Frequently Asked Questions
What does ng/mL refer to?
Nanograms per milliliter, abbreviated ng/mL, is the unit of measure commonly used for expressing drug testing cut-off levels and quantitative test results in urine and oral fluid. A nanogram is 10^-9 grams.
Why are screening and confirmation cut-off levels different?
Screening and confirmation testing utilize different methodologies with varying specificity and sensitivity. Immunoassay tests for initial screening detect a wide range of chemically similar compounds. Confirmation testing by GC/MS or LC/MS/MS identifies specific metabolites, allowing accurate quantification.
What testing methodology is used for initial drug screening?
Initial drug screening is conducted using immunoassay, a test that utilizes antibodies to detect the presence of drugs and substances in urine.
What methodologies are used for confirmation testing?
Confirmation testing employs Gas Chromatography/Mass Spectrometry (GC/MS) and Liquid Chromatography with Tandem Mass Spectrometry (LC/MS/MS). These hyphenated techniques provide identification of molecules based on characteristic fragmentation patterns.
Why isn't MDMA detected in a standard amphetamine screen?
MDMA, a synthetic amphetamine, may not be detected in standard amphetamine screens due to lower cross-reactivity. Specific reagents are used for MDMA detection.
What is MDMA/Ecstasy?
Ecstasy is a street name for MDMA (3,4-methylenedioxymethamphetamine), an illegal drug with stimulant and hallucinogenic properties.
What do the percentages mean in methamphetamine "d" and "l" isomer test results?
To assess methamphetamine origin, percentages of "d" and “l” isomers are analyzed. Medical review is recommended for all non-negative results.
What is methamphetamine "d" and "l" isomer testing?
Methamphetamine exists in "d" and "l" forms. Both forms test positive in immunoassay and confirmation assays, but a specific d,l isomer confirmation test determines their respective concentrations.
What is fentanyl?
Fentanyl is a powerful synthetic opioid analgesic, 50 to 100 times more potent than morphine, used to manage severe pain.
What is buprenorphine?
Buprenorphine is a medication for heroin addiction treatment, acting as a long-acting partial mu opiate agonist.
What are OxyContin® and oxycodone?
OxyContin® is a controlled-release oral formulation of oxycodone hydrochloride, classified as a Schedule II controlled substance.
What tests are available to detect synthetic opiates?
Various options are provided for opiate testing, including panels for codeine, morphine, hydrocodone, and other substances.
What is 6-acetylmorphine?
6-acetylmorphine (6-AM) is an intermediate metabolite between heroin and morphine, indicating recent heroin use.
How would a drug test be evaluated when nitrites are 199 mg/mL?
A nitrite level of 199 mg/mL would not interfere with the testing process, and drug tests would proceed following standard operating procedures.
Is the nitrite test threshold based on body functions, or does it allow for infection, food ingestion with high nitrates, and water consumption with high nitrites?
The nitrite threshold is set at 200 mg/mL, higher than expected from normal physiological processes. Levels > 500 mg/mL are reported as “Adulterated”
What is specimen validity testing?
Specimen Validity Testing (SVT) assesses urine specimens for substitution, adulteration, or dilution. An MRO is recommended to evaluate out-of-range SVT results.
What tests are included in the SVT panel?
Specimen Validity Testing (SVT) is conducted simultaneously with initial drug screens. The laboratory releases results based on both drug screen and SVT results.
What is a negative dilute result?
A negative dilute result means that the donor was exceptionally hydrated at the time of the test; and the urine, and everything else it contained, was diluted.
What are the state laws for employers of candidates with a negative dilute test result?
Can they still be hired if they test twice with this result? State laws do not address negative dilute results; it's determined by the company's policy. DOT-regulated companies allow only one recollection, and the second collection becomes the recorded result.
Who is tested as part of the Nuclear Regulatory Commission?
As part of the NRC Drug Testing Program, all NRC employees are subject to drug testing.
Questions about testing Hair for drugs of Abuse:
What is hair drug testing?
Hair drug testing detects drugs and drug metabolites incorporated into the hair from the bloodstream following drug use. It does not affected by soap, conditioner or dye
How does the drug detection window for hair compare to urine and oral fluid?
Drug detection times vary, with hair having the longest detection window, followed by urine and oral fluid.
What time period does a hair drug test cover?
A 1.5-inch hair sample detects drug use up to 90 days prior to testing.
How much hair is needed for a hair drug test?
A hair drug test requires 100 milligrams of hair (90 to 120 strands).
Questions about Oral Fluid Drug Testing:
Can substances such as food, beverages, over-the-counter medication, and mouthwash affect the oral fluid drug test results?
Yes, substances like food and beverages can affect oral fluid drug test results, and donors should refrain from consumption for 10 minutes before specimen collection.
How does the drug detection window for oral fluid compare to urine and hair?
Drug detection times vary, with hair having the longest window, followed by urine and oral fluid.
What is the drug detection window for oral fluid testing?
Oral fluid drug testing can detect drugs within one hour to 48 hours after the last use, depending on the drug.
Why is the oral fluid specimen placed in a fluid buffer?
The buffer solution inhibits bacterial growth.
Definitions
Random testing: Unannounced testing where all employees have an equal statistical chance of being selected.
Reasonable suspicion testing: Conducted when management has specific objective facts indicating potential drug use.
Pre-employment testing/ Applicant testing: Testing for tentative selectees who have not been subject to random drug testing before selection.
Post Accident testing: Testing authorized due to an accident or unsafe practice during job performance.
Follow-up testing: Testing for employees who completed an approved rehabilitation program.
Chain of Custody- a form filled out by lab and signed by the donor at the time a sample is provided for drug testing. This form accompanies the sample through the testing process