Updated on April 7, 2025
6 min read

What Happens If You Fail a Drug Test?

It’s normal for workplaces to have routine drug tests, but you might be wondering what would happen if yours comes back positive for a substance. What exactly happens next, and what rights or options do you have?

Drug testing can be stressful and confusing, especially if you’re not familiar with the protocols. Let’s break down the typical consequences, the internal processes set in motion, and the steps you can take to protect your rights.

What Happens If You Fail a Drug Test?

Failing a drug test can instantly alter your employment outlook. The specifics vary depending on the company policy, the industry, and whether you’re in a pre-employment phase or already on the job.

Pre-Employment Candidates

Most employers, especially in regulated industries like aviation, healthcare, and federal contracting, will rescind a job offer if you fail a pre-employment drug test. It’s often a zero-tolerance scenario, and they may not allow for a second chance.

Some companies do permit retesting at your own expense, though passing a second test doesn’t always guarantee reinstatement.

If you’re applying for a safety-sensitive job under DOT (Department of Transportation) regulations, failing a test can put you on official records. The outcome can potentially affect your future employment with other employers in the same sector.

Current Employees

Many organizations have strict policies. A first-time failure could lead to immediate suspension, job termination, or mandatory completion of a drug education or treatment program.

Some employers offer an alternative to termination, such as an Employee Assistance Program (EAP) or required counseling/rehab. While it can be a lifeline, noncompliance often leads to termination.

Pilots, truck drivers, and other safety-critical positions may be removed from duty right away, with a “return-to-duty” process involving professional evaluation, compliance checks, and follow-up testing.

What Process Do Employers Follow After a Drug Test?

Navigating the aftermath of a workplace drug test can be a complex and often anxiety-inducing experience. Understanding the steps employers typically follow can give you clarity and insight into what you can expect following a drug test.

This is the typical process following a drug test:

  1. Notification and initial review: Test labs inform the employer of the result. Certain industries mandate an immediate safety response if the test is positive or “refused to test.”
  2. Medical Review Officer (MRO) evaluation: An MRO contacts the employee to rule out authorized medications or any legitimate medical explanation for the positive result. If you have a valid prescription, the MRO might classify your result as negative or may still note safety concerns.
  3. Disciplinary steps: Zero-tolerance policies can end in termination. For less rigid policies, the HR department or a review panel might decide on suspension, rehab referral, or a final warning.
  4. Documentation: Official records are updated with the failed test outcome. In DOT-regulated roles, results might be logged in a federal database that other employers can access.
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What Could Cause a Failed Drug Test?

Failing a test doesn’t always mean intentional misuse of illegal drugs. A variety of factors can yield unexpected results, and knowing them can help you dispute a potential false positive or challenge a misinterpretation.

These are possible causes of failed drug tests:

  • Over-the-counter drugs: Ibuprofen or naproxen might show up as marijuana (though this is relatively uncommon in recent testing), while certain cough medicines containing dextromethorphan can mimic PCP (and less commonly opiates).
  • Prescription drugs: ADHD meds (e.g., Adderall) may appear as amphetamines (which is an expected true positive, not a false positive), and antibiotics like levofloxacin might show a false opiate signal.
  • Herbal supplements: CBD oils with trace THC can lead to a positive for marijuana, particularly with cumulative use. Meanwhile, poppy seeds (found in bagels or pastries) have trace opiate residue and can trigger a positive result for morphine or codeine that has led to documented serious consequences.
  • Marijuana smoke: Though typically not enough to push you over test thresholds, only extremely heavy exposure in an enclosed space might cause minimal detectable THC levels, and these would rarely exceed the standard 50 ng/mL threshold used in most drug screening.
  • Workplace chemical exposures: Some industries use chemicals that can interfere with certain tests, though this is rare.
  • Lab handling errors: Sometimes, the error is on the lab’s side; mislabeling, contamination, or faulty equipment can yield false positives.

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What Can You Do After a Failed Drug Test?

If you fail a drug test, you still have rights. While many people assume it’s game over, understanding these rights can help you challenge results, secure a retest, or mitigate workplace actions.

You can often request a retest of the same sample or provide evidence that over-the-counter or prescription drugs caused a false positive. Some states even require employers to offer a second confirmatory test.

How to Challenge a Positive Result

Here are some things you can do to challenge your positive test results:

  1. Confirmatory testing: Most tests begin with immunoassays prone to cross-reactivity. A second, more specific method (e.g., GC-MS) can clarify.
  2. Provide documentation: If you’re on prescription meds, supply the official prescription or doctor’s note.
  3. Ask for an MRO review: Requesting the Medical Review Officer to consider medical evidence can exonerate legitimate medication use.

What are Your Rights as an Employee?

Certain states (e.g., Vermont and Minnesota) mandate that first-time positives can’t immediately result in termination if employees agree to rehab or counseling. 

Marijuana-legal states may also have protective measures for off-duty cannabis use, though safety-sensitive jobs are exceptions.

Here are other considerations to keep in mind:

  • Privacy and confidentiality: Your test results must remain private and can only be shared with specific parties. Inappropriately shared results could infringe on your privacy rights.
  • Fair Credit Reporting Act (FCRA): For pre-employment tests administered by a third party, an employer must provide an “adverse action” notice, giving you a chance to dispute inaccurate results.

Tips for Self-Advocacy

Facing a positive drug test result at work can be overwhelming and intimidating, but it's essential to remember your rights and alternative actions. Advocating for yourself is crucial in ensuring fairness and protecting your interests.

Here are some tips you can follow:

  • Educate yourself: Read your employee handbook for drug testing policies. Understand the difference between initial screening and confirmatory tests.
  • Check for MRO involvement: Confirm if a Medical Review Officer verified the positive outcome.
  • Consult legal guidance: Request the official report and lab methods and have an employment lawyer review them. They can identify if any rights were violated.
  • Document everything: Keep records of all medical prescriptions, supplements, or over-the-counter medications you’re taking. Store email or phone communication about test results or HR decisions.
  • Stay calm and composed: Approaching HR or a manager calmly with your supporting documents helps demonstrate good faith. If your workplace has an Employee Assistance Program (EAP), utilize it for support or guidance.

Failing a drug test is unsettling, but it’s not always the end of the line. Equipped with awareness and documentation, you can better navigate the stress of a failed drug test, possibly mitigating negative outcomes and defending your position when needed. 

Understanding the process, potential outcomes, and your legal rights can help you respond calmly, advocate effectively, and move forward, regardless of the result.

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Updated on April 7, 2025

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