Can a 5 panel drug test detect pregnancy

Hospitals’ initial urine- screening drug tests on pregnant women can produce a high rate of false positives – particularly for methamphetamine and opiates – because they are technically complex and interpretation of the results can be difficult, some experts say.

Tests for methamphetamine are wrong an average of 26 percent – and possibly up to 70 percent – of the time, according to studies by the University of Kansas Medical Center, U.S. Substance Abuse and Mental Health Services Administration and the American Association for Clinical Chemistry.

And even the gold standard of maternal drug testing – meconium, a baby’s first stool that is analyzed to assess a mother’s drug usage over the past four or five months – can produce false positives for methamphetamine up to 70 percent of the time, said Dr. Barry Lester, a national expert on drug-exposed babies and a professor of pediatrics and psychiatry at Brown University in Providence, R.I.

False positives can be triggered by everything from cold medicines and diet pills to poppy seeds, according to a January study by the University of Kansas published in Mayo Clinic Proceedings.

The study found cold remedy compounds, herbal medications and doctor-prescribed medicines for anxiety or depression often produce false positives for methamphetamines.

On average, the study found initial urine screens for methamphetamines produced false positives 26 percent of the time. For opiates, the percentage rose to 29 percent. Less than 8 percent of tests for cocaine and marijuana resulted in false positives.

“There is a relatively good chance that there will be a false positive for those particular drugs (methamphetamine and opiates),” said Dr. Donald Frederick, chairman of the toxicology division at the American Association of Chemistry in Washington, D.C.

“I always recommend they go to confirmatory or forensic testing if they are going to use any clinical immunoassays for legal purposes.”

Hospital doctors have the discretion whether to request an initial urine screen and usually do so only if the mother exhibits signs of drug use, the baby is born premature or underweight, or other reasons occur.

If a test is positive, many hospitals perform confirmatory tests to ensure the results are accurate – but some don’t.

The U.S. Substance Abuse and Mental Health Services Administration said the federal government has required confirmatory tests for its employees since 1988 to help eliminate false positives. Confirmatory tests usually involve gas chromatography and mass spectrometry.

But James Lott, executive vice president of the Hospital Association of Southern California, said it’s not the hospital’s responsibility to conduct confirmatory drug tests.

“It’s not the hospital’s burden to do a confirmatory test,” Lott said. “It’s up to the agency that investigates child abuse whether a confirmatory test needs to be done.

“The hospital can choose to do it if it wants to, but it’s not obligated to do it.”

By Lawrence E. Buirse | 03/06/2020

There are several preventive services an employer can take advantage of to improve workplace safety, such as personal protective equipment (PPE) training and worksite risk analyses. Another cost-saving, preventive measure is pre-employment drug tests. Investment in pre-employment drug testing can help reduce costs because employers spend $740 billion annually in direct medical costs, lost productivity, absenteeism, increased health care costs, and more due to drug use.

What is a pre-employment drug test?

A pre-employment drug test is used to determine if a prospective hire uses illicit substances or abuses prescription medication. It may also be used for employees who are returning to work after an injury or absence, at which time it may be referred to as a pre-placement drug test. It is common for employers to require a job candidate to complete a pre-employment drug test, and a job offer may be contingent upon the applicant’s ability to pass. These drug tests typically screen for the use of the following illegal drugs (but can test for others if needed):

• Methamphetamines (meth, speed, crank, ecstasy)
• THC (cannabinoids, marijuana, hash)
• Cocaine (coke, crack)
• Opiates (heroin, opium, codeine, morphine)
• Phencyclidine (PCP, angel dust)

Drug testing specimen types

The most prominent drug testing specimen types are urine, hair, blood, and saliva. Urine is the most common and is mandated for regulated drug tests, such as those conducted by the U.S. Department of Transportation (DOT). However, urine testing has a shorter window of detection when compared to other types, such as the costlier hair drug test. Illicit substances are detectable for only five to 10 days in urine; whereas, hair drug tests can detect drug or alcohol use for up to 90 days.

Blood testing is very accurate, but costly and invasive. It does have a shorter detection period (minutes to hours), however. Finally, a saliva test (also known as an oral fluid test) is a less-invasive test that also has a shorter detection period (7-21 hours) than urine tests. A saliva drug test can be an effective alternative to urine testing if an employer wants to avoid issues that arise when an employee does not provide sufficient urine.

Why employers should require pre-employment drug testing

If workplace safety is of the utmost importance to a company, then conducting pre-employment drug tests can help mitigate risks associated with drug misuse. By indicating on a job application that an offer of employment may be contingent on the results of a drug test, an employer can help to deter substance abusers from applying altogether. For occupations that place employees in safety-sensitive environments, pre-employment drug testing is critical. as it can help reduce the number of costly workers’ compensation claims involving drug or alcohol use.

According to the National Institute on Drug Abuse (NIDA):

• Drug use may represent as much as a five-fold increase in workplace injury claims
• Up to 50 percent of all workers’ compensation claims are related to workplace substance abuse
• Substance impairments may lead to 3.5 times more accidents
• Substance abuse can increase by 2.5 times the likelihood of an employee missing eight or more workdays annually
• Substance abuse may contribute to productivity being 33 percent lower than it would be otherwise

The legality of employee drug testing

The legality of drug testing is evolving and can vary from state to state. Employers are advised to consult with legal counsel if they have questions about their testing program’s compliance with all relevant state regulations. There are some general best practice guidelines, which include the following:

• The applicant must know in advance that pre-employment drug testing is part of the new employee screening process
• Applicants for the same job must undergo the same type of drug test
• Drug tests must be administered at a state-certified laboratory

Pre-employment drug testing is an occupational health service

While most urgent care clinicians can perform pre-employment drug tests, many lack the expert knowledge of all types of workplace drug tests. They also are not the most qualified to assist an employer with developing a company drug testing policy. Workplace drug testing falls under the scope of services provided by occupational health providers. Concentra medical centers have trained occupational health clinicians who perform pre-employment drug tests based on the applicable state and federal testing regulations. In addition, Concentra clinicians have the expertise to advise employers on their substance abuse program and the staffing, facilities, and equipment to streamline the workplace drug testing process.

Whether your company has a global presence of more than 50,000 employees or is a local business with less than 50 employees, it’s best to partner with an occupational health provider for your drug testing needs. Learn more about Concentra workplace drug testing or contact your nearby Concentra to schedule pre-employment drug testing.