| abstract | - When an employer requests a drug test from an employee, the employee is instructed to go to a collection site. There, the employee’s urine is collected in a specially designed secure cup and sealed with a tamper resistant tape. The cup is then sent by express delivery service to a testing laboratory where it will be tested for several drugs. The first step at the testing site is to split the urine into two aliquots. One aliquot is first screened for drugs using an urine analyzer that performs immunoassay as the initial screen. If the urine screen is positive then another aliquot of the sample is used to confirm the findings by gas chromatography - mass spectroscopy (GC-MS) methodology. All test results are relayed to an MRO (Medical Review Office) where a medical physician reviews the results. If the result of the screen is negative, the MRO informs the employer that the employee is clean and has no detectable drug in the urine. However, if the test result of the immunoassay and GC-MS are positive, the MRO contacts the employee and tries to determine if there is any legitimate reason for the employee to have a positive result such as a medical treatment or prescription. However, this is problematic for several reasons. First, most employees are not chemists, and are not aware of which substances which might create a false positive test result. Without such knowledge, they may not mention them, leading to the incorrect reporting of a positive result. Furthermore, non-drug users whose results are reported as positive will have no explanation for the error, and will therefore be reported as drug users. Conversely, drug users may understand that they will only be called if the result is positive, and therefore will tell the MRO that they have been cooking with hemp oil, drinking coca tea, or other plausible explanation for the result. If the MRO determines that the positive result may be due to drug use, the MRO then informs the employer of the positive result. Statistics show that about 5% of the urine samples tested in the U.S. turn out positive for drugs
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