FAA requires six main types of drug-monitoring tests, which apply to all
employees occupying safety- or security-sensitive positions (Testing Designated
Position). TDPs are subject to:
drug test is given after an applicant has been considered for a job, but before
the employment offer has been made. This practice has been questioned legally.
Most companies now use a pre-placement test, which is given after an offer of
employment has been made. The offer of employment is made conditional upon
passing the drug screen. This is also called a post-offer test.
also known as reasonable
cause or for cause
suspicion test is given to an employee who is suspected of using a prohibited
drug. In DOT-regulated programs, “reasonable suspicion” occurs when a
supervisor (some DOT programs require two supervisors) has observed conduct or
appearance suggesting drug use. In non-DOT programs, the basis for reasonable
suspicion may be defined by state law, company policy, or by company agreements
with the employee’s union.
have a policy in which a drug test is automatically given to any employee
involved in an accident or other serious incident.
A test is given to
employees selected at random, without warning.
A test given to an
employee who has previously had a positive drug test or has previously refused
to submit to testing (and was therefore removed from work), before he or she
returns to work.
Testing done on a
frequent, unannounced schedule after an employee has passed a return-to-duty
test. Most DOT programs require a minimum of six follow-up tests in the first 12
months, and continue follow-up testing for up to five years.
Non-TDP employees are
subject only to reasonable suspicion, post-accident, and follow-up testing.
are people tested for drugs?
use can be determined by testing almost any tissue in the body. For example,
fatal accident victims are often tested by analysis of the vitreous humor inside
the eyeball. Some bodily tissues can be tested for toxic substances after a
period of months or even years—such as the bones or hair of historical figures
who died hundreds of years ago.
In current testing
programs, the following body substances are used:
Urine testing is by far the most common. It is easy to collect, can be collected
on the job site, and is a good indicator of recent drug use. Almost all drugs
can be detected in urine; an exception is methaqualone (Quaaludes).
Hair testing is usually used
for investigations when other tests are not available, such as in criminal cases
or deaths. Hair can be tested for most drugs.
advantage of testing hair is the long period of detection: the life span of a
typical hair ranges from about four months for hairs from the eyelashes or arm
pit, to four years for hair from the scalp. Hair grows at a rate of about one
quarter to one half inch per month. Drugs enter the hair while it is growing and
therefore present a record of drug use during the entire period of growth.
testing is not as accurate as other methods, however, because of contamination
from shampoo residues, hair treatments, smoke, air pollution, and other
environmental effects. Another disadvantage is that people have different types
of hair, which may affect the readings in the analysis. Dark-haired people such
as Hispanics, Asians, and African Americans have a higher concentration of
melanin, which incorporates and retains drugs at a higher rate. The result is
that a dark-haired person can be 10 to 50 times more likely to test positive
than a lighter-haired person who used the same amount of drugs.
this time, only one company, Psychemedics, performs hair drug analyses. Their
procedures are proprietary and not available for public review, and therefore
cannot be evaluated for accuracy. Because of these concerns, most federal
programs do not engage in hair testing.
Blood testing is most commonly
done for clinical, diagnostic, and drug overdose purposes. It is routine in
hospital emergency rooms. Blood testing can be done even with a severely
intoxicated, injured, or dead person, and is therefore favored for post-accident
investigation. Almost all drugs can be tested in blood, although THC (marijuana)
is particularly difficult to measure.
Sweat testing is rarely used
in aviation, but it is starting to become more popular because it is so easy to
administer. The PharmChek patch is a waterproof adhesive pad about the size of a
playing card. It is worn like a bandage for about one week. It is then removed
and sent for analysis to PharmChem Laboratories in Menlo Park, California. Sweat
testing can be done for cocaine, morphine, 6-AM (heroin), codeine, amphetamine,
methamphetamine, THC, PCP, and methadone.
Saliva testing is done only
for private insurance evaluations, since the technique is not considered
reliable enough under federal guidelines. A swab is rubbed on the inside of the
cheek and then placed in a sealed container and sent off for testing. Saliva
tests will show amphetamines, barbiturates, cocaine, marijuana, opiates, and
Since a positive
drug test can have a devastating effect on a pilot’s livelihood, and future
prospects for a job, it is critically important that great care is taken to
ensure that the testing process is secure and confidential. To do this, the
testing specimen is handled in a very precise way, called the “chain of
Most drug testing
is carried out by collecting a small amount of urine—about one ounce. The
chain of custody is the process of documenting the transfer of the urine
specimen from the donor to the collector, from the collector to the courier,
from the courier to the laboratory, and within the laboratory from one person or
department to another. Each collection procedure is documented on a custody and
control form (CCF), also known as a chain-of-custody form (COC). Most programs
use a standard seven-copy federal CCF, also known as the NIDA Form.
are collected in a controlled setting, such as a designated collection booth or
bathroom. If it is suspected that the specimen has been tampered with, a special
collection may be authorized in which the donor is actually observed urinating
into the cup. Tampering is suspected when:
The urine specimen is outside the allowable temperature range, which is
within 1 degree C (1.8 F) of the donor’s body temperature. Since the urine
supposedly just came out of the body, it should be the same temperature as the
donor. If it is not in the allowable temperature range, the urine sample will be
suspected as falsified.
The donor is observed attempting to submit a substituted or adulterated
specimen. Most drug testing bathrooms will have a blue die in the toilet water
to prevent the donor from adding water to the urine.
x The urine specimen is too
diluted. (see below, Diluted urine)
If the laboratory cannot analyze a specimen because of contamination, a
“Specimen unsuitable” report will be sent back to the collecting site, and
the donor will be suspected of tampering with the specimen.
to avoid urine drug testing can be quite creative. This product might
work—unless a special collection is authorized. If caught, the donor could
face severe penalties for trying to falsify a dru
“shy bladder” excuse
Some pilots try to
avoid a urine test by simply saying they have no urge to urinate, or cannot
urinate because they are shy. When “shy bladder” occurs, the donor will be
expected to drink up to 40 ounces of fluids and wait for up to three hours. If
he or she still cannot urinate, it will be considered a refused test.
laboratories must be extremely reliable and legally precise to avoid falsely
accusing someone of taking drugs. A negative test may be wrong, but a positive
test must be a hundred percent accurate. To ensure that a drug detected in a
sample is not from accidental exposure, a certain amount of the drug must be
present for the sample to be considered positive. This amount is termed the
“cutoff value” and is established for each type of drug assay. If the
specimen’s drug concentration is at or above the cutoff, the result is
positive; if the specimen’s drug concentration is below the cutoff, the result
is negative. “Negative,” in this case, does not mean that no drug was
detected, but simply that the amount of the drug (if any) was not high enough to
meet the established cutoff concentration for that assay.
After a laboratory
receives the specimen, it checks the Custody and Control Form for completeness
and accuracy. The specimen is then examined for evidence of tampering. If
everything is in order, the drug testing takes place.
There are two
steps to laboratory testing: screening and confirmation. A screening test is
used to “rule out” drug use. It should be quick, cheap, and easy to perform
on large groups of people. It is not necessarily very accurate. A typical
screening test might use immunoassay. Immunoassay
tests give a simple “yes” or “no” answer. They are sensitive to very
minute quantities of a drug but not very specific for it, so that a positive
result could be to due to the presence of a related substance. For example, it
is very easy to do a screening test for amphetamines, but a great many
substances will give a falsely positive test.
If the screening
test is negative, nothing more is done. If it is positive, a second,
confirmation test is done.
are extremely accurate, but they also tend to be time-consuming, expensive, and
not very practical for large groups of people. Their purpose is to “rule in”
drug use. Confirmation cutoff levels are set individually for each drug. It is
almost impossible to fool a confirmation test; however, many small companies or
organizations do not bother with this expensive additional procedure.
For a confirmation
test, the laboratory takes a further sample from the specimen and starts a new
internal chain-of-custody form for that sample. Confirmation testing uses two
analytical techniques: gas chromatography and mass spectrometry (GC/MS). Gas
chromatography is used to physically separate the different substances present
in the specimen. Mass spectrometry can then be used to identify these individual
substances. With GC/MS, the specific molecule that corresponds with a drug or
drug metabolite can be identified.
test negative for drugs are discarded. Specimens that test positive are frozen
and stored for at least 12 months in case they need to be tested again or used
as legal evidence.
Drug Tests Be Fooled?
many people try to fool the drug tests. Some of their methods interfere only
with immunoassays and not with GC/MS, which may be effective because the sample
can clear the screening process and never reach the confirmatory level. If the
laboratory has any reason to suspect adulteration, however, the confirmation
test will usually show the true amount of the drug.
are many products advertised in magazines or on the Internet that claim to fool
products contain nitrite, which interferes with the GC/MS assay for THC. The
specimen may screen positive for marijuana, but the marijuana metabolite used
for confirmation cannot be detected by GC/MS. Unfortunately for the drug user,
nitrite also removes the substance used by the laboratory as an internal
standard for detection of the marijuana metabolite. If the laboratory fails to
recover this substance, it will test for nitrite by GC/MS.
high urine nitrite levels can be caused by urinary tract infections and by
eating foods such as beef jerky, which can produce urinary nitrite
concentrations up to 300 ng/mL. However, using Klear or Whizzies will produce a
urine nitrite concentration greater than 500 ng/mL, and the laboratory will
report the sample as adulterated.
Jane’s Super Clean 13
product contains alkylphoxysulfonate, which is also present (and much cheaper)
in Joy™ and other dishwashing detergents. If this is added to urine, it may
cause an apparent decrease of marijuana metabolites when tested by immunoassay.
The results of GC/MS analysis will not be changed.
and chloride are normally found in urine but occur in especially high
concentrations when salt has been added as an adulterant. High concentrations of
salt can cause a decrease in the apparent concentrations of many drugs when
tested by immunoassay.
contains glutaraldehyde, which interferes with immunoassays of all NIDA-5 drugs.
When glutaraldehyde is added to a urine specimen, it makes the immunoassay
uninterpretable. It does not interfere with GC/MS results. Gluteraldehyde is not
found in normal urine. If the laboratory finds glutaraldehyde in the specimen,
it will be reported as adulterated.
a clever name, Urine Luck uses a clever process to fool marijuana tests. It
contains the salt pyridium chlorochromate, which dissolves in urine to form
pyridine and chromate. The effect of chromate
is similar to nitrite by interfering with the detection of marijuana. If the
laboratory cannot recover the marijuana metabolite standard, it may test the
specimen for pyridine by GC/MS and report it as adulterated.
The easiest and simplest way to fool a drug test is by diluting urine. Some people try to add
water to the urine sample, but this may be difficult in a proper testing
location. The most common way is to drink a lot of fluids beforehand, and avoid
early-morning urine (which has the highest drug concentration).
solution to pollution is dilution.
Urine is more
dense than water. It should have a specific gravity greater than 1.003 (the
specific gravity of water is 1.000). Urine also contains a certain amount of
creatinine, which is produced by the muscles of the body.
Normal urine has a creatinine level greater than 20 mg/dL. Testing urine for specific gravity and for creatinine prevents
donors from fooling the drug tests by pouring water into the sample, or drinking
enormous quantities of water to dilute their urine and therefore also dilute any
drugs that might be present.
To a certain
extent, diluting urine does increase the chance of beating a drug test. Some
drug-using employees will take furosemide (Lasix), a prescription diuretic that
produces a very dilute urine. To avoid the problem of having their urine
rejected because of a very low creatinine, they will eat a lot of red meat
beforehand. It is questionable whether this strategy works. Drinking large
quantities of water, or taking Lasix, can dilute urine as much as tenfold and
therefore lower drug concentrations. But this can also reduce the specific
gravity below 1.003, in which case the laboratory reports it as a dilute
specimen, and it is rejected. If the specimen is at or below 1.001, this is very
close to water and the laboratory report will state “Specimen substituted: Not
consistent with normal human urine.”
Dilute urine that
looks very pale or colorless will arouse suspicion. Some donors take Vitamin B
complex beforehand to give a deep yellow color to the urine.
There are many
products that claim to cleanse the system of drugs, or at least help the user
escape detection. Most of these products are supposed to be taken with large
amounts of water, and they work by simply diluting the urine. In general, they
do not actually interfere with the drug test. Some also contain vitamin B
complex to make the urine more yellow, so that it doesn’t look so diluted.
“beat the drug test” products that act by diluting urine
Choice Herbal Detox Tea
Klean Herbal Tea
Capsules and Tea
products that claim to beat the drug tests are a waste of money and give the
user a false sense of confidence. In some states, these products are illegal.
The manufacture, sale, or use of adulterants is a misdemeanor crime in Nebraska,
Pennsylvania, and Texas.
medications that can cause positive drug tests
A positive drug
test may be caused by many legitimate prescription medicines.
DOES NOT INDICATE LEGALITY FOR
FLIGHT DECK USE. SEE: FAA Approved
||Desoxyn Gradumet tablets
||Dexedrine tablets and capsules
||Anolor 300 capsules
Arco-Lase Plus tablets
||Donnatal tablets, capsules, and
||Esgic and Esgic-Plus tablets
||Fioricet tablets and capsules
||Nembutal capsules, solution,
||Phrenilin tablets and capsules
||Repan and Repan-CF tablets and
||Seconal sodium capsules
||cocaine hydrochloride (used in ear, nose, throat, or dental surgery)
Adrenaline, and Cocaine
preparation used in emergency rooms to numb the skin
||Marijuana approved for medical
||Acetaminophen with codeine
||Brompton’s Cocktail (see
||Butalbital, aspirin, caffeine,
and codeine capsules
||Capital and codeine suspension
||Codimal PH syrup
||Deconsal C expectorant and
||Dimetane-DC and Dimetane DX
||Fioricet with codeine capsules
||Fiorinal with codeine capsules
||Fiortal with codeine
||MS Contin tablets
||MSIR capsules, solution, and
||MS/L and MS/S
||Nucofed expectorant, syrup, and
||Oramorph SR tablets
||Pediacof cough syrup
||Phenaphen with codeine capsules
||Phenergan VC with codeine
||Poly-Histine CS syrup
||Promethazine hydrochloride and
codeine phosphate syrup
||Robitussin A-C and
||Roxanol and Roxanol 100
||Soma compound with codeine
||Triaminic expectorant with
||Tussar-2 and Tussar SF and
||Tussi-Organidin NR and SNR
||Tylenol with codeine (#1,2,3,
Happens When a Drug Test Is Positive?
A Medical Review
Officer (MRO) is a specially certified medical doctor with training in the
interpretation of positive drug tests. Under federal guidelines, a worker
testing positive must have an opportunity to talk about the results with an MRO
or appropriate physician to see if there might be another explanation besides
drug use. In fact, the MRO may not declare the test positive unless there has
been an attempt to contact the specimen donor. Most MROs try to call the
employee by telephone. If a “reasonable attempt” to contact the employee is
unsuccessful, the MRO may declare the drug test a verified positive. In other
words, it is up to the employee to convince the MRO that there might have been
another reason why he or she tested positive.
Mr. Smith, this is Dr. Murphy at Bay City Medical Center. I’m calling
because your drug test came back positive for amphetamines. Your company
doesn’t know this yet. I wanted to call you first, to see why this happened.
Are you taking any medicines, or do you know of any reason why your test might
The most common
excuse for a positive drug test is that the employee did not personally take
drugs but was at a party where others were using drugs. This rationalization is
often used for marijuana: “I was in a bar where people were smoking up … I
couldn’t help inhaling it.” In the 1980s, more than a dozen experimental
studies on passive inhalation were published. Some of these researchers were
able to cause a positive drug test among people passively inhaling the smoke,
but only when the exposure was extremely intense and unrealistic. They concluded
that it was almost impossible for someone to test positive because others nearby
smoked marijuana. The government decided that this excuse would not be allowed.
In the early
1980s, some health food stores sold a tea made from coca leaves called Health
Inca Tea. The tea was supposedly made from “decocainized coca leaves.” A
study in 1986 showed that this tea contained detectable amounts of cocaine and
could cause a benzoylecgonine-positive urine test result. The tea is no longer
Other excuses have
included inhaling cocaine powder when sitting beside someone cutting cocaine, or
seemingly innocent exposures. The government has determined that these types of
exposures are not enough to cause a positive drug test, and has not accepted
denied using cocaine. She claimed that her positive test was due to her body
absorbing cocaine from the semen of her boyfriend. The government did not
accept the excuse.