Doctor holds blood sample at a hospital table, conceptual image

If you were to ask your friends or coworkers how they’d feel about mandatory random drug testing in the workplace or at school, the overwhelming response would likely be immersed in anger and resentment at the disrespect for personal privacy. Now ask the same question to someone who has gone through a substance abuse issue and recovered from addiction (or a family member of one) and their answer might be quite different. Blood or urine testing during drug treatment supports relapse prevention and assists rehab facilities and the justice system in assessing drug use, best course of action for treatment and monitoring recovery.

The Difference Between Blood and Urine Samplings

Depending on where in the process a person is regarding the investigation of drug use will determine which type of testing protocol will be administered.

During a traffic stop, for example, law enforcement will use blood testing as a follow up to a saliva swab test to ensure there is no presence of drugs or to specifically identify which drugs are actively in a person’s system. The swab test, known as the Drager 5000 has been in use since 2009 and can detect,

* Benzodiazepines

* Opiates

* Cocaine

* Marijuana

* Methadone

* Methamphetamines

* Amphetamines

Blood Testing and the Window of Time

Blood tests will show all the above in addition to barbituates, LSD and PCP. The reason this method of toxicology is preferred to urine testing is in its accuracy. In fact, blood tests are near impossible to mess with so for anyone thinking that they can “buck the system” and find a workaround to detecting drug use, blood testing is the buzzkill.

Blood testing works differently than urine testing is that it hunts for the parent drug in a person. Other than benzodiazepines (Valium, Xanax) and barbituates, this form of detection is only viable for up to a 24-hour period. Because it focuses on the parent drug, it will measure what was in recent use only.

However, they are invasive, expensive, and the wait time for getting test results is lengthy (usually a week). If time is not of the essence, such as with employment screening, health insurance coverage requirements or court order, blood testing is a reliable resource, but not the standard go to for alcohol or drug rehab.

Urine Testing and Drug Recovery

Members Of Support Group Sitting In Chairs Having Meeting

Urinalysis is the most common method in drug screening during addiction treatment and recovery. It provides quick turn results and is easier to orchestrate. When a person enters into a drug treatment program, an initial medical assessment is needed to understand the full scope of a patient’s health (physical and mental) and what drugs are in their system. Urine testing provides the answer.

Drug screening through urinalysis focuses on what is known as active metabolites of drugs. The testing will pick up the altered form of the original drug used, but, within a few days has changed through metabolism. But there are other substances that metabolize within the body that can affect testing results.

Health conditions, certain foods, vitamins and supplements as well as over-the-counter medications can spur an inaccurate false-positive test. I was always told to never eat poppy seed cake or a poppy seed bagel before taking a drug screen for a new job. But for those genuinely on the road to addiction recovery, these facts are important as failing a drug test can instill doubt in therapists, family members and others who are professionally, financially or emotionally vested on sobriety success.

Others will try to circumvent a would-be positive drug test, tampering the urine with water or paying someone else to take the urine test on their behalf. Labs and medical practitioners have added more sophistication to the administration and subsequent tracking of urinalysis, making faulty tests more obsolete.

More Complex Drugs Require More Complex Screening

Many people in drug rehab require medication-assisted treatment “MAT” to help ease painful or uncomfortable withdrawal symptoms and allow for a more seamless reintegration into normal life. Known as a harm reduction model of treatment, MAT is common and, depending on the type of drug

addiction, is a widespread and accepted practice. Some of the drugs used in MAT include methadone, gabapentin, and suboxone. But there are challenges that arise, because they are drugs.

Addicted to the Drugs Meant to Help with Addiction

The very nature of addiction is a tough beast to tackle. Because cravings for drugs or alcohol can happen years after medical detox has taken place, the path to sobriety is laced with temptation. In addition, life has a way of presenting expected and unexpected triggers which also compromise sobriety, even for the most seasoned in recovery.

For these reasons, many patients find themselves looking for opportunities to use, undetected. But with drug testing being a mandatory part of addiction treatment and recovery programs, relapsing into one’s former drug of choice is not an option. But misusing what’s provided in MAT is the current trend.

For example, although gabapentin is meant to help curb illicit drug use, it is a favorite amongst those in treatment who go out of their way to take more to generate a high. Most drug tests don’t currently list gabapentin as a substance to screen for.

Drug Screening Is a Vital Part of Addiction Recovery

With relapse being a typical phenomenon in the recovery process (40% to 60% relapse rate), drug testing is not only an effective way to detect use but to offer a deterrence. Accredited treatment facilities demand clean screens. Without them, patients who are serious about their recovery are at risk from those who play at the concept of sobriety just to fulfill a temporary obligation. In fact, a dirty drug test will likely end someone’s place in that rehab.

With the amount of people who are struggling with drug or alcohol addiction compared to the insufficient numbers of treatment beds available, compromising sobriety by using during recovery hurts the bigger picture and taints the good that these programs provide.

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