Quick answer

Hospital panels mirror DOT breadth without DOT legal structure: pre-employment standard, random for high-risk departments, immediate testing after workplace injuries. Marijuana handling splits sharply by state legalization versus federal facility status.

Who this covers

Panel composition

Standard 5-panel (THC/cocaine/amphetimates/PCP/opiates) expanding to 9–12 adding benzodiazepines, barbiturates, methadone, propoxyphene, MDMA. ICU/pharmacy roles sometimes see expanded opiate specificity.

State-law collisions

Legal-state cannabis users face federal-grant-conditioned hospital policies still treating THC as terminable. VA facilities and federally-funded systems hold federal lines regardless of state votes.

Injury testing mechanics

Post-injury testing feeds workers-comp presumptions in many states — refusing muddies claims; disclosing prescriptions beforehand neutralizes false positives.

Order the required tests

Direct-access laboratory testing — no doctor visit needed. Results arrive as forwardable PDFs that satisfy most compliance offices.

We may earn a commission when you order through partner links. This guide is educational and never replaces advice from your program office, employer, or healthcare provider.

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Frequently asked questions

Do hospitals test for nicotine?

Some health systems adopted tobacco-free hiring — cotinine testing appears in their onboarding mostly in the Southeast. Check specifically; it surprises relocating nurses.

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