Ask the experts: Drug testing and prescription medication

What happens if an individual is taking prescription medication and screens positive on a drug test?

Employees in the workplace and individuals seeking employment may be required to complete a drug test. Depending on the reason for testing, the drug test may be unannounced in scenarios such as random or post-accident testing. Sometimes an individual subject to a drug test may be taking a prescribed substance, which will cause their drug test specimen to yield a presumptive-positive result. In these cases, the use of a Medical Review Officer (MRO) can help an employer consider all possible explanations for a positive drug test result.

A solution to a likely scenario

During the past two weeks, you experience pain in your mouth. You know exactly which molar and how long it has been pestering you. After a visit to your dentist, you get some tough news that not one but several teeth are beyond saving and need to be extracted. Post-procedure you return to work, but test positive for opiates on an unannounced drug test. You fill the blanks and realize you followed your dentist’s instructions and are taking your prescription for hydrocodone. What happens next?

If you work for the federal government, it is very likely that your employer utilizes an MRO. However, privately held companies have a choice when it comes to utilizing MRO services. An MRO is a licensed physician responsible for receiving and reviewing laboratory results and evaluating potential medical explanations for those drug test results. They are a neutral, independent, third-party entity that looks at the integrity of the testing process and surrounding circumstances and advocates for accuracy of the results. They typically get involved when a drug test result is:

  • Confirmed positive
  • Adulterated
  • Substituted
  • Invalid
  • And in some cases when a result screens negative

Benefits of a well-rounded drug testing program

Prescription medications are used to treat a broad range of ailments. In the scenario of the patient who had teeth extracted, medications can come via the recommendation of a licensed healthcare practitioner. That said, the opioid crisis has demonstrated how quickly people can become addicted to the habit-forming substances in this drug class. This gives employers greater cause for concern as prescription drug misuse continues to be a very real issue.

Fortunately for this employee, while he or she may be short a couple of molars, their employer uses an MRO who was able to verify that the non-negative result came as a results of a valid prescription.

Using MRO services can help employers add a layer of accountability and due process to their drug-free workplace programs. Building a robust drug testing program also ensures that all employees are treated fairly. Ultimately, drug testing aims to filter out drug users and curbs the negative impacts of drug use, which can include greater absenteeism, increased risk for injury and accidents, and lower productivity.

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