Background: There is an increasing interest in on-site testing for drugs of abuse.
Methods: Based upon our own experience and published literature, we have reviewed advantages and disadvantages of such tests. On-site testing is also evaluated in relation to the recommendations for urinary testing of drugs of abuse from the Norwegian Health Authorities.
Results: The most significant advantage with on-site testing is provision of rapid results, usually within 5-10 minutes. Disadvantages are the risks of false positive and false negative results, the fact that numerous drugs cannot be tested for, and the limited possibilities to detect manipulation. According to Norwegian regulations, on-site testing can be used for medical purposes, but cannot be used as the only method if a positive result may cause sanctions such as e.g. exclusion from school, job dismissal or loss of parental rights. There are also special requirements for the organization of such testing.
Interpretation: Before starting on-site testing for drugs of abuse, it should be considered if such testing is allowed or discouraged in the specific case. It is mandatory to know how the specific test works and to have routines for follow-up of positive test results.