Learn about workplace drug testing, including types of tests, what drugs are tested for, and how test results are verified. Workplace drug-testing programs are designed to detect the presence of alcohol, illicit drugs, or certain prescription drugs. Drug testing is a prevention and deterrent method that is often part of a comprehensive drug-free workplace program. Both federal and non-federal workplaces may have drug testing programs in place. Any workplace drug-testing program should comply with applicable local, state, and federal laws. Learn more about questions to ask when determining whether to conduct workplace drug testing. Conducting Drug Tests Federal agencies must use certified labs and follow other guidelines for drug testing. Learn more about drug-free workplace resources for federal agencies. Before beginning drug testing, ask the following questions and consider how they will affect your testing program. Be sure to address each question in your drug-free workplace policy. Who receives testing? When are the drug tests given? Who conducts the testing? What substances are tested for? Who pays for the drug testing? What steps are taken to ensure the accuracy of the drug tests? What are the legal rights of employees who receive a positive test result? Tests may be done by a trained collector who visits your workplace to collect specimens, or employees may go to a certified laboratory. To ensure accuracy, the specimen’s chain of custody must be continuous from receipt until disposal. Develop a system to protect the confidentiality of employee drug-testing records. Select a person within your organization who will be responsible for receiving employee drug test results, and make sure that the person is aware of confidentiality protocols. Explain the relationship of the drug testing program to your organization’s employee assistance plan (EAP), if one is offered. Let employees know how drug-testing results can be used to inform their treatment, rehabilitation, and re-integration into the workplace. Types of Drug Tests Drug tests vary, depending on what types of drugs are being tested for and what types of specimens are being collected. Urine, hair, saliva (oral fluid), or sweat samples can be used as test specimens. In federally regulated programs, only urine samples are collected, although the Secretary of Health and Human Service has released proposed guidelines for the inclusion of oral fluid specimens. Tests are commonly used for five categories of drugs: Amphetamines Cocaine Marijuana Opiates Phencyclidine (PCP) Additional categories may include barbiturates, Benzodiazepines, ethanol (alcohol), hydrocodone, MDMA, methadone, methaqualone, or propoxyphene. Random tests are the most effective for deterring illicit drug use. Employers conduct random tests using an unpredictable selection process. Drug testing may also be used in the following set times or circumstances: Pre-employment Tests You can make passing a drug test a condition of employment. With this approach, all job candidates will receive drug testing prior to being hired. Annual Physical Tests You can test your employees for alcohol and other drug use as part of an annual physical examination. Be sure to inform employees that drug-testing will be part of the exam. Failure to provide prior notification is a violation of the employee's constitutional rights. For-cause and Reasonable Suspicion Tests You may decide to test employees who show discernible signs of being unfit for duty (for-case testing), or who have a documented pattern of unsafe work behavior (reasonable suspicion testing.) These kinds of tests help to protect the safety and wellbeing of the employee and other coworkers. Post-accident Tests Testing employees who were involved in a workplace accident or unsafe practices can help determine whether alcohol or other drug use was a contributing factor to the incident. Post-treatment Tests Testing employees who return to work after completing a rehabilitation program can encourage them to remain drug-free. Test Results Ensuring the accuracy of drug-testing results is critical. Using an HHS-certified laboratory to test the specimens and a Medical Review Officer (MRO) to interpret the test results will help prevent inaccurate testing. MROs are licensed physicians who receive laboratory results and have knowledge of substance use disorders and federal drug-testing regulations. MROs are trained to interpret and evaluate test results together with the employee’s medical history and other relevant information. A negative test result does not indicate that an employee has never used alcohol or illicit drugs, nor is it a guarantee against future use. Federal employees or employees in safety- and security-sensitive industries regulated by the Department of Defense (DOD) or the Department of Transportation (DOT) who show positive test results have the right to have the specimen tested by a second HHS-certified laboratory. Although a second test is not required, all employers should include this right in their drug-testing programs. Depending on the workplace and the circumstances, employees who test positive may be referred to EAPs, into treatment, or for disciplinary action.