Drug Testing; Nail, Hair, or Urine?

There are many types of drug tests available, how do you know which one to use? Well, let’s look at the differences. Nail and hair drug testing have a long window of detection, making them an excellent way of testing for habitual drug use. The window for nail testing is 6-12 months and the window for hair is 3-6 months. Nails and hair take some time to grow, making these two testing methods useful for a history of drug use, but they’re not ideal for drug use that day. If you identify someone with seemingly impaired behavior, doing a nail or hair test will not confirm they were impaired at that time. The best way to determine if someone is/was recently impaired is by using a urine test. A urine test will show fentanyl in the system for 8-24 hours after last use. Codeine can be detected for 1-2 days, oxycodone for 1-4 days, morphine for 3 days, and hydromorphone & hydrocodone can be detected in the urine for up to 2-4 days after use, etc.

There are also blood and saliva tests, which in some cases may be more appropriate depending on time frames and which drug you suspect. Blood tests are used more often at the scene of an accident, to detect if those involved were under the influence. The window to detect drugs in the blood is very short, up to a few hours. Blood tests are one of the most accurate tests. Saliva tests are similar in that it does not show a person’s long term drug use, only if drugs were used recently, and it’s a very non-invasive test.

What does your facility do? Do you always use one specific test, or do you choose the testing method based on certain conditions? If you are an expert in testing, I would love to hear from you to discuss the topic.

Terri Vidals
Terri Vidals

Terri has been a pharmacist for over 30 years and is a drug diversion mitigation and monitoring subject matter expert. Her years of experience in various roles within hospital pharmacy have given her real-world insight into risk, compliance, and regulatory requirements, as well as best practices for medication and patient safety.

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