15 ng ml home drug test

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Workplace urine drug testing for an inactive THC metabolite is common in both federally regulated and non-regulated drug testing. A positive result does not document impairment, or even recent use, when impairment is likely the most important parameter being searched for by the drug testing procedure. Most cannabinoid testing does not detect imported synthetics. Currently, urine is the most widely tested matrix, but blood, plasma, oral fluid, and hair may also be accepted in federally regulated testing in the future. This article will discuss the history, the status quo, and the possible near term future of workplace testing for marijuana in employees.

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Workplace Drug Testing in the United States has become common, both in Federally regulated programs and in private industries. Usually performed with urine as the matrix, and utilizing a two step process where an initial immunoassay is used as a screen with subsequent confirmatory testing if the screen is positive, an inactive marijuana metabolite THC-COOH in urine is most commonly used as the target analyte for marijuana use.

Even though under this most commonly used procedure impairment cannot be directly determined, a positive confirmed test for this inactive metabolite may have profound consequences for both employers and employees.

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Workplace urine drug testing is commonly used in pre employment evaluations, post accident, reasonable suspicion of impairmentand in random testing scenarios per company policy. Because marijuana remains a Schedule 1 drug under federal law, federally regulated testing does not consider any marijuana use to be legitimate, with the exception of prescription cannabinoids as discussed below. Private employers not subject to federal regulations can make other policies at their discretion. The purpose of this article is to summarize cannabinoid drug testing in the workplace, and not to discuss the acute or chronic clinical effects of THC and related, nor the pros and cons of legalization.

In the United States, workplace drug testing became common after when Executive Order was ed, prohibiting federal employees from using illegal drugs [ 1 ]. The emphasis then, as now, is on illegal drugs, which has resulted in lack of regulatory testing for prescription drugs which can be impairing and commonly abused.

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Examples of these non tested drugs include oxycodone, hydrocodone, hydromorphone, fentanyl, methadone, barbiturates, benzodiazepines, and the Z drugs prescription sleep aids. Private industry commonly does test for at least some of these classes of drugs. In the Drugfree Workplace Act was passed by the US Congress establishing the 5 panel urine drug screen classes, which can be easily remembered by the mnemonic COMPA the first five letters in the word company : Cocaine metabolite, Opiates with morphine and codeine being the target analytesMarijuana metabolite, Phencyclidine, and Amphetamines as a class which includes amphetamine and methamphetamine.

Procedures for urine collection, chain of custody, split specimens, and what to do if there is a refusal to test, a dilute or adulterated specimen, or when the employee cannot urinate were specified in with the Code of Federal Regulations 49 CFR Part 40 [ 23 ]. Under this model, a positive and confirmed urine drug test result is reviewed by a physician with extra training who has been certified as a Medical Review Officer MROwhich requires both training and passing an exam specific to these procedures, with recertification every five years.

This may be problematic when the employee is in a safety sensitive position and is taking a prescription medication that may cause impairment. The employer should have policies to deal with this common scenario. Alternative matrices for testing in these companies may include hair, oral fluid, breath, or blood. Additional classes of drugs can be assessed, which offers substantial advantage toward the goal of preventing prescription drug abuse in workers. However, because there has been such an extensive experience with federally regulated testing, many private companies choose to use the same model of urine testing used by the Department of Transportation model, which includes only the 5 panel urine-based test.

The nomenclature used in drug testing for cannabinoids can be confusing. The carboxyl group in the inactive precursor is on carbon 2. Heat and 15 ng ml home drug test will decarboxylate the inactive precursor forming the psychoactive drug THC. Inactive naturally occurring precursor tetrahydrocannabinolic acid becomes active THC upon heating and drying, which is metabolized to the inactive metabolite norCarboxy-THC, the target analyte for urine drug testing.

To avoid confusion it may be valuable to use the words precursor and metabolite, or specify which carbon 2 versus 11 has the carboxyl group, when discussing the inactive precursor versus the target analyte for Cannabis testing.

The current regulatory testing for cannabinoids uses as the target analyte in urine an inactive THC metabolite that may persist for weeks or even months in chronic users after last use 4. Because the concentration of THC in marijuana has progressively increased, passive inhalation has become more of a concern as a possible explanation for a positive test [ 56 ]. The legalization of medical and recreational marijuana under state law in many states has added complexity to policy issues involving workplace drug testing.

However, a recent survey of businesses found that only a small minority changed their drug testing policies based on changes in state law regarding legalization of medical or recreational marijuana [ 7 ].

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However, internet sites and medical literature often claim a false positive test result from unrelated substances when only the initial screen has been performed, or long after the technology has been improved to address these limitations.

The negative result is laboratory nomenclature that medical toxicologists and all those who interpret drug test should understand in detail. The lab that did the testing will likely know what cross reactivities exist, or can look it up in the testing manual, or can call the manufacturer for more information. If confirmatory testing has not yet been done, it should be under regulatory authority or if in private industry there will be negative consequences for the employee.

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If confirmatory testing has been done, by what technology, and what are the potential problems with it concerning this specific drug? While urine has traditionally served as the matrix of choice for workplace drug testing, recent recommendations have been published 15 ng ml home drug test that other matrices be accepted.

The merits of both of these proposals are still being debated. There has been a large amount of research and experience with drug testing in these alternative matrices since they were last proposed by SAMHSA in The American College of Occupational and Environmental Medicine, which has been very involved in educational and regulatory activities regarding workplace drug testing, recently published two position statements [ 910 ] that included recommendations for Cannabis testing.

Although specifics varied somewhat, each emphasized documentation of impairment which might include blood or plasma THC and active metabolite levels or neuropsychiatric testing of employees as opposed to just the presence of an inactive metabolite in urine which is the status quo.

Synthetic cannabinoids such as those found in K2 and Spice pose a particular challenge in workplace testing. While clearly capable of causing severe impairment and life threatening medical problems [ 11 ], most workplace drug testing will not detect these substances because the initial screen target analyte COOH-THC is structurally different enough that a positive initial screen will not occur. Private industry can add synthetic cannabinoids to their routine workplace testing, but at considerable expense.

An ever changing array of chemical substitutions also makes detecting all currentlyl and potentially available products extremely difficult. Colorado voters approved medical marijuana in and recreational marijuana in On June 15, the Colorado Supreme Court [ 12 ] upheld the firing of a wheelchair bound employee who was using medical marijuana upon the recommendation of his physician to treat his spastic paraplegia from an automobile accident many years prior. The employee was never accused of being impaired from marijuana on the job, and claimed he only used marijuana after work.

This occurred despite the fact that Colorado also has a lawful activities statute that protects workers from being fired for participating in legal activities when not at work. The employee tested positive for THC in oral fluid in a random drug screen, and company policy non federally regulated testing guided his firing.

The company argued that if the court ruled in favor of 15 ng ml home drug test employee that the company and others would risk losing federal contracts because they would no longer comply with federal drug free workplace statutes. This important yet controversial ruling will likely be cited in future cases involving employee drug testing for cannabinoids in other states. Workplace drug testing for cannabinoids remains common yet controversial from a regulatory, political, privacy, medical, and criminal justice viewpoint.

It is rapidly evolving with likely future expanded regulatory testing of oral fluid and hair and not just urine, each matrix with its own advantages and challenges. The focus on cannabinoid testing appears to be shifting away from marijuana use of any kind at any time testing urine for an inactive metabolite to whether or not impairment from THC in the workplace exists. Impairment from illicit synthetic cannabinoids creates a whole different set of testing and policy challenges. National Center for Biotechnology InformationU.

Journal List J Med Toxicol v. J Med Toxicol. Published online Sep Ken Kulig. Author information Article notes Copyright and information Disclaimer. Ken Kulig, : moc. Corresponding author. This article has been cited by other articles in PMC. Abstract Workplace urine drug testing for an inactive THC metabolite is common in both federally regulated and non-regulated drug testing.

Introduction Workplace Drug Testing in the United States has become common, both in Federally regulated programs and in private industries. Brief History of Workplace Drug Testing In the United States, workplace drug testing became common after when Executive Order was ed, prohibiting federal employees from using illegal drugs [ 1 ].

Table 1 Initial screen and Confirmatory cutoff concentrations in federally regulated testing. Open in a separate window. Drug Testing for Cannabinoids The nomenclature used in drug testing for cannabinoids can be confusing. Recent Proposed Expansion of Cannabinoid Drug Testing Matrices Allowed under Federal Law While urine has traditionally served as the matrix of choice for workplace drug testing, recent recommendations have been published advising that other matrices be accepted.

Conclusions Workplace drug testing for cannabinoids remains common yet controversial from a regulatory, political, privacy, medical, and criminal justice viewpoint. Sources of Funding None. References 1. Title Transportation, Part 40 - Procedures for transportation workplace drug and alcohol testing programs updated May 4,U. Department of Transportation. Department of Health and Human Services Mandatory guidelines for federal workplace drug testing programs.

Part II;notice. Fed Regist. Excretion patterns of cannabinoid metabolites after last use in a group of chronic users. Clin Pharmacol Ther. Non-smoker exposure to secondhand cannabis smoke.

15 ng ml home drug test

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