Drug testing, false positives, and SSRIs
November 25, 2020 10:16 AM   Subscribe

I need to undergo pre-employment drug testing. I take two common SSRIs that are known for causing false positives. What are the chances of a false positive? To what extent am I able to maintain my privacy in the event of a false positive?

Testing facility is Labcorp, and test will be non-DOT urinalysis.

I also occasionally use Vicks decongestant spray for allergies and take Aleve/Advil fairly often for headaches, which I've heard can also cause FPs.

Am I required to disclose all the medications I'm currently taking to the testing facility, or just those that might cause false positives (i.e. do I have to disclose oral contraceptives)? Do they tell the employer about the medications you are taking? If a false positive comes up due to my use of prescribed medications, what are my rights? I'm in the U.S.
posted by Anonymouse1618 to Work & Money (6 answers total)
I can't comment on which SSRIs might cause false positivity, but I built a hospital medical record interface for an electronic medical record for Quest, Labcorp, and the hospital I was working for, and there are no tests for contraceptives that could possibly interfere with drug testing, which is typically what employers test for. For contraceptives, I can't imagine an employer testing for this, but if there is one (an anticontraceptive employer? A Catholic hospital? Hobby Lobby? a convent? Seems like a far reach and would require an amazingly broad consent from a prospective employee) these would be tests for specific hormones, and would require a blood sample anyway, not urine. I have never heard of a urine test for contraceptives.

Think opiates (prescription and street drugs), cocaine, tobacco, cannabis, alcohol (might be called ETOH), fentanyl, methadone, hallucinogens. Tobacco and cannibis are very long-lived in the body's metabolism, and are detectable for about 30 days after last use. There are a few other less-common drugs that can be tested for, as well. This is easily found by pulling up the Labcorp website and searching for urine drug tests - there are a bunch that test for different substances or combinations of substances. You can poke around on their website and look at all the different urine drug tests they offer. Labcorps might also be able to tell you about the risk of false positives from SSRIs, which, if this is true, is probably a very common question. Good luck!
posted by citygirl at 11:19 AM on November 25, 2020 [5 favorites]

I can speak to this from the hiring manager/HR side. If a candidate tests positive, we do not hear about it initially - the laboratory's medical review officer contacts the individual directly to find out if there is a legitimate reason they would have that positive result (e.g., a prescription that causes that result). If the MRO gets information on that legitimate reason, then when I as the employer see the drug test, it simply states that the result was negative.
posted by srrh at 12:53 PM on November 25, 2020 [9 favorites]

I'm a toxicologist. I've commented before on drug tests, and the simplest thing to keep in mind that you always can (should?) contest results that you disagree with. False positives and technician/equipment errors are a massive problem in the field, and sometimes it's as simple as contesting--whether that's asking for a retest, logging on the record medications that may interfere, or simply pushing back on the lab (which can and often does simply shrug at weird results and reports a negative to the company that ordered it)--to get your point across.
posted by late afternoon dreaming hotel at 1:08 PM on November 25, 2020 [3 favorites]

[I'm in Australia but] Often the screening test is of low specificity, and if there is a disputed false positive a more specific assay can be run on the sample to verify the component.
posted by chiquitita at 2:10 PM on November 25, 2020 [2 favorites]

I have some experience with this because I take stimulants, which some employers test for. For one of my jobs, I got a call exactly as srrh describes after my drug test. The medical review officer immediately asked me if I take vyvanse or adderall rather than jumping to the conclusion of anything illegal, I said that I do, and he asked that I send a photo of my most recent prescription or med bottle to the lab as proof. They were very specific in requiring that the prescription include the date it was dispensed. This was the only hiccup in the process for me, because the pharmacy I used at the time didn’t include that date on the bottles by default and I had to send a couple photos before getting the exact thing they would accept. I am forever grateful to my former pharmacist who figured out how to override whatever template he was using for labels to get me what I needed.

In my case my work contact did wind up knowing that I take a regulated substance, because the back and forth with the lab was potentially going to affect my start date, but I never disclosed exactly which drug it was.

I also take an SSRI, and that has never affected my drug testing for any job. My current job didn’t even ask about the stimulant, so there’s definitely variation from place to place.
posted by I am a Sock, I am an Island at 5:48 PM on November 25, 2020 [3 favorites]

I worked Safety for a trucking company once. The answers you have marked best are correct from my experience. Normal turnaround for negatives was 24 hours with our last testing company. The company prior to that was 48. If we didn't get results in that time frame, we knew there was a very high chance that your test would come back positive. Until we got the positive back, we had to treat the person the same as all the people who came back negative. (This is the pre-employment side. I can't remember about randoms atm and post accident I am pretty sure we were allowed to keep them off the road until result came back.

I can't say this with 100% accuracy, but the ones that were delayed were almost always someone who had a procedure and a *-caine (Lidocaine, Novocaine, etc) recently and the urinalysis showed it could be cocaine. (This we learned mostly by the drivers volunteering that information.)

Interestingly enough, We would often get a lot of happy people saying "MRO said I could test again!" These ones always came back positive for cocaine, but they knew it would be out of their system for that second test (~72 hours and it's gone).

We did what was called split sample specimen testing. So, from the same urine draw, we would put in two test tubes. The really short version is Lab A would test tube A. If it came back positive, the donor could request for test tube b to be tested at Lab B (at the company's expense, no less). Much different than getting re-tested.

So, yeah, you should be okay. Your info shouldn't go past the MRO. The company may suspect, but won't know.
posted by a non mouse, a cow herd at 4:55 PM on November 26, 2020 [1 favorite]

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