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part of a chemical class that are for one of many reasons considered more habit forming or of concern for instance oxycodone and diamorphine may be tested both sedative analgesics if such a test is not requested specifically the more general test in the preceding case the test for opioids will detect most of the drugs of a class but the employer or physician will not have the benefit of the identity of the drug employment related test results are relayed to a medical review office mro where a medical physician reviews the results if the result of the screen is negative the mro informs the employer that the employee has no detectable drug in the urine typically within 24 hours however if the test result of the immunoassay and gc ms are non negative and show a concentration level of parent drug or metabolite above the established limit the mro contacts the employee to determine if there is any legitimate reason such as a medical treatment or prescription 28 on site instant drug testing is a more cost efficient method of effectively detecting substance use amongst employees as well as in rehabilitation programs to monitor patient progress 29 these instant tests can be used for both urine and saliva testing although the accuracy of such tests varies with the manufacturer some kits have rates of accuracy correlating closely with laboratory test results 30 breath test edit main article breathalyzer breath test being used on a volunteer breath testing is a widespread method for quickly determining alcohol intoxication a breath test measures the alcohol concentration in the body by a deep lung breath there are different instruments used for measuring the alcohol content of an individual though their breath a breathalyzer is a widely known instrument which was developed in 1954 and contained chemicals unlike other breath testing instruments 31 more modern instruments include infrared light absorption devices and fuel cell detectors to get accurate readings on a breath testing device the individual must blow for approximately 6 seconds and need to contain roughly 1 1 to 1 5 liters of breath for a breath test to provide an accurate result an operator must take steps such as avoiding measuring mouth alcohol which is a result from regurgitation belching or recent intake of an alcoholic beverage 32 to avoid measuring mouth alcohol the operator must not allow the individual being tested to consume any materials for at least fifteen minutes before the breath test in the united states a driver who refuses to take a breath test can have their driver s license suspended for a period of 6 to 12 months hair testing edit main article hair analysis hair analysis to detect addictive substances has been used by court systems in the united states united kingdom canada and other countries worldwide in the united states hair testing has been accepted in court cases as forensic evidence following the frye rule the federal rules of evidence and the daubert rule as such hair testing results are legally and scientifically recognized as admissible evidence 33 hair testing is commonly used in the usa as pre employment drug test the detection time for this test is roughly 3 months which is the time that takes head hair to grow ca 1 5 inches that are collected as a specimen longer detection times are possible with longer hair samples a 2014 collaborative us study of 359 adults with moderate risk drug use found that a large number of participants who reported drug use in the last 3 months had negative hair tests the tests were done using an immunoassay followed by a confirmatory gc ms for marijuana only about half of self disclosed users had a positive hair test under identification of drug use by hair testing or over reporting was also widespread for cocaine amphetamines and opioids because such under identification was more common among participants who self reported an infrequent use the authors suggested that the immunoassay did not have the sensitivity required for such infrequent uses 34 it is worth noting that most earlier studies reported that hair tests found ca 50 fold higher prevalence of illicit drug use than self reports 35 in late 2022 the us federal motor carrier safety administration denied a petition to recognize hair samples as an alternative to the currently used urine samples drug testing method for truckers the agency did not comment on the test validity but rather stated that it lacks the statutory authority to adopt new analytical methods 36 although some lower courts may have accepted hair test evidence there is no controlling judicial ruling in either the federal or any state system declaring any type of hair test as reliable hair testing is now recognized in both the uk and us judicial systems there are guidelines for hair testing that have been published by the society of hair testing a private company in france that specify the markers to be tested for and the cutoff concentrations that need to be tested addictive substances that can be detected include cannabis cocaine amphetamines and drugs new to the uk such as mephedrone alcohol edit in contrast to other drugs consumed alcohol is deposited directly in the hair for this reason the investigation procedure looks for direct products of ethanol metabolism the main part of alcohol is oxidized in the human body this means it is released as water and carbon dioxide one part of the alcohol reacts with fatty acids to produce esters the sum of the concentrations of four of these fatty acid ethyl esters faees ethyl myristate ethyl palmitate ethyl oleate and ethyl stearate are used as indicators of the alcohol consumption the amounts found in hair are measured in nanograms one nanogram equals only one billionth of a gram however with the benefit of modern technology it is possible to detect such small amounts in the detection of ethyl glucuronide or etg testing can detect amounts in picograms one picogram equals 0 001 nanograms however there is one major difference between most drugs and alcohol metabolites in the way in which they enter into the hair on the one hand like other drugs faees enter into the hair via the keratinocytes the cells responsible for hair growth these cells form the hair in the root and then grow through the skin surface taking any substances with them on the other hand the sebaceous glands produce faees in the scalp and these migrate together with the sebum along the hair shaft auwärter et al 2001 pragst et al 2004 so these glands lubricate not only the part of the hair that is just growing at 0 3 mm per day on the skin surface but also the more mature hair growth providing it with a protective layer of fat faees nanogram one billionth of a gram appear in hair in almost one order of magnitude lower than the relevant order of magnitude of etg picogram one trillionth of a gram it has been technically possible to measure faees since 1993 and the first study reporting the detection of etg in hair was done by sachs in 1993 37 in practice most hair which is sent for analysis has been cosmetically treated in some way bleached permed etc it has been proven that faees are not significantly affected by such treatments hartwig et al 2003a faee concentrations in hair from other body sites can be interpreted in a similar fashion as scalp hair hartwig et al 2003b presumptive substance testing edit presumptive substance tests attempt to identify a suspicious substance material or surface where traces of drugs are thought to be instead of testing individuals through biological methods such as urine or hair testing the test involves mixing the suspicious material with a chemical in order to trigger a color change to indicate if a drug is present most are now available over the counter for consumer use and do not require a lab to read results duquenois reagent benefits to this method include that the person who is suspected of drug use does not need to be confronted or aware of testing only a very small amount of material is needed to obtain results and can be used to test powder pills capsules crystals or organic material there is also the ability to detect illicit material when mixed with other non illicit materials the tests are used for general screening purposes offering a generic result for the presence of a wide range of drugs including heroin cocaine methamphetamine amphetamine ecstasy mdma methadone ketamine pcp pma dmt mdpv and may detect rapidly evolving synthetic designer drugs separate tests for cannabis are also available 38 there are five primary color test reagents used for general screening purposes the marquis reagent turns into a variety of colors when in the presence of different substances dille koppanyi reagent uses two chemical solutions which turns a violet blue color in the presence of barbiturates duquenois levine reagent is a series of chemical solutions that turn to the color of purple when the vegetation of marijuana is added van urk reagent turns blue purple when in the presence of lsd scott test s chemical solution shows up as a faint blue for cocaine base 39 in recent years the use of presumptive test kits in the criminal justice system has come under great scrutiny due to the lack to forensic studies questioned reliability rendering of false positives with legal substances and wrongful arrests 40 41 42 saliva drug screen oral fluid based drug screen edit saliva oral fluid based drug tests can generally detect use during the previous few days it is better at detecting very recent use of a substance thc may only be detectable for 2 24 hours in most cases on site drug tests are allowed per the department of labor 43 detection in saliva tests begins almost immediately upon use of the following substances and lasts for approximately the following times alcohol 6 12 h 44 marijuana 1 24h a disadvantage of saliva based drug testing is that it is not approved by fda or samhsa for use with dot federal mandated drug testing 45 oral fluid is not considered a bio hazard unless there is visible blood however it should be treated with care sweat drug screen edit sweat patches are attached to the skin to collect sweat over a long period of time up to 14 days 46 these are used by child protective services parole departments and other government institutions concerned with drug use over long periods when urine testing is not practical 47 there are also surface drug tests that test for the metabolite of parent drug groups in the residue of drugs left in sweat an example of a rapid non invasive sweat based drug test is fingerprint drug screening 48 this 10 minute fingerprint test 49 is in use by a variety of organisations in the uk and beyond including within workplaces 50 51 drug treatment and family safeguarding services 52 53 at airport border control to detect drug mules 54 and in mortuaries to assist in investigations into cause of death 55 blood edit drug testing a blood sample measures whether or not a drug or a metabolite is in the body at a particular time these types of tests are considered to be the most accurate way of telling if a person is intoxicated blood drug tests are not used very often because they need specialized equipment and medically trained administrators depending on how much marijuana was consumed it can usually be detected in blood tests within six hours of consumption after six hours has passed the concentration of marijuana in the blood decreases significantly it generally disappears completely within 30 days random drug testing edit can occur at any time usually when the investigator has reason to believe that a substance is possibly being used by the subject by behavior or immediately after an employee related incident occurs during work hours testing protocol typically conforms to the national medical standard candidates are given up to 120 minutes to reasonably produce a urine sample from the time of commencement in some instances this time frame may be extended at the examiner s discretion diagnostic screening edit in the case of life threatening symptoms unconsciousness or bizarre behavior in an emergency situation screening for common drugs and toxins may help find the cause called a toxicology test or tox screen to denote the broader area of possible substances beyond just self administered drugs these tests can also be done post mortem during an autopsy in cases where a death was not expected the test is usually done within 96 hours 4 days after the desire for the test is realized both a urine sample and a blood sample may be tested 56 a blood sample is routinely used to detect ethanol methanol and asa paracetamol intoxication various panels are used for screening urine samples for common substances e g triage 8 that detects amphetamines benzodiazepines cocaine methadone opiates cannabis barbiturates and tricyclic antidepressants 57 results are given in 10 15 min similar screenings may be used to evaluate the possible use of date rape drugs this is usually done on a urine sample 56 optional harm reduction scheme edit drug checks tests also known as pill testing are provided at some events such as concerts and music festivals attendees can voluntarily hand over a sample of any drug or drugs in their possession to be tested to check what the drug is and its purity the scheme is used as a harm reduction technique so people are more aware of what they are taking and the potential risks 58 59 60 occupational harm reduction strategies edit drug and alcohol impairment while at work increases the risk of work place accidents and decreases productivity employers such as the commercial driving and airline industry may conduct random drug tests on employees with the goal of deterring use to improve safety 61 there is some evidence that increasing the use of random drug testing in the airline industry reduces the percentage of people who test positive however it is unclear if this decrease is associated with a corresponding decrease in fatal or non fatal injuries other accidents number of days absent from work 62 it is also not clear if there are other unwanted side effects that may result from random drug and alcohol testing in the workplace 62 commonly tested substances edit recreational substances edit anabolic steroids edit anabolic steroids are used to enhance performance in sports and as they are prohibited in most high level competitions drug testing is used extensively in order to enforce this prohibition this is particularly so in individual rather than team sports such as athletics and cycling methodologies edit before testing samples the tamper evident seal is checked for integrity if it appears to have been tampered with or damaged the laboratory rejects the sample and does not test it next the sample must be made testable urine and oral fluid can be used as is for some tests but other tests require the drugs to be extracted from urine strands of hair patches and blood must be prepared before testing hair is washed in o...
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