Drug Screening - Terminology & Results

The individual (applicant or employee) undergoing the drug screening and/or occupational health services on behalf of the company.

This is the form emailed to the donor or applicant when a service is scheduled through the Verified First Portal. The donor/applicant must bring this form with them to complete their scheduled drug screening and/or occupational health service.

Custody and Control Form (CCF) or Chain of Custody Form (COC) is a standardized document used to track the handling of a human specimen from the time it is collected through its transfer, testing, and final disposition. It ensures proper identification, control, and accountability at every step to maintain the integrity and security of the sample.

A BAT, or Breath Alcohol Test, is a test that checks how much alcohol is in a person’s system.

DER

 

A DER, or Designated Employer Representative, is the person at a company who is responsible for managing drug and alcohol testing for employees.

ERO
 

ERO, or Express Results Online, is a fast online drug test reporting system that allows employers to see drug test results quickly. 

MIS, or Management Information System, in drug testing refers to a reporting system used to collect and track drug and alcohol testing data, especially for companies that follow DOT regulations.

An MRO, or Medical Review Officer, is a doctor who reviews drug test results to make sure they are accurate and fair.

The DOT, or Department of Transportation, is a U.S. government agency that makes rules to keep transportation safe — including roads, trucks, buses, trains, airplanes, and pipelines.

Federal Motor Carrier Safety Administration - The agency that regulates commercial trucks and buses to make sure drivers and companies follow safety rules on the roads.

Federal Railroad Administration - The agency responsible for the safety and regulation of the railroad industry, including trains, tracks, and railroad workers.

Federal Transit Administration - The agency that supports and regulates public transportation systems like buses, subways, and light rail to ensure safe and efficient transit.

Pipeline and Hazardous Materials Safety Administration - The agency that oversees the safety of pipelines and the transportation of hazardous materials to protect people and the environment.

Federal Aviation Administration - The government agency that oversees and regulates all civil aviation (airplanes, airports, pilots) to keep flying safe and secure.

Random program consisting of multiple different companies and their employees in one large pool. DOT-Only.

Substance Abuse and Mental Health Services Administration. A U.S. government agency that works to ensure that testing & labs meet federal standards

A licensed physician, or a licensed or certified psychologist, social worker, employee assistance professional, or addiction counselor (certified by a nationally recognized organization), who evaluates employees who have violated a DOT drug and alcohol regulation and makes recommendations concerning education, treatment, follow-up testing, and aftercare.

A TPA, or Third-Party Administrator, is an independent company that helps employers manage their drug testing programs.

Specimen validity testing is intended to determine whether or not the specimen is normal human urine prior to testing for specific drugs or their metabolites. Validity testing is designed to identify specimens which contain something to destroy or mask the substances being tested for. This is referred to as adulteration. The validity testing is also designed to identify specimens which are substituted for normal human urine. 

Creatinine is the major waste product found in human urine. It is a byproduct of skeletal muscle metabolism. 

Creatinine is produced at a relatively constant rate and the amount produced is proportional to the muscle mass.

  Creatinine excretion increases with: 

• High meat diet
• Hypothyroidism
• Increased growth hormone
• Anabolic steroids 

  Creatinine excretion decreases with:

• Water loading - dilutes urine and decreases creatinine concentration
• Diuretics - increased water loss - dilutes urine
• Diabetes mellitus - increased water loss - dilute urine
• Diabetes insipidus - increased water loss - dilute urine
• Muscle wasting diseases
• Normal urine creatinine:  20 to 200 mg/DL   (mg/DL -  milligrams per Deciliter)
• Dilute urine creatinine:   ≥ 2 but < 20 mg/DL
• Substitutes urine creatinine:   < 2 mg/DL 
   

It is considered physiologically impossible to pass a normal human urine specimen with a creatine less than 2 mg/DL. 

Specific Gravity measures the weight of a volume of urine compared to the weight of an equal volume of pure water. Normal human urine specific gravity is from 1.0030 to 1.0200. In extreme water loading, the urine can be so dilute as to yield a specific gravity of 1.0010+. With extreme dehydration, the urine can be so concentrated as to yield a specific gravity of 1.0300+. An instrument called a refractometer is used to measure the specific gravity of the specimen.

pH is a validity test for urine that measures the acidity or alkalinity of a specimen on a scale of 1 to 14. Neutral is pH of 7. The lower the number below 7; the more acidic the specimen. The higher the number above 7; the more alkaline. Most human urine is between a pH of 4.5 to 8.5.

*** Abnormal pH: If the pH is moderately abnormal (between 4.0 to 5.4 (too acidic) or between 9.0 and 11.0 (too alkaline), the result is reported as  “Cancel”.  

The lab and/or the MRO confirmed that the substances being screened for are not being abused

Negative-Dilute

The lab and/or the MRO confirmed that the substances being screened for are not being abused

Positive

The MRO confirmed that the substances being screened tested positive and the donor did not have a valid prescription/medical reason for testing positive for that substance(s)

Positive-Dilute

The MRO confirmed that the substances being screened tested positive and the donor did not have a valid prescription/medical reason for testing positive for that substance(s)

Donor failed to get to the clinic before the designed time frame

Not Reviewed by MRO

Can happen for various reasons: 

• Lost in Transit - Clinic shipped but lab never received
• Damaged/Leaked in Transit
• Refusal to Test - Donor Refused to provide a valid specimen
• Tamper proof seals are damaged or broken
• Specimen ID numbers on specimen bottle and Custody and Control Form (CCF) do not match.
• Collector name AND signature are missing on the Custody and Control Form (CCF).
• CCF arrives at the lab without the specimen.
• The specimen arrives at the lab without the Custody and Control Form (CCF).
• Cancelled per MRO (Invalid Result from Lab -has abnormal physical characteristics, or has an endogenous substance at an abnormal concentration that prevents the laboratory from completing or obtaining a valid drug test result)
  • Abnormal pH (≥ 4 and < 4.5, ≥ 9 and < 11)
  • Possible Oxidant Activity
  • Immunoassay Interference
  • GC/MS Interference or LCMS Interference
  • Abnormal Physical Characteristic
  • Bottle A & Bottle B - Different Physical Characteristic
  • Adulterated/Substituted