DOT Oral Fluid Drug Testing, Collections & Mocks

The long-awaited DOT approval for oral fluid drug testing is here, the final rule was published May 2, 2023 and takes effect June 1, 2023.  STOPRead the Fine Print:  Although DOT has approved oral fluid drug testing, currently as of May 2, 2023; the United States Department of Health & Human Services (HHS) has not yet certified any laboratories to conduct oral fluid testing. Read the full rule for DOT approval of oral fluid testing.

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DOT Oral Fluid Drug Testing – What you Need to Know!

In this post we will cover

Labs are not Currently Ready for Oral Fluid Drug Testing

Once at least two labs are certified for oral fluid drug testing, we will see an approved device capable of collecting a specimen to be split so that there are two specimen in order to do split specimen testing when necessary. At least two certified labs are necessary for testing of the primary specimen and split specimen testing when necessary. This will all take some time and perhaps we may not see certified labs and DOT oral fluid drug testing until later this year or early 2024.

DOT Collector Training for Oral Fluid Drug Testing

Oral fluid collector training cannot occur until at least two labs are certified and which collection device they will use is established. National Drug Screening will be providing training for oral fluid drug test collections and also the required proficiency demonstrations (mock collections). Training options will include computer-based remote trainings, webinar trainings, custom webinar training, live training events and custom live training. Once DOT publishes the Specimen Collection Guidelines for Oral Fluid Drug Testing, training programs will become available soon after. We request our clients and those interested in this process to be patient as all of this may take some time.

Stay updated on our Oral Fluid Collector Training Program.

Who Decides When & Where to Use DOT Oral Fluid Drug Testing

Once the DOT oral fluid drug testing is up and running, employers will decide which specimen type to use for their DOT regulated covered employees. Oral fluid testing will be a choice for employers not employees. Collection sites to remain competitive and continue to get DOT drug testing business will need to be able to provide both urine drug collections and oral fluid drug collections. The Medical Review Officer (MRO) process will remain relatively the same with the review and verification of a positive result. Some employer considerations regarding this new DOT final rule allowing oral fluid drug testing include:

  • Use of oral fluid when there is a shy bladder situation with a urine collection
  • Use of oral fluid when a urine collection has a problem requiring direct observation (such as temperature out of range)
  • Use of oral fluid for all direct observation collections
  • Required use of oral fluid collection when there is a direct observation needed for a collection for transgender and nonbinary gender individuals
  • Use urine specimen when there is a dry mouth situation in an oral fluid collection event


Important to note that employers may require for different testing reasons the use of oral fluid or urine. Perhaps the employer requires oral fluid testing whenever the test reason is post-accident or reasonable suspicion, return to duty and follow-up. Then for random and pre-employment tests the specimen will be urine (this is just an example).

Oral fluid drug testing has a shorter window of detection and all oral fluid collections are direct observed.

Read DOT’s 05/02/2023 announcement which is a collection of important Federal Register notices, court decisions, and legislation regarding Part 40. The list is organized by date beginning with the most recent which is the published final rule for DOT oral fluid drug testing.

 At National Drug Screening we believe the best use for DOT oral fluid testing to be for reasonable suspicion testing, post-accident testing, return to duty testing, follow-up testing, shy bladder situations and all other collection events that will require a direct observed collection.

Drugs to be tested with oral fluid will remain the same as urine – the DOT 5 Panel Drug Test.
Call Joe Reilly at 321-622-2020 for any assistance or questions.

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