What is a drug test?

A drug test uses a biological sample (such as blood or urine) to detect the presence or absence of a legal or illegal drug. Drug tests are ordered and performed in a variety of settings with a variety of techniques.

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Drugs include legal substances such as alcohol and tobacco, as well as over-the-counter medications, prescription medications and illegal substances. A single drug test can’t determine the frequency and intensity of substance use and, thus, can’t distinguish casual substance use from substance use disorders.

Your body metabolizes (breaks down) various drugs at different rates, so the timeframe for detecting certain drugs in your system can be very specific and vary widely from substance to substance.

Urine drug testing (UDT) is the most common test for detecting drugs.

When would I need a drug test?

You may need a drug test for several reasons. The most common use of drug testing is in the workplace. Employers may require a drug screening for various reasons, including:

• Before hiring an applicant.
• During someone’s employment — an employer may randomly or periodically require drug testing after they hire an employee.
• When drug use is suspected based on signs and symptoms observed in the workplace.
• After an employee has an accident or incident while working.

Another common use of drug testing is for the diagnosis, treatment and monitoring of alcohol use disorder and substance use disorder. As a tool for monitoring, drug testing can help determine treatment adherence, monitor abstinence and detect early relapse.

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You may need this testing for court-ordered treatment programs, as a term of probation or while participating in a substance use disorder treatment program.

Other uses for drug testing include:

• Medical testing and diagnostics: People may be tested for drug use to help determine the cause of their symptoms or in emergencies when healthcare providers suspect a potential drug overdose or poisoning.
• Legal testing: There are several reasons drug testing may be required for legal purposes, including collecting potential evidence of a crime, investigating cases of child abuse or endangerment and determining if a person is under the influence of alcohol or other substances while driving.
• Monitoring for prescription drug misuse: If you take a prescription drug with high addiction potential and/or the potential for misuse, such as opioids for pain, your provider may request a drug test to check the amount of the drug in your system.
• Athletic testing:Professional athletes often have to take a drug test to screen for drugs or other substances considered performance-enhancing.

What are the types of drug tests?

There are several kinds of drug tests based on the biological sample they use and the types of drugs they detect.

Different types of drug tests based on the sample used include:

• Urine drug testing (UDT): This is the most common drug test. It requires a sample of your urine (pee). Urine drug tests are most commonly used to detect alcohol, amphetamines, benzodiazepines, opiates/opioids, cocaine and marijuana (THC).
• Blood drug testing: Healthcare providers mainly use this type of test in emergencies. It’s also typically used to detect alcohol (ethanol) levels because it can provide a precise level.
• Hair follicle drug testing: A hair sample can provide information on substance use over time. Scalp hair has a detection window of three months, while slower-growing body hair has a detection window of up to 12 months. The results can vary based on the characteristics of each person’s hair. Hair testing can detect the use of cocaine, phencyclidine (PCP), amphetamines, opioids and 3,4-Methylenedioxymethamphetamine (MDMA).
• Breath drug testing: This is primarily used to detect recent alcohol consumption. The result is called a breath alcohol concentration (BrAC). Officials often use it to estimate a person’s blood alcohol content (BAC). However, BrAC can sometimes overestimate or underestimate the BAC. Recent research has focused on the potential use of breath testing for detecting cocaine, marijuana, benzodiazepines, amphetamines, opioids, methadone and buprenorphine.
• Sweat drug testing: Sweat testing involves wearing an absorbent pad on your skin that’s collected and tested after a certain amount of time. The results provide information on how much of a substance the person consumed over the entire time that they wore the pad. Sweat testing gives a detection window of hours to weeks.

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What will a drug test detect?

When a drug enters your body, your gastrointestinal tract absorbs and distributes it to the rest of your body. Your liver and other organs metabolize the drug (break it down). Metabolic processes cause the drug to turn into different chemicals, called metabolites. After a certain amount of time, the drug and/or its metabolites leave your body, mainly through your urine.

A drug test screens for certain drugs and/or their metabolites in a biological sample (such as urine or blood).

The metabolic processes happen at different speeds for different drugs. Because of this, each drug and its metabolites have a different timeframe in which a drug test can detect them.

For some drugs like amphetamines, the main (parent) drug will be detected in urine. For most other drugs, metabolites will be detectable for a longer time than the main drug.

A drug test may look for only one drug, but most drug tests often test for multiple drugs with one sample. Although the drugs included in a drug panel test vary based on the reason for the test, the most common panel used to evaluate people for illegal drug use detects the presence or absence of five substances:

• Amphetamines.
• Cocaine.
• Marijuana.
• PCP.

Other commonly tested substances include:

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• Alcohol (ethanol).
• Antidepressants.
• Barbiturates.
• Benzodiazepines.
• Fentanyl.
• Heroin.
• Hydrocodone.
• Methadone.
• Methamphetamine.
• Morphine.
• Nicotine and cotinine.
• Oxycodone.

Are at-home drug tests available?

Yes. Some kits can test urine samples in the privacy of your own home. Some kits may use breath, saliva or hair instead. The accuracy of these products is variable. They generally are less sensitive than the formal tests done in a laboratory. This means that a home test could be negative, but a laboratory test could be positive with the same sample.

The American Academy of Pediatrics cautions parents against drug testing their children at home. Research studies have shown that at-home testing doesn’t reduce drug use. At-home testing also comes with the potential for misinterpreting results, which may negatively affect the relationship between children and parents.

How do I prepare for a drug test?

There’s nothing you need to do to prepare for a drug test.

Drug testing can be an emergency test, a scheduled test or it may be conducted randomly (for example, to meet ongoing employment requirements).

Depending on the circumstances, you may be asked to identify medications or supplements you’re taking.

What should I expect during a drug test?

Drug testing can be performed from small samples of your blood, hair, saliva, breath or, most commonly, your urine (pee).

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For more information, please visit Drug Of Abuse Tests.

For a urine sample, you’ll pee into a clean container provided to you. In some instances, you may need to provide your urine sample in the presence of a nurse or technician to make sure that the sample did indeed come from you.

For a blood sample, a phlebotomist will draw a small amount of blood from a vein in your arm or hand.

After the provider has collected the sample, they’ll send it to a laboratory for analysis

Drug Testing

What is a drug test?

Drugs are chemical substances that can change how your body and mind work. A drug test looks for signs of one or more illegal drugs or certain prescription medicines that can be misused. The test is usually done with a sample of your urine (pee). Less commonly, drug testing uses a sample of your blood, saliva (spit), hair, sweat, fingernails, or breath. The purpose of a drug test is to look for drug use and misuse, which includes:

• Using any illegal drugs, such as cocaine or club drugs.
• Misusing prescription medicines, which means taking prescription medicines in a different way than you are supposed to. This can include crushing or snorting tablets, taking more than the prescribed dose, or taking it more often than prescribed. It also includes taking the medicines for a nonmedical purpose, such as to get high. Examples of drug misuse include using a prescription pain reliever to relax or taking someone else's prescription.

A drug test can check for a single drug or for a group of drugs in your body. Drug tests commonly test for:

• Alcohol
• Amphetamines, such as methamphetamine and Ecstasy (MDMA)
• Barbiturates, such as phenobarbital and secobarbital
• Benzodiazepines, such as alprazolam or clonazepam
• Cocaine
• Marijuana (cannabis, THC)
• Opioids and opiates, such as heroin, codeine, oxycodone, morphine, hydrocodone, and fentanyl
• Phencyclidine (PCP)
• Anabolic steroids

Drug tests can find signs of drugs that you took hours to several days or more before the test. How long a drug lasts in your body depends on:

• The type of drug
• How much you used
• How long you were using it before the test
• How your body reacts to the drug

Other names: drug screen, drug test, drugs of abuse testing, substance abuse testing, toxicology screen, tox screen, sports doping tests

What is it used for?

Drug testing is used to find out whether you have been using or misusing one or more drugs but can't diagnose a drug use disorder (addiction).

A drug test may be used for different purposes, including:

• Employment. Employers may require that you pass a drug test before they will hire you. The testing may be part of a drug-free workplace program. After you're hired, they may test you to check for on-the-job drug use. If you have a work accident, you may be tested to see whether drugs or alcohol were involved.
• Sports. Professional and other athletes are often tested for drugs that are used to improve performance, such as anabolic steroids that help build muscle.
• Substance use disorder treatment. Drug testing may be used to monitor treatment in programs for drug or alcohol use disorder (AUD).
• Legal evidence. Testing may be part of a criminal or motor vehicle accident investigation. Drug screening may also be ordered as part of a court case.
• To prevent prescription drug misuse. If you take a prescription medicine that can be addictive, such as opioids for chronic (long-term) pain, your provider may order a drug test to make sure you're taking the medicine correctly.

Drug testing may be scheduled ahead of time or done randomly without notice.

Why do I need a drug test?

You may be asked to take a drug test for a job, to participate in certain organized sports, or as part of a police investigation or court case. In a hospital emergency room, a health care provider may order a drug test if you have signs of a possible drug overdose. Newborns can also be tested for possible prenatal exposure to illegal drugs.

What happens during a drug test?

Drug testing may be done in many different locations, including labs, hospitals, drug treatment centers, and workplaces.

Urine is the most commonly used sample for drug testing. You will be given instructions for how to collect your sample. In certain cases, a health care professional or other person may need to be present while you provide your sample. This is to make sure the urine is yours and isn't contaminated with anything that might affect the test results.

If a blood sample is used to test for drugs, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

Be sure to tell the testing professional if you are taking any prescription drugs, over-the-counter medicines, or supplements, because these substances may affect your test results. Also, you should avoid foods with poppy seeds, which can show up as opiates in a drug test.

Are there any risks to the test?

There are no known physical risks to having a drug test. But if drugs show up in your results, it may affect your job, your eligibility to play sports, the outcome of a legal matter, or other parts of your life.

Before you take a drug test, make sure you know:

• What you are being tested for
• Why you are being tested
• How the results will be used

If you have questions or concerns about a drug test, talk with your provider or the person or organization that is asking for the test.

What do the results mean?

If a drug test result is positive, it means that one or more drugs were found in amounts that suggest drug use or misuse. If you have a positive test result, you'll usually have a follow-up test to make sure the first test was correct. That's because the type of urine testing that's often done first can have false positive results.

A false positive means that the test showed you had a drug in your sample when it really wasn't there. False positives can happen if the test reacts with other chemicals in your body from certain over-the-counter medicines, prescriptions, and foods.

The follow-up drug test after a false positive result is called a confirmatory test. It is a more sensitive test that provides more accurate results.

If a drug test result is negative, it means that either:

• The drugs that were tested were not found in your sample.
• A very small amount of drugs was found, but not enough to count as a positive test result for drugs.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a drug test?

If you test positive for a legal drug prescribed by your provider, your employer can't punish you, unless the drug is affecting your ability to perform your job.

If you test positive for marijuana and live in a state where it is legal, employers may still be able to punish you in some states. Employers may do this because they want a drug-free workplace. Also, marijuana is still illegal under federal law.

You can buy home tests for many illegal and prescription drugs. There are two types of tests:

• At-home tests let you do the entire test at home and get rapid results. But if the test result is positive for drugs, you'll need to have a follow-up lab test to check the accuracy of the result. Before you buy an at-home test, check to see if it includes a kit for collecting a sample, often urine or saliva, to send to a lab in case the home test is positive.
• A self-collection test has a kit for gathering urine, saliva, or another type of sample to send to a lab for testing. The price of some self-collection tests includes the cost of a follow-up lab test to check the accuracy of the test if it has positive results.

When using home tests, be careful to follow all the instructions. It's best to talk with your provider about using home drug testing so you can decide if it's right for your situation.

References

1. Cleveland Clinic: Health Library: Diagnostics & Testing [Internet]. Cleveland (OH): Cleveland Clinic; c. Blood Tests; [reviewed Dec 06; cited Nov 11]; [about 16 screens]. Available from: https://my.clevelandclinic.org/health/diagnostics/-blood-tests
2. FDA: US Food and Drug Administration [Internet]. Silver Spring (MD): U.S. Department of Health and Human Services; Drugs of Abuse Home Use Test; [current as of Sep 27; cited Nov 13]; [about 4 screens]. Available from: https://www.fda.gov/medical-devices/drugs-abuse-tests/drugs-abuse-home-use-test
3. Drugs.com [Internet]. Drugs.com; c-. Drug Testing FAQs [updated Jun 10; cited Nov 13]; [about 11 screens]. Available from: https://www.drugs.com/article/drug-testing.html
4. Merck Manual Professional Version [Internet]. Kenilworth (NJ): Merck & Co., Inc.; c. Drug Testing [reviewed Dec; cited Nov 13]; [about 2 screens]. Available from: https://www.merckmanuals.com/professional/special-subjects/illicit-drugs-and-intoxicants/drug-testing
5. National Institute on Drug Abuse [Internet]. Gaithersburg [MD]: U.S. Department of Health and Human Services; Drug Testing; Nov [cited: Nov 13]; [about 12 screens]. Available from: https://nida.nih.gov/research-topics/drug-testing#drug-testing
6. Nemours KidsHealth [Internet]. Jacksonville (FL): The Nemours Foundation; c-. Getting a Blood Test; [reviewed Sep; cited Nov 11]; [about 4 screens]. Available from: https://kidshealth.org/en/parents/blood-tests.html
7. Substance Abuse and Mental Health Services Administration [Internet]. Rockville (MD): U.S. Department of Health and Human Services; Drug Testing Resources [updated Jul 19; cited Nov 13]; [about 8 screens]. Available from: https://www.samhsa.gov/substance-use/drug-free-workplace/drug-testing-resources
8. Testing.com [Internet]. Seattle (WA): OneCare Media; c. 10-Panel Drug Test; [modified Sep 26; cited Nov 13]; [about 11 screens]. Available from: https://www.testing.com/tests/10-panel-drug-testing/
9. Testing.com [Internet]. Seattle (WA): OneCare Media; c. The Best At-Home Drug Tests of ; [modified Aug 14; cited Nov 13]; [about 29 screens]. Available from: https://www.testing.com/tests/at-home-drug-test/
10. Testing.com [Internet]. Seattle (WA): OneCare Media; c. Drug Testing; [modified Aug 4; cited Nov 13]; [about 9 screens]. Available from: https://www.testing.com/drug-testing/
11. Testing.com [Internet]. Seattle (WA): OneCare Media; c. Urine Drug Tests; [modified Feb 2; cited Nov 13]; [about 16 screens]. Available from: https://www.testing.com/tests/urine-drug-test/
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The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

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