Urine Drug Collection Methods

Urine Drug Screening

Genesis Occupational Health offers non-regualted, regulated, rapid, and split specimen drug screening. Most commonly done as a 5 panel (NIDA or Non-NIDA) but can be extended to a 10 panel (Non-NIDA). Additional chemical analysis are possible and can be reviewed with one of our MRO's. We provide the following services at both our Davenport and Moline locations:

Options

Collection Only
Company uses outside Lab and MRO and we complete collection of specimen only.

MRO Only
Company uses outside Lab collection and Lab and we provide MRO function.

Collection + Lab
We serve as collector and coordinate Lab services through LabOne and company uses outside MRO.

Complete Service (Collection + Lab + MRO)
Provide seamless service with local collection, Lab services through LabOne and local MRO service.

Regional/National Services
Coordinate out of area collection and processing of specimen through LabOne and MRO services directed through our Moline office.

Hair Analysis

This information is based on a written consensus opinion from Society of Forensic Toxicologist, Inc. on applicability of hair analysis for drugs of abuse. Their concerns focused on consistency of detection of drugs and interpretation of the results and the application of the testing procedure based on the necessitating circumstances. The biggest issue was quality control.

The advantages:

• Less invasive procedure in obtaining a sample.
• Longer detection window, up to 90 days for most drugs of abuse.
• Ability to detect true break down products of certain drugs (cocaine and marijuana) in confirmation of internal exposure.
• Ability to assess chronic drug use over an extended period of time.

The disadvantages:

• Potential for contamination of the hair by drug introduced from the environment. Ex: Exposure at a rock concert to marijuana smoke in the environment.
• Concentration differences which vary based on age, sex, racial characteristics, hair color, hair type and hair treatments. This would lead to Americans with Disabilities Act (ADA) implications. Ex: People with darker hair are reputed to be more prone to positive results on hair tests.
• Inability to determine recent usage.
  Ex: Hair grows at an average of 1/2 inch per month, so this method of drug screening would be inadequate for post- accident or reasonable suspicion situations. In addition it may be difficult for an individual to remember legitimate prescription drug use as far into the past as the window of detection allows for determination of their presence.
• Inability to detect common drugs of abuse, such as prescription drugs (codeine, barbiturates, benzodiazepines) and alcohol.
• Ability for donor to alter specimen.
  Ex: Hair analysis requires a group of hair the thickness of a pencil and between 1 and 1/2 inches in length. A person could cut their hair short to remove past evidence of drug use or have their hair so short that a sample could not be adequately obtainable.
• Difficulty in determining amount of drug usage and how to set cutoff levels beyond which use of the drug would be deemed a safety sensitive risk.

MRO Suggestions:

• Currently the Department of Transportation (DOT) does not allow hair analysis as a method for testing.
• Hair analysis could be useful only in the post-job offer testing situation, but the road block would be ADA issues. We would recommend consulting your lawyer before considering this form of testing. Because of its high sensitivity and long window for detection, it may be time consuming and more costly to screen the appropriate number of applicants to fill your employment needs. It will have a higher rate of catching the sporadic user who does not have a true substance abuse problem requiring treatment.
• For all the other reasons for testing (i.e. post-accident, reasonable suspicion and follow-up to treatment) hair analysis would be irrelevant in determining recent drug use.
• If hair analysis was completed, it would still require a chain of custody method for collection purposes in order to standardize the procedure to decrease liability for those involved since it would be possible to tamper with the specimen and alter it's results.

Breath or Blood Alcohol Testing

The two most common methods of testing for alcohol include procedures which involve sampling blood or breath. If you look at the science behind the testing, both have very good reliability and research has documented direct correlation between alcohol concentration in the blood or breath and the level of impairment.

The breakdown of alcohol within the blood is determined by enzyme action. The amount of enzyme and it's activity can be affected by things such as gender, smoking status and use of certain medications. Lawyers who handle cases involving positive alcohol testing will use this knowledge to interpret the results differently.

DOT testing is done using a sample of breath. The reasoning behind this choice largely involves control of the sample and testing environment. Taking a sample of breath is much less invasive than blood. The phlebotomy (blood draw) procedure can be uncomfortable for the donor. Complications can occur with phlebotomy leading to injury to a nerve or other tissues and there would be higher risk of possible expose to a possible blood borne pathogen if done improperly.

When breath sampled according to DOT or State of Iowa regulations it involves doing a split test. If an individual completes a test and is positive then a second test is done within the next 20 minutes to confirm the presence and level of alcohol. After each positive, the certified equipment must also be calibrated to ensure that the results are accurate. The results are known immediately and the company is able to react immediately on the results to address the problem. DOT and the State of Iowa regulations also has guidelines that determine the consequences on work activity and rehabilitation based on the positive results.

A blood test requires that only one sample is taken. In a random situation, the donor would then resume work and await the results which could be delayed. Most laboratories can complete alcohol levels. The issues that may present in a legal situation dealing with blood testing would include the laboratories certification, calibration of the equipment and chain of custody procedures.

At this time my recommendation to employers are to have a policy that uses breath sampling for scheduled testing situations and use blood only if it is impossible for the donor to provide a breath sample, i.e. unconscious from an injury. The DOT regulations provide an excellent defensible model for a policy for substance abuse testing irrelevant of whether the testing falls within it's confines.

Consortium Services

Developed to help employers stay in compliance with regulatory guidance whether testing falls under federal or state Department of Transportation regulations.

We offer the following FREE services:

• Collection Site Management (local and national)
• Blind Specimen Management
• Substance Abuse Testing Policy Development
• DOT and Non-DOT Consortia Options
• Random Selection Management
• Unannounced Program Management
• Record Keeping/Statistical Reporting

The following services are Fee for Service:

• Urine Drug Collection and Testing
• Breath Alcohol Testing
• Rapid Drug Testing
• On-Site Drug & Alcohol Testing
• Blind Specimen Securement and Testing

These services can be completed locally at one of our clinics or after hours facilities or can be coordinated nationally at various service providers.

Please contact Michelle Hostens, consortium manager for more information:
By phone: 309-764-0684 or by email: hostensm@genesishealth.com