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November 3, 2015

In May of 2015, SAMSHA proposed new guidelines that allow for providers to collect and test an oral fluid specimen as part of their drug testing programs, thereby making them comparable to the way urine tests are accepted now. These guidelines follow strict standards for test analysis and methodology, oral fluid collection devices, review process by an MRO (Medical Review Officer) and positive test analysis. This is great news for those who implement and maintain a drug-free workplace program, since some of the benefits of Oral Fluid Testing include a reduction in time to collect a specimen, as well as a decline in “cheating” since it is almost impossible for a candidate to substitute or contaminate an orally collected specimen. In fact, a lot of adulterants have been tested and so far, none have been found which can effectively mask the results of an oral fluid test, when done correctly. Oral Fluid Testing may also allow for higher productivity in the long run, especially in cases of suspicion of impairment and post-accident testing.

Image showing the text "Drug Test Results" and some background charts of displayed data.

Privacy Issues & Dosage Analysis

Because oral fluid testing does not necessarily have the same privacy issues as urine testing, it allows for onsite collection, thereby reducing the time that a donor is away from work. Oral Fluid Testing can also provide a deeper insight into drug levels. In an instance where a person is legally prescribed to a certain controlled substance - they will certainly test positive - especially if their workplace tests for opioids or benzodiazepines. In a situation like this, at that point they will be able to provide a prescription. Drug testing also has to address dosage. If a person is taking more than their recommended dosage and is descending into intoxication – how is that identified? Urine tests are highly effective in detecting the presence of illegal drugs as well as prescription drugs, but a positive or negative result is measured by metabolites which do not relate to levels of intoxication. However, oral fluid tests work by measuring something called a parent compound, which is the psychoactive element of a substance. The higher the level of the parent compound, the higher the level of the substance present in the body. This means that oral fluid tests can be used to measure intoxication.

Challenges Companies Face with Their Drug Testing

There are some challenges companies face when deciding which test to use. Urine testing can be more cost effective, but oral testing is less invasive and has a faster turnaround. One consideration is that these tests do not have to be mutually exclusive. A company may interchange these tests for different situations. For example, if a company is located in a place where it is a far drive to the closest approved testing site, they may want to administer an oral fluid test. The availability of oral fluid testing does not render the urine test outdated. Urine specimen remains a very accurate, thorough and effective way to maintain a drug free workplace; lab-based oral fluid testing is simply another tool to ensure that a company is hiring and maintaining the best possible employees, as well as a safe working environment for all.

drug testing
risk-based screening