One law that often comes into play when an employer’s drug screening practices are challenged is the Americans with Disabilities Act (ADA). There are two recent developments in ADA case law that employers should be aware of:

  1. Drug screening is likely not a prohibited pre-offer medical inquiry
  2. Employers must provide reasonable accommodations in the testing process for individuals with disabilities.


Some applicants have sought legal action against companies that conduct pre-employment drug screening. They allege that pre-employment drug screening is a prohibited “pre-offer medical inquiry” under the ADA. However, guidance from the Equal Employment Opportunity Commission (EEOC) states that employers have the right to test applicants for illegal drug use. Laboratory results of the drug test should be reviewed and verified by a licensed and approved medical professional called a Medical Review Officer (MRO) to determine if a positive laboratory drug test is the result of a legal prescription medication being taken by the donor.


Courts have also held that drug screening for illegal substances is not a prohibited “pre-offer medical inquiry” under the ADA. A Pennsylvania federal court reached the conclusion that in order for a drug test to be considered a medical inquiry under the ADA, a claimant must show that (1) the drug test in question was not administered to determine the illegal use of drugs, and (2) that the drug test did not, in fact, return a positive result for the illegal use of drugs. The employer in this case was able to present credible testimony at trial showing that its only intent in performing pre-offer drug testing was to determine whether applicants were using illicit drugs.


It is important to highlight that the above challenges only exist when drug testing is conducted at the “pre-offer” stage. Employers are advised to conduct pre-employment drug screening after an offer of employment has been made in order to avoid any ADA issues altogether.



Employers must ensure that their employment drug screening process provides reasonable accommodations for applicants and employees with disabilities. In a case filed against Kmart by the Equal Employment Opportunity Commission (EEOC), Kmart was found negligent after refusing to employ an applicant after he was unable to provide a urine sample for drug testing. The applicant claimed he couldn’t provide the sample due to his kidney disease and dialysis. In addition to a $100,000 judgment, Kmart also had to revise its drug-free workplace and pre-employment drug testing policy to provide reasonable accommodations to employees or applicants in the testing processes.


In a similar case, Wal- Mart agreed to pay $72,500 to settle a case alleging that one of its stores refused to provide a job applicant with end-stage renal disease with an alternative to a urinalysis drug test. The lawsuit alleged that the applicant went to the drug testing facility to ask for an alternative test to be performed and when the facility agreed that an alternative was possible, the applicant took that information to the store manager for consideration. The manager refused to accommodate the alternative test and the plaintiff’s application was rejected for failing to take the urinalysis test.


Employers should review their substance free workplace and testing policies to ensure that they allow for accommodations to be made for applicants or employees who are unable to comply with standard drug testing procedures due to a disability.



While casual drug use is not considered a disability under ADA, individuals addicted to drugs, have a history of addiction or who are regarded as being addicted have an impairment under the law. In order for an individual’s drug addiction to be considered a disability under the ADA, it would have to pose a substantial limitation on one or more major life activities. In addition, the individual could not currently be using illegal drugs. This classification of a disability, however, does not prevent an employer from testing for current drug use. Users (even addicts) may be denied employment because of their current use of illegal drugs.


An employer’s substance free workplace and testing policy should incorporate these issues in order to avoid potential liability.


For a free, no obligation review of your current substance free workplace and testing policy, please contact Carolina Testing.



Cocaine Use on the Rise Again

The National Institute on Drug Abuse (NIDA) reports overdose-related deaths from cocaine is second only to opioids. However, cocaine’s toll on the general public receives little attention. This is largely due to the lack of remedies for the person addicted to the drug. Unlike opioids, there is no naloxone (narcan), a medication designed to rapidly reverse an overdose, or methadone or suboxone, which help people stop using heroin. For those suffering from a cocaine-fueled substance-use disorder, current options include behavioral therapies and experimental, incentive-based, therapy called contingency management.


Cocaine and the American workforce

Cocaine, classified as a Schedule II drug, is a powerfully addictive substance with a high potential for abuse, potentially leading to severe psychological dependence. Cocaine provides users with a stimulating and energetic high with burst of energy followed by significant crashes in energy levels. According to research from NIDA, adults between the ages of 18-25 years old (approximately 1.2 million people) have a higher rate of cocaine use than any other age group. Employers should be concerned because this age range represents a large portion of new-to-the-workforce employees.



According to the Quest Diagnostics Drug Testing Index™ (DTI) the positivity rate in urine testing for cocaine has increased for four straight years in the general U.S. workforce. In the federally mandated, safety-sensitive workforce, cocaine use has increased for two consecutive years. Drug tests indicating cocaine use increased 12% in 2016, reaching a seven-year high in the general U.S. workforce, and 7% among federally mandated, safety-sensitive workers.

DTI statistics reveal the ongoing threat to workplace safety posed by substance abuse. While most drug related dialogue addresses marijuana and opiate issues, cocaine, a substance with well-established dangers, continues its upward trends in use in the workforce.


To learn more about creating, implementing and managing a substance free workplace, contact us today!

“Do It Yourselfers” are a growing force to be reckoned with these days. With hit shows from Home and Garden Television (HGTV), an entire network dedicated to DIY, aptly name the DIY Network, and millions of YouTube videos at our fingertips, it is hard not to catch the DIY bug.  DIYers are tackling home projects, crafts, small repairs and now more difficult things like car repairs, major home repairs, appliance repairs, cell phone repairs and so much more. Why not DIY drug testing, right?. Sometimes, we save a little money by doing things ourselves – and sometimes it ends up costing us more money to fix a DIY attempt gone bad. I have a cell phone that should have only cost me $100 to get fixed by a professional. After my DIY attempt went horribly wrong, that repair quickly turned into a $350 repair. There are just some things better left to the professionals – like cell phone repairs and engine tune ups.


What does this have to do with drug testing?

Surprisingly, some companies have taken the DIY mentality to new heights by conducting their own drug testing in the hopes of saving a buck or two. This has become very popular in the medical and quasi-medical fields including home health agencies, nursing homes, hospitals, clinics, etc. Even some non-medical companies are looking at performing their own drug testing in house. With instant urine test kits and even the increase in oral saliva testing, executives feel that they can save money by just doing the testing themselves rather than having a certified drug testing company do the work for them. This is where things can go horribly wrong.

Executives feel that they can save money by just doing the testing themselves rather than having a certified drug testing company do the work for them. This is where things can go horribly wrong.

Companies that conduct their own “in-house” drug testing open themselves up to huge liability risks and are easy targets for discrimination claims. When a company takes on the role of “drug tester” using a store or online purchased instant urine drug test, they are effectively taking on the role of police, judge and jury and are left with nothing concrete to defend the results of the instant drug screen.


Let’s consider the following, typical scenario and dig deeper to see where the main pitfalls to DIY drug testing can cost far more than the few dollars the company saves:


The New Applicant:

Your company has elected to use an instant 10 panel urine drug test kit purchased online to conduct a pre-employment drug screen of a potential new hire. The applicant submits their application and hands it to your HR person and the HR person hands the applicant a cup and asks the applicant to go to the restroom, fill the cup with urine and bring it back out to them. The applicant goes into the restroom and returns with a covered cup filled with what is believed to be urine.   The HR person peels back the label, checks the strips like they showed her in the instructional YouTube video and makes a final determination of the drug test. Quick, easy and done, right?   Not so fast…


  • Is the “urine” provided by the applicant really urine?
  • Is the “urine” provided by the applicant THEIR urine or is someone else’s?
  • How do you know they didn’t fill the cup with warm water from the sink in the bathroom?
  • Is the urine the correct temperature?
  • Are you sure the applicant didn’t flush the balloon that was filled with his buddy’s urine down the toilet?
  • When the “result” is read and amphetamines shows up as positive on the instant test cup, what do you do next?
  • Do you send the specimen to a laboratory to be tested and confirmed?
  • Do you not hire the applicant because the amphetamines showed up?
  • You are confident the instant test cup is 100% accurate, right?
  • Was the amphetamine showing up a result of a legal medical prescription?
  • Can you legally ask the applicant about their medical history or prescription use without violating HIPPA and ADA laws?
  • The applicant is the best friend or relative of the person conducting the drug testing – is it possible a positive drug screen result might just be ignored?
  • Of course, you have a company policy that is in writing that addresses these and other concerns about drug testing, right?
  • Do you really know what substances you are testing for?
  • Is it legal to test employees or applicants in your state?
  • Isn’t marijuana legal in some states – we can ignore that positive test, right?


I know, you are saying we use instant oral saliva tests at our company so we know the specimen came from the applicant directly so there is no issue of cheating. That is great – you have the remaining 11 bullet points above covered too, right?


Does your company do random drug testing? Post accident drug testing? Reasonable suspicion drug testing?   Do you also test for current alcohol impairment? If you do testing for these reasons “in house”, you open yourself up to even more potential problems and issues such as claims of favoritism, discrimination, bias and/or unfair or illegal practices.


DIY is great for some things – drug testing is not one of them.

Drug and Alcohol Testing In Schools

The use of illicit drugs and alcohol interferes with the student’s ability to learn and is often found to be a disruption to teachers and other students. Schools, both public and private, continue to investigate the benefits of randomly testing students for drug and alcohol use. Following models established in the workplace, some schools have established testing programs that allow them to perform random testing as well as reasonable suspicion testing.


Schools that adopt random testing for drugs and alcohol seek to decrease substance misuse among its student populations by serving as a deterrent, giving students a reason to resist peer pressure. Random testing may also identify students who have recently started using illicit drugs or alcohol. These students may well benefit from early intervention. Those found to be chronic users may also be able to be identified and referred for treatment. The primary purpose of substance of abuse testing in schools is not to punish students, but rather to identify users and get them the assistance they may need.


Schools adopting reasonable suspicion testing should have clearly identified policies and training of staff and administration to identify symptoms of substance misuse through direct observation of a properly trained staff member. Without clearly identified policies and staff training, schools may find themselves subject to liability or claims of discrimination.


Depending on the individual school’s program and policies, the type of specimens being tested can range from urine, hair follicle or saliva. The types of substance and the length of time the substances can be detected vary from specimen to specimen.


Having a qualified expert in the drug and alcohol testing processes is critical in making informed decisions. Carolina Testing is happy to work with schools and school districts in providing information, options and services as needed to make these important decisions.


Construction and building is booming in the United States for the most part. This is true in one of the fastest growing areas of our country – Myrtle Beach, SC. Population growth is exploding in South Carolina and much of it is happening in the eastern upstate. With this explosion in growth comes a higher demand for construction workers including heavy equipment operators, tradesmen and laborers. Not only is the demand for these workers getting higher – so are the workers.

“Not only is the demand for these workers getting higher – so are the workers.”

According to a recent report by the Substance Abuse and Mental Health Services Administration (SAMSHA), the construction industry now has the second highest percentage (14.3%) of drug users on the job. This percentage trails the accommodations and food services industry which is the leader at 16.9% of drug users. The construction industry also comes in second place on the heels of the mining industry when it comes to heavy alcohol use.


According to Tom Jackson, in his story published in Equipment World, “Drugs bring big problems. The Department of Labor says drug and alcohol abuse contribute to up to 65 percent of on-the-job accidents and up to 50 percent of workers’ compensation claims. Substance abusers are absent from work an average of five days a month, are ten times more likely to steal from the company or other employees, use three times the normal level of employee health benefits and incur 300 percent higher medical costs.”


While some companies perform pre-employment drug screening of applicants, very few perform ongoing random drug screening to maintain a substance free workplace. Even fewer companies have comprehensive substance free workplace policies in place to implement such a program and provide protection for the company, its employees and customers. Having an effective policy in place allows a company to perform random testing, post accident testing and reasonable suspicion testing. Testing without a policy in place exposes the company to potential liability and claims of discrimination. Training should also be provided to train supervisors on how to detect, observe and report use and abuse on the job.


Partnering with a professional consultant and company that can assist in setting up and managing a substance free workplace is becoming far more cost effective and beneficial to these extremely busy and fast moving construction companies. Carolina Testing based in Conway, SC is one local, responsive and professional company able to provide a full array of substance free workplace services. Services include simple drug screening services to fully managed services including consulting services, policy creation, program management, employee screening and random program management.


We were high school sweethearts destined to be together forever. He set off for the Army and I set off for college. We parted ways for four long years, always trying to keep our relationship close throughout. Despite our best efforts, there was the occasional misstep that took our relationship into dangerous territory during these years apart as we both took the opportunity to explore other “interests.” Rest assured, that when we were able to reconnect, we did so with renewed passion and excitement. We married in 2012, got pregnant on the honeymoon and had our first son in June 2013. Our daughter was born in September 2014 and our second son, who was not exactly planned, was born in January 2016.


Jim and I had a good marriage and a wonderful family life with three wonderful, happy, healthy children. There was, however, a nagging question from Jim overshadowing the birth of our second son. You see, during the summer of 2015 I reconnected with some college friends for a weekend getaway in the mountains and we had a great mini-reunion. Old roommates, friends (including a past fling) were all there and we all had a great time. I shared everything about the weekend with Jim – including who was there. Shortly after that weekend, I found out I was pregnant and shared the exciting and unexpected news with Jim.


A year after our second son was born, the questions started floating. Our first two children had beautiful blonde hair, but our third child’s hair remained darker brown – even after a year. Jim would jokingly say that he was not the father of our third son – pointing out how he looked nothing like him. He was right. Our son looked much more like my side of the family. One night, my husband confided in me that he really was wondering if our third child was really his. He confessed that he had wondered if I had another “fling” during that summer reunion in 2015. He didn’t want to think that because he loved and trusted me so much and I had never given him reason not to trust me. Sure, we both experimented during our four years apart, but we came right back together perfectly and we were completely open about everything. The thought just kept creeping back into his head and he couldn’t shake it. At first I was hurt and kind of angry that he would even think for a moment that I would ever cheat on him, but then I realized that he had been struggling with this for quite some time and it was starting to effect our marriage.


That’s when I took action. I knew the truth and had nothing to worry about, but I had to put his concerns to rest – for his sake and for the sake of our marriage. I called and scheduled a DNA paternity test to be conducted the next day. I asked the person at the clinic how long the results took and they said that we would have the results in 3-5 business days. They explained the testing process to me and answered all of my questions.


On the third day following the testing, we received the official results from the laboratory.   Jim took one look at the results, laughed, shook his head, kissed me and apologized for letting those crazy ideas get into his head. Then he proudly announced that he knew it all along – after all, they both had brown eyes…


Sure, I could have gotten mad, defensive and argued my case, but there would have always been lingering unanswered questions. Taking that DNA paternity test was the best investment in my marriage that I could have ever made.

Hair Follicle Drug Tests on the Rise

Hair follicle drug tests are growing in popularity for two main reasons – the inability to cheat the test and the longer term detection window provided by such a test. In addition to standard hair follicle tests, some labs are also now offering environmental exposure testing using hair samples.

1. Inability to cheat the test

Hair follicle tests involve a directly observed hair collection by a trained specimen collector. Unlike urine specimen testing, where a donor is behind closed doors, this specimen collection process cannot be subverted or hidden in any manner. A quick “clean up” fix like those offered online are great money makers for those selling the products, but they have no effect on hair follicle testing results. The excuse that you were exposed to drug smoke does not hold any water either as a standard hair follicle test involves special processes to clean the hair prior to testing and the matter being tested is the inside of the hair itself.   If an environmental exposure test is ordered, the test result will clearly identify the positive reading as exposure and not use. More on exposure testing later in this article.

2. Longer detection window

Unlike urine testing which detects usage for the past 2-7 days (longer for marijuana users), hair testing typically provides a window of detection for 90 days or more. When drugs are taken, the metabolites go into the hair follicle, and then into the strands themselves, where they stay, pretty much forever. Hair on your head typically grows at a rate of approximately .5 inches per month. In this case, if your hair was 18 inches long, and you tested the entire length of hair, they could find drugs consumed more than 3 years ago! There is no reason to worry about this in most cases, because the standard hair follicle test only tests 1.5 inches from the root end of the hair strands.

If head hair is not available to collect, body hair may be collected. Body hair collection can be done from facial hair, arms, legs, chest or underarms. The detection window for body hair is estimated by some labs to be up to one year, but this has yet to be scientifically verified. A good rule of thumb, regardless of where the hair was collected from is that the detection window will reflect the past 90 days of use. There is no way to determine from test results when the drug use occurred, only that drug use did occur.

3. Types of Tests

The two primary types of hair follicle tests include standard hair testing and exposure testing.

For standard hair follicle tests, the number of drugs being tested for can be any number of combinations from 5 panel, 10 panel, 17 panel or more. Tests can also determine alcohol usage as well as drug usage. This type of testing only determines consumption/use of the substance being tested for.

For exposure tests, also known as environmental exposure tests, the hair strands are not washed prior to testing and the outer shell of the hair is tested for the presence of drugs. Exposure testing is most commonly combined with hair follicle testing which tests for exposure to drugs as well as ingestion of drugs. If exposure to drugs is detected, the test results will clearly indicate that the specimen tested positive for exposure to drugs.   Exposure to drugs does not indicate ingestion or use of drugs. It simply indicates that the person was in the presence of drug use. This is a popular test in child welfare situations and is used to determine if a child has been exposed to drug use in addition to the possibility of ingesting drugs. This test, offered by Carolina Testing is known as the Child Guard Test.

In closing, hair follicle testing offers a fool proof way to test for a wide range of testing possibilities over an extended period of time. Depending on your exact needs, the costs of hair follicle testing can typically range from $120 to over $500. Please contact your Carolina Testing professionals for assistance in choosing the right test for your needs.

Cocaine, derived from the coca plant is native to South America where many people chew the plant’s leaves to reduce pain, thirst, hunger, while giving a boost of energy. By the 1880s, doctors were studying cocaine as a miracle anesthetic for surgeries. It was also being studied for a variety of health conditions including anxiety and pain. By the turn of the 20th century, fatalities were associated with cocaine and an article in The New York Times by Dr. Edward Huntington Williams warned of the drug’s dangers, calling its effects “cocaine-craze insanity.” In 1914, Congress passed the Harrison Narcotics Tax Act which banned the non-medical use of cocaine in the United States. Today, cocaine is classified as a Schedule II controlled drug with a high potential for abuse, which may lead to severe psychological or physical dependence.


After an analysis of more than ten million workplace drug tests, cocaine made headlines in this year’s Quest Diagnostics Drug Testing Index™ (DTI) report because drug test results indicating cocaine use rose 12 percent in 2016. This increase reflects a seven-year high which has led to a trend of consecutive year increases of cocaine use in the workplace – both in federally mandated, safety-sensitive positions like transportation workers as well as general U.S. workers. Overall, cocaine drug use has fluctuated in the U.S. general workforce with its highest levels in 1998 and its lowest levels in 2012 according to the DTI.


Even more troubling is that positive drug tests indicating cocaine use are twice as high when the test was conducted in a post-accident scenario as compared to pre-employment tests.

While a positive test doesn’t necessarily prove drug use caused the accident, it does raise the question as to whether it played a role in the incident.

The most current findings from the National Survey on Drug Use and Health tell us:

  • An estimated 8.2 percent of adults (aged 26 or older), or 17.1 million people, currently use an illicit drug
  • 580,000 young adults (ages 18-25) and 1.2 million adults currently use cocaine
  • Approximately 31,000 adolescents (ages 12-17), 229,000 young adults, and 637,000 adults suffer from a cocaine use disorder, pointing to dependence and recurrent use that affects health and responsibilities at work, home, or school


Visit QuestDiagnostics.com/DTI for the full report and data.


To learn more about drug testing, visit our website or contact us online or call/text 843-972-3287.


The old adage, “time is money” has never been more true. It didn’t take long for the management team of a small asphalt company in South Carolina to realize how much money was literally waiting for them when they evaluated their current drug testing service provider. Having used a local urgent care clinic for their drug test collections for years, company representatives didn’t realize there were options available to them until they were approached by a representative from Carolina Testing based in Conway, SC.

The asphalt company maintained an average of 120 employees in 2014, all of whom were subject to pre-employment and random drug testing as well as other forms of drug testing as needed. After reviewing the previous year’s drug testing information, the company found that 58 random drug tests, 32 pre-employment drug screens and 17 other tests were completed at the local urgent care clinic, for a total of 107 drug tests in one year. Average wait time at this facility was 2 hours or more for an employee to be taken care of.


The results of their review were astounding:

  • Average wait time at clinic: 2 hours per employee
  • Average wage per employee tested: $19.50 per hour
  • 107 drug tests X 2 hours waiting = 214 hours

214 hours waiting X $19.50 per hour = $4173.00

Over $4,000.00 was paid out by the company to have employees sitting in a waiting room.

The math got even worse as they dug deeper. On average, the company bills out $54.00 per hour per employee to its customers. While employees were sitting in the waiting room, the company lost $11,556 in billable hours.


The Carolina Testing Difference

Four months after switching to Carolina Testing for their drug testing services in September 2015, the company ran the numbers again. Average wait time was found to be less than 10 minutes.

The math tells the rest of the story:

  • Average time at clinic: 5 minutes per employee
  • Average wage per employee tested: $19.50 per hour
  • 107 drug tests X 5 minutes waiting = 8.92 hours
  • 8.92 hours X $19.50 per hour = $173.94
  • 8.92 hours X $54.00 billable hours = $481.68

TOTAL SAVINGS:  $15,073.38

Please contact Carolina Testing for a free, no obligation evaluation of your company’s drug testing program including cost reporting, policy review and other savings opportunities available to your company.

No longer just a public safety issue, prescription drug misuse and abuse also weighs heavily on the workplace. According to The Clinical Journal of Pain, illegal use of prescription opioids cost the United States employers over $40 billion dollars in lost productivity in 2006 alone. Five drugs in particular, OxyContin®, oxycodone, hydrocodone, propoxyphene, and methadone, accounted for two-thirds of the total economic burden. As regulations tighten around these drugs and availability becomes more scarce, users are turning to other, more potent opioids such as fentanyl or street drugs like heroin.

One of the nation’s leading safety advocates, the National Safety Council (NSC), highlights issues in an effort to eliminate preventable deaths at work, in homes and communities, and on the road through leadership, research, education and advocacy. The NSC has highlighted prescription drug misuse as one of the critical safety issues facing our communities because of the alarming rise in addiction rates, ER visits, overdoses, and fatalities. With over 43,000 drug overdose fatalities per year in the United States, it is safe to say that we have reached epidemic levels.

Prescription Drug Addicts 40 Times More Likely To Become Addicted To Heroin

The NSC reported results from its recent survey, examining employers’ perceptions and experiences with prescription drugs. Because of misuse and abuse, employers face challenges with absenteeism, lower job performance, accidents and injuries, positive drug test results, co-workers using, borrowing, or selling prescription drugs at work, and a negative impact on employee morale. In addition, the NSC survey data shows:

  • 81 percent of companies lack a drug-free workplace policy
  • 76 percent of companies do not provide training to identify drug use/abuse
  • 41 percent of companies do not drug test for synthetic opioids such as fentanyl

Employers want to help employees, but less than 20 percent of employers responded that they were “extremely prepared” to deal with the misuse or abuse of prescription medications. Managers stated that they would like additional clarification regarding policy, benefits, insurance, treatment options, and simply identifying warning signs of potential issues.

How can the remaining 80 percent of employers get informed and gain confidence when facing this challenge? Experts suggest that companies add specialized workplace training for supervisors, implement drug testing programs, and strengthen their policies with more precise language about drug use without a prescription, employee impairment, and return-to-work protocols.

The NSC has amassed a comprehensive collection of resources such as drug fact sheets, strategy guides, videos, graphics, and survivor stories to bring greater awareness to the issue.

Download the kit for employers.