workplace drug testing

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.

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 (DATIA) annual conference, a gathering of industry professionals focused on safety, regulatory affairs, ethics, and workplace drug testing education from all over the world.

In examining the latest data, Barry Sample, Ph.D., Senior Director of Science and Technology at Quest Diagnostics, said, “This year’s findings are remarkable because they show increased rates of drug positivity for the most common illicit drugs across virtually all drug test specimen types and in all testing populations.” He noted the following key findings from millions of workplace drug test results.

  • Overall positivity in urine drug testing among the combined U.S. workforce in 2016 was 4.2 percent, a five percent relative increase over last year’s rate of 4.0 percent, and the highest annual positivity rate since 2004 (4.5 percent).
  • Cocaine, marijuana, and methamphetamine use is up broadly among the U.S. workforce across multiple drug test specimen types and testing populations.
  • Cocaine positivity increased 12 percent in 2016, reaching a seven-year high of 0.28 percent.
  • The positivity rate for cocaine in post-accident urine drug tests was more than twice that of pre-employment urine drug tests in both the federally-mandated, safety-sensitive and the general U.S. workforces.
  • In Colorado and Washington, the overall urine positivity rate for marijuana outpaced the national average in 2016 for the first time since the recreational statutes took effect.
  • Year over year marijuana positivity increased nearly 75 percent in oral fluid testing. In addition, positivity increased in both urine and hair testing in the general U.S. workforce.
  • Between 2012 and 2016, methamphetamine positivity climbed 64 percent in the general U.S. workforce and 14 percent among federally-mandated, safety-sensitive workers.
  • Heroin detection, indicated by the presence of the 6-acetylmorphine (6-AM) metabolite, plateaued in the general U.S. workforce while prescription opiate detection declines.

“Once again, the DTI statistics reveal the on-going threat to workplace safety posed by substance abuse. While the national dialogue swirls around marijuana and opiate issues, we find cocaine—a substance with well-established dangers—continuing its troubling upswing not just in the general workforce, but in safety-sensitive jobs with federally-mandated testing,” said Matt Nieman, General Counsel, Institute for a Drug-Free Workplace and Principal, Jackson Lewis P.C. “That positive test results for cocaine persist, let alone are increasing, should serve as a reminder to employers and employees that there is no substitute for vigilance in any effective effort to thwart the potential impacts of workplace substance abuse.”

Along with this year’s data, we are offering an interactive map to illustrate overall positivity and positivity by drug for the past 10 years in urine testing. Users can search by both zip code and year for six illicit drugs: 6-AM (heroin metabolite), amphetamines, cocaine, marijuana, opiates, and PCP at QuestDiagnostics.com/DrugMap.

Workplace drug testing promotes a safe, healthy and productive environment for employees. Our analysis suggests that employers committed to creating a safe, drug-free work environment should be aware of the potential for drug use among their workforce.

Media coverage for the Drug Testing Index includes an exclusive story by The Wall Street Journal. Other press featuring the DTI includes: The Washington Post, CNBC’s Closing BellTIME magazineFortune, CBS Money WatchViceMarketWatchThe Chicago Tribune, Facility Safety Management, Business InsuranceInsurance Journal, Daily Republic, FOX Denver,  Newsday, NJBIANew Jersey’s NJ.comPittsburgh Post-Gazette, North Nevada Business Weekly, Dayton Daily News, Brevard Times, The National Law Review, PoliticoThe TruckerHR DiveMedical Laboratory Observer: LabLineCrime Report, Drug ChronicleSteelers LoungeSector PublishingDaily Caller, Newsmax Wires, RTBulk Transporter, Lexology, Daily Chew, NCASJunior College, Industry Week, Salon, ExamOne blogWSJ: The 10-Point, Construction Equipment, EHS Today, Kansas City Star, Baltimore Sun, Human Resources Executive, Society for Human Resources Management (SHRM), and USA TODAY Snapshot.

In addition, the Jimmy Kimmel Live show asked cited Quest Diagnostics data and in its Pedestrian Question segment asked people if they have ever been high at work.

Read the full press release for the latest DTI data as well as drug testing news and resources.

Download our new Quest Diagnostics Drug Testing Index brochure and the this year’s DTI infographics.

For more information about drug testing, visit our QuestDiagnostics.com/DTI or contact us online.

2017 National Prescription Drug Take-Back Day

April 14, 2017News

An ambulance blazes by a sea of idling cars in the midst of evening rush-hour. Weaving through traffic, the EMT’s singular goal is to arrive at the emergency room as quickly as possible. The passenger is a victim of accidental prescription drug poisoning. This scenario plays out daily in cities across the country. In fact, […]

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Winter Storm Stella May Cause Delays

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The National Weather service has issued winter storm warnings throughout the northeast, with likely impacts including Boston, Philadelphia, Baltimore, and Washington D.C. In addition, blizzard warnings have also been issued from northeast New Jersey to far southeast New York and southern Connecticut. Be aware that this hazardous storm may impact the logistics and transportation of […]

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I’m There: Charlie Sullivan

March 6, 2017We're There

Charlie Sullivan believes that if we take care of our employees, in turn, they will take care of our customers. As a result, he trains and mentors his team to focus on providing a seamless experience at our collection sites so that a donor’s first impression is a positive one. He understands that our frontline […]

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We’re There When You Need Us – 5 Years Strong

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While businesses are driven by profits and the necessity to grow, a team is shaped by people and their collective energy and commitment to drive both the business and culture forward. In 2011, we embarked on a journey with the goal of gaining a better understanding about our culture and its impacts on our customers, […]

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By the Numbers: Heroin Positivity Continues to Rise

December 15, 2016By 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 look at the heroin positivity rate. Headlines continue to put a spotlight on startling statistics about heroin addiction and sometimes feature shocking stories to warn the public of the drug’s dangers. The […]

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Navigating Global Drug Testing Webinar Highlights

December 14, 2016Webinars

Data privacy, drug screen turnaround time, collection network coverage, and logistics form the pillars of an effective international drug testing program. A “one size fits all” approach cannot be taken because factors such as culture, customs, currency, policies, and laws can vary greatly from country to country. In our most recent webinar, our experts offered […]

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By the Numbers: Drug Detection Window by Specimen Type

December 5, 2016By the Numbers

Our ongoing By the Numbers series takes a closer look at the numbers, facts, and data that impact workplace drug testing programs. This week, we examine one of the most frequently asked questions we receive as a laboratory: how long can drugs be detected using a drug test? The answer is not simple as you might think, […]

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By The Numbers: Oral Fluid Positivity

October 12, 2016By the Numbers

Our By the Numbers series takes a closer look at the numbers, facts, data, and outputs that impact workplace drug testing programs. In this post, we examine the surge in oral fluid drug testing positivity over the past three years. Laboratory-based oral fluid is reliable for detecting recent drug use, and because the collection is […]

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