The Substance Abuse and Mental Health Services Administration (SAMHSA) is an agency within the U.S. Department of Health and Human Services and is tasked with leading public health efforts to advance the nation's behavioral health and reduce the impact of substance abuse and mental illness on America's communities.

SAMHSA sets guidelines and standards for what is considered a positive test result. These guidelines establish cut-off levels for various substances, the minimum concentrations of specific drugs, or their metabolites that must be present in a sample for the test to be considered positive.

Cut-off levels are critical in the context of Department of Transportation (DOT) and Non-DOT drug testing. DOT drug tests are regulated by federal law and have standardized cut-off levels for all safety-sensitive transportation industries, while Non-DOT tests do not have to comply with federal regulations, and thus, their cut-off levels may vary depending on the specific circumstances of the organization conducting the test.

Both types of tests use SAMHSA's cut-off levels as a baseline to ensure consistency and reliability in detecting substance use. This helps prevent false-positive results and ensures that only meaningful amounts of a substance, indicative of actual use rather than incidental exposure, are interpreted as a positive result.

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