Drug Test Cutoff Levels: Everything We Know

Drug Test Cutoff Levels: Everything We Know

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Table Of Contents:

A drug test cutoff level determines the levels at which a given amount of illicit drugs would be considered positive for drug testing. Drug testing cutoff levels are measured in Nanograms per Milliliter (ng/ml). Drug test cutoff levels aid drug-testing measures by preventing false positives from occurring, such as a positive identified for abusing cocaine based on consumption of poppy seeds.

Under the Federal Guidelines, there are two cutoff levels for positive detection of drugs. The first cutoff level is used to determine the initial screening result, followed by the second cutoff level used for the confirmatory tests. For instance, the initial screening for cocaine metabolites must contain at least 150 ng/ml, and the second confirmatory test should show at least 100ng/ml. Initial screening for drugs is performed either using immunoassay or an enzyme-linked immunosorbent assay (ELISA).

A confirmation test is required if the drug metabolite level is tested above the initial screening cutoff level. Confirmation tests employ either "gas chromatography-mass spectrometry" (GC/MS) or "liquid chromatography-mass spectrometry" (LC/MS) to eliminate false positives or false negatives. The drug test cutoff levels for workplace drug testing and the U.S. Department of transportation are established by the United States Department of Health and Human Services (HHS) and its drug regulatory agency, the Substance Abuse and Mental Health Services Administration (SAMHSA).

Disclaimer

The following drug cutoff level should be taken as general guidelines and properly reviewed before considering any drug testing. Additionally, one should seek the help of an independent medical review officer(MRO) for proper handling of the specimen, validation, and verification of the drug test results.

DOT/Federal Drug Test Cutoff Levels

The Department of Transportation Drug Test uses the following cutoff level table for initial and confirmatory drug testing.

Drug metabolite 

Initial drug cut off level

Confirmatory drug cut off level

(ng/ml)

delta-9- tetrahydrocannabinol-9-carboxylic acid(THCA)

50 ng/ml3

15

Benzoylecgonine

150 ng/ml3

100

Codeine/Morphine

2000 ng/ml

2000

Hydrocodone/Hydromorphone

300 ng/ml

100

Oxycodone/Oxymorphone

100 ng/ml

100

6-Acetylmorphine

10 ng/ml

10

Phencyclidine

25 ng/ml

25

Amphetamine/ Methamphetamine

500 ng/ml

250

Methylenedioxymethamphetamine (MDAA)/ Methylenedioxyamphetamine

(MDA)

500 ng/ml

250

Hair Follicle Drug Test Cutoff Levels

A hair follicle drug test screens for the presence of illicit drugs and the abuse of prescription drugs. A sample of hair is collected from the crown of the head, which is then observed for the presence of drugs. Hair follicle drug test also offers a large drug detection window.

Drugs and their metabolites last in the hair for up to 90 days. However, it takes 5-7 days for drugs to be discernable in hair and therefore may not appropriate for detecting recent drug use. Given below is the table providing initial screening and confirmation cut off levels for the standard 5 panel drug test:

Drug metabolite 

Initial drug cut off level

(pg/mg)

Confirmatory drug cut off level(pg/mg)

delta-9- tetrahydrocannabinol-9-carboxylic acid(THCA)

1

0.30

Cocaine

500

500

Codeine/Morphine

300

300

Amphetamine

500

500

Labcorp Drug Test Cutoff Levels

Labcorp uses immunoassay tests to perform initial drug screening and Gas chromatography/ mass spectrometry (GS/MS) in tandem with liquid chromatography-mass spectrometry (LC/MS/MS) to confirm positive drug test results. Labcorp’s standard screening and confirmation cut off level is provided in the table below:

Drug metabolite

Initial drug cut off level

(ng/ml)

Confirmatory drug cut off level(ng/ml)

delta-9- tetrahydrocannabinol-9-carboxylic acid(THCA)

50 

15

Benzoylecgonine

300

150

Codeine/Morphine

2000

2000

Methadone

300

300

Propoxyphene

300

300

6-Acetylmorphine

10

10

Benzodiazepines

200

200

Amphetamine/ Methamphetamine

1000

500

Methylenedioxymethamphetamine (MDAA)

500

250

Phencyclidine(PCP)

25

25

Barbiturates

200

200

Ethyl Alcohol

0.02%(20mg/dl)

0.02%(20mg/dl)

Quest Diagnostics Drug Test Cutoff Levels

Quest Diagnostics provides a range of different panel tests involving urine, oral fluid, and hair specimen. The table below represents the cut off level for a 9-panel Urine drug test:

Drug metabolite

Initial drug cut off level

(ng/ml)

Confirmatory drug cut off level(ng/ml)

delta-9- tetrahydrocannabinol-9-carboxylic acid(THCA)

50 

15

Cocaine (Benzoylecgonine)

300

150

Codeine/Morphine

2000

2000

Methadone

300

300

Propoxyphene

300

300

Benzodiazepines

300

300

Phencyclidine(PCP)

25

25

Barbiturates

300

300

Amphetamines

1000

500

10 Panel Drug Test Cutoff Levels

A 10 panel drug test typically tests for the presence of marijuana, opiates, phencyclidine (PCP), cocaine, amphetamines, barbiturates, benzodiazepine, methadone, methaqualone, and propoxyphene.

Drug metabolite

Initial drug cut off level

(ng/ml)

Confirmatory drug cut off level(ng/ml)

delta-9- tetrahydrocannabinol-9-carboxylic acid(THCA)

50 

15

Cocaine (Benzoylecgonine)

300

150

Codeine/Morphine

2000

2000

Methadone

300

300

Propoxyphene

300

300

Methaqualone

10

10

Benzodiazepines

200

200

Amphetamine

500

250

Phencyclidine(PCP)

25

25

Barbiturates

200

200

5 Panel Drug Test Cutoff Levels

A 5-panel drug test is the most common workplace drug testing standard. It is also the standard currently approved and recommended by the Department of Transport (DOT). A 5-panel drug test screens for marijuana, opiates, phencyclidine (PCP), cocaine, and amphetamines.

Drug metabolite

Initial drug cut off level

(ng/ml)

Confirmatory drug cut off level(ng/ml)

delta-9- tetrahydrocannabinol-9-carboxylic acid(THCA)

50 

15

Benzoylecgonine

300

150

Codeine/Morphine

2000

2000

Amphetamine/ Methamphetamine

1000

500

Phencyclidine(PCP)

25

25

Probation Drug Test Cutoff Levels

According to the 2012 National Survey on Drug Use and Health conducted by SAMHSA, out of the 3.2 million males aged 18 to 49 on probation, 40.3% had an alcohol or illicit drug use disorder in the past year. Drug testing among probationers can help identify individuals with substance misuse and improve access to treatment and community-based care to not relapse into criminal activity and behavior.

Nail Drug Test Cutoff Levels

Nail drug testing is a relatively new method of drug testing. Similar to hair, nails are composed of keratin. Also, like hair specimen, drug metabolites remain in the nail clippings for up to 6 months. However, unlike hair testing, nail samples are collected based on their weight rather than the length of the specimen. In general, nail samples must be at least 2-3 millimeters to provide a sufficient sample needed for the drug test.

DISA Drug Test Cutoff Levels

DISA is one of the largest third-party administrators (TPAs) based in Houston, Texas, providing workplace drug testing services, background screening, occupational health, transportation compliance, and financial due diligence. DISA drug testing program includes a 5-panel, a 10-panel, and a DOT drug test. Some of the most common drugs on test panels include Marijuana, opioids, Phencyclidine, Benzodiazepines, Methadone, Cocaine, Amphetamines, Barbiturates, Propoxyphene, Methaqualone, Synthetic drugs(Bath Salts), and Alcohol.

The Takeaway

A drug test is performed to detect the absence or presence of illicit drugs and the abuse of prescribed drugs. A drug cutoff level determines the levels at which a given amount of illicit drugs will be considered positive for drug testing. It involves an initial screening that provides either a negative or a false-positive result.  Correspondingly, confirmation testing is employed to confirm a false positive drug screen or, in some cases, false negatives.



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