A Comparison of Urine, Hair, and Oral Fluid Drug Testing Methods

Guest Blog – David Bell, CEO of USA Mobile Drug Testing

Drug testing is a common component in the workplace as part of the hiring and promotion process, as well as part of at-work accident investigations.  An important part of drug testing in the workplace is determining which drug testing method will provide the most accurate results and fit best with the needs of your organization.  Currently, there are three primary methods of collection which include urine, hair, or oral fluid specimens.

Urine drug testing

Urine drug testing is one of the most frequent drug testing methods often used for pre-employment screening, after accident tests, and random screens.  The window of detection of drug use on a urine specimen is generally 3 – 4 days; but that may vary based on the type of drug, frequency of use, and other factors.

How a urinalysis is performed

For a urine drug test, with a split specimen, to be successfully conducted, there must be a minimum of 45ml of urine collected in a sterile container.  The specimen will then be poured into two bottles that are then sealed with tamper evident labels. 30ml in vial A and 15ml in vial B.  The specimen is sent along with a chain of custody form to the designated lab for testing.

Pros of a urinalysis 

There are many advantages to using urine drug testing including the ease of collecting the specimen and its ability to screen for many illicit drugs as well as prescription medication.  Although mistakenly believed to be easy to dilute, a urine screen is difficult to cheat as the temperature, PH, and creatinine is checked to ensure specimen integrity.  Attempts to dilute a urine specimen will only create a specimen that is inconclusive and requires a retest.  Urinalysis is currently the only approved drug testing method for the Department of Transportation (DOT).

Cons of a urinalysis

Two of the primary cons of urine drug testing include the fact that the collection process is usually not observed which may increase the risk of tampering, and the test cannot determine the frequency of use or whether the user is currently intoxicated.

Hair drug testing

Hair drug testing is becoming a more common option because it’s a simple and noninvasive way to detect drug use over a greater length of time.  With the window of detection being as long as 90 days, hair drug testing is effective when testing for regular use of drugs such as cocaine, methamphetamines, opiates, and PCP.  These drugs can become undetectable in urine after 3 – 4 of discontinued use.

How is hair drug testing performed?

To correctly perform a hair follicle drug test, the collector will cut a hair specimen from the employee that is a minimum of 1.5″ long.  If the hair on their head is not long enough, body hair can be substituted.  The hair will be cut as close to the root as possible, and will then be sealed in a tamper-proof bag that will be sent along with a chain of custody form to the lab to be analyzed. At the lab, the hair will be tested for parent drugs and their metabolites with the data being provided to give information on the past 90 days of use.

Pros of hair drug testing

The primary advantages to hair testing are the ability to non-invasively collect a specimen with visual collection confirmation, and the capacity to determine the use of drugs up to the previous 90 days. There is no way to adulterate a hair follicle test.

Cons of hair drug testing

One of the cons of hair testing is that it cannot detect exactly how recent use was because hair grows at different rates for different individuals. Additionally, hair follicle tests can be more costly than traditional urine specimen collection and the hair sample collection will be cutting hair which some employees may complain about.

Oral fluid drug testing

A newer testing procedure that is the oral fluid test, which like a hair drug test, can be conducted anywhere in plain sight. Oral fluid testing can test for most drugs that can be detected by other means, and is used to detect very recent drug use. The window of detection on an oral fluid test is a few minutes to up to about 2 days, more commonly 24 hours.

How is an oral fluid drug test performed?

An oral fluid test can be conducted on the job site and involves collecting in the inside of the cheeks with a sterile gauze swab that is then placed in a tamper proof container and sent to the lab with a chain of custody form for the results to be analyzed.  Oral fluid testing programs are designed for the employer to collect the oral fluid specimen and ship the specimen to the lab.

Pros of oral fluid testing

There are many pros of oral fluid drug testing, the biggest of which is the ease of collection. The specimen can be collected immediately on-site which makes it more efficient and reduces the amount of time and cost for collection.  The test can detect use that has been extremely recent where urine tests require the drugs to have passed through your system to identify. This makes the testing method perfect for post-accident tests and reasonable suspicion testing.

The biggest drawback of oral fluid drug testing is that it can only detect drug use that as happened within the past few days. Additionally, the test has a slightly higher risk of contamination because contaminants can easily get in the mouth, therefore the test should be administered by someone who is trained in collection.

By David Bell, CEO of USA Mobile Drug Testing, Headquarters in Tampa, Florida

After seeing firsthand the effects of employee drug use, David Bell worked his way into the industry and up to his current role as CEO of USA Mobile Drug Testing, so that he could help employers ensure a safer and more productive workplace. Today he writes extensively on compliance and speaks at industry events to help educate employers.

A Comparison of Urine, Hair, and Oral Fluid Drug Testing Methods
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