Choosing a Drug Test Panel

What the Common Panels Cover

The five-panel is the long-standing standard: marijuana, cocaine, amphetamines, opiates and phencyclidine. Federal programs follow HHS Mandatory Guidelines, which have been revised over the years, including expanding which opioids are covered, so the exact analytes are worth confirming rather than assuming.

The ten-panel generally adds prescription classes such as benzodiazepines, barbiturates, methadone and propoxyphene. Expanded panels go wider still, and contents vary by laboratory.

The important point is that panel names are conventions, not standards. Two providers' ten-panels are not necessarily identical, which is why the question to ask is which substances are included rather than which number.

What a Wider Panel Actually Costs You

More than the price difference per test. Three other costs come with width:

• More non-negative screens to confirm and review, each one adding laboratory and Medical Review Officer cost.
• More administrative time, because most of those results resolve as verified negatives after an employee explains a legitimate prescription.
• More friction with employees, who are now having conversations about medication they take lawfully.

None of that is an argument against a wider panel where risk justifies it. It is an argument against choosing one by default.

How to Decide

1. Start from the roles. What would actually change your decision about someone in this job?
2. Check regulated requirements first. Federally regulated roles have their testing specified for them.
3. Look at your own history. If your program has run for years, what has actually come back? Panels are often wider than any result has ever justified.
4. Check your states. Cannabis rules in particular may affect what you can act on, which affects method as well as panel.
5. Decide by role group and write it into the policy so it is applied consistently.

Specimen Type Matters Too

Panel and specimen are separate choices that people conflate. Urine, oral fluid and hair have different detection windows, different collection requirements and different costs, and some states regulate which methods an employer may use. The right combination comes from what you are trying to establish: recent use, a longer history, or current impairment.

Some States Set the Cutoff For You

Panel design is usually the employer's call. In several states it is not, and the constraint runs in the direction employers least expect:

• Louisiana requires an initial marijuana cutoff of no less than 50 ng/mL. Tightening a national cutoff below that is unlawful for samples collected in the state.
• Maine sets a confirmation floor of 15 ng/mL THC-COOH in urine, and separately lets an employee demand a blood draw that takes urine off the table for alcohol and cannabis metabolites.
• Kansas lists specific GC-MS cutoffs that trigger a conclusive presumption of impairment in a workers' compensation claim.
• Mississippi restricts electing employers to urine for drugs, so a hair or oral fluid panel does not fit.
• Hawaii requires the specific substances to be disclosed in writing before collection, and bars testing for anything not on that list.
• Instant devices are applicant-only in North Carolina and Maryland, which makes a rapid-cup random program non-compliant as to current employees.