How Do Drug Tests Work for Opioids?

Drug tests are fairly standard when it comes to opioid testing. The most likely test an individual will have performed is a urine test, where they fill a small container with a urine sample, and it is tested in a lab to look for signs of opioid use. 

What Is Opioid Testing?

Opioid testing is any testing performed to detect signs that a person has used opioids. Like with most drug testing, it is typically done to definitively check if a person has engaged in opioid use. It’s often considered especially important to verify claims individuals are making about their drug use. 

While the consequences for this type of testing can sometimes be severe, the tests themselves are usually noninvasive and quick for the patient being tested.

What Might One Test for Opioid Use?

Common reasons to test for opioid use include the following:

• Making sure people are complying with a prescribed opioid treatment
• Making sure individuals in recovery are adhering to a facility’s rules
• Checking to see if someone has engaged in illegal drug use, such as when determining if a suspect has broken the law
• Testing job candidates or employees for drug use to make sure they are adhering to policy and/or can be relied upon to safely perform their duties

The ethics of this type of testing are long debated, as it touches on issues of privacy, personal autonomy, and the nature of how drug misuse (and the suspicion of misuse) should and shouldn’t be dealt with. With that said, the debate is generally about who should get tested and the appropriate consequences for people who refuse to test or who test positive for opioid misuse, not whether these tests should be performed at all.

How Do These Drug Tests Work?

These tests work by taking a sample from the person being tested and trying to see if one can detect the presence of opioids or opioid metabolites.[1] Opioid metabolites are essentially products the body produces as it processes opioids. If a lab can detect certain metabolites, it is evidence that there were once opioids in the body.

There is a careful balancing act when deciding the cutoff point for these tests. Labs need to check for a low enough concentration of these substances that people who have used opioids don’t test negative for opioid use, but high enough that people who haven’t used opioids don’t test positive for opioid use. The situation can become even more complex if a person who has been prescribed opioids is being tested for opioid misuse because that means some use is expected, and it’s only excessive use that signals an issue.

Common Types of Opioid Drug Tests

Common samples used to test for opioids include blood, hair, saliva, sweat, and urine. The most common type of test used is urine testing, as it is relatively noninvasive and offers a fairly long testing window. 

After about one month since a person’s last drug use, the only relatively reliable way to test for drug use is hair testing, which can sometimes detect drug use as long as 90 days after a person’s last use, depending on the length of their hair and the frequency and typical dose of their opioid use. 

What to Expect With Drug Testing

Whatever test you’re going to undergo, the procedure is generally similar. 

First, the organization doing the test is either going to need your consent, generally through the use of a form or getting your prior approval in some other way, or the ability to perform the test without your consent, although this is rare unless testing is deemed necessary as part of certain legal proceedings. If you’re ever unsure whether you have to undergo a drug test or not, talk to a lawyer, especially if the result may have serious consequences.

The actual testing only requires that a small sample of the appropriate type be gathered from you. In the case of a urine test, you will usually be given a sample cup and private access to a bathroom to fill it. With that said, the level of privacy you’re afforded can vary, especially if there is a serious concern you may try to tamper with the result. 

For more invasive testing, such as a blood or hair test, a professional will work with you to gather the sample safely. 

Once a sample has been provided, your part in the testing process is generally over. It will be sent to a lab where it will undergo some testing to check for signs of opioid use. 

What to Expect When the Result Comes Back

In most cases, the result that comes back from your test is going to allow a professional who knows how to interpret your results to roughly estimate your level of opioid use within the testing window. In the majority of cases, a person being tested for opioid use wants a “negative” result, meaning opioid use wasn’t detected.

Testing positive for opioid use can have serious consequences, depending on why you were tested. You may lose your job, fail to get a job, face legal penalties, and more. 

Unfortunately, some people can test positive for opioid use despite not actually having used opioids, which is referred to as a “false positive.” While rare, this can and does happen, and it’s important to react in a calm, rational manner if this occurs.[2] 

If you know the result that came back is inaccurate, remain calm and be careful about what you say or sign.[3] If possible, you should try to speak to a lawyer as soon as possible. If you must talk or put anything into writing, reiterate that you know the result is inaccurate and want to talk to a legal expert. Also, alert any relevant parties you will likely want another test performed as soon as possible once you first talk to a lawyer. 

It becomes much harder to disprove a false positive result if you openly accept the result despite knowing it is inaccurate or if you wait so long to retest that a negative result doesn’t actually prove anything about the first test’s accuracy.