The Occupational Health Blog

Lab-based vs Rapid Drug Testing

• NMS
• Aug 19, 2021

For many companies, drug testing plays an integral role in their HR process. Whether you are testing for employment, post-accident, return to duty, or random testing, it is important to choose the best drug test for your situation. For urine drug testing purposes, you can choose between a lab-based test or a rapid test.

 

What is the difference between lab-based urine drug testing and rapid urine drug testing?

Lab-based testing requires that the specimen being tested is sent to and processed by the lab. Prior to the testing your company can determine which test panel is to be used. So, if you are requiring certain substances to be tested for, that can be arranged before the employee or candidate reaches the lab. While the specimen is there it undergoes an initial process to screen for the presence of drug metabolites.  If metabolites are present, it can then be examined further to identify which drug was used and the quantity present in the employee or candidate’s system. Lab-based testing is rigorous, and the results are more detailed which can be used in a variety of situations.

 

Rapid drug testing, also known as instant drug testing, can give a result immediately. At the time of collection, a test card will be dipped into the specimen and will change color, providing results in just a few minutes. Typically, this test screens your employees or candidates for some combination of the following drugs: amphetamine, barbiturates, benzodiazepines, cocaine, marijuana, methadone, methamphetamine, opiates, oxycodone, PCP, and propoxyphene. Results will either be “negative” or “non-negative”. A rapid drug test cannot officially give a “positive” result. In the case of non-negative test results, the specimen must be sent to the lab for further testing.

 

Are there laws regarding Rapid Drug Testing?

Laws and regulations vary from state to state, so it is important to be aware of the laws in each state your business operates in. For example, some states do not allow rapid tests outright, while others allow them, but if they come back as non-negative the specimen must be sent to a lab for confirmation. It is beneficial to work with an occupational testing and laboratory team that are familiar with each states’ law and have a presence throughout the United States.

 

Federally regulated organizations, such as the United States Department of Transportation do not permit the use of rapid testing. All urine drug screens must be processed through the lab and reviewed by a Medical Review Officer (MRO).

 

Time

Time is often the first thing that comes to mind when deciding on a Rapid Drug Screen. If a rapid drug screen’s result is negative, you can have that information almost instantly. However, if the test is non-negative and needs to be sent out to a lab for further testing, it will take a similar amount of time as a lab-based test; typically, 24 to 72 hours.

 

Accuracy

Opinions are seemingly divided about the difference in accuracy between lab-based testing and rapid tests. Lab-based testing is more rigorous and has the capability to test for a wider variety of substances. Labs run through an involved process which includes an initial screen, and then a more thorough process for any specimen that has shown the presence of drug metabolites. Specific thresholds and cut-offs are in place to rule out inadvertent exposure. Rapid testing does not have protocols like this in place and employers must rely on the negative or non-negative result.

 

Cost

Rapid drug tests can be cheaper compared to a lab-based test. However, prices are determined by each individual clinic or provider. If the result of the rapid test is non-negative, further charges can accrue as it must be sent to the lab for further testing.

 

Pros and cons of lab-based testing

Pros:

• Labs provide the cut-offs and threshold levels for each substance. Employers are not responsible for determining results.
• There is a high level of accuracy.
• Labs provide a staff of highly trained experts in the field of drug testing.
• There is a wide variety of panels to test for certain substances.
• Lab-based test results are the only results admissible in a court of law. Rapid drug tests can only be used in court if they are accompanied by confirmation test results from a lab.

Cons:

• The wait time for results can be 24 to 72 hours for a negative result.
• The lab-based test, while highly accurate, is not 100% fool-proof. There is no current lab test that is 100% fool-proof.
• Lab-based testing may cost more depending on which panels are needed

 

Pros and cons of rapid testing

Pros:

• Negative results can be available in just a few minutes.
• Rapid drug tests with negative results can be less expensive.
• Rapid drug test kits are widely available.

Cons:

• Employers need to have trained personnel to handle rapid drug tests and determine the results.
• There is a limited choice of drug panels.
• While highly accurate, rapid testing is not 100% fool-proof. There is no current lab test that is 100% fool-proof.
• Rapid drug tests cannot determine quantity or duration of substance abuse.
• Federal agencies, such as the DOT will not accept rapid testing results.
• Employers must rely on clinic reporting of results opposed to larger, more efficient, lab companies. This can cause a delay in overall drug screen result turnaround times.

 

What does NMS Health recommend?

NMS Health wants to find the test that best suits your needs! In situations where speed is more important than accuracy, a rapid test may be more appealing. In other situations, accuracy and scope of testing may be needed and a lab-based test would be preferable. NMS Health completes thousands of drug screens for our clients every year. Though rapid testing can appear to be faster and deemed “instant”, we often see many more unforeseen delays in receiving results compared to lab-based options. This is a result of lack of overall reporting mechanisms offered by many clinics.

Employers need to weigh their options in accordance with the laws of each state they operate in, the federal guidelines for their employees if applicable, and determine if they have the resources to commit to reviewing the results of rapid tests.

 

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