drug test drug test a drug test is a technical analysis of a biological specimen, for example urine, hair, blood, breath, sweat, or oral fluid/saliva—to determine the presence or absence of specified parent drugs or their metabolites. major applications of drug testing include detection of the presence of performance enhancing steroids in sport, employers and parole/probation officers screening for drugs prohibited by law (such as cocaine, methamphetamine, and heroin) and police officers testing for the presence and concentration of alcohol (ethanol) in the blood commonly referred to as bac (blood alcohol content). bac tests are typically administered via a breathalyzer while urinalysis is used for the vast majority of drug testing in sports and the workplace. numerous other methods with varying degrees of accuracy, sensitivity (detection threshold/cutoff), and detection periods exist. drug testmeshd015813 a drug test may also refer to a test that provides quantitative chemical analysis of an illegal drug, typically intended to help with responsible drug use. detection periods the detection windows depend upon multiple factors: drug class, amount and frequency of use, metabolic rate, body mass, age, overall health, and urine ph. for ease of use, the detection times of metabolites have been incorporated into each parent drug. for example, heroin and cocaine can only be detected for a few hours after use, but their metabolites can be detected for several days in urine. the chart depicts the longer detection times of the metabolites. oral fluid or saliva testing results for the most part mimic that of blood. the only exceptions are thc (tetrahydrocannabinol) and benzodiazepines. oral fluid will likely detect thc from ingestion up to a maximum period of 6–12 hours. this continues to cause difficulty in oral fluid detection of thc and benzodiazepines. breath air for the most part mimics blood tests as well. due to the very low levels of substances in the breath air, liquid chromatography—mass spectrometry has to be used to analyze the sample according to a recent publication wherein 12 analytes were investigated. rapid oral fluid products are not approved for use in workplace drug testing programs and are not fda cleared. using rapid oral fluid drug tests in the workplace is prohibited in only: california kansas maine minnesota new york vermont the following chart gives approximate detection periods for each substance by test type. approximate values for detection periods substanceurinehairblood / oral fluid alcohol 6–24 hours note: alcohol tests may measure ethyl glucuronide, which can stay in urine for up to 80 hoursup to 90 days12 to 24 hours amphetamines (except methamphetamine) 1 to 4 daysup to 90 days12 hours methamphetamine 5 days- up to a week up to 90 days1 to 3 days mdma (ecstasy) 3 to 5 daysup to 90 days3 to 4 days barbiturates (except phenobarbital) 1–4 days or 2–3 weeksup to 90 days1 to 2 days phenobarbital 2 to 3 weeksup to 90 days4 to 7 days benzodiazepines therapeutic use: up to 7 days. chronic use (over one year): 4 to 6 weeksup to 90 days6 to 48 hours cannabis passive inhalation: up to 22 minutes** infrequent users: 7–10 days heavy users: 30 to 100 daysup to 90 days2 to 3 days in blood, up to 2 weeks in blood of heavy users however, it depends on whether actual thc or thc metabolites are being tested for, the latter having a much longer detection time than the former. thc (found in marijuana) may only be detectable in saliva/oral fluid for 2 to 24 hours in most cases, though in rare cases has been detected up to 28 days after consumption. cocaine 2 to 5 days (with exceptions for heavy users who can test positive up to 4/6 weeks, and individuals with certain kidney disorders)up to 90 days2–10 days, heavy users or individuals with previous substance use 6/8 weeks codeine 2 to 3 days up to 90 days 1 to 4 days cotinine (a breakdown product of nicotine) 2 to 4 daysup to 90 days2 to 4 days morphine 2 to 4 daysup to 90 days1 to 3 days tricyclic antidepressants (tca's) 7 to 10 daysundetectabledetectable but dose relationship not established. lsd 1–4 days (including metabolites)up to 4 days2 to 4 days methadone 7 to 10 daysup to 90 days24 hours steroids 3 to 30 days pcp 3 to 7 days for single use; up to 30 days in chronic usersup to 90 days1 to 3 days types urine drug screen example of a device used to screen urine for drugs. there is no line present at the benzodiazepine area, indicating a positive screen for this class of drugs. other drugs, and the negative control (labelled "c"), are negative. urine analysis is primarily used because of its low cost. urine drug testing is one of the most common testing methods used. the enzyme-multiplied immune test is the most frequently used urinalysis. complaints have been made about the relatively high rates of false positives using this test. urine drug tests screen the urine for the presence of a parent drug or its metabolites. the level of drug or its metabolites is not predictive of when the drug was taken or how much the patient used. urine drug testing is an immunoassay based on the principle of competitive binding. drugs which may be present in the urine specimen compete against their respective drug conjugate for binding sites on their specific antibody. during testing, a urine specimen migrates upward by capillary action. a drug, if present in the urine specimen below its cut-off concentration, will not saturate the binding sites of its specific antibody. the antibody will then react with the drug-protein conjugate and a visible colored line will show up in the test line region of the specific drug strip. a common misconception is that a drug test that is testing for a class of drugs, for example, opioids, will detect all drugs of that class. however, most opioid tests will not reliably detect oxycodone, oxymorphone, meperidine, or fentanyl. likewise, most benzodiazepine drug tests will not reliably detect lorazepam. however, urine drug screens that test for a specific drug, rather than an entire class, are often available. when an employer requests a drug test from an employee, or a physician requests a drug test from a patient, the employee or patient is typically instructed to go to a collection site or their home. the urine sample goes through a specified 'chain of custody' to ensure that it is not tampered with or invalidated through lab or employee error. the patient or employee's urine is collected at a remote location in a specially designed secure cup, sealed with tamper-resistant tape, and sent to a testing laboratory to be screened for drugs (typically the substance abuse and mental health services administration 5 panel). the first step at the testing site is to split the urine into two aliquots. one aliquot is first screened for drugs using an analyzer that performs immunoassay as the initial screen. to ensure the specimen integrity and to detect possible adulterants, additional parameters are tested for. some test the properties of normal urine, such as, urine creatinine, ph, and specific gravity. others are intended to catch substances added to the urine to alter the test result, such as, oxidants (including bleach), nitrites, and gluteraldehyde. if the urine screen is positive then another aliquot of the sample is used to confirm the findings by gas chromatography—mass spectrometry (gc-ms) or liquid chromatography - mass spectrometry methodology. if requested by the physician or employer, certain drugs are screened for individually; these are generally drugs part of a chemical class that are, for one of many reasons, considered more habit-forming or of concern. for instance, oxycodone and diamorphine may be tested, both sedative analgesics. if such a test is not requested specifically, the more general test (in the preceding case, the test for opioids) will detect most of the drugs of a class, but the employer or physician will not have the benefit of the identity of the drug. employment-related test results are relayed to a medical review office (mro) where a medical physician reviews the results. if the result of the screen is negative, the mro informs the employer that the employee has no detectable drug in the urine, typically within 24 hours. however, if the test result of the immunoassay and gc-ms are non-negative and show a concentration level of parent drug or metabolite above the established limit, the mro contacts the employee to determine if there is any legitimate reason—such as a medical treatment or prescription. on-site instant drug testing is a more cost-efficient method of effectively detecting substance use amongst employees, as well as in rehabilitation programs to monitor patient progress. these instant tests can be used for both urine and saliva testing. although the accuracy of such tests varies with the manufacturer, some kits have rates of accuracy correlating closely with laboratory test results. breath test breath test being used on a volunteer. breath test is a widespread method for quickly determining alcohol intoxication. a breath test measures the alcohol concentration in the body by a deep-lung breath. there are different instruments used for measuring the alcohol content of an individual though their breath. breathalyzer is a widely known instrument which was developed in 1954 and contained chemicals unlike other breath-testing instruments. more modernly used instruments are the infrared light-absorption devices and fuel cell detectors, these two testers are microprocessor controlled meaning the operator only has to press the start button. to get accurate readings on a breath-testing device the individual must blow for approximately 6 seconds and need to contain roughly 1.1 to 1.5 liters of breath. for a breath-test to result accurately and truly an operator must take steps such as avoiding measuring “mouth alcohol” which is a result from regurgitation, belching, or recent intake of an alcoholic beverage. to avoid measuring “mouth alcohol” the operator must not allow the individual that's taking the test to consume any materials for at least fifteen minutes before the breath test. when pulled over for a driving violation if an individual in the united states refuses to take a breath test that individual's driver's license can be suspended for a 6 to 12 months time period. hair testing main article: hair analysis hair analysis to detect addictive substances has been used by court systems in the united states, united kingdom, canada, and other countries worldwide. in the united states, hair testing has been accepted in court cases as forensic evidence following the frye rule, the federal rules of evidence, and the daubert rule. as such, hair testing results are legally and scientifically recognized as admissible evidence. although some lower courts may have accepted hair test evidence, there is no controlling judicial ruling in either the federal or any state system declaring any type of hair test as reliable. hair testing is now recognized in both the uk and us judicial systems. there are guidelines for hair testing that have been published by the society of hair testing (a private company in france) that specify the markers to be tested for and the cutoff concentrations that need to be tested. addictive substances that can be detected include cannabis, cocaine, amphetamines and drugs new to the uk such as mephedrone. alcohol in contrast to other drugs consumed, alcohol is deposited directly in the hair. for this reason the investigation procedure looks for direct products of ethanol metabolism. the main part of alcohol is oxidized in the human body. this means it is released as water and carbon dioxide. one part of the alcohol reacts with fatty acids to produce esters. the sum of the concentrations of four of these fatty acid ethyl esters (faees: ethyl myristate, ethyl palmitate, ethyl oleate and ethyl stearate) are used as indicators of the alcohol consumption. the amounts found in hair are measured in nanograms (one nanogram equals only one billionth of a gram), however with the benefit of modern technology, it is possible to detect such small amounts. in the detection of ethyl glucuronide, or etg, testing can detect amounts in picograms (one picogram equals 0.001 nanograms). however, there is one major difference between most drugs and alcohol metabolites in the way in which they enter into the hair: on the one hand like other drugs faees enter into the hair