Drugs of Abuse
Note: this site is for informational purposes only. To view test results or book a test, use the NHS app in England or contact your GP.
A drugs of abuse test usually analyses a urine sample (and sometimes blood, saliva, or hair) to detect the presence of commonly misused or illegal drugs and their metabolites. It is used to identify recent drug use or exposure, often to support clinical care, workplace screening, or investigations of suspected substance misuse or overdose.
Why get tested?
To detect or exclude the presence of commonly abused and/or illegal drugs. This may be carried out for a number of reasons including screening for pre-employment purposes or to comply with a drug rehabilitation programme.
When to get tested?
- If you apply for a job where drug screens are carried out as a routine. People with drug and alcohol problems have worse records for accidents and absenteeism; for this reason some employers screen job applicants prior to appointment.
- If you have admitted having a drug problem and are enrolled in a detoxification or drug rehabilitation scheme where testing is part of the programme.
- If you believe you may have taken a drug accidentally or been given a drug without consent (e.g. drink spiking).
- If you are admitted to hospital in an emergency and doctors think that your treatment could be improved if drug abuse could be proved or excluded.
- If you take part in a sport at a professional level.
- If you apply for an insurance policy – some companies perform limited drug screening on applicants.
- For legal reasons (e.g. child custody cases).
Sample required?
A random urine sample is usually collected for detection of drugs of abuse although they can be detected in blood, sweat, saliva, breast milk and hair samples.
Test preparation needed?
Some prescription and over-the-counter drugs may give a positive screening result; before you are tested, indicate any medications that you have taken and/or for which you have prescriptions.
What is being tested?
The test detects the presence of various classes of abused drugs. The initial analysis is a screening test for broad groups of drugs (e.g. opiates – heroin, morphine, codeine etc) is detected; positive results are then followed up by a more specific test which identifies the individual drug taken (e.g. morphine).
A drugs of abuse ‘screen’ usually comprises the more commonly abused drug groups, which are the opiates, benzodiazepines, barbiturates, cannabinoids, amphetamines (including Ecstasy) and cocaine. Drugs used in the treatment of opiate addiction (methadone and buprenorphine) and ‘legal highs’ are also often detected.
How is the sample collected for testing?
A random urine sample is usually collected for the detection of drugs of abuse although they can be detected in blood, sweat and saliva and hair samples can be used on rare occasions. If the outcome of the test may have legal implications you may be asked to provide a sample under supervised conditions and certify that it’s your sample.
Is any test preparation needed to ensure the quality of the sample?
Certain prescription and over-the-counter drugs may give a positive screening result. Before testing, you should declare any medications that you have taken recently and/or for which you have prescriptions so that your results can be interpreted correctly.
Common questions
Analysis of urine specimens for drugs of abuse only gives information about current or recent drug use. A urine specimen taken more than 2–3 days after a period of “drug abuse” is likely to be negative on screening for most substances. Cannabis is the notable exception to this, and can remain at detectable concentrations in urine for up to 2 weeks or even longer after prolonged exposure.
The approximate periods of time during which some drugs of abuse can be detected in urine are listed below. There is a lot of variation from one person to another and detection will depend on the dose taken, the frequency and way the drug was taken, the concentration of the urine (influenced by how much fluid has been drunk) and the speed at which the drug is broken down and removed from the body, so these periods are only a guide.
| Drug | Length of time drug can be detected in urine after ingestion |
|---|---|
| Alcohol | Up to 1 day |
| Amphetamines & Ecstasy | 1–3 days |
| Barbiturates | 1–3 days |
| Benzodiazepines | 1–3 days |
| Cannabis (THC) | Up to 2 weeks |
| Cocaine | 1–3 days |
| Codeine | 1–2 days |
| Dihydrocodeine | 1–2 days |
| Heroin (morphine) | Up to 1 day |
| Methadone | 1–3 days |
THC = tetrahydrocannabinol
Drugs of abuse can also be detected in other body fluids such as saliva but with saliva the period of detection is much shorter than in urine.
To detect or exclude the presence of abused and/or illegal drugs. This may be carried out for a number of reasons including for a pre-employment screen or to comply with a drug rehabilitation programme.
A result reported as ‘positive’ in a screening test suggests that the concentration of drug present is greater than a specified cut-off concentration threshold for that particular drug. Most UK laboratories use the same concentration to define a positive result and conform to the Substance Abuse and Mental Health Services Administration (SAMHSA) guidelines.
The sensitivity of drug detection will be reduced in urine specimens which are very dilute. At concentrations below the cut-off limit, the drug will normally be reported as not detected. Excessively dilute urine specimens may be rejected as not valid.
Certain foods and prescribed drugs can interfere and give false positive results with the initial screen for certain drug groups (e.g. taking codeine-containing preparations or eating poppy seed bread can give a positive opiate result). For this reason positive results are usually confirmed by a second, more specific laboratory method before they are reported.
Codeine is an opiate drug and will therefore give a positive opiate test; it is however common in prescribed painkillers. Most UK hospital drug screens have a second confirmatory step that will allow codeine to be identified and reported.
If you need urgent help, call 999. Be wary of accepting help from a stranger and don’t leave with someone you don’t know.
If you feel unwell, someone you trust should take you to your nearest accident and emergency (A&E) department. Tell the medical staff that you think your drink has been spiked.
Arrange for a trusted friend or relative to take you home and stay with you until the drugs have fully left your system.
Report it to the police as soon as you can. They may ask you to provide blood and urine samples. Most drugs leave the body within 72 hours of being taken (the date rape drug GHB leaves the body within 12 hours), so it’s important to be tested as soon as possible.
Yes, home or Point of Care tests are available usually by mail order. These tests usually only detect the drug groups (e.g. opiates) rather than the individual drugs such (e.g. morphine). They do not have the second confirmatory step which is required to eliminate false positive results and the quality of the measurement is generally inferior to that provided by an NHS laboratory. Home testing alone is not suitable where legal action might be considered.