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Can Creatinine Levels Make or Break a Drug Test?

Home / Drug Testing / Can Creatinine Levels Make or Break a Drug Test?

May 5, 2023 by David Bell

Last updated: November 27, 2023

If you suffer from shy bladder syndrome and are scheduled for a drug test, we’d like to give you a word to the wise. Don’t keep refilling your cup in hopes of providing the bare minimum required to be called a specimen. Rather than doing all you can to remain in compliance with your company, you could be messing with the body’s natural creatinine levels.

And, subsequently, that could cause a raised eyebrow even without drugs in your system.

The ebb and flow

Creatinine is the byproduct of a chemical compound called creatine. Creatine helps our muscles get the energy they need. Creatinine is the waste product left behind after the process is complete. It’s removed from the body through the urine.

Turns out, as drug testing technology evolved, creatinine actually serves a purpose when it comes to urine drug testing. The creatinine level in the urine draws a fine line as to whether or not a specimen is deemed diluted. That’s because it determines whether or not there is excess liquid in the urine. If there is, the test result comes back as inconclusive and marked either a positive or negative dilute as the reason.

What’s the difference?

A positive dilute result indicates that in addition to drugs being found in the system, excess liquid in the urine was discovered as well. The majority of employers treat this result as they do any positive drug test. The employee is immediately terminated. However, some employers are believers in a second chance.

As a matter of fact, in September 2022, the United States Air Force began giving second chances to join the service to those recruits who test positive for marijuana. The policy applies to those aspiring to join Space Force. The policy was put in place in hopes of allowing this branch of the military to reach recruitment goals. Those who pass the second test are invited to join up.

On the other hand, a negative dilute result on a drug test is marked as inconclusive as well. In other words, there is no evidence of drug use but the specimen is diluted to the degree that the creatinine levels are off. A negative dilute result indicates that someone may have been making an attempt to mask drug use.

There are two ways that employers could handle this situation. Moreover, one of them isn’t firing the employee due to the red flag raised by the diluted specimen. It could cause someone to bring a lawsuit against you. Why? The specimen didn’t actually contain drugs. Instead, employers can treat the negative dilute as a negative drug test and nothing more comes of it.

Many employers of the general workforce follow suit after the Department of Transportation’s (DOT) drug testing guidelines and require a second drug test. The second test is accepted as the final result. If the specimen is deemed diluted but negative for drugs, the employee suffers no adverse consequences.

Alternative testing approved by DOT

The DOT published a final ruling last week that included the authorization of using the oral fluid drug test as an alternative to the urine drug test. Moreover, someone suffering from shy bladder syndrome who finds themselves unable to produce a specimen has an out now. They may request the oral fluid test instead.

That’s good news for those who have previously spent hours at the test site hoping for the best as they sip their allotted 40-ounce beverage to try and get things flowing in the right direction.

Even though the final ruling is out, employers of the safety-sensitive workforce aren’t able to introduce the oral fluid, otherwise known as the mouth swab, test until there are two SAMHSA-certified laboratories available to handle the testing—at the moment, there are zero. It won’t be too long a wait though now that the government-regulated workforce has approved the addition.

Urine testing will no longer be the only approved government-mandated drug testing method. As a matter of fact, there’s another request out there to drop the urine test entirely and switch to the hair follicle drug test. Employers of the safety-sensitive workforce are getting behind that idea. The results are impossible to cheat. That’s because the drug metabolites stored in the hair follicles actually grow out into the hair shaft leaving a permanent record of drug use.

At the moment, the hair follicle test is the most expensive drug testing method. Even so, some trucking companies require employees to take two drug tests because they want infallible results.

We don’t blame them.

Dangerous combination

Drugs and the workplace don’t mix. People under the influence of narcotics or other drugs aren’t thinking clearly, may have compromised motor skills, and, could even doze off entirely. All these things could result in causing an accident and that’s just not acceptable.

Employers who drug test are taking a stand for workplace safety. We applaud them and are sure the majority of their employees do too.

Filed Under: Drug Testing

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About David Bell

After seeing the damage caused by drug use first-hand, David sold his previous company and worked his way up through the ranks in the drug testing industry to help employers keep drugs and alcohol out of the workplace.

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