Questions & Answers

Consider these pertinent facts:
- Employees who abuse drugs work an average of 30-35 percent less that non-users.
- Employees who abuse drugs cost employers 300 percent more in medical costs and benefits.
- Employees who abuse drugs and alcohol cause over 40 percent of on-the-job injuries.
- Employees who abuse drugs are more likely to steal to support their habit.

Is drug abuse increasing?
For the first time in 13 years, the Quest Diagnostics Laboratories survey shows an increase in positive drug tests in the workplace. According to R.H. Barry Sample, Ph.D., Director of Science and Technology for that company, the increase appears to be due to increased substance abuse among current general workforce employees rather than employees who test under Department of Transportation programs.

What are the chances that your business employs substance abusers?
Approximately 70 percent of current illicit drug users 18 and older are employed. That is about 10 million U.S. workers. What are the chances that your employees abuse on the job: Whether they use on the job or not, they bring the effects of their problems with them since drugs affect their systems for several days. (3 to 5 days is very common.)

Which groups are most likely to use?
A survey by the federal government showed full time employees who admitted to being current drug users tend to be:
- Between 18 - 25(12.4 percent of workers in this age group said they were current users.
- Between 26 - 34(8.6 percent said they were current users)
- Between 35 - 49 (5.4 percent said they were current users)

Obviously, since those are admitted numbers, the real percentages are something more than those above.

How do drugs affect your employees’ performance?
The U.S. Postal Service study found that abusers are involved in 55 percent more accidents, experience 95 percent more on-the-job injuries, and have a 78 percent high rate of absenteeism. Other government studies show that abusers are 33-35 percent less productive.

What does it cost your company?
While it is difficult to do more than reach an average, unless wrongful death or injury is involved, the U.S. Navy estimated several years ago that the average cost of each abuser to a company is $6,600 annually. They also estimated that the actual average number of abusers in a company with 450 employees is 17 percent. If you multiply 17 percent of the number of your employees times $6,600 you will get an estimate of the cost to your company. A way to estimate wasted salary cost is to multiply the total number of your employees times 17 percent. Add up the salary of that 17 percent and calculate what 35 percent would equal. That dollar amount would be equal to time those employees don’t work while you are paying them.

Do your other non-abusing employees know about the employees who do?
Approximately 62 percent in an Ohio based study said they either know or know someone who has personal knowledge of a co-worker whose abuse has interfered with their work. Over 57 percent in a Gallop survey said abuse in their own workplaces affected attendance, productivity, morale, health care costs and safety.

Why use urinalysis substance abuse testing?
Urinalysis testing started in the Armed Services in the early 1980’s. It has solid science, a two test screen and confirmation processes, you can add an optional protective Medical Review component, and is admissible in any court in the United States. The policy and procedures developed by both the Armed Services and the Federal Government protect both the employer and the employee. The procedures include a complete system of checks and balances. Substance Abuse testing can decrease workplace accidents, cut production costs, save wasted salary dollars, cut increased medical costs, decrease workers’ compensation premiums, lower employee turnover, reduce theft and shrinkage, and increase morale and loyalty.

Adulteration is the tampering of a urine specimen with the intention of altering the test results, rendering a positive reading into a negative one. Users of illicit drugs have attempted to defeat drug test by adding adulterants to the sample after collection as a way to invalidate the testing procedures. The use of adulterants can cause false negative results in drug test by either interfering with the screening test or converting the drugs present in the urine to other compounds. In addition, some donors try to substitute their specimen with another liquid and others may dilute their specimen by consuming excessive amounts of fluid or by adding water/other liquids to their specimen after collection.

How bad is this problem?
Experts estimate that 4% of the urine samples currently submitted are adulterated and that the problem is only growing. They are easily obtained from magazines, "head shops", and the internet.

Do adulterants work?
Most do not work very well. However some adulterants do affect the results of drug testing. New generations of adulterant products are becoming more effective.

What is the nature of these adulterants?
There are 2 classes of adulterants. For Example:

Household Products
- Water
- Bleach
- Detergents

Commercial Adulterants
- "Stealth" (oxidant)
- "THC-FREE" (acid - pH)
- products designed to dilute the specimen (specific gravity)
What can be done to combat this problem?
Preventative measures include random drug testing (little or no notice before a drug test) and observed collections. Since these aren’t always appropriate measures in all circumstances one of the best ways to identify specimen tampering is to perform specimen validity testing.

How does Specimen Validity testing work?
One of the best ways to detect adulteration is to look for certain characteristics such as pH, Specific Gravity, Oxidants, color and Temperature,

- pH test for acidic or Alkaline products in urine. Normal pH should be in the Range of 4.0 to 9.0. Values outside this range may indicate the sample has been "spiked" or altered

- Oxidants/PCC (Pyridinium Chlorochromate): test for the presence of oxidizing agents such as bleach and hydrogen peroxide. Pyridinium Chlorochromate (sold under the brand name UrineLuck) is a commonly used adulterant. Normal human urine should not contain oxidants or PCC

- Specific Gravity test for sample dilution. The normal range is between 1.003 and 1.030. Values outside this range should be considered adulterated.

- Glutaraldehyde: test for the presence of an aldehyde. Adulterants such as UrinAcid and Clear Choice contain Glutaraldehyde which may cause false negative screening results by disrupting the enzyme used in some immunoassay test. Glutaraldehyde is not normally found in urine; therefore, detection of Glutaraldehyde in urine specimen is generally an indicator of adulteration.

- Nitrite: test for commonly used commercial adulterants such as Klear or Whizzies. They work by oxidizing the major cannabinoid metabolite THC-COOH. Normal urine should contain no trace of nitrite. Positive results generally indicate the presence of an adulterant.

- Creatinine: is a waste product of Creatinine; an amino-acid contained in muscle tissue and found in urine. A person may attempt to foil a test by drinking excessive amounts of water or diuretics such as herbal teas to "flush" the system. Creatinine and specific gravity are two ways to check for dilution and flushing, which are the most common mechanisms use in an attempt to circumvent drug testing. Low Creatinine and specific gravity may indicate dilute urine. The absence of Creatinine (<5mg/dl) is indicative of a specimen not consistent with human urine.


- The Temperature of a urine specimen should be between 91 and 98 degrees Fahrenheit when checked within 4 minutes of collection. Urine that is submitted at body temperature will exceed 90.5 degrees. Temperature below that range is suspect.

- A clear Color may indicate that the sample has been watered down. Unadulterated, normal urine should be pale to Dark Yellow to Amber in color. However, a sample should not be considered adulterated by color alone, but should suspect for closer examination.

How do you interpret the test results?
By comparing the pad color to the color chart on the card provided. The status (normal or Abnormal) will assessed.

What do I do if the sample test positive for adulterants?
Be sure to review your drug testing policy for guidelines on adulterated samples. We recommend you do not interpret The drug test results and either retest the sample or collect another specimen.

Hair offers the ability to stop more than twice as many drug users at the door, before they are employed. There is a growing interest in replacing abstinence monitoring urine programs with routine 90 day hair analysis, thereby reducing the number of times a donor must submit to a drug test and improving fidelity of detection.

Why use hair analysis for pre-employment testing in the workplace?

Urine appears to be more susceptible to adulteration, hydration and substitution. Hair analysis provides a greater challenge to these applicants who try to cheat for a number of reasons.

- The applicant cannot replace his or her hair with someone else’s.
- The applicant cannot adulterate hair by placing anything in or on the sample while in the specimen collection area.
- The collector takes the hair directly from the applicant and the sample is never out of the sight.
- The applicant cannot eat or drink anything that will dilute a hair sample.
- We often hear of people who strip, bleach, and re-dye their hair to its original color. This may be effective if the applicant is an occasional user and his/her levels were at or near the cutoff. In most cases, the cutoff level used by the more sophisticated laboratories is low enough that stripping the hair will not remove the entire drug that has be deposited.

Is hair analysis appropriate for post accident or

No: Because hair testing detects drug use over a long period of time, usually from 10 to 90 days prior to collection, it is not an appropriate method for post-accident or reasonable suspicion testing. In both of these situations, the result should detect the drug use of an individual as close as possible to the time of the incident. Urine combined with a breath, oral fluid, or blood alcohol specimen is the appropriate sample for this type of testing.

How do drugs deposit in or on hair?

Current scientific research indicates that drugs deposit in hair by several methods. The principle method is transmission from the blood supply. Deposition through perspiration and skin oil is a second important method. In addition, drugs are externally deposited on the hair by environmental smoke or, more reasonably, by smoke from the users own ingestion. As with the smoke from tobacco users, an individual’s hair will be more susceptible to environmental smoke from his or her own drug use activity.

What are the issues of environmental contamination?

Cocaine has been the principal focus of studies on environmental contamination. Cocaine seems to be the drug most attracted to hair. Cocaine, in its smokable form (crack), can deposit on hair. As mentioned above, the crack smoker will not only ingest cocaine, but will add more cocaine to his/her hair by mere proximity to the smoke during use. Most individuals who do not use cocaine will also not be around smoked cocaine. If an individual lives with a cocaine user, he or she could be subject to cocaine exposure in the living environment. The cocaine residue left by the user could result in both a urine and hair drug test positive if accidentally ingested by a non-user. If the donor lives with or spends time with a cocaine smoker, it is possible that the non-user may have some cocaine smoke deposited in his or her hair. If external exposure is limited, the cocaine will wash out of hair using normal hygienic methods. If the exposure is more intense, normal hygiene may not be sufficient to remove all of it.

How does the laboratory avoid reporting an environmentally contaminated sample as a positive from a user?

When metabolites of drugs are detected in the hair along with the parent compound, we can be sure that the drug entered the hair from the blood stream after being ingested. A sample positive for the parent drug, but negative for metabolites is presumed to be externally contaminated and is reported as negative. In addition, the hair samples are chemically washed before testing to remove contamination. Finally, the cutoff levels for reporting a positive are set conservatively high to avoid reporting traces of external contamination.

How are hair samples collected?

Compared to urine collection, hair collection is a simple, non-intrusive process. There are, however, some important things to remember:

In order to be fair to the donor, we must have enough hair to repeat assays if necessary. If the hair is over 1 1/2 inches long, then we require a width of 1/2 inch when spread out flat on a ruler. If the hair is shorter than 1 1/2 inches in length, more hair is required (1 inch length requires 3/4 inch width; 1/2 inch length requires 1 1/2 inch width). The reason for this is that although the laboratory describes the sample quantity in width of sample for collectors, the test requirements are actually 100 mg of hair by weight.

Will the test results really reflect 90 days use of drugs?

Approximately: Head hair grows approximately 1/2 inch per month. If you cut the hair close to the scalp and test the first 1 1/2 inch from the root end, you would be testing a 90 day period. The problem with this is that it takes hair approximately one to two weeks to grow from the hair follicle through the scalp to a level above the scalp accessible to scissors. Therefore, a hair analysis of a 1 1/2 inches covers a time span of approximately 90 days one to two weeks after drug use.

Can you go back further than 90 days?

Theoretically it is possible to test the entire length of hair in segments. This type of testing is of questionable validity. Since the distribution of drugs through the hair includes sweat and body oil, the drugs will diffuse along the shaft. In addition, normal hygiene and treatment of hair removes drugs slowly over a period of time. Therefore, at this time, the lab only tests the first inch from the root end.
Will the laboratory defend hair analysis results in court, if necessary?
Yes, as with all testing performed, our professional toxicologists are available to all clients in interpreting drug test results and provide expert witness testimony should results be questioned in administrative or legal hearings.

Hair testing will test for the five drugs most often found abused; amphetamines (methamphetamine and amphetamine, MDMA and MDA), cocaine, opiates (heroin, morphine and codeine), phencyclidine (PCP) and marijuana (Carboxy THC).

Hair analysis is performed by mirroring the federal forensic Substance Abuse and Mental Health Services Administration (SAMHSA) employment drug testing guidelines as closely as possible for a solid sample. Urine, of course, comes to us in liquid form. Hair must go through additional extraction procedures in order to release the drugs from the hair before testing, thus part of the increased cost.

The sample is received in the secured hair preparation area to be verified for complete chain of custody, adequate sample volume, and computer data entry. The sample is cut and weighed. Once the sample has been cut into very small pieces, it is then mixed to create as homogeneous a sample as possible. An internal chain of custody is created and a portion of the cuttings of each sample is sent to the hair-testing laboratory for screening.

Samples are washed to remove externally exposed drugs and to clean off interfering cosmetic materials.

The samples are prepared and the drugs are extracted into a liquid form. As with urine, the screening process is performed by immunoassay techniques, however, hair is screened using ELISA. Those samples, which test negative, are then reported as negative. If the screening process produces a suspected positive, a request is made from the hair preparation area to weigh out a new sample from the remainder of the original cuttings.

The second portion of the original cuttings is then subjected to washing, extraction, and confirmation testing by either gas chromatography mass spectrometry (GC/MS) or gas chromatography tandem mass spectrometry (GC/MS/MS). If the confirmation test is negative, there is no metabolite present, or the result is less than the cutoff, the sample is reported as negative. If the sample is positive above the cutoff for the drug and it’s metabolites, the laboratory reports the sample as positive.

Yes. It is important that you wait to see if a line in the test region appears before reading your result. This might take the entire suggested number of minutes for the test region line to appear. Within one minute of the urine specimen activating the pads on the adulteration strips the colors can be compared.


The test card and panel results remain stable for up to 1 hour after test initiation. For specimen validity testing test results cannot be read after 4 minutes.


The shade of red in the test line region (T) will vary, but it should be considered negative whenever there is even a faint pink line. Not applicable for Specimen Validity Testing.

A negative result does not necessarily indicate drug-free urine. Negative results may be obtained when a drug is present in the urine but below the cut-off level of the test.

A red/pink background is normal as the sample flows up the test strip and will not affect the test result. As long as it does not interfere with the interpretation of the line(s), the background can be disregarded.

As an internal procedural control, a red line appearing in the control (C) region confirms the addition of sufficient specimen volume and the performance of correct procedural technique.

No. The intensity of the red color in the test line region (T) will vary. Any shade of a red line in the test (T) region (darker than, the same color as, or lighter than the control line) along with a red line in the control (C) region is considered a negative result.

No. Even though a negative result may appear earlier, it is important that the test be allowed to fully develop for amount of the suggested minutes.

The test provides only a qualitative, preliminary analytical result. A secondary analytical method must be used to obtain a confirmed result. Gas chromatography/mass spectrometry (GC/MS) is the preferred confirmatory method.

No. The test device should not be used under any circumstances past their expiration date.

Review each of these four categories frequently until you know them well.

This will enable you to be "on the lookout" for these signs and symptoms and to recognize them in your home, your workplace, or school. By "getting involved" and helping those you love or care for, you may prevent drug problems before they reach crisis level!

First, an important caveat: while the following in combination represent "known-indicators" of drug-abuse, they certainly do not "prove" abuse of drugs. For example, a few of these indicators can be attributed to a newly-acquired emotional stress (death in the family, job loss, a divorce, etc.). Frankly, a few of them are also identical to symptoms a person exhibits when they simply have the "flu-bug"! You may even recognize that some of these symptoms are a "standard description" of how you might define the "personality" of someone - or a number of "someones" - whom you know very well. In other words, "’s just the way they have always been".

On the other hand, in combination, these symptoms could well be drug-abuse related....that’s especially if you observe a "sudden" appearance of a combination (e.g., 3-4-5 or more) of these indicators in an individual you personally know very well. If you recognize that these "indicators" represent "new" behavior for them, the possibility is strong that those sudden changes are a result of newly-begun drug-use. Please keep the above caution in mind as you familiarize yourself with the following:

"Performance" indicators that are often (but not always) specific to drug-abuse

- excessive absenteeism or tardiness
- lower productivity, lower grades in school
- missed deadlines
- excessive equipment breakdown because of poor maintenance
- deteriorating work quality
- poor morale
- increased minor accidents, mistakes
- multiple reports of theft, missing personal items by co-workers, classmates

"Behavioral" indicators that are often (but not always) specific to drug-abuse

- sudden change in attitude, work, or behavior- a new, "I don’t care attitude"
- sudden deterioration of long friendships, relationships
- "explosive" arguments and disagreements over small matters
- frequent hangover symptoms
- using drug culture jargon
- secretive behavior
- avoiding "straight" (non drug-users) co-workers or classmates
- erratic behavior-forgetfulness-indecision
- deterioration in personal appearance and hygiene
- hyper-activity, constant toe or heel-tapping and/or "drumming" of fingers
- easy excitability
- restlessness, increased physical activity
- wearing of long-sleeved garments in very warm weather
- new financial problems or frequent borrowing of money

"Physical" indicators that are often (but not always) specific to drug-abuse

- small blood spots or bruises on skin
- bloodshot or watery eyes
- runny or irritated nose, irritating cough, sore throat
- speech pattern changes, slurred speech, faster speech, slower speech
- tremors or jitters
- constant scratching of skin, "picking" at skin and hair on arms, etc.
- poor coordination, tripping, spilling, bumping into things and other people
- large or small (dilated) pupils
- a faint skin odor- either sweet or acrid
- easily fatigued or constantly fatigued
- hyper-excitability

"Paraphernalia" indicators that are often (and almost always) specific to drug-abuse

Possession of hypodermic needles, balloons, aluminum foil wrappers, mirrors or flat metal, short straws, glass pipes, smoking pipes, capsules, vials, or folded paper envelopes, a cigarette lighter (or small butane torch) when carried by a known "non-smoker"

Can a person passively inhale enough marijuana smoke, when in the company of marijuana smokers, to cause them to have a positive urine test?

The answer is; NO, it is very unlikely!

The following studies published in scientific journals show no instances where passive inhalation of marijuana smoke, even under extreme conditions, caused urine specimens of non-marijuana users to test positive for THC (the active ingredient in marijuana) using the screening and confirmation cutoff levels currently mandated by SAMHSA (the Substance Abuse and Mental Health Services Administration). Reference to the actual studies are given below so that the information can be admissible in court when this issue is raised.

The first study was conducted by Perez-Reyes and co-workers in 1983. (1-3) The study consisted of three different experiments; one conducted in an automobile, and two in a small room. Of the specimens collected for analysis, two specimens were found positive for THC metabolites by the EMIT screening test at a cutoff level of 20 ng/ml. One of these was measured by gas chromatography-mass spectrometry (GC/MS) and gave only 3.9 ng/ml of the THC-acid metabolite. The conditions in these studies were relatively severe.

Law et al. (4) performed a passive inhalation study in a room approximately 10 x 12 x 8 ft., four nonsmokers played cards over a 3 hour period, at the start of which six other males each smoked marijuana. The concentrations found in the passive inhalers did not exceed 7 ng/ml of total THC metabolites. The authors concluded that the amount of THC metabolites detected in the urine is clearly dependent on the size and ventilation of the room and on the amount of marijuana smoked.

Morland et al. (5) performed a study in which subjects in a car smoked either marijuana or hashish mixed with tobacco, equivalent to 90 mg THC in the presence of naive passive inhalers. Analysis of the urine samples from the passive inhalers showed no detectable levels of THC metabolites in the subjects involved in the hashish study, but the subjects passively exposed to marijuana smoke did show occasional urine specimens that were positive at concentrations ranging from 14 to 30 ng/ml of total THC metabolites. The author noted that "the discomfort caused by the heavy cannabis smoke during the exposure period was universal among both active and passive smokers."

1985 - 1990:
Cone and co-workers (6-8) performed a series of rigorous double-blind marijuana passive inhalation studies. The maximum urine concentration of the THC-acid metabolite obtained by GC/MS analysis was 12 ng/ml. The conditions during this test were so extreme, that all the subjects wore goggles to protect their eyes from the dense smoke in the room. The exposure conditions of these studies were more severe than would be expected under "real world" conditions of passive exposure.

Mule’ et al. (9) conducted a study involving eight marijuana smokers (each smoking four cigarettes with 27 mg THC per cigarette) and three nonsmokers passively inhaling the marijuana smoke in a closed 10x10x8 ft. room with no windows. He consistently reported less than 10 ng/ml of THC metabolites as a result of passive inhalation.


These studies showed that although it is true that passive inhalation of marijuana smoke results in absorption of THC in the body, none of the THC levels from the non-marijuana users were high enough to cause a positive result using the current screening and confirmation cutoff levels mandated by SAMHSA; 50 ng/ml cutoff for the screen test and 15 ng/ml for the confirmation test.


( 1 ) A.P. Mason, M. Perez-Reyes, A.J. McBay, and R.L. Foltz.Cannabinoid concentrations in plasma after passive inhalation of marijuana smoke. J. Anal. Toxicol. 7: 172-74 (1983)

( 2 ) M. Perez-Reyes, S. DiGuiseppi, and K.H. Davis. Passive inhalation of marijuana smoke and urinary excretion of cannabinoids. J. Am. Med. Assoc. 249: 475 (1983)

( 3 ) M. Perez-Reyes, S. DiGuiseppi, A.P. Mason, and K.H. Davis. Passive inhalation of marijuana smoke and urinary excretion of cannabinoids. Clin. Pharmacol. Ther. 34: 36-41 (1983)

( 4 ) B. Law, P.A. Mason, A.C. Moffat, L.J. King, and V. Marks. Passive inhalation of cannabis smoke. J.Pharm. Pharmacol. 36: 578-81 (1984)

( 5 ) J. Morland, A. Bugge, B. Skuterud, A. Steen, G.H. Wethe, and T. Kjeldsen. Cannabinoids in blood and urine after passive inhalation of cannabis smoke. J. Forensic Sci. 30: 997-1002 (1985)

( 6 ) E.J. Cone and R.E. Johnson. Contact highs and urinary cannabinoid excretion after passive exposure to marijuana smoke. Clin. Pharmacol. Ther. 40: 247-56 (1986)

( 7 ) E.J. Cone, R.E. Johnson, W.D. Darwin, D. Yousefnajad, L.D. Mell, B.D. Paul, and J. Mitchell. Passive inhalation of marijuana smoke; urinalysis and room air levels of delta-9-tetrahydrocannabinol. J. Anal. Toxicol. 11: 89-96 (1987)

( 8 ) E.J. Cone. Marijuana effects and urinalysis after passive inhalation and oral ingestion. In Research Finding on Smoking of Abused Substances.C.N. Chiang and R.L. Hawks, Eds. Natl. Inst. Drug Abuse Rs. Monogr. Ser 99: 88-96 (1990)

( 9 ) S.J. Mule’, P. Lomax, and S.J. Gross. Active and realistic passive marijuana exposure tested by three immunoassays and GC/MS in urine. J. Anal. Toxicol. 12: 113-16 (1988)
(10) Journal of Analytical Toxicology, Vol. 19, October 1995 pp. 450 - 453

What is Oxycontin?

OxyContin is a semisynthetic opioid analgesic prescribed for chronic or long-lasting pain. The medication’s active ingredient is oxycodone, which is also found in drugs like Percodan and Tylox. However, OxyContin contains between 10 and 160 milligrams of oxycodone in a timed-release tablet. Painkillers such as Tylox contain 5 milligrams of oxycodone and often require repeated doses to bring about pain relief because they lack the timed-release formulation.

How is OxyContin used?

OxyContin, also referred to as "Oxy", "O.C." and "killer" on the street, is legitimately prescribed as a timed-release tablet, providing as many as 12 hours of relief from chronic pain. It is often prescribed for cancer patients or those with chronic, long-lasting back pain. The benefit of the medication to chronic pain sufferers is that they generally need to take the pill only twice a day, whereas a dosage of another medication would require more frequent use to control the pain. The goal of chronic pain treatment is to decrease pain and improve function.

How is OxyContin abused?

OxyContin abusers either crush the tablet and ingest or snort it or dilute it in water and inject it. Crushing or diluting the tablet disarms the timed-release action of the medication and causes a quick, powerful high. Abusers have compared this feeling to the euphoria they experience when taking heroin. In fact, in some areas, the use of heroin is overshadowed by the abuse of OxyContin.

Pharmacy diversion: Pharmacy workers take the drug directly from the shelf. People create fraudulent prescriptions.

Doctor Shopping: People with or without true illness visit several doctors, perhaps even in several states to obtain a large quantity of the drug.

Improper Prescribing Practices: Dishonest doctors write improper prescriptions for money or favors.

Street Value: On the street, the drug sells for 50 cents to over a dollar per milligram. Some pharmacies have stopped selling the drug and posted signs indicating they do not carry the drug, in an effort to thwart robberies and criminal activity brought on by OxyContin abuse

Nicknamed "hillbilly heroin", the first known reports of OxyContin abuse were in rural areas with common characteristics such as job scarcity and high unemployment, isolation, and a large elderly and disabled population. However, abuse of the drug has since spread.

The states with the highest abuse rates are West Virginia, Pennsylvania, Kentucky and Virginia. According to the 2001 National Household Survey on Drug Abuse, 975,000 persons were reported using OxyContin for nonmedical use. Abuse and potential abuse of the drug, especially among young people, has raised great concern. Another national survey reported that 1% of 8th graders, 3% of 10th graders and 4% of 12 graders had used the drug recreationally. The estimated street value of one 40-milligram OxyContin pill is about $40.

Drug Enforcement Agency (DEA) officials say that the drug may have played a role in 464 overdose deaths from the years 2000 and 2001. Most OxyContin deaths are the result of first-time, large dose illicit use.

How does OxyContin abuse differ from abuse of other pain prescriptions?

Abuse of prescription pain medications is not new. Two primary factors, however, set OxyContin abuse apart from other prescription drug abuse. First, OxyContin is a powerful drug that contains a much larger amount of the active ingredient, oxycodone, than other prescription pain relievers. By crushing the tablet and either ingesting or snorting it, or by injecting diluted OxyContin, abusers feel the powerful effects of the opioid in a short time, rather than over a 12-hour span. Second, great profits are to be made in the illegal sale of OxyContin. A 40-milligram pill costs approximately $4 by prescription, yet it may sell for $20 to $40 on the street, depending on the area of the country in which the drug is sold.(1)

OxyContin can be comparatively inexpensive if it is legitimately prescribed and if its cost is covered by insurance. However, the National Drug Intelligence Center reports that OxyContin abusers may use heroin if their insurance will no longer pay for their OxyContin prescription, because heroin is less expensive than OxyContin that is purchased illegally.(2)
Why are so many crimes reportedly associated with OxyContin abuse?
Many reports of OxyContin abuse have occurred in rural areas that have housed labor-intensive industries, such as logging or coal mining. These industries are often located in economically depressed areas, as well. Therefore, people for whom the drug may have been legitimately prescribed may be tempted to sell their prescriptions for profit. Substance abuse treatment providers say that the addiction is so strong that people will go to great lengths to get the drug, including robbing pharmacies and writing false prescriptions.

What are the short-term effects?

The most serious risk associated with OxyContin is respiratory depression. Because of this, OxyContin should not be combined with other substances that slow down breathing, such as alcohol, antihistamines (like some cold or allergy medication), barbiturates, or benzodiazepines.

Other common side effects include constipation, nausea, sedation, dizziness, vomiting, headache, dry mouth, sweating, and weakness.

Toxic overdose and/or death can occur by taking the tablet broken, chewed, or crushed. People who abuse the drug (by removing the time-release coating) will experience effects for up to 5 hours. The high that is felt is opiate-like -- a sedate, euphoric feeling.

What are the long-term effects?

Using OxyContin chronically can result in increased tolerance to the drug in which higher doses of the medication must be taken to receive the initial effect. Over time, OxyContin will be come physically addictive, causing a person to experience withdrawal symptoms when the drug is not present. Symptoms of withdrawal include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps, and involuntary leg movements.

What is a "pool" group?

A pool refers to a group of individuals subject to a specific set of random selection parameters, such as the rate (i.e. 50%) and periodicity (monthly) of selections.

What is the random "rate"?

The rate is the number of selections as a percentage of the pool size. For example, if there are 100 people in the pool, and the annual rate is 50%, then 50 selections will occur over a years time. Because the process is random, it is probable that a significant number of the 50 selections will repeat, meaning that some people get picked more than once. So a random rate of 50% of a 100 person pool means that you’ll conduct 50 drug tests, not test 50 different people.

What is the "program period" or "program year"?

The program period refers to the period of time during which the random rate will be calculated. The easiest program period to use is one year, however, it’s possible and sometimes advisable to have shorter program periods. The program period is divided into a specific number of selection periods, which is called the frequency. Testing activity may fluctuate over the course of the program period, but by the time the period closes, the number of completed tests should equal the random rate.

What is frequency?

Frequency is the number and spacing of selection periods during the program period. Typical frequencies are monthly, weekly, quarterly, or daily. Other frequencies are possible and sometimes helpful. A high frequency of selections, i.e. daily, results in a very high level of deterrence. However, it also tends to be more difficult to administer. As a general rule for establishing deterrence, you should use the highest frequency possible given your administrative capabilities. For example, if all of your pool members are located at a single facility with on-site collection capabilities, then weekly, or even daily selections are possible. But if the same number of people are spread out over a large geographic area with diverse work schedules, monthly or quarterly selections may be more appropriate.

The key factor that helps determine frequency is the ability to locate, notify, and collect a sample from the individual selected for testing. That ability is driven by your communication abilities, management practices, geographical structure, and collector arrangements. Of course, all of these are related to the cost of the testing program.

What is a selection period?

The selection period is an interval within the program period for which a given number of random selections are performed and their corresponding tests completed. Typical selection periods are one month, one week, one quarter, or one day. For example, if you have chosen a frequency of monthly each month would be a new selection period. There are a couple of important things to remember about selection periods:

1) When using simple random sampling with replacement, the prior selection periods have absolutely no impact on the current selection period! (Hint: Think of it as a new roll of the dice - the dice have no memory of previous roll.)

2) The easiest and most objective way to administer testing is to excuse all pending tests at the end of each selection period. Carrying over can introduce all sorts of problems, most of which result from bias. Remember, random testing is about performing a specific number of tests on the subject population. If you’re finding it difficult to accomplish the desired number of tests in each selection period, you may have to adjust management practices, communication, or the logistics of collection. You may also simply need to increase the number of selections per period (over sampling), or, at the start of the next program period, change the frequency.

What is "over-sampling"?

Over - sampling refers to the practice of selecting more people for testing than the rate requires. This is done in anticipation of some number of tests not being completed. Over - sampling is required in almost every random testing program because it is simply not possible to conduct a test on every person that is picked by the computer. People get sick, go on vacation or leave, change responsibilities, or are otherwise unavailable for testing. An over sampling rate of 20% is quite common. It can be much higher or lower, depending on the situation. Again, the emphasis of random testing is completing a given number of tests during the program period in an unbiased fashion. Some measure of over sampling is required to meet that goal.

How does the computer pick individuals for random testing?

Random selection is a mathematical process driven by several parameters: pool membership, the program period, rate, and frequency (selection period).

STEP 1. A pool group is created. The pool group includes those employees subject to random testing. The operator also specifies the rate of random testing, or a specific number of pool members to be selected each period. For example, the Department of Transportation requires a 50% annual testing rate. This means that, over the course of one year, at least 50 drug tests must be conducted for every 100 employees in the pool.

It is important to understand that the 50 tests do not have to be conducted on 50 different individuals. In fact, this is highly improbable, if not impossible. At a 50% selection rate, the actual probability is that 37 or 38 different individuals will be selected for the 50 tests. This means that 12 or 13 of the 100 individuals in the pool will be selected at least twice or more.


STEP 2. Before beginning the selection process, the Random Selection Program (RSP) figures out how many tests need to be conducted for the selection period. The selection period is usually a week or month. The Department of Transportation requires that each member of the pool have an equal chance at being selected for a test every selection period. When figuring out how many tests are needed for the period, the RSP takes into account absenteeism, incomplete tests, etc. to make sure that the minimum number of required tests is accomplished.

STEP 3. The RSP uses a random algorithm, or mathematical equation, to assign an index number to every one in the pool. The employee’s index number is usually different every selection period, however, it is possible for the computer to assign the same index number, to a specific employee, two or more periods in a row. The number of index numbers is always equal to the number of people in the pool for the selection period. The index number becomes the identity of each member of the pool group for the selection period.

For example, if the pool group has 100 members, then each member in the pool will receive a randomly assigned index number between 1 and 100.


STEP 4. Using a random algorithm, the RSP generates a series of random numbers equal to the number of tests required for the period. The RSP then looks at the index numbers that are randomly assigned to the pool group members and matches up the numbers.

For example, if the RSP determined that 5 tests were needed for the period in a pool group of 100 members, it would randomly pick 5 different numbers between 1 and 100. For illustrative purposes, let’s assume that the numbers 34, 45, 67, 35 and 10 were picked by the RSP. The RSP would then search through the 100 index numbers and find out which pool group members were assigned the index numbers of 34, 45, 67, 35 and 10. Those five individuals would be selected for a test.



It is also important to know that the random algorithm used by the RSP has been thoroughly tested and documented. The RSP’s random number generator verification is available upon request. Statistical analysis has also determined that computer algorithms are the best random generators because they are free from physical biases and can thoroughly document the random selection process.

If the explanation above seems a little confusing, the following example will help illustrate how the RSP selects individuals for random tests:

Let’s assume that there are 52 people in a room that are subject to random testing. Let’s also assume that 5 people need to be picked for random tests. We can accomplish this goal fairly with two decks of playing cards. First, we would shuffle both decks of cards. We then take the cards from one deck and pass out one card, face down, to each person in the room. Next, we would draw five cards from the second shuffled deck and place them face up on a table. Everyone in the room would then turn their playing card face up. The five cards on the table from the second deck will match up to five individuals in the room holding cards from the first deck. These five individuals are now picked for a test. We could repeat this exercise time and time again, shuffling both decks each time and passing out the cards. The odds are that some individuals will never get picked, and, in like manner, some individuals will be picked several times. 

Why are some people picked for testing more than once and others are not picked at all?

The card analogy explains it in detail, but there are many other familiar random processes that help you understand how this happens. When you flip a coin thousands of times, it’s probable that you’ll get heads as many times as tails. Each incidence of flipping the coin has nothing to do with the previous flip. However, it is unlikely that each flip will have the opposite result of the preceding flip. You may get a whole series of heads before another tails flip. So, if everybody in your pool participated long enough, it’s likely that selections would end up being evenly distributed. However, in the real world, people move in and out of the pool at a rate that makes that impossible. This is especially true given the relatively low rates of selection used in drug testing (i.e. 10%-50%).

Some words of caution: It is possible for someone to have an increased chance of being picked if they are entered in the pool more than once. The computer won’t let someone with the same unique ID be entered in the pool twice, but if a mistake is made whereby an individual exists in the pool under two or more unique ID’s, the odds of that person being picked go up (like having two raffle tickets).

Another common problem is not removing unavailable people from the pool on a regular basis. If the pool contains ID’s of individuals that cannot be tested (no longer working, extended leave, etc.), those that are available will be subjected to a higher incidence of testing events.

Creatinine and New Use of Marijuana

Marijuana (THC) can persist in the urine long after use - from two days for the occasional user to six weeks for the chronic user. Metabolism rate and body fat are also factors in the length of time THC may be detected in urine. Whereas the THC levels in the body tissues will decline steadily, actual urine levels may fluctuate due to varying degrees of urine hydration/dilution. There is often a need to determine if a current positive THC result reflects new marijuana use or previous use. In principle, the urine THC level should decrease over time following the last use, however, the level also depends upon the urine concentration. In order to handle this concentration variable, the THC level is divided by the creatinine level (CR). The THC/CR ratio should decrease over time when there is no new use. The rule-of-thumb is that when comparing two results, the THC/CR ratio should decrease by 50% every two to ten days depending on the individual. A light or infrequent user will decrease faster than a heavy or frequent user.

When comparing levels, it is important to compare results derived from the same test method, either compare EMIT values with EMIT values, or compare GC/MS values with GC/MS values.


The following table shows data from one donor who provided three specimens on three different dates.

Specimen A B C
Collection Date: 02-02-08 02-10-08 02-20-08
THC level 350 540 180
Creatinine level 52 150 180
THC/CR ratio 6.7 3.0 9.0

By following the THC level alone, one might conclude that there was new drug use between specimens A and B since the THC level increased. However, the THC/CR ratio decreased from 6.7 to 3.0 indicating no new use. In contrast, the THC/CR ratio increased from 3.0 to 9.0 indicating new marijuana use between specimens B and C.

The following are based on the Mandatory Guidelines for Federal Workplace Drug Testing Programs. For testing programs that are not Federally Regulated you may choose to model your collection procedures after some or all of these time tested methods. Some States also have requirements for drug testing, which you should consult prior setting up your testing program. You may contact MD Technical Support at 866-933-0964 for information about your State.

•Provide a restroom/stall/portable toilet with adequate privacy, and ensure that access by the general public is limited during the procedure. Ensure that undetected access (e.g., through a door not in your view) is not possible.

•Ensure proper identification of the donor. (either via picture ID or donor is known by the collector).

•Secure water sources or otherwise make them unavailable to the donor (ie. Turn off water or secure handles and tank lid with tamper proof tape, put bluing agent in toilet and tank).

TIP: The cheapest and easiest way make a bluing agent is to by blue food coloring (Adams Extract" is a common brand) at you local grocery store. Clean out an empty clear shampoo or water bottle with a squeeze spout. Fill it with water and add several drops of blue coloring and shake until you get the color you want. A few squirts in the toilet will turn the water blue. Bluing Tablets are also available to purchase.

•Inspect the site to ensure that no unauthorized substances are present. (ie. no cleaning agents, soap, etc.) and secure areas and items (e.g., ledges, trash cans, under sink areas, paper towel holders) that appear suitable for concealing contaminants.

•Ask donor to remove any unnecessary clothing (eg. coats, hats, purses, etc.). Providing a locked area or receipt of personal items may help ensure that personal items are kept secure.

•Ask donor to empty pockets. If nothing is there which could be used to adulterate the sample, the donor may place items back in pocket. If donor refuses to empty pockets this can be considered a refusal to cooperate in the testing process.

•Instruct donor to wash and dry hands prior to collection, but further access to water may not be allowed. Liquid soap is recommended. A solid bar of soap gives donor a chance to conceal soap shavings under his/her fingernail and subsequently use them to attempt to adulterate the specimen. Access to a sink area near the bathroom being used for the collection can be helpful, so the collector is not constantly securing and un-securing a sink water source for hand washing. An alternative to soap/water for hand washing after (not prior hand washing) is the quick drying anti bacterial hand washing gel.

•Ensure access to collection materials, test devices, and specimen’s is effectively restricted.

•Inform donor of minimum specimen level. Generally speaking 30 mL is sufficient.

•Write donor name, ID #, and date in the designated area on the collection container and give to donor.

•Set a reasonable time limit for the donor to be inside the restroom.

•Upon receiving the specimen from the donor, place security seal over collection container, check the specimen volume, temperature, and for adulteration or substitution. Do not wait longer than 4 minutes to check the temperature after receiving the specimen. The acceptable temperature range is 90 - 100 degrees F.

•Inspect for unusual color, presence of foreign objects or material, or other signs of adulteration (e.g., specimen is blue, foaming when shaken, smells of bleach).

•Any sample suspected of being adulterated should be considered INVALID and another sample should be collected. Direct observation of the second collection should be considered. If they are unable to provide another sample immediately, start Shy Bladder Procedure.

Shy Bladder Procedure (donor is unable to provide a sample)

•First, begin the process. Ask them to try. Explain that most people can provide 30 mL of urine even when they think they can’t.

•If they demonstrate inability to provide a sample, note the time. Tell them they have up to 3 hours to provide a sample. Encourage donor to drink up to 40 oz. of water while waiting.

•Do not combine urine collected from separate attempts to create one specimen of sufficient volume.

•If unable to provide a sample in 3 hours, discontinue the collection. This may require an immediate medical evaluation ( explaining this during the process may provide the motivation to provide a specimen).

Disposal of Urine, Collection Cups, and Rapid Testing Devices

•Urine and Saliva are not considered carriers of blood borne pathogens, and not considered bio hazardous waste, and therefore regulations regarding medical waste are not applicable. That said, Universal Precautions, should always be practiced (ie. gloves, and other PPE). Urine and saliva samples and containers may be discarded in the regular trash. It is recommended that you double bag trash cans used for this purpose for extra caution and sanitary purposes.

•It is recommended that you always conduct a rapid drug test immediately after the collection and in the continued presence of the donor. This accomplishes 2 things:

•It maintains chain of custody of the sample with the donor. Additionally, if your policy calls for confirmation testing of a positive screening result, having the donor present for the completion of laboratory forms, etc. is an added convenience for the collector and donor. If the sample isn’t sealed until after the rapid test is performed the donor should also be present.

•After the test is performed and results are recorded if there is no additional need for the sample the collector may instruct the donor to return the sample to restroom and dump the urine in the toilet, flush, and throw the collection cup into a designated trash can. This further minimizes urine exposure to the collector.

For Assistance setting up your Collection Procedures call
Micro Distributing Technical Support at 866-933-0964

What does a positive reading look like with the QED® test?

When a QED® test result is positive, a dark purple color bar forms within the measurement scale. This color is distinctly darker than the pink or orange color seen as the sample fills the device. The color bar on a positive test -- the same color seen in the QA Spot™ -- develops in 2 minutes.

How hard should I press down with the QED applicator?

Gently apply slow and even pressure when placing the swab in the entry port. Too much pressure can jam the test. For best results, gently twist the collector into the entry port until the cotton touches the red filter pad and then begin pressing.

What does the Clinical Laboratory Improvement Act (CLIA) waiver mean for work site testing?

Because work site testing is considered forensic testing, CLIA regulations do not apply. The waived status for the QED Saliva Alcohol Test under CLIA ’88 makes testing easier in hospitals, rehabilitation centers and treatment facilities where our test is used as an in-vitro diagnostic tool.

Does the QED® test measure residual alcohol in the mouth or is it measuring the alcohol within the entire body (blood stream)?

Beverage alcohol (ethyl alcohol) is absorbed directly and unchanged into a person’s body and is evenly distributed throughout the blood stream and other bodily fluids, including saliva. The QED test measures the amount of alcohol in bodily fluids, commonly called blood-alcohol concentration, or BAC. Residual alcohol in the mouth just after a person takes a drink is quickly absorbed, swallowed, or evaporated, and a person’s mouth is "clear" of residuals 10 minutes after eating or drinking.

One customer asked if "using the QED Saliva Alcohol Test was just a matter of spitting on to those little thermometers?"

The QED test does provide laboratory accuracy with on-site simplicity, but spitting is not polite and we wouldn’t want to support bad manners.

When are you going to make a Screening Test Technician (STT) training video for non-Department of Transportation (DOT) settings?

While the STT Training Video is DOT-approved and covers the DOT regulations, it should not be viewed as a "DOT only" product. Companies with alcohol testing policies would do well to use the DOT program as a model, in case their program was ever challenged. Similarly, test technicians should consider DOT-certification as a way to further validate their ability to do the testing.

How can a company use your Screening Test Technician (STT) training video to certify an STT if no one at the company is already certified?

The DOT requires that the STT Training Video Facilitator be someone with at least one year’s experience working as an STT or training STTs. Without that experience, a Facilitator must complete a "train the trainer" STT course offered by OraSure Technologies or an authorized QED Distributor or STT Trainer.
8. Can a "facilitator" become certified while taking a student through the video course?
No. The DOT ruled that STTs cannot certify themselves. However, once a student is certified, the student can be the facilitator, and the facilitator becomes the student.

How will planned revisions to the DOT Regulations affect my certification?

The DOT has released its proposed new rule, the comment period on which closed April 7, 2000. The DOT is advocating re-certification for all STTs every two years. OraSure Technologies, Inc. will continue it’s "train the trainer" program for STTs to help people comply with current and future regulations.

Can books in the (Screening Test Technician) STT video kit be copied?

No. The materials are copyrighted and therefore cannot be reproduced. It is for that reason we have produced additional student kits. QED distributors price extra student kits inexpensively to encourage additional certification under the law.

Will the QED test react with ketone often found in the saliva of diabetic patients?

No. Unlike breath analyzers and other saliva tests, the QED test is specific to ethyl alcohol and will not cross-react with acetone and ketone produced by diabetic patients.

Will the QED device work if it is stored at temperatures outside the range on the packaging?

Storing and using QED tests at room temperature (15-30°C, 59-86°F) insures optimal performance and a full shelf life. However, the QED test will work fine if exposed to temperatures outside that range for limited periods. We tested the QED device under a wide range of temperatures and storage conditions -- simulating the inside of a vehicle glove box on a hot summer day (about 120°F) and the lonely cold of North Dakota in January (about 0°F). In all cases, the test performed as it should. Before using a QED Saliva Alcohol Test exposed to extreme heat, allow the device to cool to room temperature; if the QED device is exposed to extreme cold, put it into a pocket to warm it up.

How can companies using the QED test in very remote areas comply with the DOT’s requirement that confirmation tests on positive screening tests must be conducted within 30 minutes?

The DOT will accept results of confirmation tests conducted more than 30 minutes after a positive screening test. Look to 49 CFR Part 40 section 40.65, paragraph (b). The DOT added a sentence which directs the Breath Alcohol Technician (BAT) to simply explain "why?" if a confirmation test is done more than 30 minutes after a screening test. This is not a fatal flaw.

Why should I buy the QED Saliva Alcohol Test if I need an Evidential Breath Testing (EBT) to confirm positive test results?

The QED test is much less expensive to operate than a breath test, unless you conduct a very high volume of tests in a central location. By and large, each test done on saliva instead of breath saves money. Plus, performing two independent tests is more legally defensible on the rare occasion an employee does test positive for alcohol.
What are the quality control (QC) requirements for the QED test?
Control checks, using OraSure Technologies’ QED ethanol control solution should be run once per lot number of QED® tests. CLIA waived status eliminated the need for daily control checks.

How do I order?

QED tests are sold in cases of 100, cartons of 30 and boxes of 10 by a national network of safety, medical, occupational and laboratory distributors.

Pregnancy Testing

Catalog No. Test Description



CPT Code



FHC-101 Pregnancy hCG Strip Tests Urine Testing - 81025 $8.84
FHC-102 Pregnancy hCG Cassette Tests Urine Testing - 81025 $8.84
FHC-144 Pregnancy hCG Dip Device Tests Urine Testing - 81025 $8.84
FHC-202 Pregnancy hCG Combo (Urine/Serum) Tests Serum Testing - 84703 $10.49


Ovulation Testing

Catalog No. Test Description



CPT Code



FLH-103 LH Ovulation Predictor Midstream, 5 Day Test Kit 84830 $14.02


Strip A Testing

Catalog No. Test Description



CPT Code



IST-501 Strep A Strip - Waived 87880QW $16.76
IST-502 Strep A Cassette 87880 $16.76
IST-502T Strep A One-Step - Waived 87880QW $16.76


h. Pylori Testing

Catalog No. Test Description



CPT Code



IHP-402 h. Pylori 86318 $18.09
  h. Pylori - Waived, Whole Blood 86318QW $18.09


Mono Testing

Catalog No. Test Description



CPT Code



IMO-402 Mono 86308 $7.23
  Mono  86308QW $7.23


Drugs of Abuse Testing

Catalog No. Test Description



CPT Code



Varies Drug Screen: Multiple Drug Classes *QW 80100 $20.32
Varies Drug Screen: Single Drug Class *QW 80101 $19.24


*Drug screening for routine work related issues or testing related to chemical dependency treatment are not covered. This test reports qualitative screening to detect the presence of specific drugs or classes of drugs.

** Add "QW" Modifier only to denote use of CLIA Waived product for Medicare and Medicaid Patients.

Important Note:

The list of CPT Codes and Average Reimbursement (estimates) are provided as suggestions and estimates only. The use and implementation of CPT codes and reimbursement levels on a state and/or federal basis may vary greatly in a given area and change over time. The relevant Medicare and/or Medicaid agencies may also take a view that the suggested CPT codes and/or reimbursement levels set forth herein are not applicable. Thus, the accuracy of these suggested CPT codes and reimbursement levels cannot be guaranteed. Please contact your own regional third party payers to confirm the correct CPT codes and reimbursement levels.

For state by state fee schedule go to

How can specimens be stored prior to testing?

Urine specimens may be stored at 2-8 degrees C for up to 48 hours prior to testing. For prolonged storage, specimens may be frozen and stored below -20 degrees C. Frozen specimens should be thawed and mixed well before testing.

For specimen undergoing Specimen Validity testing, test specimens immediately for best results. Storage of urine specimens should not exceed 2 hours at room temperature or 4 hours refrigerated.

How should urine specimens be collected?

The urine specimen must be collected in a clean and dry container. Urine collected at any time of the day may be used. Urine specimens exhibiting visible precipitates should be centrifuged, filtered, or allowed to settle to obtain a clear specimen for testing.

Will menstrual blood have any effect on the test?

No, menstrual blood should not affect the test. Urine specimens exhibiting visible precipitates should be centrifuged, filtered, or allowed to settle to obtain a clear specimen for testing.

How does the test work?

The test is a lateral flow chromatographic immunoassay for the qualitative detection of an identified drug or the identified drug metabolites in human urine. The S.V.T. test is a semi-quantitative color comparison screen for the detection of adulterants.

If the test is used before the refrigerated specimen reaches room temperature, is the result reliable?

No. If refrigerated, the test and the specimen must be at room temperature (15-30 degrees C) before the test is performed. Specimen at body temperature does not need to reach room temperature before running the test.

What factors could cause the test to be invalid?

Improper testing procedure, unsealed packaging, damaged membrane and unsuitable specimens could cause the test to be invalid.

If the test strip was removed from the foil pouch and dropped on the floor prior to using it, will it still work?

If the test is intact and the exposed membrane in the reaction window was not damaged, it can still be used and expected to function properly.

How many tests is it possible to run at a time?

It depends on the proficiency of the user. However, even in experienced hands, we do not recommend running more than 10 tests at a time.



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Rapid Response Drug Testing
P.O. Box 9504
Tampa, FL 33674
Phone: 757-289-9746
Toll Free: 800-668-0031
Business Hours: M-F, 8 - 5 EST
Email for Info:
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