Ask the Experts

Ask the Experts: What is POCT?

by Nicole Jupe on December 8, 2017

POCT is a common acronym in our industry that stands for point of collection test — an instant or rapid drug or alcohol test. A POCT  collection begins with a test administrator uses a portable device to screen urine or oral fluid and the device typically yields a result within minutes. This POCT snapshot be enough reflect a final test result for an employer. An instant test can be performed on-site at a place of business or in the field. However, some employers prefer that the test is collected and interpreted by a trained drug testing technician or collector at a brick and mortar collection site.

Best practices require that if an instant test specimen screens non-negative, it is sent to the laboratory for confirmatory testing. The lab will re-test the specimen to determine if drugs or alcohol are present and report a final result.

Employers tend to choose instant testing when the fast turnaround time of drug test results is a key requirement for their program. Although convenience and time are important variables of your program, it’s critical to consider all of the criteria and complexities before making a choice on a testing method. Factors to evaluate may include:

  • Overall objectives of your substance abuse program
  • State laws where your company conducts business
  • Added responsibility of collecting and interpreting test results
  • Drug panel configurations
  • Cutoff levels and device sensitivity
  • Susceptibility to donor adulteration or cheating
  • Value of an accurate drug test

At Quest Diagnostics, our drug testing methodology is sound. Laboratory certifications are in place to ensure that our processes, instrumentation, results, and personnel adhere to the highest standards of quality. Therefore, it is not a matter of choosing the single best drug and alcohol testing method, but rather selecting a method or combination of methods that best fits your company’s needs. In the end, accurately and reliably screening job applicants and employees to deter workplace alcohol and drug use remains paramount.

Weigh the pros and cons of instant drug and alcohol testing.

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

Staying compliant with new DOT regulations

by Nicole Jupe on November 29, 2017

Earlier this month, the U.S. Department of Transportation (DOT) amended its drug testing program regulations for all DOT employees effective January 1, 2018. This harmonizes DOT regulations with guidelines established by U.S. Health & Human Services (HHS) for federal drug testing programs. The most notable change with this new regulation is the addition of four Schedule II semi-synthetic opioids to the test panel: hydrocodone, oxycodone, hydromorphone, and oxymorphone.

Secretary of Transportation Elaine Chao said in a November 13 bulletin, “The opioid crisis is a threat to public safety when it involves safety-sensitive employees involved in the operation of any kind of vehicle or transport. The ability to test for a broader range of opioids will advance transportation safety significantly and provide another deterrence to opioid abuse, which will better protect the public and ultimately save lives.”

Dr. Barry Sample, Senior Director of Science and Technology,  Quest Diagnostics was interviewed by Transport Topics and said, “We fully expect to have more laboratory positives. And, I would expect there will be more Medical Review Officer positives as well. There will be additional specimens that screen positive that in the past would have been verified negatives. So those will have a longer turnaround time.”

Understanding the language in the Final Rule can be challenging. Therefore, our experts have answered some of the most frequently asked questions about the new guidance in an effort to prepare you for the DOT deadline.

Will there be a new name for the 5-panel DOT test since it will include additional drugs?

The DOT still considers this a 5-panel drug test, because there are no new classes, or groups, of drugs. Because all of these drugs are opioids, the test will continue to be referred to as a 5-panel test.

What is the difference between the terms opiates and opioids?
The term opiate has historically referred to a psychoactive substance found in, or derived from, the opium poppy, with certain structural characteristics common to the entire class. Opioid is a more modern term and includes naturally occurring (e.g., morphine), semi-synthetic (e.g., oxycodone), and synthetic (e.g., fentanyl) substances, as well as antagonists (e.g., naloxone) that interact (bind) with the opiate receptor in the body. In the context of the new DOT regulations, “opioids” refers to six specific opioid drugs included in the DOT panel.

Has Quest Diagnostics made any recent changes to its opiates panel?
Yes. We began using a new reagent/assay in April 2017 that is more sensitive and specific for detecting hydrocodone and hydromorphone in our semi-synthetic opiates immunoassay screening (initial) test. This enhancement offers a greater ability to detect these opiates.

Will my DOT look-alike drug test panel change on January 1, 2018?
No. This new regulation only impacts automatic changes made to the DOT drug testing on January 1, 2018. If you want your non-regulated panel, or DOT look-alike panel, to mirror the new DOT drug test panel, please contact your Sales or Account Management representative to make these changes.

When will the Federal Custody and Control Form (CCF) change with the new regulations?
Federal CCF forms used for DOT drug testing will not change until after January 1, 2018. Additionally, the 2014 Federal CCF is authorized for use until June 30, 2018. At this time, you should not order new paper CCF forms. For more information, see the DOT’s Notice: Federal Drug Testing Custody and Control Form

Can I use electronic Custody and Control Forms (eCCF) for DOT drug testing?
Yes. The eCCF process helps to bear the administrative burden and the eCCF form is available to begin using today, at no additional cost. Benefits of eCCF include fewer data-entry and legibility issues, less paper to manage, and improved overall efficiency. Get started today.

We are refining our laboratory testing and updating our IT systems to comply with all DOT requirements. Rest assured that all of Quest Diagnostics drug testing laboratories will be ready on January 1, 2018. Contact your Quest Diagnostics representative if you have additional questions about this new guidance.

The DOT Drug Testing: Employer DOT Policies – the Part 40 Changes helps to clarify company policy issues.

The most current guidance, DOT Drug Testing: Part 40 – Employee Notice, was published on December 12, 2017.

Read the full text or the Part 40 Final Rule – DOT summary of changes.

Get news and updates via email from the DOT by subscribing to the notification system , or list serve.

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


Ask the Experts: Cheating an oral fluid drug test

November 2, 2017Oral Fluid testing

Q: Is it possible for a donor to cheat an oral fluid drug test? Over time, we have heard about numerous attempts by individuals trying to cheat an oral fluid drug test. Examples include excessively rinsing with antiseptic mouthwash, chewing ice, eating Altoids® mints, drinking excessive amounts of water, using products that claim to clean […]

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Ask the Experts: Hair drug test specimens

October 17, 2017Hair testing

Q: Can a hair drug test be performed on someone with little or no hair? We get many questions from both individuals scheduled for a drug screen and employers in anticipation of a hair drug test. They wonder how much hair is needed, what part of the head is the hair is cut from, whether […]

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Ask the Experts: Hair drug test collections

August 4, 2017Hair testing

Question: How much hair is needed for a drug test? Rumors abound about exactly how much hair is snipped for a hair drug test. Some imagine they will suffer with a choppy, bad haircut or bald spot. Others fear they will lose their precious locks and require a hat wherever they go. In fact, quite […]

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Ask the Experts: Drug testing cutoffs

July 18, 2017Drug Testing

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 […]

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Ask the Experts: Six Sigma Quality

October 18, 2016Ask the Experts

Question: What is Six Sigma? Six Sigma is defined by the Council for Six Sigma Certification as “a set of business tools, statistical theory, and quality control knowledge that helps improve your business procedures. A Six Sigma process is expected to be free of defects with no more than 3.4 defective defects per million opportunities (DPMO).” […]

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Ask the Experts: Drug Test Collection Quality

September 30, 2016Collections

Question: With thousands of collectors across the U.S., how does Quest Diagnostics help ensure the quality of each drug test collection? As one of the first steps in the drug testing process, collections help build the foundation that enables our laboratories to operate as efficiently as they do. As such, it is imperative that we […]

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Ask the Experts: Drug Test Collection Site Options

July 26, 2016Collections

Question: With three types of drug test collection sites and thousands of locations, how do employers know which location best meets their needs? Our drug test collection site network consists of more than 8,000 locations across the U.S. This vast geographical coverage helps provide a convenient experience for our employer customers and their donors. That […]

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Ask the Experts: Effects of Hair Treatments on Drug Test Results

June 27, 2016Hair testing

Question: Can products and treatments affect hair drug test results?  Some employers who use hair testing as part of their workplace drug testing program wonder if hair products – like shampoos, sprays, gels, coloring, bleaching, and perming – can have an impact on their test results. We asked Dr. Barry Sample, Director of Science and […]

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