Blog Series

Ask the Experts: Drug Testing Cutoffs

by Nicole Jupe on July 18, 2017

Question: Can you explain cutoff levels for laboratory-based drug testing?

In workplace drug testing, the industry standard process involves two-tiered testing – an initial screen on one portion of the specimen, followed by a confirmatory test on a second portion of the original specimen. The initial test is designed to separate negative specimens from further consideration. The confirmatory test uses definitive methods, such as chromatography-mass spectrometry (e.g., GC-MS, LC-MS/MS), that specifically identify and quantify the drug/metabolite in the specimen. Drug testing detects the presence of drugs and drug metabolites using cutoff levels to determine whether a specimen tests positive or negative for the use of a specific drug.

Cutoff levels are expressed in nanograms (ng) per milliliter (mL) for urine and oral fluid testing or picograms (pg) per milligram (mg) for hair testing. It is important to select a specimen type and cutoff level based on the desired window of detection and any regulatory requirements. Only when a drug or drug metabolite is identified at a concentration equal to or above the administrative cutoff is a specimen reported by the laboratory as positive. Consequently, a negative drug test does not necessarily mean that no drug is present. While that may be the case, other possible interpretations are that a drug was present below the cutoff or the testing panel did not include the drug the individual was using.

Cutoff levels for federally-regulated drug testing programs are established based on mandatory guidelines set by U.S. Department of Health and Human Services (HHS). Additionally, the U.S. Department of Transportation’s (DOT) rule 49 CFR Part 40 harmonizes with HHS and describes the required procedures for conducting drug and alcohol testing for the federally-regulated transportation industry. Many non-regulated employers mirror the cutoff levels established by the government while others customize their drug testing panels to be more sensitive to certain drugs based upon their program needs and unique workforce.

Download our Complete Line of Drug Testing Solutions to see the most commonly ordered non-regulated drug test panels and their cutoff levels.

Take our Drug Testing Needs Assessment to evaluate the benefits of different solutions for your program goals.

For more information about drug testing, visit our website or contact us online.

America’s Favorite Illicit Drug: Marijuana

by Nicole Jupe on July 7, 2017

Marijuana is the product of the hemp plant, Cannabis sativa, containing the psychoactive chemical delta-9-tetrahydrocannabinol (THC). Despite its illegal status, the drug reigns as America’s favorite and most commonly detected illicit drug. Since the 1920s, marijuana has been the subject of myths and propaganda while also being glamorized by pop culture, movies, and television. Attitudes relaxed in the 1960s and the drug gained popularity among the upper middle class and with counter-culture movements like Woodstock. Experimentation and widespread marijuana use followed. Thirty years later, voters passed Proposition 215 in 1996 and California became the first state to allow the medical use of marijuana. Today 30 states and the District of Columbia have their own versions of marijuana legislation; however, it remains a Schedule I Controlled Substance under Federal law.

Marijuana positivity continues to trend upward. The latest Quest Diagnostics Drug Testing Index™ (DTI) data indicates that marijuana use has increased significantly in the last three years. Among the federally-mandated, safety-sensitive workforce, which only utilizes urine testing, marijuana positivity increased nearly 10% (0.71% in 2015 versus 0.78% in 2016), the largest year-over-year increase in 5 years. In the general U.S. workforce, marijuana positivity climbed in urine testing (2.4% in 2015 versus 2.5% in 2016) and hair testing (7.0% in 2015 versus 7.3% in 2016). The most remarkable data pointed to a nearly 75% increase of marijuana positivity in oral fluid drug tests in the general U.S. workforce in the last 3 years (5.1% in 2013 to 8.9% in 2016).

Quest has also been analyzing data for several years in states that have passed medical and recreational marijuana use statutes. “2016 is the first year since Colorado and Washington approved recreational use that the rates of year-over-year change were sharply higher than the national average,” said Barry Sample, PhD, Senior Director of Science and Technology, Quest Diagnostics Employer Solutions.

Globally, there are 182.5 million cannabis users, or 3.8% of the total population, according to the World Drug Report. Not surprisingly some employers report difficulty in finding job applicants who can pass a drug test. The most current findings for the United States from the National Survey on Drug Use and Health tell us:

  • An estimated 22.2 million adults, 8.3% of the total population, aged 12 or older currently use marijuana. The increase in marijuana use among people aged 12 or older reflects the increase in marijuana use by adults aged 26 or older.
  • About 1 in 5 young adults aged 18 to 25 (19.8%) were current users of marijuana.
  • Approximately 651,000 adolescents (ages 12-17), 1.8 million young adults, and 1.6 million adults suffer from a marijuana use disorder, pointing to dependence and recurrent use that affects health, responsibilities at work, home, or school.

That said, research and data indicates that marijuana use in society is up. Drug testing continues to be an important tool to maintain a safe, healthy, and productive drug-free workplace.

Visit QuestDiagnostics.com/DTI for the full Drug Testing Index™ report and data and download the latest Quest Diagnostics Drug Testing Index brochure.

To search for marijuana positivity rates by 3-digit zip code in the United States for the past 10 years, visit QuestDiagnostics.com/DrugMap.

To learn more about drug testing for marijuana, visit our website or contact us online.

Mapping Drug Use in the U.S. Workforce

June 9, 2017Drug Testing

Which drugs are popular in my county? How does workplace drug use in my state compare to the rest of the country? Has drug use in the American workforce changed significantly during the past decade? Employers, media, government, and policymakers frequently look to Quest Diagnostics for insights about their specific geographies. These inquiries are especially […]

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Cocaine Continues Upward Trend

June 1, 2017Drug Testing

Cocaine is derived from the coca plant native to South America where many chew its leaves to squash pain, thirst, hunger, and fatigue. By the 1880s, doctors as famous as Sigmund Freud were studying cocaine as a “miracle drug” as an anesthetic for surgery and for a variety of health conditions including anxiety, addiction, and […]

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Increases in Illicit Drugs, Including Cocaine, Drive Workforce Drug Positivity to Highest Rate in 12 Years

May 16, 2017Drug Testing

The Quest Diagnostics Drug Testing Index™ (DTI) reveals insights into patterns of drug use among the American workforce. It has been published annually for more than 25 years as a public service for government, employers, policymakers, media, and the general public. This year’s report will be presented at the Drug and Alcohol Testing Industry Association […]

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Prescription Misuse Epidemic Affects 7 in 10 Employers

May 11, 2017Drug Testing

As one of the nation’s leading safety advocates, the National Safety Council (NSC) spotlights issues in an effort to “eliminate preventable deaths at work, in homes and communities, and on the road through leadership, research, education and advocacy.” The organization has identified prescription drug misuse as one of its key safety issues because of the […]

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An Exploration of Addiction: The Teen Years

May 5, 2017An Exploration of Addiction

Recreational drug and alcohol use is oftentimes perceived as harmless, non-habit-forming behavior. In reality millions suffer from substance-abuse disorders that surfaced under the mask of recreational use. In this installment of our Exploration of Addiction series, we examine how addiction can take hold when our brains are at their most vulnerable and when life is […]

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Series: An Exploration of Addiction

March 21, 2017Blog Series

The term “recreational” defines as an activity done for enjoyment when one is not working. Skiing, knitting, sporting leagues, and book clubs are examples of recreational activities that can enhance our overall life experience. Recreational is also a word used to describe the casual use of mind-altering substances such as drugs and alcohol. Because recreational […]

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By the Numbers: Going Green with eCCF

March 1, 2017By the Numbers

Our By the Numbers blog series takes a closer look at the numbers, facts, data, and outputs that impact workplace drug testing programs. In this post, we examine the environmental impact of moving from paper-based custody and control forms (CCF) to electronic custody and control forms (eCCF). Paper-based CCFs have been a mainstay of the drug testing […]

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Weeding Out the Facts Webinar Recap

February 21, 2017Illicit drugs

Employers face challenges as states continue to pass marijuana legislation, while the substance is still illegal under federal law.  In our recent webinar, two highly-regarded industry experts, Dr. Barry Sample, Senior Director of Science and Technology, Quest Diagnostics, and D. Faye Caldwell, Attorney at Law, Caldwell Everson, presented facts and insight about marijuana and the workplace […]

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