Welcome to Your Drug Test

What to Expect From Your Urine Test

Imagine you're a high school student in one of the five percent of districts nationwide that drug tests students. The majority of schools test only athletes, so let's say you're on the basketball team. Or maybe you work for one of the major U.S. companies that drug tests their employees. According to the American Management Association, nearly 100 percent of Fortune 500 companies conduct pre-employment and random drug tests on employees. In either case, this is it. You've been called to report for a urine test. Here's what to expect.

In most high schools, students are tested in the school building. Some tests are administered by the school nurse or the school contracts a team from the testing lab to come once a month to collect urine from students. Most companies require their employees to go to a lab for their test.

You'll probably be asked to present an acceptable form of identification, so that the person trained to receive, inspect, and ship urine samples (the "collector") can confirm that you are the person to be tested. The collector will note what type of identification you offer.

The collector will ask you to remove unnecessary layers of clothing (e.g., coats, jackets, or a sweater), and may tell you to empty your pockets. Collectors are instructed to look for evidence that a donor plans to tamper with the collection process. Donors are typically allowed privacy while urinating, but if the collector thinks you intend to substitute, dilute or adulterate your sample, he or she will most likely decide to conduct a direct-observation collection (in which a same-gender observer accompanies you into the bathroom stall).

You will be given a sealed collection container with graduated markings. Collection containers have a wide mouth, and are large enough to hold at least 55 mL of urine -- a bit larger than a shot glass.

Before producing the sample, you should wash and dry your hands. Any chemicals or other residue on your skin could contaminate the specimen, and
invalidate the test. After you wash your hands, water in the sinks may be cut off. The water in the toilets will likely be dyed, to prevent you from diluting or adulterating the sample. Unless there are reasons to suspect you will tamper with the specimen, you should be allowed to fill the specimen cup in the privacy of a closed toilet stall. The collector may stand outside the stall, however, to listen for any unusual noises.

Once the collection cup is filled, you should seal the lid and hand it to the collector, who will measure the specimen's temperature, the volume, and inspect it visually for evidence of contamination (e.g., floating particles, unusual color or odor). SAMHSA's standards allow a temperature range between 90 and 100 degrees, and require a minimum of 30 mL of urine. Depending on what kind of testing is to be done, the sample may be transferred to a single specimen bottle, or divided into two specimen bottles.

You and the collector both have to sign a chain-of-custody form, affirming that the specimen is appropriately labeled and that there were no irregularities in the collection. The form is then sealed in a plastic bag with the specimen and sent to an outside laboratory for analysis.

At the laboratory, specimens are initially screened for validity (any evidence of adulteration or contamination), and then for a specific group of drugs or drug metabolites. The most common urine test screen for evidence of THC (the active ingredient in marijuana), cocaine, amphetamines, opiates and phencyclidine (PCP). This first round of testing is most often done by immunoassay (a process where antibodies react in the presence of target chemicals or metabolites). Specimens that test negative for all drugs and metabolites are presumed to be negative, and undergo no further testing.

Methamphetamine:3-5+ days in urine

1-3 days in blood

Cocaine:5 hours in blood

12 hours-3 days in urine

Codeine:2-3 days in urine
Morphine:3-4 days in urine
Heroin:3-4 days in urine
PCP:1-3 days in blood

3-7+ days in urine

Marijuana (THC):2-3 days in blood, infrequent user; up to 2 weeks in blood,

heavy user

Several days to 30 days in urine; up to 3 months in heavy user

Specimens that test positive on the initial test are re-tested, using a more exact method, usually gas chromatography/mass spectrometry. This confirmatory test provides better evidence that a specific drug or metabolite is present. Finally, SAMHSA's guidelines call for a physician to consult with the donor, to learn whether any prescription medicines could have affected the testing procedure and, if that is not the case, to consult with the donor on substance abuse treatment.

One of the fastest-growing segments of the industry is on-site testing, in which testing companies provide simple kits for employers or schools to do their own testing. While these kits must still be approved by the FDA, they rely solely upon immunoassay analysis for their results. SAMHSA recommends all positives be confirmed by an outside laboratory, but legal guidelines vary widely. If you fail an on-site test, you may want to seek out another kind of testing, through an independent lab that performs gas chromatography/mass spectrometry.

An Office of National Drug Control Policy pamphlet on drug testing.(.pdf file)
Drug Policy Alliance page on drug testing.
Recent Monitoring the Future study on effectiveness of school drug testing. (pdf file)
Article on saliva testing in schools from the International Journal of Drug Testing.
Draft SAMHSA guidelines for federal workplace drug testing programs.
Federal workplace urine specimen collection handbook.