Ask the Experts

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.

Ask the Experts: Six Sigma Quality

by Nicole Jupe on October 18, 2016

six-sigmaQuestion: 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).” In many organizations, Six Sigma means a standard of quality near perfection. It champions total customer satisfaction. The Six Sigma methodology was introduced in 1986 by an engineer in Motorola and Jack Welch brought it greater fame in the 1990s when he put it at the core of GE’s business strategy and culture. Many industries used Six Sigma today.

At Quest Diagnostics, Six Sigma means that subject matter experts, armed with data and knowledge, work together in teams to identify defects and improve the quality of our processes and products. A defect, according to Six Sigma, is anything outside customer specifications. Our company has Black Belts (project managers) deployed in every Quest Diagnostics business unit trained lead Six Sigma improvement projects that touch areas such as our laboratory, Patient Service Centers, logistics, specimen processing, client services, billing, and information technology.

Furthermore, Six Sigma is integrated in The Quest Management System (QMS) which guides all of our employees to work using the same foundational values and behavioral norms. QMS prioritizes efforts according to what’s most important to our customers and what continually advances our operational efficiency.

We are committed to exceptional quality in drug testing. We embrace change, strive to solve problems and take corrective actions, listen to employee feedback and customer insights, and engage the hearts and minds of our workforce to achieve success. These same qualities mirror the fundamental practices of Six Sigma.

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

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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Ask the Experts: Marijuana Legalization and Workplace Drug Testing

April 1, 2015Drug Testing

Question: Does marijuana “legalization” affect workplace drug testing? 23 states and the District of Columbia (D.C.) have legalized marijuana for medical purposes and five of these jurisdictions – Colorado, Washington, Oregon, Alaska and D.C. – have legalized marijuana for recreational use. However, the federal government still classifies marijuana as a Schedule I drug – meaning […]

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Ask the Experts: Under the Influence

September 8, 2014Oral Fluid testing

Question: Marijuana legislation is impacting the state in which I run my business. I’ve heard that oral fluid is the best drug test specimen type for determining whether an employee is under the influence of drugs – particularly marijuana – while they’re at work. Is this true? This is a newly emerging and complex issue that is most […]

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Ask the Experts: Urine – The ‘Gold Standard’ of Drug Testing

August 28, 2014Urine testing

Question: Why is urine testing the most frequently used method for drug testing? Businesses that drug test their applicants and employees do so to minimize their exposure to the risks of employee drug use. While all drug test specimen types – urine, oral fluid and hair – have their advantages, urine drug testing is by […]

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Ask the Experts: Reasonable Suspicion Drug Testing

July 17, 2014Ask the Experts

Question: If I suspect my employee is under the influence of drugs or alcohol at work, what can I do? Employers who implement pre-employment drug testing programs do so to protect their businesses from the impact of drug abuse before making hiring decisions. As a result, they help to strengthen the integrity of their workplace […]

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Ask the Experts: Hair Testing vs. Hair Follicle Testing

July 3, 2014Hair testing

Question: What is the difference between hair testing and hair follicle testing? Calling a hair test a hair follicle test is a common misnomer. We looked to Jarod Rowland, a scientific expert in our Lenexa, Kansas hair testing laboratory, to better understand hair testing terminology and the hair testing collection process. The hair follicle is […]

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