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Let’s Talk About How Drug Tests Work & What False Positives Are

I’ve always found one of the best ways to keep up to date on drug testing policy, understand the thinking behind it, the technology, and how to avoid the whole mess, is to read the industry blogs and papers.

I follow them on Twitter, I have an RSS feed dedicated to following relevant industry news, and I have tried to keep up to date on changes in technology and public information.

What you have to understand is that it’s an industry. Driven by stoking fear around your workforce being incompetent because they are off their faces.

That’s obviously simply not true, and the fact is that less than 4% of the American population regularly take illegal substances or prescription medications they shouldn’t; yet most employers spend millions every year trying to eradicate that small amount of people.

So I want to do here is recapture on some of the latest things being chatted about by drug industry people. Specifically, the basics around drug testing, policies, ideology, and importantly, the topic of false positives which many people simply don’t understand.

The Challenges Facing Drug Testing Right Now

The biggest challenge facing drug testing is obviously the pandemic. Read industry blogs and it’s all they talk about, but that’s in common with pretty much everything right now.

Also, the USA especially is going through and opioid abuse crisis. It’s getting worse, and not enough is being done.

Even worse than that, is the problem around the legalization of marijuana. That’s an absolute legal minefield, especially when state law suddenly says recreational use is fine, that company policy forbids it. What happens if they fire someone for having cannabis metabolites in their system?

According to Quest Diagnostics, in 2021 positive drug tests have hit their highest level in 20 years.

Now that’s surprising to me, because I would have thought that those rates were going up and up from the 1960s onwards, but in actual fact they have been going down until recently.

It doesn’t take a genius to work out that the pandemic is part of the problem. There’s a lot of social despair out there, and a lot of social gap filling being undertaken with illicit substances.

Interestingly, when they talk about drug testing, they are also talking about alcohol testing. That’s becoming more widespread now than ever, and I suspect that’s part of the problem. So a takeaway for me is that alcohol needs to be thought of far more seriously when you go for a drug test than previously.

Why Companies Do Drug Testing

In order to understand how to evade a drug test you have to understand why companies do them in the first place.

The reasons for implementing drug policies will be different depending on the employer.

Some are simply regulated industries which require testing. This is mostly due to safety. Think about truck drivers needing them, would you want to be on the road with someone high on cocaine driving a 30 ton semi?

It’s also about saving face. This is the case for federal employees. It may not impact on your job, but obviously the federal government, and even companies who are contractors of the federal government, are mostly subject to rigorous drug testing policies in comparison to the private sector.

It’s also about legal action. If you’re intoxicated, you could cause problems with clients and customers, lose the company money and reputation, or cause injury or damage.

Bizarrely, but potentially unsurprising to most people, drug testing is rarely about people’s ability to do a job.

The percentage of people turning up at work who are unfit to do their job because of drugs or alcohol is absolutely minuscule, and simply doesn’t justify the multibillion-dollar industry set against them.

So be clear here, companies don’t drug test to get you to perform better on an individual basis. They do it to save money, save face, stop lawsuits, and comply with legislation. All stoked with fear by the multibillion-dollar drug testing industry who are always right there to tell everyone how people who ever take drugs are causing companies a loss in revenue.

Whether that loss in revenue is anywhere near what it costs to sustain the incredible level of drug testing in the USA is never answered.

Is Your Employment Contract/Employer Clear On Drug Test Policy?

So there are a multitude of reasons why companies have drug test policies, and none of them really relate to the issue around drugs they should. It’s all about money in all honesty. That comes out on the blogs I read.

It’s crucial you understand the drug test policy the company you work for. You have to understand when you should be drug tested, could be drug tested, employment expectations around drugs, and what happens if you fail a test or refuse one.

The problem is it’s complex because the company policy can contradict state law, and industry regulations.

Why Do Drug Test Policies Vary So Much?

Drug test policies vary because of everything I’ve just mentioned. The huge morass of state law, federal law, social conventions and expectations, mixed up with company procedures, and even localized city and county laws/regulations. All rolled up with different industry regulations and guidelines as well.

A lot of people go online to research drug testing for the company they work for (or are looking to work for) and get very confused. Some sites like “glass door” will have hundreds of people telling you that X company does Y type of drug testing in Z location.

Someone else will come along and contradict that. Then someone else contradicts it again.

You have to remember the morass I’ve just talked about. Also thrown into that mix is the fact that a lot of companies are decentralized, and can even be franchises.

I’ve worked for a company that was a franchise business. The branch I worked at had urine sample drug testing during pre-employment, and urine sample drug testing with reasonable suspicion of being under the influence.

Down the road, literally a mile away, an identical branch of the franchise didn’t bother testing people I knew during pre-employment, and did mouth swab drug testing on the spot under suspicion.

Company policy didn’t specify any specific type of drug test or situation, just the clause about reasonable suspicion. That’s exactly why you can get so many contradictory pieces of evidence that don’t allow you to prepare a certain type of drug test under a certain set of circumstances.

False Positives Explained

People may have heard of them, but very few understand what happens when you have one, or in fact what causes one in the first place.

The false positive happens when the panel test react to the presence of a substance that isn’t actually in your sample.

In some studies, as many as 5% of drug tests produce false positives, even in the modern digital age.

One example of this is kratom. It’s not a full agonist of the opioid receptors in the way that heroin and other opiates are, yet it can produce waste products that are similar, and it can trigger false positives on a drug test.

That has led to assumptions amongst people online drug test to look for kratom. The truth is drug tests do not look for kratom, it’s these false positives amongst people who test the kratom, who then can’t explain the false positive other than to admit kratom use, that is the actual problem.

If there is a false positive you will be contacted by an officer from the company you took the test. They will ask you more detailed questions about your lifestyle and what you may have taken in the two or three days before your test to try and pin down the false positive could be.

That’s why you have to be incredibly careful about get caught out this way and answering those questions. It’s better to say “I don’t know”, than to start blurting out that you take kratom.

What Can Cause A False Positive?

Let’s just finish by telling what can cause a false positive. It could be over the counter prescription drugs, things like painkillers and cold remedies.

Nasal decongestants, diabetes medications, there’s actually a huge list of things which can in rare circumstances trigger false positives.

For example, hayfever remedies, cold remedies, nasal decongestants, and some bodybuilding supplement can all test positive for amphetamines.

Nootropics, not looked for on drug tests, can be stimulants, or mimic benzodiazepines, barbiturates, or even methadone.

So before you go for a drug test, be very aware of what you are taking and how it could cause a false positive.

My advice is if you have taken literally anything in three days before a drug test, you should be half expecting a call about a false positive result. Be aware, and have your response prepared.