After over a year of unemployment, I finally got a job offer from [a major company] that I accepted. I’m relieved if not in disbelief, especially with the holidays coming up! The start date is in a month, and HR requires a (urine) drug test, which does not surprise me. But I have a concern. I take prescription medication and I’m worried my meds will turn up in the test results. The meds are for a chronic condition I do not want to reveal to the employer. (The condition will not affect my ability to do the job.) How do I do the test and protect my privacy? Should I just go cold turkey and hope my meds don’t trigger a positive result? Should I tell HR in advance what I’m taking? How about if I just discuss this with the testing lab when I show up?

Nick’s Reply

drug testI’m not a Human Resources expert or a lawyer. Because drug testing regulations vary by state in the U.S., you should check the law about what proper procedures are — and what your rights are. NOLO offers a good discussion about laws on employee drug testing. Not all companies approach drug testing the same way, though there are some standards.

An HR expert addresses your drug test

For corporate insight, I turned to a long-time HR manager I respect and asked about going cold turkey, and about whether you should disclose your prescription to HR or to the lab. She has worked for companies large and small. She said no on all three counts.

Here’s her advice:

  1. Review the consent form you signed. She says an employer is required to disclose what they’re testing for before you consent to it. This is referred to as informed consent. So, you should already know what drugs they will test you for. She says the drug list is often “in the fine print” — but they must disclose it to you in advance. Armed with this information, you should then…
  2. Contact your doctor who prescribed the meds in question. Ask whether the defined tests might be affected by your meds. That is, could your meds trigger a false positive on the specific tests? Proceed from there with your doctor’s advice.
  3. Google the company name plus “drug testing.” She looked this up while we were talking and immediately found a list of drugs the company tests for. The most common drug tests look for five substances: THC, Opiates, PCP, Cocaine, and Amphetamines. You might do this Google search first, but the drugs listed on your consent form are the key.

Relax about your drug test

My HR manager friend suggested that if you’re taking a drug on a prescription in the care of a doctor, and don’t use other drugs illegally, you should not worry about these tests. You’re more likely to raise red flags than to protect yourself. If a test turns up a false positive, you can ask for full results. The employer will likely ask you to explain at that point, and your doctor should back you up.

Congratulations on landing a job right before the holidays!

As long as your medical condition will not affect your job, and you want to keep it private, it may be best not to raise the matter with the employer or with the lab. And going cold turkey is not a good tactic! Review the consent agreement you signed to see what drugs the test is for, and discuss this your doctor before you do the test.

I wish you the best!

What’s your experience been with employment drug tests? Have you ever triggered a positive result? Did prescription meds have a role? If you’ve been through this yourself, what’s your advice to this reader?


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  1. This is a good question on a complicated subject, and a good answer on how the company SHOULD behave.
    Some random drug facts as background:
    THC sticks around in the body for weeks, so you can have a positive test weeks after using MJ.

    Amphetamines are legally prescribed for ADHD, and opioids for control of chronic pain or SUD. They will both show up in urine tests, but as I understand it, that becomes an ADA issue. (I am not a lawyer.)
    If you stop for a few days, they will be out of your body, except for methadone which has a week-long half life.

    Wellbutrin (bupropion) frequently enough gives a false positive for amphetamines to be worth mentioning. Follow up more specific testing may or may not distinguish between them.
    The HR person’s list doesn’t include benzodiazepines like Ativan; I think these are also frequently tested for. Benzos have a wide range of half lives, ranging from hours to a week or more. Valium, for example, has an active metabolite that gets stored in fat tissue and comes out for weeks after stopping.

    While I appreciate the HR expert’s knowledge on what the law requires and what best corporate practices are, we all know that companies don’t always follow the law, and there’s not much we can do about it. My personal “I don’t really trust employers very much” perspective is IF you can stop for a week without serious problems, AND you’re taking a short half life drug, AND you’re not reassured by the company statements about how they use the drug tests, I would consider pausing it for a week before the test and drink lots of water the day of the test. Just because you’re paranoid…

    In short, consider the likely consequences of pausing vs. the company’s reaction to a positive test.

    The company can always be glassbowls.

    I would echo Nick’s advice to discuss with your doctor, read the contract, and would definitely look at NOLO.
    Good luck!!

  2. Congratulations & Bring On 2022 with a Resilience.

    A gentle reminder in the context of the current work environment pulse — after the romance period of the training program and meeting the ‘who is who’ within the organization, stay grounded with and align yourself with your professional strengths, moral character and deliver the daily goals of the job.

    Whisper to yourself, based on Nick’s words:’HR is NOT MY friend’; Adding fuel to Nick’s wisdom: Neither does your supervisor or their manager or co-workers have your best interest at heart.

    Zip thy lips ?from sharing details about your personal life journey and expressing personal opinions on any topic; You have the right to preserve your private personal life separate from work life.

    Just remember: human nature has perceived biases, quick to judge without facts resulting in uncontrollable diarrhea of the mouth towards their target.

    Lay low and do the ‘work’ that you are hired to do. Keep Life Simple.

    Relax and Take Good Care of Your Sense of Well Being, as your own Christmas present.

  3. Problem with the question is it’s too vague. Not that I would expect someone to just post intimate medical details online. Also depends on employment, not to mention State and/or Federal law.

    If your job is commercial pilot, there are certain medicines you just can’t take, and fly aircraft. Period. Prescribed legitimately or not, if you take certain medicines, you don’t fly, and concealing the fact that you’re on the meds will get you into a world of hurt.

    Now that’s specialty jobs. Commercial pilot. Air traffic controller. I would imagine a number of jobs requiring national security clearance, but not familiar with that.

    If the medicine is most psychiatric medicines, the antidepressants, even mood stabilizers and antipsychotics, the employers will not test for those. At least I’ve never encountered that.

    If you’re on an opiate for chronic pain, amphetamine for ADHD, legitimately prescribed, usually just the physician note “I’m his/her doctor and I’m prescribing for a medical condition” is enough. Depends on the job, of course.

    Oh, and Suboxone, buprenorphine. I have never seen any employer even test for that. I suppose somewhere, someone does, but I’ve never encountered that.

    Which brings up the issue of “opiate”. The medical term for “opiate” refers to any of a number of structurally different molecules that happen to stimulate opiate receptors in the human body. Pain relief, respiratory depression, euphoria, constipation, any of a number of effects from stimulating the opiate receptor.

    “Opiate” in a urine drug test refers to a molecule. Specifically, the molecule that comes from a poppy plant, morphine codeine, and a few related molecules.

    Semisynthetic opiates, hydrocodone, oxycodone, require different testing. Those molecules may or may not cross-react on the “opiate” channel on a urine drug test. Fentanyl requires a separate test. So does buprenorphine. All those molecules have “opiate” effects on the body, but are not all picked up on a drug test for “opiate”.

    Marijuana, all bets are off. Legal in some states, has some medical use, but not legal at a Federal level.

    Step one, ask your physician. Your concerns might be misplaced. You might be on a medication that no employer bothers looking for. Remember, it costs money to run a urine drug test. Theoretically, one could create a urine drug test for the hormones in birth control pills. Or blood pressure medicine, etc. Unless you plan on excluding employees who don’t want to get pregnant or want to prevent heart attacks, why are you spending money on the test?

    Another trick. This I highly recommend. Just go to your local pharmacy. There are at-home urine drug testing kits, and accuracy is reasonably good, not much different from commercial kits. The employers are using the same immunochemical urine dip kits, similar to the pharmacy. They are not going to go to gas chromatography and mass spectroscopy (expensive), unless the (cheap) urine dip is positive.

    Look for a multi-channel kit covering the usual opiates, THC, PCP, cocaine, etc. Or get the individual kits if you want. Just more expensive to get one kit fot marijuana, another for opiates, another for cocaine, etc. Test yor own urine at home. If you are negative on home testing, it is most likely your pre-employment test will be negative as well.

    If you want, test a couple times to be sure.

  4. And it the company plans to do the testing properly and avoid lawsuits. Step one is obtain the urine sample. The technicial should split the sample, each half tested with the immunochemical urine dip. Both have to agree.

    Both negative – no problem.
    One negative, one positive – invalid test. Start again.

    Both positive – both samples are sent off for laboratory confirmation by gas chromatography and mass spectroscopy. So two GC/MS tests, one on each sample. Same as before, both have to agree, or start again.

    If both agree, then the data, and your medical history, has to go to a “Medical Review Officer”, a physician with a certain certification to interpret the tests and the interpretation will be recognized in court, if it goes to litigation for any reason. Any physician may interpret the test, but without the MRO credential, no value in court.

    The MRO will use training, interpret testing and medical history, to provide an opinion as to whether the test really reflects use of whatever drug was in question, whether it was prescribed, or whether it was a cross-reaction with some other medication.

    So the whole process is not cheap, at least not if you want to do it right and avoid litigation.

  5. I can speak to this specifically as an employee who failed the test but got the job.

    I was forthright in the interview process and told my (now) employer, “I have a disability that requires me to take a prescribed drug that will appear on my drug screen. If passing a drug screen without taking this into consideration is contingent upon employment, we should stop this interview now.”

    My ADHD isn’t a choice, and I certainly don’t want to work for a company that fails to recognize that.

    In the end, their concern was for drugs for which one does not have a prescription for. I don’t feel embarrassed for sharing and ultimately, my vulnerability was viewed as a positive to my employer!

    I know that I’m privileged to work for a company that honors employees in this way and has been nationally recognized for doing so, but as I’ve learned over the decades…its not worth working for a company that doesn’t put its people FIRST. I used to think it was Company > Customer > Employee and I realize now that it’s the exact opposite and that culture is difficult to achieve – it takes a special blend of folks to make that magic happen. Hopefully in the future, it’s not such a difficult task.

  6. You will be asked to disclose your legally prescribed medications on a form. I honestly forgot about listing a certain legally prescribed medication that I sometimes take with very small doses of a benzo in it on the form I was listing my other medications, and it showed up dirty several days after last taking one dose. All I had to do was come back and bring my prescription drug bottle showing it was legally prescribed. The nurse or tech taking my urine and doing these tests did not care about my personal information and was not nosy. It was an in-house department at a hospital. I was then considered “clean” on the urine test and went on to work there. And some companies make one be drug tested again if one has an accident on the job. So if you want this job and your prescription medication is legally prescribed, just consider disclosing on the drug test form in my opinion. If you have a disability, sometimes there is a lot of shame and not wanting anyone to know. We have to overcome this shame and reticence and make it not marginalized to need some kind of medical or psychological help. I know someone who got good HR protection when she got diagnosed and came to work with a letter from their physician saying what her accommodations had to be. They were about to be fired due to an incident at the job, and these protections kept this person in the job. Besides lots of people take meds for all kinds of reasons. I am leaving out medical marijuana because even in the states where it is legal, some companies ban it and alcohol from use on the job.

  7. Prescribed medications will not be an issue, but need to be disclosed when the sample is dropped off.

    The murky area is marijuana. In states where it can be prescribed by a doctor, it can vary. Especially for Federal government work. For this, you need to discuss with an employment attorney who is familiar with the labor laws in the jurisdiction where you intend to work.

  8. Watch what you say to HR. Here’s a story to ponder:

    The company I worked for took over a contract at a residential educational facility operated under a Federal program in 2010. I was part of the onboarding team in an HR sub-field and worked with an HR manager getting all the new hires through multiple orientation meetings and paperwork submissions. One polite young man who worked in the cafeteria’s kitchen missed the mass meetings I conducted for my part in the onboarding process so I met with him one on one to bring him up to speed and get the paperwork I needed from him. As he was getting ready to leave, the HR manager joined us to ask the worker for other paperwork she needed. He gave her some papers and, as she was checking them to make sure they were in order, the young man asked her if he had passed his drug test. Red flags started waving!

    The young man was ultimtely not hired because his inquiry about the drug test was interpreted as an admission of recent use. The prior contractor was lax running the place. Residential counselors, teachers, and/or other staff were believed to be dealing drugs and a large part of our company’s mandate for the contract was to clean up that and other employee issues. Some folks just never showed up again after they were informed of the test requirement. The shop steward for the security guards’ union raised fairly spurious objections which delayed testing and dropped them after about ten days, just enough time for the guards to get clean.

    Dealing with that contract site was really “interesting”.

    • That is insane. Asking if drug tests is back yet is in no way and admission of anything. I have asked about this before since that was the last step before onboarding.

  9. An old recommendation was to avoid poppy seed rolls and similar, since they could produce false positives.

  10. Wow — some wonderfully detailed comments and suggestions. I think we all recognize what a thorny issue this is and how much experiences will vary depending on the integrity of the employer and its HR staff.

  11. Poppy seeds is a real thing. Poppies do naturally produce a soup of opiate molecules, morphine, codeine, thebaine, papaverine, probably others. Some species of poppy produce more than others. The species that makes baking poppy seeds do contain the opiates, same as any other poppy, just in negligible amounts. BUT……it’s enough to show up on a drug test.

    A medical urine drug test, you want to pick up these trace amounts. Pre-employment is another matter. As pointed out, a positive test requires gas chromatography/mass spectroscopy and Medical Review Officer consultation. This costs money.

    Employers and HR departments, hardly saints (I don’t need to tell you that), but still, it’s not in their interest to spend that money chasing down positive tests because someone ate a poppy seed muffin for breakfast. I would imagine they also do not want to lose possible hires or deal with litigation over same.

    USUALLY the pre-employment drug tests set their OPIATE threshold for positive a little higher, so they don’t have to deal with the positive tests from the poppy seed pastry.

  12. As the local chief drug tester, a job function that I never aspired to, at the local park that is part of a national chain of amusement parks, I can say that the corporate legal eagles have managed to straddle the fence. We have a two tiered system with regard to THC. About half of the 4,000 jobs at our park are non safety sensitive and are not subjected to THC testing. The remainder are so called safety sensitive and are subject to THC (aka marijuana) drug testing.
    I’ve performed close to a thousand drug tests in the last year and here are my conclusions with respect to the way the drug tests are given here. Please note that the drug scan that I perform is not the final answer. If any drug tests presumptive positive, the sample is sent into a lab to confirm the result. This is important for prescription drugs that test positive for methamphetamine including ADHD drugs such as Adderol (sp?). All presumptive positives are sent to a lab for further analysis. Almost all come back as negative for the illicit drug. In which case the new hire goes forward, or a current employee is paid for any missed time while waiting for the results of a random drug test.
    My issue with the whole drug testing issue is THC (aka marijuana). It is detectable at very low levels for up to four weeks after ingestion. The problem is that the amount of THC detected is not scientifically connected to impairment thanks the the US federal government that prevented any research into the dose versus impairment data that was collected for alcohol after MADD made it a political issue for drunk driving in the 80s. I personally have no dog in this fight since I do not use any form of THC. Given the so called worker shortage, I wonder if any of it is attributed to obsolete drug testing policies. I have heard that the big tech companies have ceased to test for THC in hiring drug testing protocols. That’s all above my pay grade, but I just say “what a shame” when the powers that be where I work complain that they can’t fill jobs. I learned a long time ago that it’s useless to try to talk to upper management about these things, and they need to learn it own their own the hard way.
    To quote Kurt Vonnegut, “and so it goes”

    John Z

    1. For prescription drugs that trip

    • @John Z: Thanks for that detailed and insightful insider’s look at drug testing. It’s astonishing to see all that employers are doing to make hiring and retention harder — while they complain about the challenges of hiring and retention.

      My favorite recent e-mail from a reader: She’s a manager tasked with recruiting, hiring and training a new employee who will be paid more than the manager is paid. (I don’t have a problem with staff earning more than their boss, if their special skills warrant it.) Her own boss told her that if the company were to raise every employee’s salary to match the higher offers they’re making to job candidates, the company would not survive. He pointed out that if he and she wanted higher pay, they’d have to change employers.

      So much for retention, eh? And who would train that new hire? Duh…

      I really don’t buy the nonsense explanation that a company just can’t afford to raise everyone’s pay to match job offers to new hires. Something smells. If a company’s business plan/model can’t afford workers at current market rates, maybe they need to fold and let a better-managed competitor take over the customers.

  13. Oh God I thought this would be about forced COVID tests and cause a sh*tstorm of comments pro and anti vaccines. Y’all are too rational and reasonable here

    • @G.D. — Yup. The standard of discourse here is high and the denizens are smart and share good ideas. I’m proud of them. Thanks for the compliment!

  14. It truly depends upon the kind of job, the employer’s requirements, plus any state and/or federal requirements (if any). I remember having to pee in a cup for a drug test for an office job (no Top Secret security clearances, not doing anything remotely dangerous or that would put me or my future colleagues in harm’s way), and I remember being told that they (the company) was concerned about illegal drug usage, and that if anything weird popped with the test, they’d ask the new hire about it and make him/her go through a more detailed drug test. I remember my soon-to-be boss telling me NOT to eat poppy seed bread or a poppy bagel as that will throw off the drug test.

    I would think that if the employer wants you badly enough, and you test positive due to a legally prescription (you’re under a doctor’s care), then it wouldn’t matter. But employers are squirrely, so I would hold off on disclosure unless it was part of your on-boarding paperwork (there would be a form you’d be required to complete listing the prescribed drugs you are taking).