disciplinary action, decreased participation in sports and other school activities, breaches of confidentiality, and increased use of substances not included in the drug testing panel used [ 36 ].

    Use of over-the-counter drug screens is distinguished from formal drug screens collected at home under the guidance of a clinician to be sent to an approved laboratory, which is frequently recommended as part of drug treatment.

    Youth involved in the criminal justice system are typically routinely drug tested and the specifics of this practice vary from state to state [ 8 ]. Once a practitioner feels that drug testing usually urine would be helpful clinically, he or should have a careful discussion with both the adolescent and parent regarding the potential benefits i. Any questions should be addressed, and then the clinician should communicate to the adolescent the recommendation for drug testing, emphasizing the potential benefits confirming a history of no recent substance use, improving trust with parents, etc.

    Assent should always be obtained from the adolescent, and permission to share results of any drug tests with his or her parent should be sought. In addition to the usual privacy provisions dictated by the Health Insurance Portability and Accountability Act of HIPAA , programs providing substance use diagnosis, treatment, or referral for treatment are subject to stricter confidentiality requirements under federal regulations [ 9 ].

    As always, if emergent clinical care for the adolescent is required, consent is implied and written permission need not be obtained. Many readers of this chapter are unlikely to be affected by Part 2 regulations.

    The age at which an adolescent can independently seek, consent for, and receive substance use treatment services varies from state to state [ 37 ]. Readers are encouraged to seek out regulations in their own states; the National District Attorneys Association NDAA compiles a list of relevant state laws and regulations that providers can review [ 38 ].

    The clinician should also carefully consider what tests should be included in a drug screen. The SAMHSA-5, though widely available, notably misses a number of commonly used substances, including alcohol, opioids and synthetic cannabinoids, among other drugs and their metabolites [ 39 ]; clinicians should ensure that the laboratory they work with is able to broadly test for these commonly used substances.

    In fact, where prevalence is low, a positive PCP screen is likely to be false, having been triggered by cross-reactivity by with another compound e. For adolescents who use marijuana, metabolites are detected in the urine for longer than for other substances owing to the fat solubility of cannabinoids. For intermittent users, metabolites can be detected in the urine for up to one week after last use; for daily users, they can be detected for up to one month [ 13 ].

    For adolescents who drink alcohol, urine ethyl glucoronide ETG and ethyl sulfate ETS are helpful tests with a window of detection of several days. Liver tests, such as asparate aminotransferase AST , alanine aminotransferase ALT , and gamma-glutamyl transferase GGT also are also somewhat sensitive to alcohol use, but have poor specificity thus limiting their use [ 41 ]. Random drug testing is preferred to scheduled drug testing [ 8 ].

    Since the window of detection for most substances varies between 1 to 3 days, adolescents who hope to evade detection on a drug test simply need to abstain from substance use for several days beforehand though a longer period of abstinence is required for marijuana, as highlighted above. Carefully counseling the adolescent and his or her family beforehand about the expectation to immediately complete random drug tests as part of the treatment plan is essential.

    Random tests should occasionally be done on consecutive days to avoid drug use immediately after testing. Proper specimen collection procedures are critical for ensuring an adequate urine sample for drug testing. The internet provides advice on a host of mechanisms for defeating urine drug tests that range from simple to sophisticated.

    A survey of practicing pediatricians found that while the large majority have ordered urine drug tests for an adolescent patient, most often these tests are collected without supervision, making it relatively easy for an adolescent to defeat a test [ 11 ].

    The most easily accomplished methods for tampering with a urine sample are adding water or other fluids or substituting a previously collected sample. Simple specimen validity checks described below can identify most samples that have been adulterated.

    Nonetheless, supervised sample collection is recommended to discourage tampering and increase the utility of testing. The DOT describes two adequate methods for collecting a urine sample for drug testing [ 12 ].

    For most routine workplace testing with adults, a collection protocol is used that does not involve direct observation. In this protocol, urine samples are collected in a private bathroom without running water, soap, or other liquids, and with toilet water stained blue. No outer clothing, bags or brief cases are permitted in the bathroom. The sample is checked for temperature immediately after it is produced. While effective, this protocol is expensive to implement and monitor.

    Some commercial laboratories may offer this service, though it must be ordered separately and adds significant expense to the cost of a test, which may not be covered by insurance. An alternative acceptable collection method requires direct observation of the specimen as it is being produced.

    This method is more invasive, though is simpler and does not require a specialized bathroom. This alternate collection protocol is often not practical in a clinical office. For adolescents receiving treatment for substance use problems or disorders, urine specimens can be collected at home under the supervision of a parent or guardian.

    First morning specimens are recommended because the bladder is reliably full and urine is most concentrated. Random, unannounced tests are difficult to prepare for and repeated testing over several weeks is likely to detect ongoing use. A series of negative drug tests over several weeks provide strong support for a report of abstinence.

    Thus home urine collection may be a reasonable mechanism for monitoring an adolescent that is receiving treatment for a substance use disorder. While urine specimens may be collected at home, it is recommended that all urine drug tests be coordinated with a medical professional and only ordered in the context of an appropriate clinical indication.

    As noted earlier, the AAP recommends against suspicionless drug testing — whether at home, school, medical offices or in other settings — because these tests provide little useful clinical information and may cause tension between an adolescent and parents, school administrators, physicians, or other adults.

    Furthermore, the AAP discourages physicians from recommending drug tests for home use interpreted by families because they rely on relatively non-specific and insensitive enzyme linked panels and may generate false-positive and false-negative results. Again, this is distinguished from home collection of drug tests to be sent to a laboratory for formal interpretation under the guidance of a clinician in a substance use treatment program, which is commonly indicated. Regardless of collection procedures, validity checks are recommended for all urine specimens.

    The DOT recommends checking temperature, creatinine and specific gravity on every urine sample [ 12 ]. Temperature is checked immediately after voiding. Urine specimen cups with temperature strips that fluoresce between 90 and degrees Fahrenheit facilitate temperature validation.

    Urine creatinine and specific gravity can be ordered together with a drug test panel. Many commercial labs also offer adulterant panels that can detect many substances added to a test in vitro. Creatinine is a product of muscle metabolism that can be used as a marker of urine concentration. Since adolescence is the period in life during which muscle mass is greatest, this creatinine range may need to be adjusted for larger teens.

    A dilute specimen suggests that a teen has recently consumed a large volume of fluid. This may occur incidentally or intentionally in attempt to drive the concentration of a drug or metabolite below the detection level of the test. It is not possible to distinguish between these possibilities based on the results of a urine test alone, and clinical correlation is advised whenever interpreting negative drug test.

    Repeat drug testing may be warranted using first morning specimens if possible. A dilute urine sample can still be positive, although in such cases it is possible to miss other substances present in lower concentrations. For example, a urine specimen may be positive for marijuana but too dilute to identify low levels of cocaine.

    As with all laboratory tests, urine drug tests can yield false positive and false negative results. Unlike most other laboratory results, however, results of urine drug tests can be accurate and still yield misleading information — in other words a test can yield a true negative result in the context of ongoing psychoactive substance use e.

    Because of their differing properties, different interpretation strategies are required for IA screening tests as compared to confirmatory GC-MS tests.

    Enzyme-linked IA tests are relatively quick, inexpensive, and easy to perform and as such are often used by laboratories as a first line screen. This testing format identifies drugs or metabolites above a certain threshold concentration in the urine. Typically the threshold concentration is set high enough to limit detection of low levels of drugs or metabolites that may be found in foods. For example, poppy seeds contain very low levels of morphine that can be detected by sensitive tests, but under usual circumstances concentrations of morphine in the blood and urine from consuming typical amounts of poppy seeds will be well under the detection threshold.

    IA is non-specific and cross-reactions can occur. As an example, quinolone antibiotics can cross react with an opioid panel yielding a false positive test result.

    To eliminate this type of error, IA tests should be confirmed with a more definitive chromatographic test e. Chromatographic tests generally take longer to perform, are more labor intensive and more expensive than IA, though newer technologies may address these issues. Chromatographic tests are specific and are not susceptible to cross-reactions, thus false positive results are rare. However, chromatographic tests can detect prescribed medications such as stimulants used for ADHD treatment and it is impossible to distinguish whether a patient used the medication as prescribed or misused it by using more than prescribed or using an alternate route of administration e.

    Whether IA or chromatographic testing is preformed, special consideration should be given to the interpretation of negative tests. A drug test will be negative despite ongoing drug use in four different circumstances:. Reviewing positive urine drug test results presents the simultaneous challenges of sharing relevant information while maintaining a therapeutic alliance with an adolescent patient and his or her family.

    Prior to ordering a drug test, a discussion of how results will be reported and to whom can help maximize the utility of drug testing. In most instances it is useful to have a private conversation with the adolescent to clarify interpretation of the drug test result.

    If the patient gives a history that is consistent with the drug test results the conversation can move on to a discussion of next steps — which could include changes to the treatment plan. Sharing drug test results together with a plan may facilitate a positive conversation. For example, a clinician may report to a parent that their son has recently used marijuana and has now agreed to speak with a counselor about anxiety and marijuana use.

    When a drug test result is dilute or otherwise ambiguous a clinical interview may be helpful. If a patient does not report substance use the clinician can review methods for reducing the chance of a dilute specimen — by providing a first morning urine if possible, or if not, limiting water intake in the hour prior to giving a sample.

    Repeat testing may be useful. During a clinical interview an adolescent may offer an explanation that is consistent with the observed drug test results, such as a new prescription medication or supervised use of cold medication.

    Drug Testing FAQs

    Quick testing drug screens produce either a negative or However, lab testing will provide the % positive result an employer may need. If they threw my urine sample in trash after my freshtag.me that mean i passed. When negative, there is no need for the split specimen to be tested. However, for every lab-positive result for federally mandated test, a Medical The employer must allow the split test to take place regardless of who is paying. Yes you can get a drug test to see if you are clean before your employer negative i wanted him to have it anyway but if it was positive I wanted the In other words, if you can pass the drug store's home kit test, you can pass the clinic's test.

    Enjoy this blog? Please spread the word :)



    Quick testing drug screens produce either a negative or However, lab testing will provide the % positive result an employer may need. If they threw my urine sample in trash after my freshtag.me that mean i passed.


    When negative, there is no need for the split specimen to be tested. However, for every lab-positive result for federally mandated test, a Medical The employer must allow the split test to take place regardless of who is paying.


    Yes you can get a drug test to see if you are clean before your employer negative i wanted him to have it anyway but if it was positive I wanted the In other words, if you can pass the drug store's home kit test, you can pass the clinic's test.


    [Company Name] will pay for the cost of the testing, including the confirmation of any positive test result by gas chromatography. The testing lab.


    The majority of negative test results are delivered within hours of collection . certified in drug and alcohol testing for DOT and non-DOT employers.

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