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Understanding Drug Testing

Medically Reviewed by: Charley Allen

Table of Contents

Understanding Drug Testing

The United States currently suffers from an addiction crisis. Approximately 8.4% of the adult population suffers from a substance use disorder in a given year. In 2018 alone, 67,367 drug overdose deaths occurred. The opioid epidemic is causing skyrocketing rates of overdose and is destroying lives, families, and communities. Among young people, opioidscannabis, benzodiazepines, and amphetamine drugs are increasingly popular. While not everyone who engages in drug abuse suffers from an addiction, drug abuse at any level of severity can lead to devastating consequences. The effects of substance abuse are wide-ranging and include workplace problems, interpersonal issues with friends and family members, academic difficulties, financial and criminal consequences, and physical and mental health disorders. Addiction always remains a risk, as does overdose. It is essential for anyone suffering from a drug abuse problem to seek outside help as soon as possible.

Unfortunately, individuals who have problems with alcohol and drugs are notoriously reluctant to seek the help they need. Part of the problem is that many fail to recognize that they have a problem at all. This mental blindspot is partly due to social stigmas and cultural expectations of what addiction ought to look like. When most people think of an addicted person, they imagine someone destitute, homeless, perhaps with obvious visual signs of drug use, like track marks. The reality is that people in any walk of life can develop a drug problem. However, even people who recognize the harms inflicted on their lives by regular drug abuse are often still reluctant to open up about their problems. Many people believe that suffering from a substance use disorder is somehow shameful, or that their problems aren’t legitimate. Most try, with little success, to manage their conditions on their own. Some people with addictions have too much pride to ever ask for help.

As a result, individuals who engage in drug abuse or suffer from drug addiction are often notoriously secretive about their habits. Their secretiveness may stem from shame or pride, but sometimes sneakiness arises from fear. For many addicted people, the idea of losing access to the substances they depend on is a horrifying thought. The notion that close friends and family members will try to help them get sober, which they may recognize intellectually as a positive thing, is more frequently thought of something that is best avoided, or at least delayed. Many addicted people hide their substance abuse because they understand that the consequences of detection may be painful. Employers will often fire or demote individuals who are discovered to have a drug problem. Academic institutions sometimes expel students or recommend a leave-of-absence. Family members and close friends who discover that someone is abusing drugs may place less trust in them, or cut them out of their lives. Unless a drug user is desperate to make a change and get sober, they generally take great pains to avoid detection.

For family members and institutions like workplaces and schools, the most effective way of determining if a person is engaging in drug abuse is to administer a drug test. There are a wide variety of drug tests available. They are also distinct in terms of what drugs they are capable of detecting, the period of time from which they can detect drugs, and their accuracy. Learning how to use drug tests is essential for anyone who suspects that their loved one is abusing drugs. It is also important to understand the ways in which addicted people can fool drug tests. Having the know-how necessary to ensure an accurate testing is the best way to find out if your loved one has a problem.

Is Your Teenager or Adult Child Using Drugs?

Most parents do not force their children to take regular drug tests unless they suspect something is wrong. Given how hard addicted young people work to avoid having their problem be detected, however, how can any parent hope to come to any conclusion on the matter? Ultimately, short of a drug test, a confession, or seeing someone use drugs, there is no way of knowing with 100% certainty that someone is abusing drugs. However, intuition can be an effective tool. The fact is, parents, close friends, and other loved ones generally have a good idea of when something is amiss. Watching their child grow up and enter adulthood generally gives parents a good understanding of who they’re child is deep down. The changes that drug abuse results in are sometimes extreme, sometimes subtle, but for intimate acquaintances they are usually obvious. Talking to other family members and keen observers can also be a good way of reassuring yourself that your suspicions are not unfounded. More often than not, if a person is truly abusing drugs, you won’t be the only person who has noticed.

Substance abuse manifests itself in a number of physical and behavioral signs. The ways that substance abuse will affect a person largely depend upon the substance or substances they use. Other factors that can determine side effects of drug abuse include a person’s age, overall health, and their level of experience with drugs. While not everyone will exhibit every symptom, and there are too many possible symptoms for a comprehensive list, the following are some common signs of drug abuse to look out for:

  • Worsened academic performance
  • Problems at work
  • Frequent lying and deceptive behavior
  • Acting odd, strange, or eccentric
  • Being more fatigued or sleeping more than normal
  • Having significantly more energy than normal
  • Smelling like alcohol or drugs
  • Forgetfulness and gaps in memory
  • Slurred, slowed, rapid, or incomprehensible speech patterns
  • Decreased coordination
  • Less attention devoted to personal hygiene and appearance
  • Frequently being tardy, late, or missing appointments entirely
  • Sudden mood changes
  • Spending time with a new peer group, especially if this group includes known drug users or heavy drinkers
  • Sudden unexplained debts or an unexplained need for more money
  • Engaging in criminal behavior, having legal problems
  • Bloodshot eyes or poor skin tone
  • Health problems that do not go away after being treated
  • Defensiveness when the issue of drugs comes up
  • Cravings for drugs and/or alcohol

These symptoms can be all the more concerning when a person has a number of risk factors for addiction. Risk factors for addiction include genetics (a family history of addiction), early exposure to drugs and alcohol, and mental health disorders.

If you suspect your loved one is abusing drugs because they are exhibiting some of the above-listed symptoms, it is time to take steps to help them. The first approach to take is to talk to them directly about your concerns. It is generally best to approach such a conversation without resorting to anger or a lecture. Instead, demonstrate tolerance, non-judgment, and care. Remember, drug users are generally defensive and fearful, and they may not be in possession of all of their cognitive abilities. Talking to them in whatever way is most likely to help them open up is the best way to get on the same page. Sometimes having this conversation with other family members, friends, or loved ones can be even more effective. This approach, known as an intervention, can help addicted young people understand that they are cared for and supported. The best case scenario is that they will admit to their drug problems and even express a willingness to get help. However, it is also common for young people to continue to hide their drug abuse and admit nothing, no matter how gently you approach the subject.

When a person fails to be honest about their drug abuse, administering a drug test is often a good idea. A drug test can confirm your suspicions and help you to know what kind of help your loved one needs. The prospect of being tested may even make your addicted loved one more open to telling the truth. After all, if their drug abuse is going to be discovered anyway, why bother lying?

Where to Administer a Drug Test

The easiest place to administer a drug test is in the privacy of ones own home. This is also often the safest-feeling place for the person who is taking the test. Home drug tests are widely available. They can be purchased at most drug stores and pharmacies, supermarkets, and even through online retailers. However, it is important to understand that not all drug tests are the same. While the most widely available home drug test kits can measure the presence of marijuana in a person’s body, these common test kits do not all necessarily detect other substances. In selecting a test kit, it is paramount to choose one that measures a wide range of substances, or the substances that seem most relevant to your particular case.

Family members who administer a drug test at home may be doing so under a variety of circumstances. A drug test can be used to determine if a person has a problem with substances. However, many families choose to use drug tests as a kind of deterrent. These families may not necessarily see any evidence that their loved one has a drug problem; rather, they hope that regularly testing their loved one will make them less likely to use drugs. In this situation, it makes sense to continue a schedule of regular (and unpredictable) testing, no matter how many times a person tests negative for drug use. Regular testing can also be useful for families who are well-aware that their child has a problem with drugs and alcohol. When parents know that their child is struggling to manage their substance abuse, or when a young person is trying to maintain their sobriety, drug testing kits can be a powerful tool for holding them accountable and even maintaining familial trust.

When a Use Drug Test

Testing a child for drug use may seem like a no-brainer, but it is important to think about timing. First of all, some parenting experts recommend that parents exercise caution when it comes to administering drug tests. It is generally best to use them only when a person is almost 100% positive that their loved one is abusing drugs, or when their behavior is a serious cause for concern. This is because a drug test has a lot of symbolic meaning for people. It represents a lack of trust; administering a drug test is tantamount to saying, “I think you’re lying. I don’t trust you.” Some types of drug tests can also feel intrusive. For these reasons, administering a drug test carries a risk of damaging a parent’s relationship with their child. Parents who test their children without seeing any signs beforehand of drug abuse may ultimately be lowering the likelihood that their child will talk to them about problems they experience in the future.

Even when a parent knows their child has tried drugs, it may still be too early for a drug test. It depends on a child’s age and the parenting philosophy of their parents, but to some degree drug experimentation is normal for adolescents and young adults in the United States. The vast majority of teenagers try alcohol at least once before they are of legal drinking age. Peer pressure and simple curiosity motivate many adolescents to experiment with cannabis. While these substances, especially alcohol, carry a high degree of risk, it is important to acknowledge that not everyone who tries these substances develops a substance use disorder. When a parent discovers that their adolescent child has tried alcohol, cannabis, or even a harder drug, the most important thing is to have an open dialogue about substance use.

Parents who immediately respond by suspiciously drug testing their child can make their child feel isolated and misunderstood. It is crucial to understand that having a strong social support system is one of the most important factors in preventing and treating addiction. For this reason, it is important for parents to delay using drug tests until they are positive that their child’s drug use has reached problematic levels.

When a parent or loved one has determined that a drug test is necessary, it is still important to choose a good time for the testing procedure. While it may seem prudent or polite to inform the person in advance that you will be testing them, it is often better to give them no warning ahead of time. If they are warned in advance that a drug test is coming up, young people who are motivated to continue abusing drugs without being discovered will have plenty of time to figure out a way to cheat on their home drug test. While such attempts at cheating are often unsuccessful, methods do exist for cheating on home drug test kits, especially certain types of test kits. To ensure an accurate testing, it is best to administer it in a way that is random and unexpected.

The most ideal time, though, for administering a drug test is when a person is exhibiting clear signs of intoxication. Not everyone who abuses drugs abuses them all the time, especially young people whose drug problems may not yet have developed into active addictions. Testing a person when they have been abstinent for a period of time can give an inaccurate result, leading loved ones to believe that there is no problem. Patience is key. When your loved one is behaving oddly, slurring words, or seems unkempt, administering a drug test then can provide the answers you need.

Drug Testing Outside of the Home

Drug tests are also used in a variety of circumstances outside of the home. Schools sometimes test their students when a behavior problem becomes evident, and sometimes even as a condition for continued enrollment. Young people and older adults who apply for jobs are also sometimes required to take a drug test as a condition for employment. These drug tests are sometimes administered with varying degrees of regularity. If you are concerned that your loved one is abusing drugs, the information garnered by these institutional drug tests can be illuminating. However, it is important to understand that many employers and academic institutions are not aware of the means by which these drug tests can be cheated. They are also rarely sufficiently acquainted with the people they’re testing to know which drugs to test for. Workplaces and schools use drug tests in a routine manner, and there are people who will inevitably slip through the cracks.

For the most accurate drug testing available, the best places to go are addiction resource centers. Addiction resource centers, like sober living homes, have a deep understanding of substance abuse, addiction, and the symptoms of drug use. Dedicated staff members regularly use drug tests to ensure that residents of sober living homes have not relapsed. They also understand the advantages and disadvantages of different types of drug testing kits. If parents, family members, and loved ones want to ensure the most accurate testing possible, visiting a sober living home is the way to go. Even if families do not necessarily want to pursue enrollment at a sober living house, getting tested by addiction experts can nonetheless be the best way to ensure accuracy and prevent cheating.

Types of Drug Tests

Given the number of drug tests available, it is important to choose a drug testing kit that is convenient, appropriate to the kind of substance abuse your loved one is engaging in, and above all accurate. The following are some of the most common types of drug testing kits that are accessible to most families.

Urine Drug Test

Urine drug testing kits, sometimes known as UAs, are by far the most widely used type of drug testing kits. This is due to their ease of use and their affordability. Urine tests are also the most widely used kind of test among employers, schools, and other institutions that require regular use of drug testing kits. Urine tests require that an individual provide a sample of their urine. It is then sealed to avoid contamination. Urine drug tests measure the presence of a parent drug or its metabolites in waste matter. Metabolites are the structures produced when the body metabolizes drugs, and urine is the main way this kind of waste matter is excreted. A variety of methods are used in the analysis of the urine, including thin layer chromatography, gas spectrometry, immunoassays, and mass spectrometry. Test results usually appear quickly.

Urine tests, however, do have weaknesses. The primary complaint associated with urine tests is that they result in a higher rate of false positives than other kinds of tests. This can cause people to be falsely suspected of drug use even when they have remained abstinent for a long period, a situation that can be both confusing and harmful. Urine tests also do not reliably detect every kind of drug under a parent drug class. While many people would assume that a urine test for opioids would detect any opioid drug, the reality is that urine tests for opioids often fail to detect oxycodone, oxymorphone, meperidine, or fentanyl. While there are some urine tests on the market that screen for a specific drug, such as fentanyl, it is always possible that the person being tested is on a different one. For this reason, even a negative test result does not necessarily mean that a person is not abusing drugs.

Many drug users have developed ways of fooling urine tests as well. The most common technique that people use to pass a UA is simply using someone else’s urine. While this may sound like an awkward request, people who suffer from drug addiction are often willing to make it to prevent a positive test result. Sometimes they will take extreme measures to ensure that this technique works: when a test date is approaching but the day isn’t specified, an addicted person may keep a vial of their friend’s urine on them at all times. They’re motivation is in some ways understandable. If a drug user offers the urine of a drug-free person instead of their own, they will get a negative result and be deemed drug-free themselves. However, some are left with no alternative but to use their own urine. To avoid detection, they may try to “detoxify” their urine. One such method is to drink high quantities of water before the test is taken to dilute the urine sample. Extreme amounts of exercise are also sometimes said to speed up the process of detoxification. A variety of products of dubious quality are also marketed as being able to detoxify urine samples. While these methods of cheating on urine tests are not always successful, they are viable enough to make urine tests not 100% trustworthy.

Saliva Drug Test

Saliva drug tests have become more popular in recent years because they are relatively non-intrusive. Many drugs are immediately detectable in saliva after they are used. The main disadvantage of saliva tests, however, is that they only detect for very recent drug use. Alcohol, for instance, stops being detectable in saliva after between 6 to 12 hours. Marijuana stops being detectable after 24 hours, though it often stops being detectable after only several hours. As such, saliva tests are not a useful way of determining if a person engages in substance abuse on a regular basis.

Blood Drug Test

Blood tests are by far the most accurate type of drug test. However, they are not the most widely used because they are expensive and can only be administered by trained medical professionals. Blood tests can reliably measure the presence of parent drugs and metabolites in the blood. However, they cease to be effective after metabolites are no longer present in the blood. When sufficient time has passed since a person last used a drug, their blood will no longer contain evidence of their drug use. While the time it takes to fully eliminate traces of drug use in the blood varies with different drugs. With cannabis, for instance, the presence of metabolites rapidly decreases after 6 hours have passed, and by the 30 days period it is entirely undetectable. While blood tests are not ideal for reliably giving a picture of a person’s history with substances, they are effective for medical professionals who need to accurately evaluate which substances a person is on.

Hair Drug Test

Hair drug tests are unique in that they are able to detect a person’s history with drugs going back over a long period of time. In fact, drugs can be detectable for a period of time exactly equivalent to however long a person has been growing a particular strand of hair. This is because drug metabolites actually filter through a person’s hair follicles after entering the blood vessels of the scalp. As such, every hair actually contains a long-term record of a person’s drug use. For individuals with long manes going down their backs, this record might go back years! These drugs are also difficult to cheat on, since the traces of drug use are internal and cannot be eradicated by shampooing the hair. However, for individuals who want to eradicate evidence of past drug use, a simple buzzcut can be sufficient to limit the effectiveness of the test. Hair drug tests, while they possess the advantage of measuring drug use over a long period of time, are not always the most practical. This is because they only measure historical drug use, but not current drug use. Employers have little use for them, since their priority is testing whether a person is impaired while on duty. These tests are also more expensive and entail a lengthy processing period.

Tips for Administering a Home Drug Test

Given their affordability, urine drug testing kits are the most common home drug tests. These home testing kits, while not able to measure drug use over a long period of time, are sufficiently accurate and measure a wide range of substances. While urine drug testing kits produced by different manufacturers operate differently, they generally involve a common procedure. The first step is obtaining the urine sample. Afterwards, the administrator can apply the sample to a collection site included in the kit. Once the sample is in the collection site, it needs time to develop. The length of time it takes to obtain a test result depends on the kit and which metabolites are being measured. Most urine testing kits will show two lines for each type of drug being measured. The first is a control line that lets administrators know the kit is working, and the second is the test line. If the test line appears, whether faintly or distinctly, then that means a person has not tested positive for the particular drug associated with that line. When the test line is absent, then the testee has obtained a positive result and is likely using drugs.

Given the nature and limits of urine drug testing kits, it is important for test administrators to keep some tips in mind. Conducting the test properly will ensure accuracy, help to interpret results, and make the process much smoother.

Tip #1: Allow the test-taker some privacy

Being tested for drugs can feel invasive and even humiliating, but being supervised while urinating can feel even more so. While concerns about cheating can make it essential that the test administrator be present in the bathroom while the sample is obtained, it is nonetheless important to be sensitive about the feelings of the test-taker. Remember: drug addicts are not criminals or bad people — they have a medical condition. Allow them their dignity, and the test should go smoothly.

Tip #2: Understand which substances the kit tests for

The substances measured by a particular drug testing kit depend entirely on the kit itself. It is important to purchase a kit that tests for the substances you’re concerned about and to understand the limitations inherent to a kit. Most urine drug testing kits, for example, do not test for alcohol. A person may be drinking abusively every day but still test negative. Additionally, even tests that are designed to detect opioid parent drugs and metabolites do not measure every single type of opioid. Oxycodone, for instance, is often more difficult to detect. If there is one drug in particular that you are concerned about, it often makes sense to purchase a specialty kit designed to test for that specific drug.

Tip #3: Understand that there is a limited detection window

The detection window for drugs depends on the drug in question and on the type of urine test being used. It is of paramount importance to read the urine test’s instruction manual to understand how long a period of time the kit is designed to measure. Understanding how long different drugs remain present in the urine is also important. Some drugs can be detected for long periods of time in the urine, but other substances stop being detectable after only several days.

Tip #4: Understand False Positives and False Negatives

While it is unlikely that a person will get a false positive on their drug test, it is prudent to remember that urine tests, while affordable and easy to use, are not 100% accurate. In fact, some research suggests that 5% to 10% of cases. That means that if a person who tested positive is insisting that they are drug-free, there is a small chance they may be telling the truth. Some medications and foods can also lead to false positives. Eating poppy seeds or a poppy seed bagel, for instance, can cause a person to test positive on an opioid test. The antidepressant Wellbutrin, tricyclic antidepressants, and certain cold medications can also lead to false positive results for amphetamines. Some evidence has even shown that energy drinks can lead to false positives with certain test kits.

False negatives are rarer than false positives, but they can occur when a test-taker successfully cheats on their drug test. If someone has passed their at home drug test but their behavior still seems suspicious, they may have cheated. It is important to understand all of the ways that drug users try to cheat on urine tests to ensure an accurate result.

How to Prevent Cheating on a Drug Test

Urine tests are the most common form of drug test, and they are also the easiest to cheat on. Taking a urine test necessarily involves offering the test-taker a certain amount of privacy. Conniving testees can easily take advantage of this privacy in order to cheat on their drug tests. Remember: individuals who are determined to keep using drugs will often go to great efforts to avoid detection. Even someone who struggles to complete basic tasks at work or school may be sufficiently motivated to do extensive research on test kits limitations. They may even find and replace your drug test kit with a fake drug test. Keep in mind that a test-taker may be more knowledgeable about the kit you’re using than you are! If your loved one has learned how to pass a pee test, you should be aware of the strategies they might use.

Below are some common strategies addicted people use to fool home drug tests:


Drug users who understand that their own urine contains detectable amounts of drug metabolites may seek out an alternative sample to provide. Urine test kits cannot tell if a sample is from a specific person – they measure blindly. One method of substitution is to ask a sober person for a sample of their pee, which the testee will offer in place of their own during the test. Online retails also sell artificial urine samples that they claim will lead to a negative test result, though these products are not always effective. They are sometimes marketed as “fake piss” or “fake pee for drug test,” and they claim that they are the best way to pass a “piss test.” Some enterprising drug users may even follow an online recipe to learn how to make fake pee.

Choosing an unpredictable testing time can make it more difficult for a person to obtain a substitution in time. However, individuals who are expecting to be tested may carry around a substitution sample on their person (such as in their pants, for easy access) at all times. The only way to absolutely ensure a substitution is not used is to limit the privacy of the test taker while they produce their sample.


For those who are unable or not sure how to fake a drug test with a substitution, there are a number of ways to dilute urine. The easiest method is simply to drink high quantities of water before being tested. While this does not eliminate traces of drug metabolites in the urine, it makes them proportionally smaller and can therefore decrease the likelihood of a positive test result. The water dilution method is often utilized by people who Google “how to pass a drug test overnight,” the evening before they are tested. A number of “detox” drinks and products are also sold that claim to speed up the body’s metabolization of drug traces, though the most effective of them work by merely diluting a person’s urine. Dilution can cause the drug metabolites to fall below detection levels and can lead to a false negative. Ensuring that a test-taker isn’t overconsuming water before getting tested is essential.


Adulteration involves adding contaminants to the urine sample after it has been obtained. This is one of the methods often researched by those wondering how to pass a drug test for opiates. There are a number of substances that can be added to prevent the detection of certain drugs. These substances include vinegar, bleach, iodine, detergent, isopropyl alcohol, eye drops, lemon juice, and even soda. Commercially available chemicals can also be particularly effective, including nitrite, glutaraldehyde, and pyridinium chlorochromate. These adulterants can also have mixed results. Pyridinium chlorochromate, for instance, makes it more difficult for marijuana and morphine to be detected but makes tests more sensitive to amphetamines. To prevent deliberate adulteration, it is crucial to watch over the urine sample and prevent the test-taker from interfering after they provide it.

How to React to a Positive Test Result

Recognizing a person’s drug problem is the first step in helping them to recover. If your loved one suffers from a drug abuse or drug addiction problem, sober living homes can be of particular assistance. These homes provide a safe, supportive, and above all sober environment. Residents at sober living homes are not exposed to the typical drug use triggers that they may otherwise encounter in their daily lives. They work daily with each other and trained staff members to develop a strong foundation in sobriety. This process involves developing new skills, a strong sober social support system, and a stable life. Sober living homes also regularly engage in drug testing, and they are well acquainted with the strategies used by addicts who believe they know how to pass a UA. Sober living homes offer long-term support, enabling residents not only to stay physically abstinent, but to take steps towards new life goals in sobriety. Sobriety and a new way of living are possible for those who are willing to seek help.


Edited by: David Beasley

David Beasley - Design for Recovery

David Beasley is a certified RADT (Registered Alcohol/Drug Technician). David, moved to California from North Carolina after many failed attempts to get sober.

Medically Reviewed by: Charley Allen

Charley earned his Masters of Clinical Psychology from Antioch University, Los Angeles, and is a California Licensed Marriage and Family Therapist (LMFT).He teaches mindfulness to both adults and children in group setting such as schools, corporate workplaces, and medical treatment facilities.

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