Procedures for Drug Testing
The procedures for collection and testing of urine are very detailed. Some of the most asked about provisions are presented here.
Chain of custody:
These are the procedures beginning at the time of collection to account for all handling and storage of each specimen.
A second laboratory procedure used to analyze a positive test result from a screening test. Gas chromatography/mass spectrometry (GC/MS) is the only authorized confirmation test.
The concentration of a drug or drug metabolite in the urine at which a specimen is considered positive.
Medical Review Officer (MRO):
A licensed physician who is qualified to interpret and evaluate test results and other relevant medical information.
Specimens may only be tested for the covered drugs and the specimen may not be used to conduct any other analysis or test.
An employer may only test for other controlled substances if approved by DOT, and if there is a Department of Health and Human Services (DHHS) approved testing protocol for that substance.
Preparation for Testing
The employee is not to provide any information about prescription or over-the-counter medication to the employer or the laboratory. A standard drug testing custody and control form must be used.
A statement on the form informs the employee that if there is a positive test, the Medical Review Officer (MRO) will contact the employee about prescription and over-the-counter medications. The employee may list medications only on the employee's copy of the form.
Specimen Collection Procedures
The area must be secure.
The chain of custody form must be completed and shipped with the specimen.
An employee's direct supervisor may not serve as the collection site person unless it is impracticable for any other person to perform this function. The collection site person is the individual that ensures that the urine specimen is collected according to required procedures.
Collection of urine specimens must allow individual privacy unless there is reason to believe that a particular person may alter or substitute the specimen. If specimen collection is directly observed by a non-medical person, the person must be of the same gender as the employee. The following circumstances are the only grounds to believe a person may alter or substitute a specimen:
The urine specimen is outside the normal temperature range (32.5°C, 90.5°-99.8°F) and the employee will not allow an oral body temperature to be taken, or the oral body temperature is 1°C/1.8°F different from the temperature of the specimen;
The collection site person observes behavior that clearly indicates an attempt to alter or substitute a specimen; or
The employee has previously been determined to have used a controlled substance and the test is a follow-up test after return to service.
A "split sample" of urine is collected. In the split sample method the urine specimen is divided into two containers. The purpose of the split sample is to allow the employee the opportunity to have the specimen retested at a different certified laboratory.
An employee must provide at least 45 ml (milliliters) of urine. Failure to provide an adequate amount of urine is considered a refusal to submit to a controlled substance test and the employee is considered to have engaged in actions prohibited by these rules. If the employee is unable to provide the minimum amount of urine, the collection site person is to have the employee drink up to 24 ounces of fluid and try to provide a sample within two hours. If the employee is still unable to provide a complete sample, the test is stopped and the employee is sent for a medical evaluation to determine if there is a legitimate reason for failure to provide a specimen or there is a refusal to submit a specimen.
Laboratory Analysis Procedures
The initial test is performed by an immunoassay test. The cutoff levels for screening tests are listed below and are expressed in nanograms per milliliter (ng/ml), or billionths of a gram per thousandth of a liter:
A confirmation test is performed on all initial positive tests. The cutoff levels for confirmation tests are:
The laboratory must retain the sample in frozen storage for a minimum of one year.
After being notified of a positive test result, the employee has 72 hours in which to request that the MRO have the specimen tested in a different certified laboratory.
Reporting and Review of Results
A MRO examines all positive confirmed test results to determine if there is an alternative medical explanation for the positive test result. Before making a final decision as to whether a positive test is valid, the MRO provides the employee with the opportunity to discuss the test result. If the NMO determines there is a legitimate medical explanation for the positive test result, the MRO reports to the employer that the test is negative.