Did you know that over 21 million Americans aged 12 and older meet the criteria for substance abuse or dependency?1
Denial of a drug or alcohol problem is common among those who struggle with a substance abuse disorder. A simple drug test is one way to offer irrefutable proof that help is needed. A drug test can be a fairly accurate indication that substance abuse is occurring, and it may also be a useful tool to prevent substance abuse in the future. Drug testing can also help a person in recovery maintain accountability, prevent relapse, and stick to goals of wellness.
When to Use Drug Testing
Drug tests may be used for a variety of reasons. There are a number of scenarios in which drug testing is useful, including:
- Drug testing may be used to ease family stress, or to demonstrate good health for parenting and custody causes.
- Many employers require drug tests in order to ensure safety in the workplace.
- Law enforcement officers may administer drug tests if impaired driving is suspected.
- Courts may mandate drug testing after certain offences.
- Sports teams or organizations may use drug tests to check for performance enhancers or other substances.
- Drug tests may be used during an intervention as a tool to help a loved one understand the scope of the problem before they accept treatment for a problem with drugs or alcohol.
The difficulty begins when a loved one resists a drug test. A drug test is only best used during an intervention at the advice of an experienced interventionist or counselor. After treatment, it may be easier to encourage a loved one to participate in testing. Many families make drug testing part of the long-term recovery checklist.
Once a drug test is used, it is important to realize that not all drug tests are created equal, and that drug tests are not 100 percent reliable all the time. Drug tests may, however, be a useful part of a more complete treatment model, as a method of helping someone to realize the need for treatment and maintaining honesty during rehab and recovery.
Types of Drug Tests
The Substance Abuse and Mental Health Services Administration(SAMSHA) has identified six main methods of drug testing:
- Urine: tests for the presence of drug metabolites in urine for a few days after ingesting
- Breath: breath-alcohol test determines the amount of alcohol currently in the bloodstream, or blood alcohol concentration (BAC), for a few hours after consumption
- Blood: can test for current levels of drugs or alcohol in the bloodstream for a short window of time, usually a few hours
- Hair: can provide a complete drug history for up to 90 days, not including current levels of impairment; longest testing window
- Oral fluids: can detect drugs currently in the system by a swab of saliva from the inner cheek, usually for a few hours after ingesting drugs
- Sweat: tests for the presence of drugs through a skin patch as long as the patch is worn, typically around seven days2
Professional drug tests may be administered in clinics, at laboratories, in hospitals, at treatment facilities, or even at home. Larger laboratories, laboratories tied with law enforcement, and laboratories used by many large-scale employers operate under strict federal guidelines that regulate certify laboratories through rigorous testing procedures. Home drug tests may not be subject to the same rigorous checking.3
Urine testing is generally the most popular method of testing for illicit drugs, while testing breath is usually the most common way to determine the presence of alcohol. Not all the testing methods test for all types of substances, and each has different accuracy levels. The different types of tests will detect the presence of different substances depending on the half-life of the substance, type of test administered, and duration of abuse. Substances are detectable for longer periods in chronic substance users.
Accuracy of Drug Tests
A urinalysis is a common type of drug test as it is usually the cheapest and one of the easiest to administer – all you have to do is urinate into a cup. Initial drug screening usually utilizes an immunoassay test that can rapidly detect the presence of cocaine and marijuana. It may be less accurate in detecting amphetamines and opioids.4
Certain medications or vitamin supplements may interfere with the validity of urine tests. Drug tests may provide false negative results as much as 10 to 15 percent of the time and false positives 5 to 10 percent of time. Oxycodone and some sedative or hypnotic drugs may be regularly missed, while cold medications or antibiotics may cause a false-positive result.5
If someone receives a positive result through their screening test, the next common step is to order a more detailed test. The second, more detailed test may be more expensive and may take longer to produce a result, but it is more accurate. Urine tests are also often tampered with or attempted to be beat by adding chemicals to the urine, diluting it with water, or ingesting substances that are known to interfere with the test. Many drug and alcohol facilities will require testing to be monitored closely in order to avoid tampering.
Hair tests may be more accurate than urine tests and provide a bigger drug abuse picture, although they are more expensive. Since hair grows slowly, it can take a few weeks for drugs to appear in hair follicles. Blood tests may be better at detecting drugs than urinalysis as well, although drugs may pass quickly from the bloodstream and only be detectable for a few days.
Oral drug tests may be very accurate at detecting amphetamines, cocaine and marijuana and determining current levels of impairment, although drugs are also not detectable for as long in saliva as they are in urine.2
Sweat tests are administered by placing a large adhesive type bandage with a gas-permeable membrane directly on the skin and leaving it there for around a week. This test may a reliable way to determine compliance in a drug rehabilitation program.6
Drug Tests in Rehab and Recovery
Drug tests are used throughout the drug rehab and recovery process for a variety of reasons. Drug tests are generally administered prior to admission to a drug or alcohol program in order to determine the level and type of substances in any incoming patient’s system.
Addicted people may not be entirely honest when entering a program, or they may not remember or be aware of how many substances they have used. It is a good idea to know what drugs may be in the system before facilitating detox or administering adjunct medications during treatment. Drugs (including alcohol) may interact with each other, causing unintended and dangerous side effects; therefore, it is important to have a clear picture of exactly what and how much might be in the system before treatment can begin.
Drug testing may also be administered at regular or random intervals during rehab and recovery in order to keep individuals accountable, honest, and drug-free during treatment. Random drug tests are harder to predict and therefore harder to beat. Drug testing may also prevent dangerous relapsing episodes. Both outpatient and inpatient treatment programsalike may use drug testing for positive reinforcement.
Drug testing is not a treatment method, but rather a tool that can be used before and during rehab and while in recovery to facilitate and encourage an abstinent lifestyle. Detox may be the initial step in a drug or alcohol treatment program after a positive drug test. After reaching a stable physical balance, behavioral therapies, individual and group counseling sessions, and peer support groups will all be incorporated into a successful treatment plan in order to facilitate a successful recovery program.
Drug testing may be more frequent at the beginning of treatment and less frequent during recovery. Drug tests can be specified to include certain or particular drugs of abuse as well.
2 SAMHSA. Clinical Drug Testing in Primary Care. 2012.
3 United States Department of Labor. E-Laws: Drug-Free Workplace Advisor. Nd. Web. Accessed 15 Apr 2018.
4 Standridge J., Adams S., Zotos A. Urine drug screening: a valuable office procedure. Am Fam Physician. Mar 2010.
5 CBS News. Drug Tests Not Immune from False Positives. 1 Jun 2010.
6 De Giovanni N., Fucci N. The current status of sweat testing for drugs of abuse: a review. Curr Med Chem. 2013.