Opiates and Your Drug Screening Panel

Hello! This is Todd Shoulberg again, launching our new company blog—For the Public Record. In this blog, you will hear thought leadership from the most seasoned experts on our staff, across all functions of the background screening process. I am excited to start off with a look at some significant misconceptions with drug screening, which involve testing for opiates.

Many companies are confused on which opiates they are actually testing for when they run a 5- or 10-panel drug screen. The answer is: only codeine and morphine. Heroin is also tested for, but only if certain codeine or morphine levels are reached. And remember, this is the case for the 5- and the 10-panel.

The much publicized, and rightfully so, Opioid Epidemic, which is taking the lives of 130 Americans each day, refers mostly to Hydrocodone, Hydromorphone, Oxycodone, and Oxymorphone. There are also other synthetic opiates such as Fentanyl and Meperidine. None of these opiates are even tested for in a 5- or 10-panel drug screen.

Of course, these additional drugs can be tested for, if you ask your drug screening provider to add them. This is sometimes referred to as an Expanded Opiate panel. Keep in mind though, not all expanded opiate panels are the same, so you will want to make sure which “extra” opiates they are including in their expanded panel. For example, we include the two Hydro’s and the two Oxy’s in our expanded panel. We can also add Fentanyl and Meperidine, based on the client’s needs.

Another confusing part of opiate panels is the cutoff levels. Each drug tested for has an initial screening cutoff level and a confirmation cutoff level. This means you are actually allowed a small amount of each drug in your system before it registers a positive. This is meant to account for secondhand marijuana smoke or incidental contact with a substance. Since 1998, the federally-approved cutoff level for opiates is 2000 ng/mL. Prior to this, the level was 300 ng/mL. The level was raised, “because of concerns that small doses of codeine and foods containing poppy seeds would give a positive opiate-screening result”, according to the U.S. National Library of Medicine.

It is important for employers to be aware of what opiate testing level they are using. If opiates are being tested at the 300 ng/mL level, from over 20 years ago, you will want to make sure your drug-free workplace policy addresses this. There is a high likelihood that certain foods can register a positive result, and it’s important the candidate/donor know this up front. Your written policy should explain why you are testing opiates at this reduced level and if any additional food restrictions are being placed on employees prior to testing. It would be very unfortunate for a candidate to be denied a job, or a current employee to lose their job, for eating poppy seed bagels or muffins before their drug screen; with no notice that this type of food may register a positive result. Again, this would only be a concern if your drug screening panel is using the 300 ng/mL level, instead of the 2000 ng/mL level.

I hope this blog helped you better understand how you can test for opiates in your drug screening panels. You may need to check with your drug screening provider to see what you are really testing for and update your panels, if needed. The most important thing is to make sure you and your candidates/employees are informed. This is For The Record.


Todd Shoulberg - EVP, Medical Information Services

Todd Shoulberg provides direction and leadership to the daily operations of ClearStar’s Medical Review Office. He is responsible for keeping all drug testing clients in compliance with state, federal, and local regulations, and identifies new testing methods and products for clients to utilize in their drug testing programs.

Before joining ClearStar, Todd served as Vice President of Florida Drug Screening, Inc., where he oversaw operations of the Medical Review Office, including Sales, Marketing, and Customer Service.

At ClearStar, we are committed to your success. An important part of your employment screening program involves compliance with various laws and regulations, which is why we are providing information regarding screening requirements in certain countries, region, etc. While we are happy to provide you with this information, it is your responsibility to comply with applicable laws and to understand how such information pertains to your employment screening program. The foregoing information is not offered as legal advice but is instead offered for informational purposes. ClearStar is not a law firm and does not offer legal advice and this communication does not form an attorney client relationship. The foregoing information is therefore not intended as a substitute for the legal advice of a lawyer knowledgeable of the user’s individual circumstances or to provide legal advice. ClearStar makes no assurances regarding the accuracy, completeness, or utility of the information contained in this publication. Legislative, regulatory and case law developments regularly impact on general research and this area is evolving rapidly. ClearStar expressly disclaim any warranties or responsibility or damages associated with or arising out of the information provided herein.

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