Does Your Drug-Testing Panel Actually Test for the Drug You’re Concerned About?

“We use a 10-panel drug test.”
“We use a 4-panel drug test.”

That sounds like a pretty complete answer. But what substances are actually tested in these panels?

Does it test for fentanyl? What about oxycodone, methadone, buprenorphine, or benzodiazepines? Are you using the same panel for every type of test? For every type of employee?

More importantly, does your testing panel include the substances your policy prohibits – or the substances you are most concerned about in your workplace?

Employers can become comfortable with terms such as 5-panel, 10-panel, expanded opiates panel, etc. Unfortunately, the name or number of the panel does not always tell an employer enough about what is actually being tested.

Unfortunately, the employer’s evaluation of their drug testing panel may not become obvious until an incident has already occurred.

A Negative Result Only Answers a Specific Question

A negative drug test result is not a general statement that an employee has not used drugs, much less has never used drugs. It tells you whether the laboratory detected the particular drugs or metabolites included in the ordered panel at or above the applicable reporting cutoffs. At the office, we colloquially say, “X substance was/was not in the donor’s system at that time of testing.”

Let’s consider an employer who orders a reasonable-suspicion test because an employee is displaying concerning behavior. The test result comes back negative, and everyone assumes drugs have been ruled out.

But what if the employer was concerned about fentanyl or was witnessing symptoms of fentanyl abuse and the panel didn’t include fentanyl in the testing?

Or, what if the employer believed that an “opioid” test included every opioid?

What if the symptoms displayed at the time of the incident raised concerns about a drug that was never part of the panel?

Is the employer permitted to test for the substance according to their company policy and/or able to take employment decisions regarding the test result?

In those situations, a negative test may be accurate, but it may not answer the question the employer thought they were asking.

Non-DOT Employers Have Choices

Unlike a DOT drug test, a non-DOT drug-testing panel is not automatically established by one federal transportation regulation. Depending on the employer’s needs and the laws that apply to its workforce, there may be several available panel configurations, testing methods, and specimen types.

That flexibility can be helpful. It also can be even more complicated. The employer needs to make informed decisions, and they may not always have a guide to help them with this decision.

A non-DOT employer should not rely only on the phrase “10-panel” or assume that a higher number means every drug of concern is included. The employer should know the exact laboratory panel being ordered and the specific drugs or drug classes included in it.

Two panels with similar names may not include the same substances. One panel may include marijuana while another excludes it. Some may include oxycodone or certain expanded opioids, while others require those drugs to be ordered separately. A 10-panel drug test from one lab can severely differ from a 10-panel drug test from another lab.

The number of drugs listed in the panel’s name is just the starting point.

“Opiates” Does Not Necessarily Mean Every Opioid

This is one of the most common areas of confusion.

The terms opiates and opioids are often used interchangeably in everyday conversation, but drug-testing panels may separate these substances into different categories.

A panel may test for traditional opiates such as codeine and morphine. Expanded testing may include additional substances such as hydrocodone, hydromorphone, oxycodone, and oxymorphone.

Other substances—including fentanyl, methadone, buprenorphine, tramadol, and certain other synthetic or semi-synthetic opioids—may require a specifically selected test, depending on the laboratory and panel being used.

An employer may have a policy that broadly prohibits the misuse of opioids. But does the actual testing panel cover the opioids the employer believes it does?

The policy language and the drug testing panel need to work together.

What Are You Trying to Accomplish With the Test?

Before choosing a panel, employers should step back and consider what they are trying to accomplish.

A pre-employment testing program may be designed to screen applicants for a consistent group of commonly misused substances. A post-accident or reasonable-suspicion situation may raise a much more specific concern.

Would the employer use the same panel in both situations?

If a supervisor observes signs that may be associated with a drug that is not part of the company’s standard panel, does the policy allow the employer to order an expanded or specifically targeted test?

Who has the authority to make that decision? Can the collection site access the correct panel after normal business hours? Can your supervisor communicate the specific drug/substance needs in the test to the collection site?

These questions are much easier to answer before an incident than while an employee is waiting to be transported for testing. By then, it’s often too late.

More Drugs Are Not Automatically Better

The solution is not necessarily to select the largest panel available. Every substance added to a testing program creates additional considerations. The employer must determine whether testing for it is appropriate, legally permitted, addressed in the company’s policy, and supported by a suitable result-review process.

Testing may identify legally prescribed medications. Employers should know whether results will be reviewed by a qualified Medical Review Officer before they are reported as positive (for New York employers, non-DOT tests are required by law to be reviewed by an MRO before the result is submitted to the employer. Other states may have different laws). They should also understand how their policy addresses medications, safety concerns, and an employee’s ability to perform assigned work.

State and local laws must also be considered.

For New York employers, marijuana testing requires particular attention. State law provides employment protections connected to lawful off-duty cannabis use, subject to certain exceptions. The fact that a laboratory panel can include marijuana does not, by itself, answer whether or how an employer may use the result.

The panel, policy, workplace need, and applicable law must align. Please ensure that your company policy follows the state and local laws necessary.

Questions to Ask About Your Non-DOT Panel

An employer reviewing its testing program should be able to answer the following:

• What is the exact name and laboratory code for our panel?
• Which drugs and metabolites are included?
• Does the panel include marijuana?
• Does it include oxycodone and other expanded opioids?
• Does it include fentanyl?
• Are methadone, buprenorphine, or tramadol included?
• Are benzodiazepines and barbiturates included?
• Are non-negative screening results confirmed using a more specific laboratory method?
• Are results reviewed by a Medical Review Officer?
• Do we use the same panel for pre-employment, random, post-accident, and reasonable-suspicion testing?
• Does our written policy authorize the testing we are ordering?
• Are there state or local restrictions affecting how we conduct testing or use the results?
• Does the panel change when we use urine, oral fluid, or hair?

Your testing provider should be able to give you more than a panel number. Ask for the actual list of drugs and drug classes included in the test.

Then, compare that list to your current company policy.

What About DOT Drug Testing?

DOT drug testing works differently.

For a DOT test, the employer does not select the panel. The drugs included in the test are established under 49 CFR Part 40, and the employer cannot customize the DOT panel or ask the laboratory to add other substances to the DOT specimen.

Employers sometimes hear “DOT 5-panel” and assume the test looks for only five individual drugs. In reality, the panel is organized into five drug categories that include several individual drugs and metabolites.

The DOT panel includes:

• Marijuana
• Cocaine
• Amphetamines, including amphetamine, methamphetamine, MDMA, and MDA
• Opioids, including codeine, morphine, heroin metabolite, hydrocodone, hydromorphone, oxycodone, and oxymorphone
• Phencyclidine, commonly known as PCP

This means that the DOT opioid category is broader than some employers may realize. However, the word “opioids” does not mean that every opioid is included. For example, the DOT panel does not currently include fentanyl, methadone, buprenorphine, tramadol, benzodiazepines, or barbiturates.

An employer should understand both sides of the panel: what the DOT test does include and what it does not.

Additional Drugs Require a Separate Non-DOT Test

When a DOT-regulated employer wants to test an employee for substances outside the federally required DOT panel, the additional testing must be conducted as a separate non-DOT test.

The employer cannot ask the laboratory to add fentanyl, benzodiazepines, or another drug to the DOT specimen. The DOT and non-DOT tests must remain completely separate. The DOT test takes priority and must be completed before the non-DOT test begins.

For a urine collection, any excess urine remaining from the DOT test must be discarded. The employee must provide a separate urine specimen for the non-DOT test. The Federal Custody and Control Form used for DOT testing also cannot be used for the non-DOT test.

For example, an employer undergoing a reasonable suspicion event and is concerned about fentanyl could order:

1. The required reasonable suspicion DOT drug test; and
2. A separate non-DOT test that specifically includes fentanyl.

These are two different tests with separate orders, documentation, specimens, reporting, and consequences.

The non-DOT test must also be authorized by the employer’s policy and permitted under the laws that apply to the workplace. It does not become a DOT test simply because it was ordered at the same time or involved a DOT-regulated employee. Another important note – the employer must communicate this testing decision to the collection site as well!

Employers should therefore know in advance whether they intend to conduct additional non-DOT testing, which panel will be used, and how that testing will be ordered without interfering with the required DOT process.

Know What You Are Ordering Before You Need It

You don’t need to become a laboratory toxicologist overnight, but you do need to understand the testing program your company has selected.

• Ask your testing provider for the exact panel.
• Review the substances included and the substances excluded.
• Compare the panel to your written policy, your workplace needs, and the laws that apply to your organization.
• Determine whether you have a process for ordering additional testing when a specific concern arises.
• A negative test result can only tell you what was – and was not – detected within the panel that was actually ordered. It cannot rule out a substance the laboratory was never asked to test for.

The question isn’t just, “Do we drug test?”. The better question may be:

“Does our drug testing program test for the drugs we believe it does?”

Sources and Further Reading

• 49 CFR § 40.13 — How DOT Drug and Alcohol Tests Relate to Non-DOT Tests
• 49 CFR § 40.82 — Drugs Included in DOT Drug Testing
• 49 CFR § 40.85 — Cutoff Concentrations for DOT Urine Drug Tests
• U.S. Department of Transportation — DOT 5-Panel Notice
• SAMHSA — State and Local Drug-Free Workplace Laws and Regulations
• New York State Department of Labor — Adult-Use Cannabis and the Workplace
• New York Labor Law § 201-d — Discrimination Against Certain Legal Activities

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This article is intended for general educational purposes and is not legal advice. Employers should review their testing program with qualified legal counsel and appropriate testing professionals based on the laws and regulations that apply to their workforce.