By A Pharmacist For Pharmacists
There are several different reasons why an over-the-counter (OTC) drug test may prove beneficial to patients throughout the year. Whether it is for employment, random testing, or medically required, patients may approach your pharmacy with questions about OTC options before taking a real test.1 For this reason, it is important to know about the various options available to patients for at-home drug testing.
The most common drug test used by employers that can be found in the OTC section is a urine home drug test.2 Urine tests often screen for drugs like marijuana, cocaine, amphetamines, PCP, and opiates.1,3 Unlike saliva test, urine screens can reveal drug use for an extended period after the effects of the drug have worn off.4
Fortunately, many OTC home drug test options can give patients a good idea about the likelihood of passing a professionally administered test. These screens can be found at most pharmacy chains providing a selection of different options to choose from. Some tests come with the capability of only testing for one illicit substance, such as marijuana, where others may screen for multiple drugs including amphetamines, opioids, cocaine, and others.3 Generally, the tests designed for only one drug are cheaper, but patients may benefit from a more comprehensive panel depending on their situation.
At-home urine screens are less accurate than ones done professionally. These tests are only designed to give a pass/fail reading to patients at a specific threshold.2 This means that some tests done professionally may be stricter, requiring a lower concentration of drug to be found in the urine to pass.2 In addition, urine screens can occasionally give false positives when trying to detect usage. Certain foods, OTC medications, vitamins, and prescriptions can trigger a positive result on a drug test.5 Therefore it is important to consider this when positive results do occur.
Unlike urine screens, saliva tests will only show as positive if a substance was used recently, usually within a 24-hour period.3 Therefore, it is important to know exactly what kind of test the patient will be undergoing before recommending an OTC home drug test.
However, if the patient is reasonably sure they will undergo a saliva test it will often prove to be the cheapest option when purchasing over the counter.2 Saliva testing kits will often come with additional tests, unlike most urine screen alternatives, making them an excellent option for people that may be screened frequently. The major downside stems from the fact that this option will not provide an accurate reading for those who undergo a urine or hair screen.
Hair screens are widely known to be the most accurate option with the longest testing period compared to their counterparts. Hair tests can often reveal drug use for a period of up to 90 days in most people – as the hair follicles can come from almost any location on the body.3 These screens are by far the most expensive option to consider when looking to purchase an at-home drug test.2
At-home drug tests for hair are best fitted for people who will undergo more extensive or strict screens. These screens are often regarded as “cheat-proof” since the user cannot simply abstain from drugs for a short period of time as they could with saliva or urine tests.3 People subjected to hair tests would have to be drug-free for at least three months if not longer to pass their screen. However, hair screens may fail to catch drug usage within the first 7-10 days after consumption – making them less reliable to detect recent usage.5 People who may work for institutions with strict drug and alcohol policies may want to become familiar with this option.
Hair screens may also be used in the event of a positive urine test where the individual challenges the result. Since hair screens are so accurate, they can be used to definitively say whether a person had used drugs within the last 90 days. In the event of a positive urine screen with an OTC drug test – using a hair screen may be advised to best predict the odds of passing or failing a professional screen. However, due to the cost of these kits compared to urine and saliva tests it is always important to determine the requirements established by their institution.
Parental Drug Testing
Another common use for at-home drug tests are parents who suspect their children are using illicit substances. Parents considering this option need to understand how to start difficult conversations about drug abuse, when drug testing for their children would be appropriate, which method is best to use, and how to do it sensitively.
The primary reason to consider drug testing as a parent concerns the long-term physical and mental health of their child. Numerous studies have been conducted to assess the risks associated with drug use in children. Children who use drugs under the age of 18 have been found to be at an increased risk of dependence to drugs extending into adulthood.5
The American Academy of Pediatrics lists several symptoms that a child may exhibit if they are using illicit substances. Common symptoms include excessive fatigue, unusual moodiness, or problems at school.5 When parents observe these behaviors in excess, it may be reasonable to consider drug testing their child. However, it is important to consider them as an adjunct to other changes in their lifestyle to avoid breaching their privacy.
Parents must use caution when choosing to drug test their children as it can lead to several issues resulting in further damage to their relationship. One thing to consider when testing is that results can sometimes be misinterpreted. For example, these tests can yield false-positive results (especially urine screens). For the best results, parents need to be aware of the most effective type of test they should use and the time frame in which they use these tests. For example, results may be inaccurate if parents choose to use a hair screen too soon after drug use or a urine test too long after substances were consumed.
Testing a child may help to prevent substance abuse but can come at a cost to their relationship and trust. Remember if a positive drug test is observed, it may not represent actual substance use as these screens can sometimes trigger false positives. Parents need to be careful when interpreting results and remain open-minded. The American Academy of Pediatrics views such a situation as an opportunity to have an honest discussion with their kid to gather more information before making accusations.5 Doing so will help maintain trust and prevent damage to relationships.
- Knowing what kind of test is being conducted and how strict the test administrators will be are critical considerations for patients looking for OTC drug test options before making their purchase.
- Hair tests will provide users the most accurate result revealing drug usage from up to a 90-day period.
- Urine screens are less accurate than hair tests and usually only show drug usage from up to a 30-day period.
- Saliva tests are the least reliable at-home testing method – making results less accurate 48 hours from the user consuming any illicit substances. Before purchasing a home drug testing kit, customers need to know their institutions’ requirements. Workers within industries associated with stricter drug and alcohol policies include but are not limited to:
- Airline workers
- Government workers
- Healthcare workers
- National Institute on Drug Abuse. (2017, May 04). Drug Testing. Retrieved August 18, 2019, from https://www.drugabuse.gov/related-topics/drug-testing
- Drug Tests 101 – Everything You Wanted to Know About Screening. (n.d.). Retrieved August 18, 2019, from https://addictionresource.com/drug-testing/
- Types of Drug Tests. (2019, July 09). Retrieved August 18, 2019, from https://disa.com/drug-alcohol-testing/types-of-drug-tests
- Hadland, S. E., & Levy, S. (2016, July). Objective Testing: Urine and Other Drug Tests. Retrieved August 18, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4920965/
- Levy S, Siqueira LM, . Testing for Drugs of Abuse in Children and Adolescents. Pediatrics. 2014;133(6). doi:10.1542/peds.2014-0865.