Introduction to the 12-Panel Drug Test

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5 September 2023

Introduction to the 12-Panel Drug Test

The 12-panel drug test extends your drug testing program to include the widest possible range of both illicit drugs and prescription drugs that that might pose a safety hazard for workers in safety sensitive positions. Because of the breadth of drugs it tests for, it is typically slightly more expensive than other panel tests, but it does serve to identify and reduce drug related risks and exposures in the workplace. (Learn more in Drug Test Types: When To Use 5, 7 or 12 Panel Urine Screening).

Given that 70% of current illegal drug users are employed and over one third of American employees claim to have witnessed illegal drug sales in their workplace, you want to be sure your workplace is safe. Generally, the 12-panel test adds an expanded list of amphetamines and opioids to the 10-panel drug test. Typically, the 12-panel drug test includes:

Expanded amphetamines

This panel tests for MDMA/6AM, a synthetic drug better known by the street names ecstasy or molly. Although these are mostly used as weekend party drugs, their effects can often last well into the workweek. There are also workers who will take these drugs for an energy boost at work. Unfortunately for employers, MDMA/5AM affects both perception and concentration, making users exceedingly dangerous to themselves and their fellow workers. Other workplace issues caused by this drug can include:

  • Overconfidence
  • Risk taking
  • Reduced coordination
  • Lowered reaction times

These are all a concern for workers who drive company cars or operate heavy machinery, but MDMA/6AM can also produce extreme irrational behavior, affecting workers' interactions with customers and fellow workers.

Expanded opiates

The term expanded opiates refers to semi-synthetic opioids such as Percodan, Percocet, Oxycodone, Oxymorphone and Hydrocodone. These painkillers are now included in the latest version of the Department of Transportation (DOT) 5 panel test but it’s important to note that they are not included in standard 5 and 10 panel drug tests. (Learn more in Prescription Opioids and Safety Sensitive Work).

These drugs are commonly prescribed to combat moderate to severe pain but are highly addictive and are also frequently misused or used illegally. Opiate abuse places a huge financial burden on employers, the largest of whom paid over $2.8 billion in 2018 just for treatment for their employees. Billions more is spent due to chronic absenteeism, lost productivity and additional health care costs. Opiate use, even under prescription, can also result in several other effects which directly affect workplace safety including:

Opioid use, both legal and illegal, is an expensive habit and can put workers under severe financial strain. The risks of addiction and overdose are both extremely high with opioids.


Methadone is an opioid often prescribed to treat opioid addiction and to reduce cravings for those drugs. The effects of methadone tend to mimic opioids but are generally less severe.

Unfortunately, methadone is also addictive and withdrawal from it can be serious. Initially methadone can cause symptoms from blurred vision to mood swings, posing a significant threat to workplace safety and morale. Withdrawal can cause additional effects including:

  • Anxiety
  • Panic Disorder
  • Lightheadedness
  • Depression

While employers cannot discriminate against workers seeking addiction treatment, identifying and understanding the risks of methadone use can protect your company and your workers.


Propoxyphene is an illegal, highly addictive drug with effects similar to other opioids. Propoxyphene is rarely detected in testing today, but it is a serious drug and can be fatal if ingested with alcohol. Propoxyphene has also been linked to increased risk of suicide. These effects pose substantial risks to your workplace as do the effects of long-term propoxyphene use such as:

  • Changes in behavior
  • Lightheadedness
  • Confusion

Propoxyphene use can be serious in safety sensitive positions, but it can also pose substantial risks in other areas of the workplace and negatively affect company morale.

Methaqualone (Quaaludes)

Methaqualone is an illegal drug better known by its street name, Quaaludes. In the workplace the major risk of this particular drug is drowsiness, as this can lead to accidents, injuries and even death.

Even low dosages of Methaqualone can cause fatal overdoses and the risk is greatly increased when methaqualone is taken with alcohol. Additional side effects can include:

  • Dizziness
  • Nausea
  • Fatigue
  • Seizures
  • Mental confusion
  • Loss of muscle control

All of these effects pose significant risks to workers and co-workers operating machinery or using motor vehicles.


Cocaine is often difficult to detect in the workplace, as many of its effects mimic those of normal workplace stress or lack of sleep.

A cocaine high initially induces mental clarity, increased focus and alertness. These initial effects generally last only thirty minutes, however, after which the user will feel depressed, agitated, nervous and fatigued.

Additionally, cocaine use can trigger:

  • Hypersensitivity
  • Irritability
  • Paranoia

Cocaine users also struggle with concentration, attention, decision-making and memory long after the high has disappeared. Eventually this has an effective on both cognitive and physical functions in the workplace.


Marijuana is rapidly gaining both medical and recreational legal acceptance in both the United States and Canada.

Unfortunately for employers, legalization doesn’t imply safety. High doses of marijuana can induce paranoia, hallucinations and anxiety and these effects can last up to 24 hours. In the workplace, marijuana can also:

  • Impair concentration
  • Affect the ability to think and make decisions
  • Reduce reaction time
  • Affect coordination

These all pose significant risk for positions that include driving or cognitive tasks, as the effects can last for up to three or four hours. Impairment varies widely by individual tolerance level and between occasional and long-term users.


Phencyclidine (PCP) is a popular club drug with dangerous and mind-altering effects.

Even in moderate amounts, PCP causes users to feel a misplaced sense of strength and invulnerability and put themselves and co-workers at risk. These effects begin within minutes and can last 6 to 48 hours.

PCP can have numerous other effects on your workers that include:

  • Loss of coordination
  • Hallucinations
  • Psychosis

PCP is highly addictive and over the long-term users can experience memory loss, depression and problems with both speech and learning.


Amphetamines, including methamphetamines, are popular stimulants that speed up the central nervous system.

The effects of amphetamines can vary, leaving one user feeling excited and invincible, another nervous and tense, and still another hostile and aggressive. In the workplace their abuse can lead to:

  • Difficulty concentrating
  • Lack of concern for serious matters
  • Exhaustion, particularly at the beginning of the work week
  • Aggressive and risky behavior while driving or operating machinery
  • Restless and excessively excitable behavior with coworkers or customers
  • Aggression or hostility directed to coworkers or customers
  • Paranoia, delusions, chronic exhaustion

Users will feel the effects of amphetamine use up to four hours after ingestion but for heavy and chronic users, effects such as paranoia, delusions and aggressive behavior can last for days. All of this poses a potential threat for both your workers and your workplace.

Basic Opiates

Made from the opium poppy plant, opiates include drugs such as opium, codeine, heroin and morphine.

Even legal opiates are highly addictive and susceptible to substance abuse. Prescriptions for opiates will often include a warning to the user not to operate heavy machinery and even when used as prescribed, opiates can cause impairment and increase workplace accidents, errors and injuries. A few of the obvious effects of opiate use on the job include

  • Falling asleep at workstations or desks
  • Mood swings
  • Major changes in energy levels

As they come down from the high, users may exhibit withdrawal symptoms including irritability, anxiousness, nausea, shaking and sweating. Employees abusing opiates will sometimes mix in other drugs to create a functional high, which deepens the risks to your workplace.


Benzodiazepines are some of the most frequently abused legal drugs. They include brand names such as Valium and Xanax and are frequently prescribed to control conditions such as anxiety and sleep disorders.

Even when used as prescribed, these drugs tend to induce drowsiness or dizziness, making it incredibly dangerous for users to drive or operate machinery. They can also negatively impact your employees' social abilities affecting both their interaction with co-workers and with customers. At work, benzodiazepine abusers may also exhibit:

  • Slow reaction time
  • Confusion
  • Poor concentration and memory
  • Unsteadiness
  • Vision problems

Benzodiazepine abuse frequently involves the use of another substance such as alcohol or opioids, exacerbating its effects and increasing the chance of an accidental overdose.


Barbiturates are a seldom prescribed drug that initially induce happiness, relaxation and reduced inhibition. However, there is a very thin line separating therapeutic use from abuse, and barbiturates quickly become dangerous if taken in excess.

Barbiturate abuse often mimics the symptoms of alcohol intoxication. Tolerance and subsequent addiction build quickly, usually within a few weeks. Workers can be put at risk from several side effects of its use including:

  • Confusion
  • Dizziness
  • Drowsiness
  • Irritability
  • Poor judgement

How long the effects of barbiturates last can vary widely but even withdrawal from the drug can cause severe effects including agitation, anxiety and depression putting workers and the public at further risk.

What You Need To Know

The 12-panel test is the most comprehensive test on the market and is best suited to companies with greater safety responsibilities or those with strict zero tolerance drug policies in place. It is also useful in situations where demographics suggest a variety of drugs are likely to be consumed or abused. Your industry and company culture should also be considered in choosing the 12-panel over less comprehensive tests.