Q: I was told by my attorney that I need to get a drug screen. Is there a “regular” drug screen, or one that tests for everything?
A: Unfortunately, no. There are dozens (if not more) of different drugs that can be included in a drug screen. There is no such thing as a “regular” screen, or a one size fits all screen. Every situation is different, and while one person may need to prove that they aren’t using something like THC or cocaine—another person may need to prove that they aren’t using a prescription for an opioid like Oxycodone, or that they have recently ingested alcohol. Not all drugs are included on every drug screen, and the number of drugs that need to be included in the drug screen are directly related to how much it will cost. To provide a substance abuse screen that meets your specific needs we need to at least know what you have been accused of—or what you would like to test for. Once we know those things we can make recommendations and provide pricing for your test.
Q: Since THC has now been legalized in many states, why is it a problem if my drug screen shows I’m positive for it?
A: Although THC is legal in many states now, the decision to allow it or not in a workplace is up to the employer who has ordered your drug screen. In States such as Washington and Oregon—the drugs that are included in employers’ workplace testing policies are determined by the employers, not by the State or the government. If you are an employee covered by Department of Transportation (DOT) regulations, the DOT does not currently recognize THC as an uncontrolled substance and therefore it is not allowed, regardless of what State you live in, or what your reasons are for using it. If you use THC, It is best to ask your potential employer about their drug testing policy regarding THC before you apply for the job so that you know what to expect.
Q: What is the difference between an opiate and an opioid and aren’t they on all drug screens?
A: Opiates include heroin, codeine and morphine. Opioids include prescription narcotics used to control pain. The most common opioids are hydrocodone (Vicodin), oxycontin, oxycodone and hydromorphone (Dilaudid). Fentanyl and Sufentanyl are also opioids. Although most drug screens include opiates, opioids must be added by request and will normally add to the cost of the test.
Q: What happens if I test positive for something that I have a prescription for?
A: If you are being tested by your employer and your results are positive due to a prescription, your employer can request a medical review. A physician called a Medical Review Officer (or MRO) who is trained to review drug screen results will call you to go over your results with you. You may be asked to provide proof that your prescription is valid, meaning that it belongs to you, that it is not expired, and that you are using it as prescribed. Based on this interview, the MRO has the authority to “overturn” your results from positive to negative. Keep in mind that if you work in a position that is considered to be safety-sensitive, the MRO may also recommend that you undergo a fitness for duty exam to determine if your prescription could interfere with your ability to perform your job while taking it.
Q: I have to have a hair follicle drug screen. Will my hair be pulled out or cut? Where will it be taken from?
A: Hair is never pulled out of the scalp for a hair drug screen as it is not necessary to have the root of the hair follicle to determine if drugs (or alcohol) have been used. Instead, hair is cut at the scalp and then placed onto a foil strip with the root ends pointing the same direction. The foil is then carefully folded or closed around the hair and placed into a paper envelope along with a copy of the completed chain of custody form for transport to the lab. Hair on the scalp is collected from what is called the “crown” of the head, which is a horseshoe-shaped zone on the top of the back of the scalp, where a hat (or crown) would sit. Hair is taken from this zone because hair in this area is more active in the uptake of nutrients (and metabolites) from the circulatory system than hair from other parts of the scalp. If there is not enough hair on the scalp to collect, hair can be taken from the body. Body hair is collected with an electric razor is also never pulled from the body.
Q: I color my hair. Can it still be used for drug screens?
A: Color can affect the accuracy of a hair drug screen. For this reason, hair that has very recently been colored should not be collected. If enough time has passed that uncolored hair has grown above the scalp, the specimen collector may proceed with the collection, but notes must be added to the laboratory chain of custody so that the laboratory knows that the sample may contain colored and uncolored hair. If you have recently colored your hair and you are using your hair test results for a court case, you should check with your attorney before proceeding with the specimen collection.
Q: What if I bleach my hair? Can it be used for drug screens?
A: No. Bleached hair is not acceptable for drug screens, as the bleach destroys the hair follicle, making it brittle and easily broken.
Q: I have to have a nail drug screen. What should I expect?
A: In order for nails to be used for a drug screen they must be free of colors or gels. Any paint or gel must be removed professionally. Nails that are covered by acrylics can not be used and must be grown out naturally before they can be collected. In order to collect nails for a drug screen, all 10 digits (fingers or toes) must have enough nail grown out so that a minimum of 2mm can be cut from each one. If nails are broken or chipped, even from just one finger or toe—it may not be possible to proceed with the test. During the collection, the specimen collector will open a sterile collection kit and will then use clippers that have been cleaned and disinfected. The collector will ask the donor to cut his/her nails under supervision, clipping them over a clean, white background. Nails are collected from each digit and then placed into a foil container. The tops of the finger or toenails that remain on the hand or foot are then lightly sanded and the powder placed into the same foil container. The specimen is then placed into a specimen bag along with the completed chain of custody and sent to the lab for analysis.
Q: I have been instructed to take a urine drug screen for court. What should I expect?
A: All drug screens that are used in court, or for legal purposes, are directly-observed by a same gender specimen collector who will watch the urine pass from the body into the cup. This is required in order to provide proof that the donor has not adulterated their specimen.
About the Insulin Treated Diabetes Mellitus (ITDM) Assessment Form, MCSA-5870
As a part of the medical certification process for insulin treated diabetes mellitus (ITDM) individuals, the Federal Motor Carrier Safety Administration requires that the Insulin Treated Diabetes Mellitus Assessment Form (ITDM), MCSA-5870, be completed by the ITDM individual’s Treating Clinician attesting that the individual has a stable insulin regimen and properly controlled diabetes. ITDM individuals are required to provide the ITDM Assessment Form, MCSA-5870, to the Certified Medical Examiner within 45 days of completion by the Treating Clinician.
Merchant Mariner Credential Medical Evaluation Report (CG-719 K) and the Merchant Mariner Evaluation of Fitness for Entry Level Ratings (CG-719 K/E)
The CG-719 K/E form should be used only by mariners seeking an entry level merchant mariner credential. This form is limited to applicants for the following rating endorsements: Ordinary Seaman, Wiper, or Steward's Department (food handler). The CG-719K form should be used for all other endorsement applications.