Pre-Employment Drug Testing: What to Expect & How to Prepare (Compliantly)

Pre-employment drug testing helps employers build safe, consistent, and legally defensible hiring programs. If you’re a hiring manager, this guide explains how testing fits into your background screening workflow—and how to roll it out in a fair, compliant way. If you’re an applicant, you’ll learn what to expect on test day, how results are reviewed, and what your rights are. No shortcuts, no “hacks”—just a transparent overview you can trust.

Hiring now? You can add a drug test to any package and order online in minutes.

GET STARTED TODAY: Easily order an Employee Background Check and add a drug test at checkout (transparent pricing, fast TAT). We take care of scheduling and providing an email-friendly donor pass.

Why employers include drug testing

Employers add drug testing for three primary reasons:

1. Safety & risk management. In safety-sensitive environments (field services, logistics, construction, healthcare), drug testing helps reduce incident risk and supports a culture of safety.

2. Client and carrier requirements. Many customer contracts and insurance policies mandate pre-hire or random testing for certain roles.

3. Consistency and documentation. A clear, written policy—applied consistently—reduces liability and supports objective decision-making when results require follow-up.

Drug testing typically accompanies other checks—criminal records, employment and education verification, professional license checks, healthcare sanctions, and (optionally) social media reports—so that hiring decisions consider the full picture, not a single data point.

Common test types (and when they’re used)

There isn’t a single “best” test. Choice depends on your policy, the role, and turnaround requirements.

• Urine (most common): Generally detects recent use across standard panels; widely available collection sites; typically the best mix of cost, coverage, and speed for pre-hire.

• Oral fluid (saliva): Shorter detection window but excellent for observed collections and remote/near-instant scheduling; strong option when you need quick, defensible collections.

• Hair: Much longer look-back; useful for roles where longer-term patterns of use are a concern; typically higher cost and longer turnaround than urine/oral fluid.

• Blood: Rare outside post-accident or clinical contexts; not common for standard pre-employment screening.

Your policy should specify which test type(s) you use, the panel (e.g., 5-panel, 10-panel), when tests occur (pre-hire only vs. post-accident, reasonable suspicion, return-to-duty), and how results are handled.

Before the test: simple, compliant preparation (for applicants)

Applicants don’t need special products or complicated routines. A smooth collection comes down to simple readiness:

• Bring a valid government ID. Collection sites must confirm identity.

• Arrive a little early. Paperwork and chain-of-custody forms take a few minutes.

• Follow site instructions. Collection areas are controlled; tamper-evident seals and temperature checks may be used depending on the test.

• Prescription medications: If a laboratory flags a specimen for confirmation, a Medical Review Officer (MRO) may contact you privately to verify legitimate prescriptions. Share medical details only with the MRO, not with the employer.

• Normal routine: Maintain ordinary hydration and avoid new supplements right before your test; laboratories can detect dilution/adulteration, and unusual changes to routine can complicate interpretation.

What happens on test day (step-by-step)

1. Check-in & forms. The collector verifies your ID and completes a chain-of-custody form that tracks the specimen securely from collection to laboratory.

2. Collection. The specimen is collected in accordance with your employer’s policy and test type (urine, oral fluid, or hair).

3. Sealing & shipment. Samples are sealed with tamper-evident materials and shipped to the laboratory for analysis.

4. Screen & confirm. The lab screens first; if a result is non-negative, confirmatory testing is performed using a different analytical method.

5. MRO review (if needed). For results requiring context, the MRO—an independent physician—may contact the applicant to discuss legitimate prescriptions or other factors.

6. Employer result. Employers receive a simple outcome (e.g., negative, positive, canceled, dilute, invalid). Employers do not receive private medical information.
   

Turnaround time depends on test type, lab capacity, and whether a result requires confirmation and MRO review. Many negative results come back quickly; non-negatives take longer because confirmatory steps and outreach are involved.

After the test: how results are reviewed and communicated

• Negative: No prohibited substances detected per your panel and cutoffs.

• Positive: Confirmed presence of substances on the panel without a valid medical explanation provided to the MRO.

• Dilute/Invalid/Canceled: The lab or MRO could not render a standard result; policy typically calls for a recollection.

• Refusal: Not appearing for the test, declining to test, or tampering may be treated as a refusal under policy.
  

Employers should document next steps in their policy, including any adverse-action workflow for non-DOT contexts: provide a pre-adverse action notice, share the report, allow time for the candidate to respond, then send final notice if the decision stands. Here's a summary of a candidate's rights under FCRA

Building a clean, defensible program (for employers)

A strong program is both fair and repeatable:

1. Write the policy. Cover who is tested, when (pre-hire, random, reasonable suspicion), which test types/panels, and how results are handled.

2. Use certified labs and MRO review. This safeguards quality and privacy.

3. Train supervisors. Especially for reasonable suspicion; document observations and ensure prompt testing according to policy.

4. Keep results confidential. Store results separately from general personnel files with limited access.

5. Apply consistently. Avoid ad-hoc exceptions; consistency strengthens fairness and legal defensibility.

6. Remote candidates. Use e-chain documents so candidates can schedule at a convenient collection site; this supports multi-location hiring without delays.
   

   * Global Background Screening streamlines the drug testing process by providing the applicant or employer to choose the collection site. (By default, the applicant will have the option to pick their closest location)

Applicant rights and fairness

Rights vary by jurisdiction and testing context (DOT vs. non-DOT), but common themes include:

• Informed consent and privacy. Applicants should know what’s being tested and how results are used.

• MRO confidentiality. Medical information discussed with the MRO is private; employers receive only the result status.

• Dispute mechanisms. Policies may allow retesting or a second specimen in specific circumstances; follow the written process.

• Adverse-action transparency (non-DOT). If a result affects employment, employers should use a compliant adverse-action process and provide required notices.

If you’re unsure about local requirements, consult counsel or your screening provider for jurisdiction-specific guidance.

Frequently asked questions

Do I tell the employer about my prescriptions? No. If the lab flags your specimen for confirmation, the MRO may contact you. Share prescription information only with the MRO. Employers receive a final status, not medical details.

What if my result is “dilute,” “invalid,” or “canceled”? Most policies require a recollection. Laboratories and MROs check for dilution/adulteration; follow the recollection instructions promptly to avoid delays.

How long do results take? Turnaround depends on test type and whether confirmation/MRO review is required. Many negative results are fast (1-2 Days from when test is taken); non-negatives take longer due to additional steps, with an average of 3-4 days.

Can we test remote or out-of-state candidates? Yes. Electronic chain-of-custody (e-chain) forms let candidates schedule easily at a nearby collection site based off their zip code, keeping hiring timelines on track. With partnerships with Labcorp and Quest Diagnostics, Global Background Screening provides one of the biggest drug testing networks available to employers.

Can we add drug testing to our existing background package? Yes. You can add drug testing at checkout when you order an Employee Background Check. Currently, drug tests are only available in the USA.

Related Reading

• Ultimate Guide to Drug Testing: how to order employment drug tests

• 4-panel drug test: substances screened and typical use cases