Buyer Beware: Pitfalls of Self-Administered Rapid Drug Tests

Buyer Beware: Pitfalls of Self-Administered Rapid Drug Tests

On 18 Aug 2015, in

Marketing Promise: Our rapid drug tests have been found to be highly accurate by the most sophisticated laboratory testing and quality assurance programs.
Pitfall: Rapid tests are reliable but they only provide a preliminary sign of drug use. Rapid tests are “qualitative,” which means they determine only the presence of drugs. Non-negative results must undergo a “quantitative” laboratory process called GC/MS confirmation. GC/MS is the court of law-preferred confirmation method because it determines, with a very high degree of certainty, the amount of drug present. “A rapid test indicating a non-negative result, without GC/MS confirmation, does not provide sufficient evidence for disciplinary action and/or termination,” says Marla Sherrill, supervisor of BarnesCare’s medical records and substance abuse program. “A rapid test alone will not withstand the legal process.”

Most employers who self-administer rapid tests are not properly prepared to handle a non-negative test. A relationship with a drug testing laboratory must be established, along with the services of a Medical Review Officer (MRO), to review positive results from the laboratory.

Marketing Promise: Anyone can perform our simple-to-use drug test and have results within minutes.
Pitfall: Rapid drug test kits are available for saliva and urine tests. Urine testing is the most established method because of its high reliability and low cost. Variations of the rapid urine test differ depending on the manufacturer. Some tests require that you dip the device into a cup containing the urine specimen. Other tests feature a specimen container that has the test built into it, which minimizes handling of the urine. Reagents and antigens within the device react with urine to produce a line or color indicating test results, similar to the technology used for some over-the-counter pregnancy tests.

According to Thomas Kibby, MD, MPH, CIME, BarnesCare chief medical officer, employers self-administering rapid tests should follow exact procedures during every test. “If flawed collection procedures or misuse of the test device occur, the test results could be contested by the employee and may result in the actual results being overturned in a court of law,” says Dr. Kibby. “Specimen collectors should be professionally trained and follow written procedures for each individual test.” Procedures should include the completion of a Custody and Control Form (CCF). The CCF is the donor consent to specimen collection for the purpose of drug testing. It requires the collector to verify the donor’s identity and confirm that the temperature of the specimen is within acceptable range. If the rapid test result is non-negative, the completed CCF should accompany the specimen to a laboratory for GC/MS confirmation.

Marketing Promise: Our pricing is highly competitive and we provide the smart alternative to laboratory testing.
Pitfall: Rapid test manufacturers sell to employers via direct mail and the Internet. Employers often realize increased savings when they purchase rapid test kits in bulk. Compared to laboratory test pricing, which includes costs associated with sales, specimen collection, shipping, customer support and result reporting, self-administering rapid testing may appear to be a cost savings -- at first. However, employers need to factor in their own labor costs for training collectors and the actual time spent on specimen collection. They also need to prearrange laboratory services for confirmation on non-negative tests. Buying test kits in bulk also has its downside, as most rapid test kits have a shelf life of only up to 18 months from the date of manufacture.

“One of our client companies did an analysis that compared the total cost of self-administering rapid testing to clinic-based rapid testing,” says Tim Reardon, BarnesCare business development manager. “They concluded that the cost savings to self-administer was not significant enough to continue their in-house program. They were also concerned about employee relations and the potential litigation costs if and when there was a contested test result.”

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