By Adam Hall, Staff Writer & Editor
Do Drug Testing Levels Matter to Employers?
This information is provided for educational purposes only. Reader retains full responsibility for the use of the information contained herein.
As an employer, have you ever received a positive test result for an employee and wondered to yourself, “how positive was this result?” Fortunately, you are not alone if you have wondered this. Unfortunately, there is not really a clear answer to the question of how positive a test result is.
The drug testing process relies on pre-established cutoff levels to determine if a donor’s sample is positive or negative. Based on a laboratory’s findings, a Medical Review Officer (MRO) will make a final result determination, which is then passed on to the employer. In most cases, lab results are not visible to an employer. Instead, they simply receive a result stating whether a donor’s test was negative or positive. This seemingly hidden component of drug testing is kept from employers for good reason, as employment decisions should only be based on objective findings rather than potentially subjective levels of impairment.
In this article we will take a closer look at the laboratory testing process and how cutoff levels are utilized, hopefully creating a better understanding for employers on the receiving end.
Laboratory Cutoff Levels
The most common methods of workplace drug testing include urine, saliva, and hair testing, all of which utilize method-specific cutoff levels. Those levels can be predetermined by federal regulations, state or contractual requirements, or even by employers. Employers should be aware of what their testing cutoff levels are, as this information should be included in company drug testing policies. Employers should not be concerned with the final, or actual, level upon receiving a positive result.
Each substance on a drug testing panel has its own unique set of cutoff levels. The term “set” is used because there are two phases of testing, and the cutoff levels may differ in each phase. For example, the initial test cutoff for marijuana is 50 ng/mL, whereas the confirmatory test cutoff is 15 ng/mL. Similarly, the initial test cutoff for cocaine is 150 ng/mL, and the confirmatory test cutoff is 100 ng/mL. Please note that these examples are specific to Department of Transportation (DOT) urine testing requirements, which are often mirrored for non-regulatory requirements as well.
Testing Phases
There are two phases to a laboratory test, the first being the initial test or screening phase. A simple way of viewing this portion of the overall process is the qualitative phase of testing. During this phase the laboratory is testing specific classes of drugs, such as opiates or amphetamines. If nothing is detected, or the level detected is below the screening cutoff, the laboratory will report the result as negative. If a level above the screening cutoff is detected, the initial test is considered positive and a confirmatory test must be conducted. It is important to note that a positive screening test only represents an entire class of a substance. It does not isolate specific analytes needed for confirmation.
The second phase of a laboratory test is the confirmation test. This can be viewed as the quantitative phase of testing where the lab is targeting specific analytes of a drug class to determine an actual level. For instance, a screening test may yield a positive result for opiates. In the confirmation phase, the test will reveal levels for specific opiate analytes such as codeine, morphine, or 6-Acetylmorphine (heroin). If the actual level of these tests exceeds their respective confirmation cutoff level, this is reported as positive to the MRO. From there, the MRO will complete the review process of discussing the result with the donor, verifying medication information if necessary, and ultimately sending the final result to the employer. With few exceptions, this final result will not indicate the actual level detected by the laboratory.
Food For Thought
To paint a clearer picture, consider the following scenario. An employee reports to work and the supervisor suspects the employee of being impaired. Based on the strong odor detected by the supervisor, it is likely the employee has recently consumed one or more alcoholic beverages. When confronted, the employee claims to be only a little drunk. Sure, it can be argued that there are varying degrees of inebriation, but when it comes to company policy impairment is impairment. Therefore, the employee has violated the policy.
Although this scenario depicts alcohol use, it can easily be paralleled to illicit drugs, and impairment caused by drug use. The idea that drug testing levels can be considered almost negative, or barely positive is absurd and not a reliable way for employers to make decisions. The bottom line is that actual drug testing levels do not correlate to impairment. Instead, they indicate the level of a substance found in a donor’s sample at the time of the test. Action should only be taken upon receiving a negative or positive result.
Have questions about drug testing in your workplace? Reach out to the Current Consulting Group at info@currentconsultinggroup.com to speak with one of our experts.
