TAKEAWAY: Relapse is a very real danger for anyone who uses drugs. In fact, some studies suggest that up to 85% of drug users will use drugs again following intervention or treatment. The possibility of a relapse is why return-to-duty and follow-up testing is crucial for employers, particularly those with employees working in safety-sensitive positions. Here’s what you need to know.
Jump Ahead
- What are Return-to-Duty and follow-up testing?
- Frequently Asked Questions
- My employee is returning after being on leave. Shouldn’t they take a return-to-duty test?
- What is the difference between a return-to-duty and follow-up and a follow-up and a pre-employment or pre-access test?
- What is the return-to-duty process?
- How many follow-up tests have to be taken?
- Do follow-up tests replace random testing?
- How can SureHire help?
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What are Return-to-Duty and follow-up testing?
Return-to-duty and follow-up testing are usually part of the return-to-work process for a safety-sensitive employee who has failed a drug test. However, depending on an employer’s drug and alcohol policy, they may also be used in other circumstances.
What are the legal obligations of employers conducting return-to-duty testing?
Whether in Canada or the U.S., employees subject to Department of Transportation regulations must submit to return-to-duty testing before they return to a safety-sensitive position. They will also be required to take at least six additional random tests as part of their return-to-work plan. Substance Abuse Professionals (SAP) may require further random tests. SAPs may also prescribe follow-up testing for up to 5 years following a positive test.
While return-to-duty testing is a requirement for DOT employers, it is a best practice for most non-DOT employers. These employers must ensure they clearly define procedures and consequences in their drug and alcohol policies. They will also need to meet additional requirements in municipal, state, and Americans with Disabilities (ADA) legislation.

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SureHire USA has more than 6,500 testing locations in the USA including facilities in Texas State. Contact us today to inquire!
In Canada, return-to-work testing is considered reasonable for any employee who has failed a drug test. A workplace policy could include such testing at regular or random intervals for a specific period of time.

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Frequently Asked Questions
My employee is returning after being on leave. Shouldn’t they take a return-to-duty test?
The short answer is no. An employee returning from leave, for whatever reason, or a re-hired employee should take a pre-employment drug test rather than a return-to-duty test. Although employers may use return-to-duty tests as pre-employment tests, it is essential to note that pre-employment may not be used as return-to-duty tests.
What is the difference between a return-to-duty and follow-up and a follow-up and a pre-employment or pre-access test?
Follow-up and return-to-duty tests are conducted as part of the return-to-work process following a failed drug test. Pre-employment tests are included as a condition of employment, while pre-access tests are given as a condition of granting access to specific locations or duties in a workplace. For example, employers may request these tests to provide top-secret security access. However, the most significant difference between these types of tests is that an individual of the same sex observes the collection process in return-to-duty tests. In contrast, pre-employment or pre-access tests are generally unobserved. Employees who fail a drug test must also complete other steps in the return-to-duty process before taking their test.
What is the return-to-duty process?
Before a worker can return to a DOT safety-sensitive position, they must successfully complete a return-to-duty process. The return-to-duty drug test typically comes at the end of this return-to-duty process. Prescribed by a Substance Abuse Professional (SAP), it will often include:
- A thorough face-to-face assessment
- completion of a required plan of treatment and education
- Monitoring of the worker’s progress through that plan
- A face-to-face follow-up evaluation to verify the completion and success of the recommendation
Once this process is complete, the SAP will send a report to the employer, who will order a return-to-duty test. If the employee passes, they will return to the job but be subject to follow-up or random testing. Positive tests mean a new violation and the process will restart or the employee may be dismissed. If the employee refuses to take a test, the SAP reports non-compliance to the employer. The employer’s drug and alcohol policy will determine the consequences at that point.
How many follow-up tests have to be taken?
The number of follow-up tests required for non-DOT employers is at the employer’s discretion. However, for DOT employees, there are specific requirements. For DOT-covered employees who fail drug tests, SAPs must set up a follow-up testing regiment that includes at least six unannounced tests over at least 12 months. However, the SAP can require additional tests over the next five months. All of the specimen collections must be observed.
Do follow-up tests replace random testing?
No, follow-up tests cannot replace random testing because follow-up tests require direct observation during the collection process. All employees must be included in the random testing pool regardless of any requirements of random testing and must also complete all of the regular requirements for follow-up testing.
How can SureHire help?
SureHire can service your testing needs across North America no matter the reason for testing. Our extensive suite of Drug & Alcohol Testing Services includes:
– Pre-Employment
– Pre-Access (Site Access)
– Return-to-Work (Return-to-Duty)
– Follow-up Testing
– Reasonable Suspicion/ Cause Testing
– 24/7 365 Post-Incident/ Near-Miss Testing
– Substance Abuse Programs
– Reasonable Suspicion Training
– On-site/ Mobile Testing
We offer 5, 8, and 13-panel drug tests; express and lab-based tests; and oral fluid, urinalysis, and hair follicle testing.

Looking for a Provider in Texas?
SureHire USA has more than 6,500 testing locations in the USA including facilities in Texas State. Contact us today to inquire!
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