Drug testing has become second nature in today’s employment community. Employees are tested for a variety of reasons: pre-employment (post-offer), random, reasonable suspicion and post-incident (post-injury when medical care is needed, or post-accident when medical care is not necessary but property damage has occurred). The U.S. Department of Transportation (DOT) only recognizes urine as the preferred method for drug-testing people carrying CDL licenses or a medical card for driving certain vehicles. For a collection site, the most reliable way to collect a patient’s specimen is by following DOT collection procedures. These procedures are standardized and court-tested, and ensure the specimen’s reliability.

Considering how common drug testing is today, many people have probably taken at least one drug test. Thus, the stigma attached to someone handling urine is, for the most part, an outdated argument. Between two clinics, IWIRC performs about 1,200 drug tests per month with a clientele of roughly 3,000 employers, making it one of the largest drug testing vendors in Illinois and the largest downstate occupational health provider. Of these employers, a small percentage uses something other than urine when testing for drugs. Some use saliva, while others use hair, but both have limitations. Consider hair testing:

• It takes seven to 10 days after use for a substance to show up in the hair follicle. That means if someone uses a drug on Saturday, their hair sample won’t detect the substance until the following Friday or Saturday, in the best-case scenario. Obviously, delayed results pose a problem with post-injury or post-accident cause testing, as they may not be timely.
• Each half-inch of hair represents roughly the last 30 days of drug use; thus, one and half inches closest to the hair root represents approximately 90 days of testing. Any hair collected beyond this length produces less accurate results, as the degradation of the sample occurs gradually over time.
• If head hair isn’t long enough, body hair is used. But body hair recycles itself once per year on average. There are different timeframes for detection: three months versus 12 months. And if body hair isn’t one-and-a-half inches in length, urine is still used as the backup testing method. This presents timeframe incongruity, as most substances are detected almost immediately through urine, but leave a urine specimen anywhere from 72 hours to 30 days after use.

Yes, urine is still the gold standard. Employers should consider that it is most reliable, most commonly utilized, and most cost-effective compared to the other testing methods. PM