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How Does Urinalysis Drug Testing Work?

Home / Drug Testing / How Does Urinalysis Drug Testing Work?

February 23, 2022 by David Bell

Last updated: January 23, 2023

If you’re a member of the general workforce, urinalysis drug testing probably doesn’t consist of anything more than signing in, peeing in a cup, and handing it off to the technician on your way out. Urine tests are used by far more employers than any other employee drug testing method. In fact, it has become so commonplace that no one even bats an eye at the mention of taking one.

The “standard” 5 panel test includes five of the most abused drugs in the workplace. They are:

  • Amphetamine
  • Cocaine
  • Marijana
  • Opiates
  • PCP (phencyclidine), also known as angel dust

Employers of the general workforce are free to set up their own drug testing policies and procedures. It’s a different story for those employed as part of the safety-sensitive workforce though. Employers regulated by the Department of Transportation (DOT) must follow a very specific process. Moreover, failure to follow each step in the process is seen as a failure to comply. That can mean fines and penalties for the employer.

Not good.

Remaining in good standing

Most employers of the safety-sensitive workforce partner with a third-party administrator (TPA)—like us, for example—to handle their drug testing programs for them. The position is classified as a C/TPA by the DOT and most TPA agencies act as a consortium (C) as well.

A consortium often manages the random drug testing programs of several companies, allowing for a larger drawing pool. This is very beneficial for smaller companies. Consortiums can also enroll owner-operators who aren’t allowed to manage random drug testing themselves. The role consortiums play for owner-operators is unique in that they may perform a number of employer functions but they are prohibited from acting as the designated employer representative (DER).

There aren’t any specific DOT qualifications outlined for a consortium or TPA. However, the representative is expected to know all of the employer requirements and responsibilities under 49 CFR 40 and Part 382, otherwise known as Driving of Commercial Motor Vehicles.

It’s important to note that, ultimately, employers are responsible for any errors made by their service agents. While not required by the DOT, it’s important for employers to establish a written contract outlining all aspects of the duties that the C/TPA performs.

DOT regulations

When Congress passed the Omnibus Transportation Act in 1991 to enforce regulation of drug testing employees, the urinalysis drug test was the only available test on the market.

The DOT initially required that the following drug panels be included on the drug test:

  • Amphetamine
  • Cocaine
  • Marijana
  • Opiates
  • PCP (phencyclidine), also known as angel dust

Because of the ever-increasing abuse of opioids in our nation, the DOT added four synthetic opioids to the panel in January 2018. They are hydrocodone, hydromorphone, oxycodone, and oxymorphone.

The basic process

Safety-sensitive employees take a urinalysis drug test under the following conditions—for that matter many employers of the general workforce require testing under these conditions as well:

  • Pre-employment
  • Randomly at set times throughout the year—if their name is chosen from the pool of drivers
  • Immediately following an accident
  • Reasonable suspicion
  • Prior to returning to duty

During a post-accident drug test. if an employee requires medical attention, don’t delay it in an attempt to collect a urine specimen.

In all other situations, the employee is greeted by the technician when reporting for the test. They sign in and the technician explains the process. They, then, present the employee with a specimen cup. The test subject removes any outer clothing, such as coats or jackets, and females are asked to leave their purses behind. Then, the technician accompanies the subject to the restroom used for testing.

After obtaining the specimen the employee returns the urine sample to the technician. The technician applies a strip seal to the specimen cup that is dated and initialed. The employee signs off as having completed the test and is free to return to work.

The technician then sends the specimen to the laboratory for testing.

What happens at the lab?

All specimens undergo a test called an immunoassay (IA) test—commonly referred to as the initial screen. It’s a cost-effective test that produces results quickly. The test determines a positive or negative result but doesn’t determine the type of drug identified or the level of any drugs found in the system.

Technicians sign off negative tests as complete. A positive result requires a second test. It’s called a gas chromatography/mass spectrum (GC/MS) test. It’s more expensive and time-consuming to conduct but produces extremely accurate results. It detects the specific drug identified and the level found in the specimen.

Test results

The urine test has three possible results.

They are:

  • Positive results indicate drug use
  • Negative results report no drug use
  • Inconclusive results mean neither a positive nor negative result

Inconclusive results can be due to a number of factors. It’s possible that human error played a part and either the collection specialist or a lab technician made a mistake. However, it’s far more likely that someone tampered with the sample in one way or another.

Tampering with the test

The urinalysis drug test is becoming increasingly sophisticated thanks to advances in the industry, both in testing technology and laboratory equipment. So, the odds are that anyone who tries to “get over” with a false negative result will fail.

One highly praised method online for obtaining a false negative result is to drink a lot of water. The problem is that there is a very fine line between the pass and fail mark for this method. Too much water will produce an inconclusive result.

There are two types of inconclusive results. They are:

  • Positive dilute—The indication here is that even though the specimen was diluted, the test identified drugs in the system. The employers follow their positive drug test policy.
  • Negative dilute—This test result indicates a diluted sample was submitted, however, no drugs were found. Still, the employee isn’t out of hot water. A diluted specimen might affect the outcome of the test. Moreover, a diluted sample indicates someone may be trying to mask drug use. The employee must submit to a second—observed—drug test according to DOT regulation. Employees of the general workforce may be more lenient.

Still number one

Even though there are other employee drug tests on the market, such as the hair follicle or mouth swab drug tests, the urine test remains the most popular. It’s cost-effective, accurate, and, frankly, most employees expect to take a urine test when learning their employer requires one.

Employee drug testing is one of the most effective ways to curb drug use in the workplace. Most people don’t use drugs, but those who do are likely to think twice about showing up on the job with drugs in their system.

Statistics show that employers who enforce a drug-free workplace policy have fewer accidents on-site, employees are absent less often, and their turnover rate drops. If you don’t have a drug-free policy in place, perhaps now is the time to start.

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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