Drug Testing - How much does drug testing cost?

The cost and accuracy of drug testing depends on a number of factors. The testing methods used to screen for various drugs is a primary factor in determining cost and accuracy.

Two general methods of testing are immunoassay or radioimmunoassy (RIA) and Gas Chromatography-Mass Spectrometry (GC-MS). Immunoassay is used for initial screening of many drugs, like amphetamines, marijuana (cannainoid or THC), cocaine, opiates, and phencyclidine (PCP). However, GC-MS is the acceptable industry standard testing procedure for steroids and for confirming any positive test results. The cost for each immunoassay screening package ordered to test for all the drugs listed above typically costs $20 to $50. To also test for alcohol, nicotine (tobacco), and LSD typically adds another $10 per substance per screening test ordered. Including anabolic steroids in the initial screening would cost between $80 and $120 per test ordered because GC-MS is required to test for steroids and is a more expensive testing procedure. All positive results of initial tests should be confirmed by GC-MS. Thus, a higher percentage of initial positives drives up the cost of a testing program.

Testing procedures detect either the substance itself or one of its breakdown products (metabolites). However, the rate of elimination of substances and/or their metabolites from the body vary widely. Alcohol (ethanol) may be detected for only several hours after ingestion, cocaine and even some steroids for a few days and marijuana and some other steroids may be detected for weeks and months. Some of those who undergo drug testing quickly learn these elimination rates and switch to using drugs with faster elimination rates to avoid detection. Thus, frequent, short notice or unannounced, year-round testing is needed to overcome the use of drugs with faster elimination rates or drugs which increase mass and strength prior to the season. Other techniques to avoid detection by urinalysis include diluting urine, substituting other urine, and using masking agents to cover the presence of a drug or its metabolite. Because of these tactics, drug testing programs must be carefully administered including observing those giving a urine sample. More sophisticated testing includes checking for masking agents, and the presence of a masking agent can result in a positive test.

Many procedures are followed to avoid false positive tests. False positive tests are positive test results obtained when, in fact, drugs have not been used by the individual tested. A urine specimen is split into two samples, usually labeled "A" and "B", so that a confirmation test can be run if the initial test result shows the presence of a drug. Limits for a positive test are usually set high to allow for very small amounts of a drug being unintentionally ingested (such as second hand smoke) or for variations in body levels of naturally occurring substances like testosterone and other steroids. Government certified laboratories (certified by the Substance Abuse and Mental Health Services Administration) maintain high standards of accuracy including a low rate of false positive tests. Unless tampering occurs false positive tests are rare. Good testing procedures take many precautions to avoid tampering, To further ensure accurate testing, a medical review officer reviews results and makes the final determination if a test is positive or negative. A medical review officer is usually a physician and is certified in drug testing.

False negative results (a negative test result when indeed the individual did use a screened drug) are more difficult to determine. Because of the high thresholds for a positive test, an individual could have used a drug, but because of the small amount used, the rate of elimination, or the use of a masking agent the test could be yield a low level and be read as negative. Because a drug test is negative does not necessarily mean that the individual did not use drugs.

For further information about testing procedures, cost and accuracy see the Interscholastic Athletic Administration (Volume 24, No. 1, Fall, 1997) article by Joseph C. Franz, M.D., entitled: Legal Issues: Options should be explored before starting student drug-testing program, or the NFHS NEWS (Volume 13, No. 1: September, 1995) article, entitled: Supreme Court rules in favor of drug testing. "The Steroids Game," authored by Dr. Charles E. Yesalis and Virginia S. Cowart and "Anabolic Steroids in Sport and Exercise," edited by Dr. Charles E. Yesalis also contain information on these topics. Both are available from Human Kinetics.