From Collection to Result: How the Non-DOT Drug Testing Process Works
Drug testing is an important component of a comprehensive Drug-Free Workplace Program, but what actually happens after an employee is told they need to take a drug test?
For employers and employees alike, understanding the process can remove uncertainty, help protect the integrity of testing, and ensure everyone understands their responsibilities. Unlike testing regulated by the U.S. Department of Transportation (DOT), non-DOT drug testing is generally governed by the employer's written Drug-Free Workplace Policy, applicable state and local laws, and the procedures established with the employer's testing provider and laboratory. This means there is no single federal non-DOT testing process that applies to every private employer.
However, a professionally administered non-DOT testing program generally follows several important steps.
Step 1: The Employer Determines That a Test Is Required
The process begins when an employer determines that an employee or applicant needs to be tested under its Drug-Free Workplace Policy.
Depending on the employer's program, testing may occur for reasons such as:
Pre-employment
Random selection
Reasonable suspicion
Post-accident
Return-to-duty or return-to-work
Follow-up testing
Other circumstances specifically authorized by the employer's policy
This is one reason having a clear, comprehensive and consistently administered written policy is so important. Employees and supervisors should understand when testing may occur, what substances may be tested for, what constitutes a refusal, and the potential consequences of a policy violation.
Employers should never simply assume that because a particular type of testing is common, they are automatically permitted to conduct it. State and local laws can affect when and how non-DOT testing may be performed.
Step 2: The Employee Reports for Collection
Once a test has been ordered, the employee is directed to an authorized collection site or testing provider. The employee will typically be required to provide identification and complete the necessary testing documentation. Depending on the employer's testing program, the specimen may be urine, oral fluid, hair, or another permitted testing method. For urine testing, the collection process normally includes procedures designed to protect both the employee and the integrity of the specimen. The collector follows established procedures for receiving, identifying, handling, sealing, and documenting the specimen. Most routine urine collections are conducted privately. However, certain circumstances may require additional collection procedures depending upon the employer's policy, applicable law, and the testing provider's protocols.
Step 3: Chain of Custody Protects the Integrity of the Specimen
One of the most important components of drug testing is the chain of custody.
Chain of custody documents what happens to the specimen from the time it is collected until testing is completed. The process is designed to establish that the specimen tested by the laboratory is the same specimen provided by the individual being tested and that it has been appropriately handled throughout the process. The specimen is properly identified, sealed and documented before being transported to the laboratory. Employees should generally be given an opportunity to verify identifying information and the integrity of specimen seals as part of the collection process.
Step 4: The Laboratory Tests the Specimen
Once the specimen reaches the laboratory, testing begins.
Laboratory-based drug testing generally uses a two-step process when a specimen initially indicates the possible presence of a drug or drug metabolite.
Initial Screening
The first stage is an initial screening test. If the specimen does not meet or exceed the laboratory's established cutoff concentration for the substances being tested, it is generally reported as negative.
If the initial screening indicates the possible presence of a drug or drug metabolite at or above the applicable cutoff, additional testing is performed.
Confirmation Testing
An initial positive screen should not automatically become a final positive drug-test result.
A laboratory confirmation test uses a more specific analytical method to identify and measure the particular drug or drug metabolite. This confirmation step helps distinguish a scientifically supported positive laboratory finding from an initial screening result.
Step 5: The Medical Review Officer Reviews Applicable Results
Many well-designed workplace testing programs utilize a Medical Review Officer, commonly called an MRO. An MRO is a licensed physician with specialized knowledge of drug testing who serves as an independent medical reviewer of laboratory results. This is an important protection for both employers and employees.
For example, a laboratory may identify a substance that could potentially be explained by a legitimate prescription. Rather than having an employee disclose private medication information directly to a supervisor or Human Resources, the MRO can contact the employee and determine whether there is a legitimate medical explanation for the laboratory finding. The MRO may ask the employee to provide appropriate documentation, such as pharmacy or prescribing information.
When a legitimate medical explanation is adequately verified, the MRO determines how the result should be reported in accordance with the applicable testing program. When there is no legitimate medical explanation, the MRO may verify the result as positive.
The MRO—not the employer—is generally responsible for evaluating legitimate medical explanations for laboratory findings when an MRO process is part of the employer's program.
Step 6: The Employer Receives the Final Result
After laboratory testing and any necessary MRO review are complete, the authorized employer representative receives the final result. Depending upon the circumstances and testing program, results may include classifications such as:
Negative
Positive
Negative dilute
Positive dilute
Invalid
Adulterated
Substituted
Other outcomes may also require action, such as a cancelled test or a recollection.
It is important for employers to understand that these terms do not necessarily mean the same thing or require the same response. For example, a dilute specimen does not automatically mean that an employee attempted to defeat a drug test. An invalid result may require additional evaluation or recollection rather than disciplinary action.
Employers should work with qualified testing professionals and follow their written policy before determining what happens next.
What Happens if an Employee Refuses to Test?
A Drug-Free Workplace Policy should clearly define what constitutes a refusal.
Refusal is not necessarily limited to an employee simply saying, "I'm not taking the test."
Depending on the employer's policy and applicable requirements, refusal-related conduct might include failing to report to the collection site within the required timeframe, leaving before the collection is completed, failing to cooperate with required collection procedures, or engaging in conduct intended to interfere with the testing process.
Because non-DOT programs are not automatically governed by DOT's federal refusal rules, employers should clearly define prohibited conduct and testing obligations within their own policy and ensure those provisions comply with applicable law.
What Happens After a Positive Test?
A positive test result does not automatically dictate one universal employment outcome.
The employer should follow its written Drug-Free Workplace Policy and applicable law.
Depending on the employer's program, consequences could include disciplinary action, removal from safety-sensitive duties, referral to an Employee Assistance Program (EAP) or other resources, requirements for treatment or evaluation, return-to-duty testing, follow-up testing, or termination.
The key is consistency.
Employers should avoid making testing and disciplinary decisions on an improvised, case-by-case basis when their written policy establishes a specific process.
Confidentiality Matters
Drug-testing information should be treated as sensitive and confidential.
Results should generally be provided only to individuals who have a legitimate business need to know and handled in accordance with applicable laws and company procedures.
Employers should also be careful about asking employees for detailed medical or prescription information themselves when an MRO is available to perform that function.
Protecting confidentiality is an important part of maintaining employee trust while administering an effective Drug-Free Workplace Program.
Drug Testing Is Only One Piece of the Program
One of the biggest mistakes an employer can make is thinking that having access to a drug test means it has a comprehensive Drug-Free Workplace Program.
A drug test is a tool. A Drug-Free Workplace Program is a system.
An effective program should begin with a well-written policy and may also include:
Employee education
Supervisor training
Reasonable-suspicion procedures
Reliable collection and laboratory services
Medical Review Officer services
Employee Assistance Program (EAP) or other support resources
Clear procedures for responding to positive tests and refusals
Return-to-duty and follow-up procedures when applicable
Consistent documentation and confidentiality practices
Supervisors also need to understand their role. They should know how to recognize and document observable signs of possible impairment, how to initiate reasonable-suspicion procedures, and how to respond appropriately when an incident occurs.
Why Understanding the Process Matters
Drug testing can have significant consequences for both the employee and the employer. A poorly administered testing program can create confusion, inconsistent decisions and unnecessary risk.
A well-designed process provides safeguards at every stage—from determining whether a test is authorized, to properly collecting the specimen, maintaining chain of custody, conducting scientifically reliable laboratory testing, obtaining appropriate MRO review, protecting confidentiality, and responding consistently to the final result.
For employers, the goal should not simply be to "send someone for a drug test."
The goal should be to maintain a comprehensive Drug-Free Workplace Program that promotes safety, consistency, accountability, employee support and compliance.
Need Help With Your Drug-Free Workplace Program?
Working Partners® helps employers build and maintain comprehensive Drug-Free Workplace Programs that go far beyond simply having a policy on paper. From customized policy development to our Working Partners® Consortium Membership Program, we provide employers with access to the resources, trusted professionals, and ongoing support needed to effectively manage their Drug-Free Workplace Program.
Through Consortium membership, employers receive access to trusted and vetted vendors, along with valuable services and member discounts, including employee education and supervisor training, drug and alcohol testing services with Medical Review Officer (MRO) services built into the testing price, Employee Assistance Program (EAP) resources, HR support services, and more.
Members also receive unlimited troubleshooting with one of our experienced Drug-Free Workplace consultants when real-world situations arise—whether it's reasonable suspicion, post-accident testing, a positive test result, a refusal to test, return-to-duty questions, or another challenging workplace situation.
In addition, members receive our monthly Working Partners® Wayfinder newsletter, designed to keep employers informed about emerging Drug-Free Workplace issues, regulatory developments, best practices, important dates, resources, and trends affecting today's workplaces.
Whether you're developing a new program or strengthening an existing one, Working Partners® can help ensure you have more than a policy sitting on a shelf—you have a comprehensive program, trusted resources, and experienced support your organization can turn to when it matters most.
Trusted. Proven. Compliant.
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