Free guide · Monitoring
A positive screen, and who calls you about it
If you’re reading this because a screen just came back positive, here’s the single most useful thing on this page: the process starts with questions, not conclusions.
The phone call that comes first
Typically, the first time you hear about a positive screen is a phone call from a medical review officer. That’s usually a physician, and they’re the first line for gathering information to explain a positive screen. From the beginning, they’re looking for medical reasons the screen may be positive. Is there a medication that interacts? Is there a medical condition that could cause it?
They usually don’t tell you exactly what it is at the start. They take a history first, and gather information, before they tell you which part of the screen was positive. That’s not a trick; it’s how a medical review works. Knowing it in advance changes how the call feels.
A false positive and a real one are different problems
Some ordinary ingredients look enough like something else that an initial screen reads positive and confirmation testing later clears it. That one resolves, but not before the phone call.
I’ve had one of those myself. I tested positive for alcohol when it turned out I was diabetic, and my blood sugar was 850 or so the first time I ever checked it; enough glucose in your urine can cause a false positive for alcohol. The medical explanation was the whole story, and that positive didn’t bring program consequences. A positive result isn’t a verdict.
And some positives are real, because the substance was really in the product and you really took it. Ordinary cold medicine can do it. I’ve had that call myself, and the cold medicine guide exists for exactly that reason: it goes ingredient by ingredient through what’s on the shelf.
What helps, before it ever happens
Read the prohibited-substance section of your contract carefully; the monitoring contract page covers why that section is the one people skim. And if something seems out of place with a screen, call your contact at your health program. Honesty with them is the whole game here: these programs are on our side, and the fastest way to ruin that is to skip over facts that are going to come out anyway.
What only your own situation answers
What happens after the call, in your program’s process. What your contract says about a confirmed positive. Whether your panel is prone to the false-positive problem at all, and what documentation your program wants when a screen needs explaining.
Those genuinely vary. The medical review officer, and the history taken before conclusions, don’t vary much at all.