Many employees in the health-care industry have access to drugs. Consequently, 48 percent of health-care employers require pre-employment drug screening, as of 2011. According to a 2007 U.S. Department of Labor survey, 6 percent of full-time health-care and social assistance employees used illicit drugs within 30 days of a job interview. Depending on the type of job, employers can opt for several types of drug screenings.

Federal health-care agencies follow drug-testing procedures established by the Substance Abuse and Mental Health Services Administration, or SAMHSA. While private health-care companies have more leeway in drug testing, many also follow the SAMHSA guidelines, which call for a chain-of-custody form, initial screen and confirmation screen. A doctor who specializes in substance abuse reviews all positive drug-test results and talks to the potential hire about medical conditions and prescriptions before reporting a positive test result to the employer.

Methods

Most health-care companies test the urine of potential employees to screen for illicit drugs. For employers, urinalysis is the least-expensive option. The down side is that some job seekers try to cheat by taking detox pills or herbs to dilute or mask drugs in their systems. Blood tests, saliva swabs and breath analysis can measure the amount of alcohol or drugs in the body at the time of the test. Hair analysis can indicate drug use over a 90-day time frame, but not current drug use. Sweat, collected by a skin patch, can also be tested for drug and alcohol use.

Types of Drugs

Health-care companies have the option to test for a wide variety of drugs. The most common pre-employment screen, the 5-Panel Drug Test, identifies amphetamines; THC, or marijuana; cocaine; opiates, such as heroin, codeine or morphine; and PCP, or angel dust. Many health-care employers also use the 10-Panel Drug Screen to test for the standard five drugs, plus overuse of prescription drugs such as barbiturates, benzodiazepines, methaqualone, methadone and propoxyphene. Depending on the potential employees' access to drugs, the company may require an Expanded Opiates Drug Test to determine painkiller abuse from hydrocodone, oxycontin and other synthetic opiaites.

Results

Pre-employment drug tests by urinalysis tend to be accurate, although there may be false-positives and false-negatives. Factors such as weight, race and age can affect urine tests. Those applicants who test positive can opt to have the test redone at their own cost, and laboratories keep their samples for this purpose. Drug-test results should remain confidential. Health-care job applicants should understand their rights before signing a release-of-information form.