Medical Review Officer. If your test result is 'negative', the information can be given directly to your employer. However a 'positive' test result is usually sent directly to a nominated Medical Review Officer (MRO), a qualified physician who reviews and interprets the results on behalf of the employer and independently of the laboratory. The doctor may consider your medical history and prescribed medication when assessing the results. Sometimes he may ask to speak with you.

When samples are sent to the laboratory for analysis, a special chain-of-custody form is completed. Laboratory reports are linked to an individual donor’s sample by unique identifiers; donor names are generally not included in the laboratory report.

Your employer has the right to set up a testing program for alcohol and drug abuse. Under most circumstances the types of tests, and the drugs included in the test panel, can all be determined by your employer. There are 'standard panels' however which are used by many employers. Local drug abuse patterns may also be taken into consideration by your employer when choosing a drug panel.

A cut-off level is a drug concentration value used to determine if a sample is to be considered positive or negative. Much research has been carried out to determine optimum cut-off levels and these have been standardized within the drug testing industry. For example, if the test were to be too sensitive (low cut-off), there could be the danger of a positive result being given for innocent exposure to a drug - such as 'passive' smoking of cannabis.

When both screening and confirmatory tests are conducted, the combined tests themselves are virtually 100% dependable.

Most company drug testing policies call for some form of disciplinary action up to and including dismissal.

Collection usually occurs on company premises. Sometimes the collection may take place in NIVHA premises.

A urine collection site must at a minimum provide:

- An enclosure where privacy for urination is possible.

- A toilet for urination

- A source of water for washing hands; alcohol-free wipes can also be used.

- A suitable writing surface for completing the required paperwork

- Restricted access so that the site is secure during collection.

An oral fluid collection site does not require the availability of toilet facilities.

Most employee drug testing involves the collection & testing of urine or oral fluid (saliva) specimens. Test results are reported as either POSITIVE or NEGATIVE for drugs.

Analysis cannot determine if a particular individual is "impaired" by the drug, and it cannot tell accurately when an individual last used a drug.

Testing is a two-stage process. First, an initial (screening) test is administered. If it is positive for one or more drugs, then a second, confirmatory test is conducted for each identified drug.

Screening tests may be carried out on-site (at the time of collection) or in the laboratory.

The confirmation test uses a different, more sophisticated analytical process in a laboratory. It ensures that any drugs present are identified with certainty and their concentrations determined.

Samples to be submitted for laboratory analysis are collected by a person trained in the collection process. Samples are sealed and labeled and along with accompanying paperwork, are sent to the laboratory. Each step of the process is documented on a "chain of custody" form. The collection and chain of custody procedures ensure the specimen is properly identified and tracked throughout the testing process.

A urine specimen is divided into 2 or 3 portions at the time of collection. All bottles are sent to the laboratory, but only the primary specimen is opened and used for the initial screening and confirmatory tests. The other specimen bottle remains sealed and is stored at the laboratory.

In oral fluid testing, a single sample of fluid is initially collected and usually tested on-site using a screening device. If a positive screening result is obtained, a further sample of oral fluid (or urine) must be collected for laboratory analysis. In some circumstances a laboratory sample can be collected at the outset and sent to the laboratory for analysis.

If the confirmation test on the primary specimen is positive, the employee can request that the other specimen (commonly referred to as the ‘B’ sample) be sent to another accredited laboratory for analysis. The split specimen procedure essentially gives employees an opportunity for a "second opinion" if their drug test comes out positive.

You do not have to strip or wear a gown. The collector however can ask the individual to remove any unnecessary outer garments such as a coat or jacket that might conceal items or substances that could be used to tamper with or adulterate the individual's urine specimen.

It should also be noted that if a collector, during the course of a collection procedure, suspects an individual may attempt to tamper with or adulterate a specimen, as evidenced by a bulging or overstuffed pocket, for example, the collector may request that the donor empty his or her pockets, display the items and explain the need for them during the collection.

Oral fluid collection is much less susceptible to tampering or adulteration.

Not very much. At least fifty (50) milliliters is required.

If the donor is unable to provide a specimen initially, water is offered, with the dual objective of assisting the willing donor and encouraging the non-willing donor. If after a reasonable waiting time a specimen is not forthcoming, the employer is informed that the donor has been unable to provide.

If fluid is ingested during this time period it is highly unlikely that a sample could not be provided. In such circumstances it may be necessary to determine if there could be a medical reason for the inability to provide a sample and consequently the case can be referred to a Medical Review Officer (MRO) for review.

Urine - That depends on the drug, the amount of drug and your metabolism. Many of the tested drugs can be detected for several days after use. Cannabis metabolite can be detected for longer - up to several weeks in regular users.

Oral Fluid – in general, the detection window  for drugs in oral fluid is shorter than for urine, depending on dose.

Research experiments have been conducted where non-smoking individuals have been exposed to heavy concentrations of marijuana smoke in confined spaces. Although nonsmoking individuals can absorb some of the drug, it would be highly unlikely for the drug concentration to exceed the industry standard cutoffs.

If you are taking prescribed medication for a specific condition, you should continue taking it. You will be given the opportunity to declare any medication at the time of sampling and advise the MRO of this fact. As for food and drink, there's no reason not to eat and drink as usual. Women need not declare use of the birth control pill. Men need not declare use of erectile dysfunction drugs such as Viagra.

Testing laboratories use "cutoff limits" to determine if a specimen is positive or negative. Cut-off limit guidelines are used for both oral fluid and urine drug testing. A negative result indicates the level of a drug or alcohol being tested for is either not present or is below the cut-off concentration. A positive result indicates the substance is present at a level above the cutoff limit.

Internationally agreed  and standardized cut-offs are usually used for this type of work.

Physical impairment according to a given concentration is not the issue. The issue is whether or not illegal drugs are being used at all, and whether or not drug and alcohol abuse is taking place.

This is probably the most confusing issue regarding drug testing. Simply put, the tests are very accurate. If, during screening, a positive result is obtained, it is called a "presumed" positive. Some over-the-counter and prescription medications can give rise to presumptive positive results, but the subsequent confirmatory tests will rule out any illicit substances. What is generally called a "false" positive is simply a result that has not been confirmed to be a target drug of abuse.

The MRO is a registered physician with knowledge of substance abuse disorders. Typically an MRO is a qualified occupational physician.

You can request a re-test. You will not be permitted to provide a new specimen. The secondary specimen (‘B’ sample) taken at the time of donation will be opened and tested in another laboratory to confirm or refute the first positive report. You will normally have to pay for this re-test. It is worth noting that ‘B’ samples are routinely transferred directly between laboratories and are not returned to the individual concerned.

That's a question you have to answer for yourself. But you owe it to yourself, the people who work with you and the person with the problem to seriously consider discussing it with your supervisor, shop steward or union representative. Whether or not you discuss it with the person who has the problem depends to a great extent on your relationship with that person. Most of the time it's not advisable. A person with a serious problem, whether it's drugs or alcohol, usually needs professional help.

That depends on your company and its policies and procedures. However, company policies usually facilitate treatment & encourage self-referral.

Study your company's Policies and Procedures carefully.

Usually not. However, if you dispute a test and request a re-test in another laboratory, you will normally be expected to pay for it.

Usully not. However, if you dispute a test and request a re-test in another laboratory, you will normally be expected to pay for it.

Urine alcohol and drug testing is well established. Since the 1980's many millions of specimens have been collected throughout the world for this purpose and much research has taken place with respect to workplace urine testing.

Oral fluid testing is now increasing in popularity due to its ease of collection and donor acceptance. Guidelines exist for oral fluid testing practices.

Because of health and safety issues the sampling of blood from individuals for workplace testing is not recommended. Oral fluid testing is now becoming the primary testing sample type.

Alcohol - breathtesting is the primary means of detecting alcohol. The technology for breathtesting is well established and the principles are enshrined within drink-drive legislation.

Drugs - saliva (oral fluid) testing represents an attractive alternative to urine drug testing and is now mainstream in many circumstances.

Hair Testing can be appropriate if retrospective drug abuse is to be detected. The detection of drugs in urine is only possible for a finite time after the last instance of use (several days, although cannabis can be detected for weeks). Drugs however become incorporated into growing hair and the analysis of a hair sample can provide useful historical drug abuse information. As scalp hair grows at about 1 cm per month, the analysis of a proximal 3-cm length of hair represents a 3-month retrospective time period. Hair testing reflects drug use over the entire growth period of the hair however and is unlikely to detect occasional or low-level use. Hair analysis can also be used to help in the assessment of alcohol consumption.