Healthcare Drug Screen vs. Drug Test: What Are the Differences?

The healthcare professionals who join your organization must be fully capable of performing their job duties, and to do so, they need more than the required credentials. In addition to possessing the necessary experience and qualifications, prospective employees must also be free of drugs that could impair their performance and potentially endanger patients. As a result, comprehensive background and drug screening are critical elements of a healthy and compliant hiring process.


Though the terms drug screening and drug testing are used interchangeably, they can mean different things and result in different outcomes affecting your hiring process. To operate a quality employment screening program, you should understand the difference between drug screening versus drug testing, and when to use each.

Drug Screen vs. Drug Test: Differences and Similarities

Drug screening and drug testing are similar in that they can both check for evidence of a broad range of substances in a person’s system, including marijuana, amphetamines, opioids, cocaine, and alcohol. However, there are differences in the methodology, cost, and accuracy of a drug screen vs. drug test. You should not only understand those differences, but also when to use one method vs. another.

Drug Screening

Drug screening is often considered a simpler, faster process for seeking evidence of specific drugs in a person’s urine, saliva, or hair. Because drug screening is often modestly priced and delivers results relatively quickly, it makes a great addition to modern employment background screening programs.


Drug screening typically uses a laboratory testing method called the enzyme multiplied immunoassay technique (EMIT). Though drug screening using EMIT methodology is quite efficient, it will only provide a positive test result if the amount of a substance in a person’s system is above a certain threshold.

Drug Testing

Drug testing takes longer to complete than drug screening, and it usually costs more because the testing process is more in-depth. Using a more sensitive testing methodology called mass spectrometry/gas chromatography (MS/GC) testing, drug testing is also considered more accurate than a quick drug screen, as it can detect very small amounts of a substance in a person’s urine, saliva, or hair.

When to Use a Healthcare Drug Screen vs. Drug Test

In healthcare, drug screening and testing not only support a safe patient care environment, but they can also help you to protect your prescription drug inventory from individuals with a drug addiction. And it’s not just healthcare organizations that value drug screening. In the 2021 Professional Background Screening Association (PBSA) annual survey, nearly two-thirds of employers (65 percent) said they conduct some kind of drug screening or testing in their background screening activities. 


When you know the different scenarios in which you can use a drug screen vs. drug test, your organization can become even better at identifying and avoiding risky hires. However, when making a determination, there are multiple factors you need to consider. Of course, accurate results are critical, but you should also figure in factors such as turnaround time, cost, and ease of use. For example, drug testing is more in-depth, but it is also more costly and can take a week or longer to deliver results. 


To meet your goals for delivering a positive candidate experience and keeping your hiring process moving without going over budget, drug testing may not be a practical choice for every hiring scenario. Conversely, drug screening offers accuracy at a lower price and a faster turnaround time, and is often a more appropriate choice when you’re managing a high hiring volume. For healthcare organizations busy hiring staff to serve patients during the COVID-19 pandemic, drug screening offers speed, accuracy, and a reasonable cost to help you hire efficiently.


While drug screening is an efficient and affordable option, there are times when drug testing may be necessary to confirm positive drug screening results, a more common occurrence in recent years. According to Quest Diagnostics, employees who used Quest’s services tested positive for drug use at a higher rate in 2019 than in any of the previous 15 years.


A key reason to use drug testing to confirm drug screening results is the possibility of false positives in drug screening. A Millennium Health study found the results from immunoassay testing most commonly used in drug screening can possibly yield false positives. Drug testing, on the other hand, is associated with a lower rate of false positives and can provide a more accurate result. Therefore, if a candidate’s drug screening results are positive, performing the more in-depth MS/GC drug test can definitively confirm or refute those results. 


Another scenario in which drug testing may make more sense than drug screening alone is when you are testing an employee suspected of drug impairment while at work. In this scenario, you may conduct a drug test to confirm the results of a drug screen, or skip the drug screen entirely and go straight to a drug test. 


Conducting drug tests for verification not only helps to support a fair and transparent drug screening process, but it also assures candidates and employees that your organization takes steps to confirm positive results using the most accurate testing methods available. Moreover, conducting a drug test to confirm drug screening results can also validate your drug screening processes in the event of a dispute or lawsuit.

Operate Your Drug Screening Program with Confidence

Drug screening and drug testing are both valuable tools to help you successfully screen new hires and protect your employees and patients. Together with other background screening services—such as criminal record search, healthcare sanction checks, and employment and education verifications—drug screening and testing can help you avoid risky hires and build a more capable workforce.


When operating your healthcare employment drug screening program, deciding when to use a drug screen vs. drug test is just one of many determinations you’ll need to make. You’ll also need to determine when to screen employees after hire and which substances you will include in your program. 


One key drug screening challenge you’re sure to face is how to approach screening candidates and employees for marijuana. As more states legalize medicinal and recreational marijuana use, organizations, including those in healthcare, must determine how to conduct legally-compliant drug screening across all hiring locations and job types. To help you understand how marijuana legislation could impact your organization’s drug screening program, read our Guide to Marijuana Legislation.