The Drug Testing Process: How does it work?

There are 3 steps to a drug test: Collection, Lab, and MRO. As an employer, it is important that you understand these steps and the role they play when managing an effective and efficient drug testing program. Read below for details on each important step in the drug testing process:

 

1 Collection

The first step in a drug test is the collection of the specimen from the donor. This is performed by a Certified Specimen Collector using a Custody and Control Form (CCF) that accompanies the specimen through the testing process. The Collector is responsible for filling out the CCF accurately and completely. Strict procedures must be followed to ensure the collection is compliant and accurate. After collection, specimens are bundled together and shipped to a certified lab, typically every afternoon. Specimens are typically sent out of state, overnight to a SAMHSA-certified lab via FedEx or a lab courier.

2 Lab Analysis

After collection, drug test specimens are shipped to a certified lab to be analyzed. A typical lab processes thousands of specimens every day using Gas Chromatography-Mass Spectrometry (GCMS) or Liquid Chromatography-Mass Spectrometry (LCMS). After arriving at the lab, the specimen is opened and processed by a lab technician and accessioned for testing. Each specimen is touched/hand-entered by a lab employee. About 90% of tests received by the lab are analyzed and reported by EOB the same day they are received at the lab.

3 MRO Review

Once the specimen has been analyzed and reported by the lab, the result is sent to the Medical Review Officer (MRO). Two possibilities:

  • Negative Result: The MRO team matches the CCF to the result and reports the result to the employer
  • Non-Negative Result: A Medical Review Officer contacts the donor for an interview to determine if there is a legitimate/medical reason for the non-negative result. If the donor has an explanation that the MRO determines to be medically warranted, the MRO will release the result to the employer as a Negative. If the MRO determines there is not a medical explanation for a non-negative result (i.e., no valid prescription provided), then the result will be released as a Positive. The Non-Negative review process can take anywhere from 1 to 10 days depending on donor availability/cooperation, employer policy, and federal regulation.

 


Pro tips

For the quickest turnaround time, send employees for testing early in the day to ensure the specimen is shipped the same day.

 


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