Drug Testing – Urine is Still the Gold Standard

O.K., the title of the article may be crass, but it holds true.  Urine drug testing is still the most widely used method for detecting substances in a person’s body.  Drug testing has become second nature in today’s employment community.  Employees are tested for a variety of reasons: pre-employment / post-offer, random, reasonable-suspicion / for-cause, and post-incident (post-injury when medical care is needed or post-accident when medical care is not necessary but property damage has occurred).  Federal DOT (Department of Transportation) only recognizes urine (and blood in certain rare circumstances) as the method for drug testing people carrying CDL licenses or a medical card for driving certain vehicles.  As a collection site, the most reliable way to collect a patient’s specimen is by following DOT collection procedures.  These procedures have held up in court and make it difficult to tamper with a specimen’s results.

Considering how common drug testing is in today’s society, many people have probably taken at least one drug test, thus the stigma attached to someone handling urine is, for the most part, an outdated argument.  Between two clinics, IWIRC performs about 1,200 drug tests per month with a clientele of roughly 2,000 employers, thus making IWIRC one of the largest drug testing vendors in Illinois and the largest downstate occupational health provider.  Among those 2,000 employers, less than 10 of

them use methods other than urine for their drug tests.  Hair testing is another method utilized for detecting drug use; however, there are a few issues with hair testing that need to be shared:


  • It takes 7-10 days after use for a substance to show up in the hair follicle.  If someone uses a drug on Saturday, their hair sample wouldn’t detect that usage until the following Friday or Saturday at the earliest.  This obviously poses a problem with for-cause testing when looking for on-site intoxication or random testing as that person may never be drawn in the random pool again.
  • Each 0.5 inch of hair equals roughly the last 30 days.  The first 1.5 inches of hair starting at the root is used to go back 90 days.  Beyond the first 1.5 inches the hair sample is less reliable and results are not as accurate.
  • If your head hair isn’t long enough, then your body hair is used.  But, body hair recycles itself once per year on average.  So now there are different time frames for detection – 3 months vs. 12 months.  And, if your body hair isn’t 1.5 inches in length, urine is used as the backup testing method.  Now there’s another time frame incongruity, as substances are detected almost immediately through urine, but leave a urine specimen anywhere from 72 hours to 30 days after use.


The question to ask when considering which testing method to use:  in an age when urine collection is still 1) the most reliable and tried, 2) by far, the most commonly utilized, and 3) cost-comparable to the other methods; why utilize another method?  Chances are good that your company will be using urine drug testing in at least some circumstances anyway, so why not use urine for all your drug testing needs?