Expertox

FREQUENTLY ASKED QUESTIONS (FAQs)

Toxicology and Drug Testing Basics:

What drugs are tested in a five (5) panel drug test?

What drugs are tested in a ten (10) panel drug test?

What drugs are tested in a basic Date Rape Panel?

How long after last use are drugs detectable?
Should I bring copies of my prescription medications to my drug test?
How long does THC (Marijuana) stay in the body?
What is the average turnaround time for test results?
What does it mean when the report indicates “non-detected”?
What does it mean when the report indicates “Dilute”?
What is “Limit of Detection” and do you test this on every drug test? 

 

Drug Testing with Hair Specimens:

How long does it take from time of consumption for drugs to grow out into the hair shaft?

What are the different timeframes associated with hair testing?

Can I find out if a person used drugs on a month-by-month timeframe through hair testing?

Is there an extra charge for hair segmentation?

What does “external exposure” mean?

What is included in an extended opiates drug test using a hair specimen?  What are the cut-off levels?

If I submit hair for a Date Rape Panel, is there any additional information you need when the specimen is submitted?
Can hair specimens be adulterated?
Can I collect a hair sample if the donor’s hair is wet or damp?
Do I need to let the laboratory know where the hair specimen was collected from on the body?

 

Nails:

How do you collect a nail specimen?


Blood/Serum: 

What are ExperTox’s cut-off levels for serum drug screens?  What is your acceptance/rejection policy for serum drug screens?

 

Meconium:

What is meconium?

Is every baby’s meconium tested for drugs?
Is there anything special I need to know about shipping a meconium sample?

What is ExperTox’s cut-off level for meconium drug screens?  What is your acceptance/rejection policy for meconium drug screens?

 

Unknown Substances, Poisons and Toxins:

What is an Unknown Substance Scan/Analysis?

What is an Unknown Poison and Toxin Analysis?
How do I submit a sample for this type of test?

Miscellaneous: 

Does a Medical Review Officer (MRO) need to review every positive test result?

How can you tell if a person is taking “crystal meth” if he/she has a prescription for Desoxyn

 


Toxicology and Drug Testing Basics:

What drugs are tested in a five (5) panel drug test?
Marijuana (THC), Methamphetamine, Amphetamine, Cocaine, Opiates and Phencyclidine (PCP)

 

What drugs are tested in a ten (10) panel drug test?
Marijuana (THC), Methamphetamine, Amphetamine, Cocaine, Opiates, Phencyclidine (PCP), Propoxyphene, Methadone, Barbiturates and Benzodiazepines

 

What drugs are tested in a basic Date Rape Panel?
GHB, ketamine and various benzodiazepines, including rohypnol. You can view a breakdown of our date rape panels by clicking here.

 

How long after last use are drugs detectable?

The answer depends on which drug; type of specimen; each person’s own metabolism; drug concentration and/or dosage; how often the drug was used; and the sensitivity of the testing procedure.

 

Oral Fluid:

Very recent use up to 2 days, depending on the drug

Blood:  

Most drugs are non-detectable after five to 48 hours, depending on the drug. A good rule of thumb is only use blood for drug testing if the person is impaired at the time of collection.

Urine:

May allow detection for several days, sometimes even more than a week.  However, urine analysis does not generally permit any toxicological evaluation of drug impairment, merely drug use.

Hair:

Drugs stay in the hair, so detection is dependent on the length submitted for testing.  A standard hair drug test is 1 ½”, or 90 days

Nails:

This includes Nail Clippings (from the tips of the nails) and Nail Shavings/Scrapings (from the surface of the nail).  Nail clippings yield an approximate thirty (30) day timeframe, six (6) months prior to collection.  Nail clippings and shavings yield up to a six (6) month timeframe

 

 

Should I bring copies of my prescription medications to my drug test?
No, it is not for the initial drug test.

In situations where a Medical Review Officer (MRO) will be involved, it is better to wait until the MRO's office contacts you so that any personal information, including a copy of your actual prescription, is communicated directly to the MRO.  Copies of your prescriptions will prove you are medically required to take some drugs that can show up as positive in a drug test.  The prescriptions help us to determine whether or not the prescriptions are consistent with the drug test results. 

 

How long does THC (Marijuana) stay in the body?
This answer depends on your metabolism, the frequency of smoking and concentration of THC.  Even if a person has been clean for a month, they may still test positive on a drug screen because there are still residual amounts of the drug in their body.  If a person was a heavy smoker and had a slow metabolic rate, it is more likely that THC will stay in his/her body longer than someone who smoked less frequently, and had a higher rate of metabolism.

 

What is the average turnaround time for test results?
The below-listed screen and test result turnaround times are for our most commonly ordered tests.  Note that turnaround time begins upon receipt of the specimen at the laboratory.

 

 

Negative Drug Screens using Urine or Blood Specimens 24 Hours

Negative Drug Screens using Hair, Nail or Oral Fluid Specimens

24 – 48 Hours
Positive Drug Confirmations

72 Hours
(48 Hours after Screen Completed)

Heavy Metals Panels 5 Business Days
Date Rape Panels

10 Business Days

Unknown Substance Analysis

10 Business Days

Unknown Poisons and Toxins Analysis 10 Business Days

 

What does it mean when the report indicates “non-detected”?
There are no all-inclusive drug tests.  Only specific drugs or drug categories may be addressed by any test or series of tests.  When the toxicology report indicates that no drugs were detected, this merely indicates that none in the specific categories mentioned were found at or above detection limits.  Lower drug concentrations cannot be excluded.  Furthermore, it does not exclude the presence of drugs in categories not tested.

 

What does it mean when the report indicates “Dilute”?
Creatinine concentration is checked during standard urine drug tests.  High creatinine levels indicate a pure test while low amounts of creatinine in the urine can indicate a possibly manipulated test, either through the addition of water in the sample or by drinking excessive amounts of water.  It should be noted that people who drink excessive amounts of water on a regular basis may also register with a low creatinine level.  Therefore, adulteration should not be automatically assumed, but merely considered.  Creatinine is a breakdown product of creatine phosphate in muscle, and is usually produced at a fairly constant rate by the body.  Normal creatinine levels for adults are >20mg/dl.  If creatinine is diluted, the overall test procedure results will be reported as “Dilute”.

 

What is “Limit of Detection” and do you test this on every drug test? 
The standard in toxicology testing is to utilize cut-off levels.  Limit of Detection means reporting any detectable amount of drug.  A test can be performed using Limit of Detection; however, this must be requested in writing on the chain-of-custody form.  There is a $25.00 fee for this service (this fee is not applicable to meconium drug tests or drug-facilitated sexual assault panels).

 

 

Drug Testing with Hair Specimens:

How long does it take from time of consumption for drugs to grow out into the hair shaft?
Approximately 10 – 14 days

 

What are the different timeframes associated with hair testing?
Every one-half inch (1/2”) of head hair is approximately equilavent to a thirty (30) day timeframe.  Body hair yields an aproximate six (6) month timeframe.  A standard hair test is 1 ½”, or 90 days, though longer time periods can be tested, depending on the length of the hair.

 

Can I find out if a person used drugs on a month-by-month timeframe through hair testing?
Yes, if you request the laboratory to segment the hair sample.  Segmentation of hair must be specified on the chain-of-custody form.  For example, if a client wishes to evaluate the last three (3) months for drug use but wants to evaluate each month separately, the following format should be written in the comments section on the chain-of-custody form:

(0-30), (31-60), (61-90)

The numbers refer to days in the month.  If there is no timeframe specification reflected on the chain-of-custody for hair testing, the standard cut of 1 ½” is tested as a 90 day test.

 

Is there an extra charge for hair segmentation?
The hair will be cut in the laboratory into thirty (30) day segments.  Each segment will be a separate hair test; therefore, a test fee will be charged for each segment tested.  As an example, if a person submits 1 ½” of hair and requests 30-day segmentation, the hair will be cut into three (3) thirty (30) day segments.  The cost will be the hair test price x 3.

 

What does “external exposure” mean?
Any hair submitted with “external exposure” indicated is not washed in the laboratory after initial preparation.  The specimen will go directly into incubation in order to preserve as much of the external contaminants present as possible.

 

What is included in an extended opiates drug test using a hair specimen?  What are the cut-off levels?
Codeine, morphine, hydrocodone, hydromorphone, oxycodone, oxymorphone, tramadol and meperidine.  The cut-off level is 200 pg/mg.

 

If I submit hair for a Date Rape Panel, is there any additional information you need when the specimen is submitted?
Yes.  The suspected incident date must be included on the chain-of-custody form.  Make sure that a sufficient length of hair is submitted to coincide with the date of the alleged incident.  There should be at least 7 inches of hair because of the timeframe that will need to be tested. This will ensure there is enough of the sample. As an example, if someone suspects an incident four months ago, a 2” piece of hair must be submitted for testing.

 

Can hair specimens be adulterated?
It is very difficult to adulterate hair.  Donors attempt to adulterate this type of sample through dyeing or bleaching their hair in an attempt to pull the drugs out of it.  Some even try special shampoos that claim it will rid the drugs from their hair.  These attempts may reduce the level of drugs detected; however, in most cases it does not fully remove the drugs from the hair.

 

Can I collect a hair sample if the donor’s hair is wet or damp?
If a person’s hair is wet or damp, or smells of bleach, it is important to note this on the chain-of-custody form.  It may be a sign of attempted adulteration.

 

Do I need to let the laboratory know where the hair specimen was collected from on the body?
Yes, it is important to note the area of origin, since there are completely different timeframes between head hair and body hair.  A note can be as simple as “head hair” or “collected from underarm”.

 

 

Nails:

How do you collect a nail specimen?
See ExperTox’s Nail Collection Protocol.  The nails of either all ten (10) fingernails or all ten (10) toenails will be collected.  The collector will also file the surface of the donor’s nails over the aluminum packet contained in the collection kit.  Both the clippings and shavings will be submitted to the laboratory for testing.  Nail clippings and shavings may be submitted together for testing, and this should be noted on the chain-of-custody form.

 

 

Blood/Serum:

What are ExperTox’s cut-off levels for serum drug screens?  What is your acceptance/rejection policy for serum drug screens?

 

Marijuana (THC): 5 ng/ml
Methamphetamine 10 ng/ml
Amphetamine: 10 ng/ml
Cocaine: 10 ng/ml
Opiates: 10 ng/ml
Phencyclidine (PCP): 5 ng/ml

 

The acceptance/rejection policy states that as long as the sample is delivered with the specimen seal intact, we will accept the sample. If, however, the specimen seal arrives broken, ExperTox will reject the sample and inform the appropriate party.

 

Meconium:


What is meconium?
Meconium is a newborn’s first stool, usually present during labor and delivery.

 

Is every baby’s meconium tested for drugs?
No.  A newborn’s meconium may be tested if his/her mother is suspected or known to have used drugs during her pregnancy, if the baby is born with low birth weight, if the baby is born premature, or shows symptoms of drug withdrawal.

 

Is there anything special I need to know about shipping a meconium sample?
Meconium testing is most commonly performed on a STAT basis.  Therefore, the sample must be couriered (if in the Greater Houston Metropolitan Area) or sent via overnight, early morning delivery.  Immediate handling of the specimen is critical to the care of the newborn.  ExperTox takes extra steps when working with meconium samples, immediately faxing the test results to the ordering agency with a follow-up call to ensure the results were received.

 

What is ExperTox’s cut-off level for meconium drug screens?  What is your acceptance/rejection policy for meconium drug screens?
Meconium drug screens have no cut-off levels.  ExperTox treats meconium samples with Limit of Detection.  This means that any traceable amount of drug(s) found in the meconium samples are reported as positive on a ten (10) panel drug screen.  As long as the sample is delivered with the specimen seal intact, ExperTox will accept all meconium specimens.  If, however, the specimen seal arrives broken, ExperTox will reject the sample and inform the appropriate agency.

 

 

Unknown Substances, Poisons and Toxins:

What is an Unknown Substance Scan/Analysis?
An unknown substance scan/analysis is a toxicology test that looks specifically for drugs, usually when someone has found an unknown pill, powder or other substance they suspect is or contains a drug.  ExperTox refers to a number of libraries and databases for an extensive reference and comparison of drugs used during this analysis.  The unknown substance scan includes a 10-panel screen, followed by an unknown drug scan via GC/MS technology.

 

What is an Unknown Poison and Toxin Analysis?
Following the same methodology outlined within the unknown substance scan/analysis, ExperTox tests for unknown chemicals, poisons and toxins that include but are not limited to pesticides, organic exposure chemicals, painting/cleaning type products, rat poison, volatiles (blood only) and inhalants (blood only).  Note this particular analysis does not screen for drugs or heavy metals.

 

How do I submit a sample for this type of test?
Due to the complex nature of unknown toxicology testing, it is imperative you first contact ExperTox at 1-877-973-7869 (XPE-RTOX) or customerservice@expertox.com.

 

 

Miscellaneous:

Does a Medical Review Officer (MRO) need to review every positive test result?
No, an MRO reviews test results on an as-needed basis.

 

How can you tell if a person is taking “crystal meth” if he/she has a prescription for Desoxyn?
The “D” in Desoxyn stands for “dextro” which is the Latin word for “right”.  If a person is taking street crystal methamphetamine, the racemic mixture is considered “dirty” and will show up as two peaks in a chromatogram (dextro – right; levo – left), one to the right and one to the left.  If a person is taking Desoxyn, there will only be a peak to the right present on the chromatogram.


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