special subjects
Drug Testing
Introduction
Drug testing is done primarily to screen people systematically or randomly for evidence of use of one or more substances with potential for abuse. Testing may be done in the following: Certain groups of people, commonly including students, athletes, and prisoners People who are applying for or who already hold certain types of jobs (eg, pilots, commercial truck drivers) People who have been involved in motor vehicle or boating accidents or accidents at work People who have attempted suicide by unclear means People in a court-ordered treatment program or with terms of probation or parole requiring abstinence (to monitor adherence) People in a substance abuse treatment program (as a standard feature, to obtain objective evidence about substance abuse and thus optimize treatment) People required to participate in a drug testing program as part of custody or parental rights Members of the military Notification or consent may be a requirement before testing, depending on jurisdiction and circumstances. Mere documentation of use may be sufficient for legal purposes; however, testing cannot determine frequency and volume of substance use and thus cannot distinguish casual users from those with more habitual use. Also, drug testing targets only a limited number of substances and thus does not identify many others. The clinician must use other measures (eg, history, questionnaires) to identify the degree to which substance use has affected each patient’s health and functioning. The substances most commonly tested for are Alcohol Toxicity and Withdrawal None Amphetamines None Sedatives None Sedatives None Cocaine None Marijuana (Cannabis) None Opioid Use Disorder and Rehabilitation None Ketamine and Phencyclidine (PCP) None Urine, blood, breath, saliva, sweat, or hair samples may be used. Urine testing is most common because it is noninvasive, quick, and able to qualitatively detect a wide range of drugs. The window of detection depends on the frequency and amount of drug intake but is about 1 to 4 days for most drugs. Because cannabinoid metabolites persist, urine tests for marijuana can remain positive longer after use is stopped. Blood testing can be used to quantify levels of certain drugs but is less commonly done because it is invasive and the window of detection for many drugs is much shorter, often only hours. Hair analysis is not as widely available but provides the longest window of detection,≥100 days for some drugs. . Also, Hallucinogens , 