What is a Drug Screening: 2 Common Types

A person applying for a particular position or role must undergo a drug screening¹. But, what is a drug screening? It is necessary to check for any traces of drug and alcohol use. You may have to pass through drug screening when you are at the last stage of being hired or in part of negotiations for a job offer.

If the company has permission from the state law, the employees, before joining the company, will have to sit for a drug screening and ensure they are not found positive.

There are lots of organizations that use drug tests to confirm if drugs or alcohol are present in their system or not. They perform various tests, including blood tests, hair tests, urine tests, saliva testing programs, and sweat drug screening.

In this article, we will learn more about drug screening, urine drug test, their methods, and other things.

1. What is a Drug Screening and Their types 

Some states have set some limitations on drug screening². To get hired, you must pass the drug and alcohol examinations and analysis.

Many different types of drug tests³ cover drug screening. Let us know about some drug tests performed to check the drug results.

1.1. Blood Drug and Alcohol Tests

The blood drug test is typically used when a candidate or employee has been tested for illicit drug use or illicit substance. This test measures the total amount of substance found in the blood.

The drug that is tested can vary from person to person. But the most popular tests are for amphetamines, opiates, cocaine, nicotine, methamphetamines,⁴ alcohol, and marijuana.

1.2. Hair Drug Test

The hair drug test can give reports from the past three months. However, it does not indicate any current substance levels. In addition to this, it is not able to detect the presence of alcohol impairment or use.

The person’s hair can be used for screening opiates, marijuana, cocaine, phencyclidine⁵, and methamphetamines.

1.3. Breath Alcohol Test

To test the alcohol, which is known Breathalyzer. It is used to check the amount and levels of alcohol content in the body during the testing program.

This type of breath alcohol test results gives accurate levels of intoxication. However, this will not give any results for alcohol consumed in the past.

1.4. Mouth Swab Drug Test

The mouth swab or drug test is also known as saliva or oral fluids. This method of drug testing involves taking saliva from inside the mouth.

This drug abuse testing can result in drug use in the past few hours of drug testing and even up to a couple of days before the screening day.

1.5. Urine Drug Test

A urine drug test is the most commonly used test for job candidates and currently working employees. It can give good results when performed under some frequency.

Under urine drug screening always shows the presence of any drug residues in the body for quite a time only after the drug has infiltrated the system. Under urine drug screening, one can check for

• Cocaine

• Alcohol

• Opiates

• Marijuana

• Amphetamines

• Methamphetamines

• Nicotine

The urine drug testing panels can range from five to ten drugs. If you are placed on any particular responsibility or department role, you must undergo a urine drug test.

2. What are the Methods of Drug Testing

Specimens collected from the person can be blood, urine, sweat, saliva, and even nails. They can provide different levels of sensitivity and accuracy. However, the urine drug test is a widely used drug testing method.

Since the drug concentration tends to be higher in the urine, it gives flawless drug testing results.

Typically there are two types of Urine Drug Screening (UDS) used.

2.1. Immunoassay

In this method, the initial screening, the antibodies are used to detect the presence of some specific drugs or metabolites. In this method, the lab technician can include large-scale screening from automation and rapid detection.

In addition to this, the immunoassay technique involves

• Cloned enzyme donor immunoassay

  ⁶

• Enzyme-multiplied immunoassay technique

  ⁷

• Fluorescence polarization immunoassay

• Radioimmunoassay

• Immunoturbidimetric assay

Disadvantages of Using Immunoassay

This form of testing is also used in many home-testing programs or kits. However, the main disadvantage of immunoassay is that it can give some false-positive results. In such cases, the specimen will require another set of test results for confirmation.

This is why immunoassay results are always considered presumptive until any laboratory testing confirms it by GC-MS. But, if the column is designed to test certain illegal drugs like codeine or morphine, it can fail to identify the positive specimen collection for hydromorphone or fentanyl.

2.2. Gas Chromatography-Mass Spectrometry

This test is often considered the criterion standard for the confirmatory testing program. The method used in this testing can even detect the minor amounts of the substance used and the presence of any certain drugs.

This drug testing program can confirm the presence of drugs like opiates or morphine. This form of urine testing is considered the most accurate, reliable, and sensitive testing method. In addition, no further testing is required to confirm the substance abuse.

The only disadvantage of this drug screening method is that it is time-consuming and requires a highly qualified person to perform this drug-testing program. Also, this method is not cost-effective.

So, Gas chromatography-mass spectrometry (GC-MS) is only performed when positive results are found from the immunoassay.

In the postmortem analysis, the lactate dehydrogenase⁸ and lactate can interfere with the results of assays for particular substance abuse. So, the confirmatory test is performed for patients with illnesses typically to confirm the false-positive results.

3. What is a Drug Screening and Drug Testing

Often you may misunderstand a drug test to be a drug screening. The screening and testing are different, and the consequences of thinking them to be the same can cost you money, emotions, and time.

A drug test takes a lot of time, whereas a drug screening can give immediate results. Drug screening is a cost-effective way by which you can quickly review all the specimens collected. Drug screening often tends to be reactive, but it is not selective. This misconception often leads to false positives, especially when testing for a particular substance.

The substance, which includes ibuprofen, poppy seeds, and some sinus medications, often gives false positives. In addition, when a person is undergoing drug screening, the screen cannot identify the ibuprofen and the drug’s metabolite.

It is seen that over 60 percent of screens that are found positive for amphetamines are negative when the samples were passed for a complete drug test. Such results show that of 10 people, six will show positive results for amphetamines even though the results for illegal drugs are negative.

Now you may have doubts about why labs perform drug screening even though the results provided by this method are faulty.

To conclude this in short, we can tell you that it is cost-efficient. Drug testing would be time-consuming and very costly for the labs to perform separate tests for different substances.

4. Why Perform Drug Screening

Drugs can affect the productivity of a workplace. It can affect the company’s judgment and concentration and even put employers at risk if any illegal drugs are included in it. According to the National Council on Alcoholism and Drug Dependence, it has been concluded that drug abuse costs companies over $81 billion per year.

In places where heavy machinery is used, or the health and safety of others are included, employers should be keen to look out for illicit drug use. The company wishes to have workplace drug testing to reduce such unnecessary risks against the employers.

5. Understanding Urine Drug Test

Urine drug tests are the most common method of screening used for drugs. They are straightforward to perform, quick, cost-effective, and all above, it is painless. Some signs of drugs can stay in the person’s system for an extended period. So, to determine the presence of specific drugs, urine drug testing is performed.

5.1 Aim of Urine Drug Test

Especially the doctors, employers, and sports officials who request urine drug screening.

1. To Check if The Patient Has Undertaken Drugs

The doctor may request a urine drug screen if someone has been using illegal or prescription drugs for some time. A doctor may also ask for urine drug screens if he feels the patient is prescribed opioid medication. In addition to this, the members of the emergency services may also ask for a urine drug screen if they find any person is up with some dangerous and strange behavior due to the influence of prescription drugs.

2. To Check If Any Employees Use Drugs

In some companies, employers request drug testing for new staff. In some cases, the staff may have to undergo drug testing regularly.

The drug and alcohol rehabilitation programs may also request a person undergo drug screens during their initial assessments and then follow up with some appointments.

3. For A Fair Gameplay

Many sporting officials take urine tests to confirm whether the sportsman has been using any performance-enhancing drugs or not. Often athletes use anabolic steroids to boost their stamina. They inherit a workplace drug testing program to ensure that none of the athletes are using drugs and are participating in a fair competition.

5.2 Drugs Detected from a Urine Sample

The technician can identify different types of drugs from a urine drug screen.

• Barbiturates

• Opioids

• Cannabis

• Phencyclidine (PCP)

• Methamphetamine

• Cocaine

• Benzodiazepines

• Amphetamines

Sometimes, urine drug tests are also capable of detecting nicotine and cotinine. It is produced when the body breaks down nicotine. In addition, the urine test can detect the presence of alcohol, and it is done at the request of legal authority. Sometimes, they are asked for a breath or blood test.

5.3 Preparing A Urine Drug Screening

To perform a urine drug screen for a particular drug, several preparations are required so that it does not give any false-negative results. The person who undergoes this test must give urine specimens in a plastic container and return them to the technician or the doctor.

The urine sample is then measured for its temperature and whether it is suitable for performing the test or not. The urine specimen is sealed in a plastic bag. However, if the person cannot hand over the urine sample to the lab within one hour after collecting it, it should be sealed in a plastic bag and stored in a refrigerator.

Since some medications and abused substances can cause a false-positive result, in this case, the person must provide every detail about their prescription drugs, herbal remedies, supplements, and over-the-counter medicines. In some cases, the technician may even accompany the person to ensure they are giving the sample correctly. However, the technician has to explain the reason for this supervision.

5.4 Results of Urine Drug Test

The urine drug screen results take a few days. However, in most cases, the result is given on the same day. If the urine sample shows a positive result, then the sample has to undergo a second confirmation test. It can be made through the GC-MS test since it gives the most accurate results. The person performing the screening tests is responsible for explaining the results.

6. Can You Cheat A Drug Test

It is one of the most popular questions searched worldwide. Most people want to appear for a job and pass the drug screening without hassle. So, you may want to be over-prepared regarding your job position. In those cases, you should know certain things.

If you had drugs due for some reason, they could stay in your system for specific reasons. It can be:

• Metabolism

• Type of drug used

• Frequency of the drug used

• Drug dosage or the amount of concentration in it.

• Type of drug screening you are asked to undergo.

In addition to this, you may have to give different types of specimens for the drug screening:

• Hair

• Blood

• Nails

• Saliva

• Urine 

The nail specimens and the hair samples can show results under drug screens from the past three to six months. The drugs mostly stay concentrated in the urine for a long time. So, the urine drug screen is mainly used to test employees and other suspects.

The drug in the urine may stay up to at least ten days. In addition, the blood and saliva also show results for any drug immediately used. The concentration of the drug will be higher if the person who is tested appears to be impaired during the time of screening.

However, it is possible to cheat a drug screening. The drug screening can be cheated if you dilute the tested urine. Any synthetic urine or sample dissolved with an oxidizing agent can produce false results.

7. Is Urine Drug Screen Reliable

If you consume some legal substance, it can lead you to false-positive IA test results. Just like if you consume dextromethorphan in high amounts right before your screen, it can cause a positive result for Phencyclidine or PCP. Even the ingredients found in cough syrup can trigger the drug screening of federal employees or others undertaking this test.

Typically the Generic IA test shows results for amphetamines, opioids, cocaine, cannabinoids, and PCP.

For these reasons, urine drug screening has some cut-off limits and mandatory guidelines to follow to reduce false-positive results. The cut-offs the technicians have to follow can reduce the false results that can happen due to the oral fluid consumed by patients during their tests. Another example of a substance that can trigger false results is smoking nicotine.

However, the Generic IA and GC-MS have some chances to give false-negatives results and put health and human life in danger. Furthermore, it can fail even to detect the presence of recent drug use by the patient.

8. Substances that Can Contribute to Positive Drug Results

Several substances can contribute to random testing for producing false-positive results. But again, some other legal substances can even produce false-negative results. Let us know some illegal substances that people consume.

8.1. Alcohol

It is a legal substance mainly for adults in the United States, and it is the most widely used substance for intoxication in the entire world. Before elimination in the urine, this substance is oxidized in the liver for more than 90%.

In addition, only one to two percent of ingested alcohol is excreted unchanged in the urine. However, the urine alcohol screen is used less frequently than the breath or blood tests.

8.2. Amphetamines

It is among the 5 drug testing assays that the Department of Health and Human Services DHHS requires. Amphetamines and methamphetamines are also available in prescription drugs for therapeutic use. Even amphetamines are mainly used for the stimulant and euphoric effects. But these amphetamine assays are specially designed to detect the racemic compounds, dextroamphetamine, and methamphetamine.

The amphetamine immunoassays have low sensitivity for detecting MDMA (methylenedioxymethamphetamine.⁹) So, MDMA needs to have a high concentration in the system if it wants positive results in urine drug testing.

However, there are specific tests specially designed to incorporate amphetamine, methamphetamine, and MDA.

8.3. Benzodiazepines

This substance makes it very difficult to identify the substance’s pharmacological use and abuse with the UDS (Unified Diagnostic Services); however, if there are compounds with differences in their chemical structure, flunitrazepam, chlordiazepoxide, and midazolam.

8.4. Opioids

Opioids are a specific class of drugs that comprises both the prescribed and illicit agents. But, morphine and the codeine in the opium poppy seed are naturally occurring alkaloids. The Papaver Somniferum is one opioid that has these naturally occurring alkaloids. In addition to this, opioids, when consumed, can give different therapeutic effects, including antitussive, analgesic, and antidiarrheal properties.

8.5. Cocaine

Cocaine and amphetamines can stimulate the central nervous system and are mostly abused for their euphoric effect when consumed. To detect these illegal substances, the immunoassay screen is widely used.

The urine drug screen can evaluate the ingestion and presence of cocaine’s primary metabolite and benzoylecgonine. However, when these substances and the screen cross-react, the cocaine mostly disappears. So, the urine drug screen is the best in detecting the cocaine consumed recently.

If the person consumes food from the internet and some other sources and has some adultered natural products, it can give a positive test result for the cocaine screen.

9. What is a Drug Screening: Bottom-Line

Though the urine drug test can be rapid and easily detect illegal drugs and even prescription drugs, it always has some flaws.

Since this screening test can detect a wide range of legal and illegal substances, doctors must ask sports officials and employees to undergo urine drug screening.

Some drugs can remain in the body for a long time and get positive results. So, you will have to know what is drug screening, and by any chance, if your initial result is positive, then you will have to take a second test.

1. Lin, Xiaoqian, Xiu Li, and Xubo Lin. “A review on applications of computational methods in drug screening and design.” Molecules 25.6 (2020): 1375. ↩︎
2. Macdonald, Scott, Samantha Wells, and Richard Fry. “The limitations of drug screening in the workplace.” Int’l Lab. Rev. 132 (1993): 95. ↩︎
3. Shafer, Robert W. “Genotypic testing for human immunodeficiency virus type 1 drug resistance.” Clinical microbiology reviews 15.2 (2002): 247-277. ↩︎
4. Cruickshank, Christopher C., and Kyle R. Dyer. “A review of the clinical pharmacology of methamphetamine.” Addiction 104.7 (2009): 1085-1099. ↩︎
5. Baldridge, E. Bradford, and Howard A. Bessen. “Phencyclidine.” Emergency medicine clinics of North America 8.3 (1990): 541-550. ↩︎
6. Armbruster, David A., et al. “Cloned enzyme donor immunoassay (CEDIA) for drugs-of-abuse screening.” Clinical chemistry 41.1 (1995): 92-98. ↩︎
7. Porstmann, T., and S. T. Kiessig. “Enzyme immunoassay techniques an overview.” Journal of immunological methods 150.1-2 (1992): 5-21. ↩︎
8. Holbrook, J. John, et al. “4 lactate dehydrogenase.” The enzymes. Vol. 11. Academic Press, 1975. 191-292. ↩︎
9. Green, A. Richard, et al. “The pharmacology and clinical pharmacology of 3, 4-methylenedioxymethamphetamine (MDMA,“ecstasy”).” Pharmacological reviews 55.3 (2003): 463-508. ↩︎

Last Updated on July 24, 2024 by Sathi Chakraborty, MSc Biology