Growing Popularity of Oral Fluid Drug Testing

Introduction

In recent years, the landscape of drug testing has experienced a remarkable shift towards a more convenient and reliable method: oral fluid drug testing. 

In combatting substance abuse, this innovative approach has emerged as a game-changer to identify drug use and ensure safer environments. Unlike traditional urine or blood tests, oral fluid testing offers several distinct advantages, including non-invasive sample collection, shorter detection windows, and improved accuracy. With these benefits, it’s no wonder that oral fluid drug testing has gained significant traction across industries. 

Here, we delve into the growing popularity of oral fluid drug testing and explore the reasons behind its increasing adoption.

Key Takeaways

  • Oral fluid drug testing has been growing in popularity as an alternative to traditional drug testing methods due to its ease of use, non-invasiveness, and accuracy.
  • Saliva samples are collected via swabbing from an individual’s mouth for analysis and detection of drugs and its metabolites.
  • It can detect various drug classes such as amphetamine, cocaine, opiates, cannabis, and other illicit drugs.
  • Oral fluid drug testing is a convenient method of drug testing with a short detection window for the detection of recent drug use.
  • Oral fluid drug testing has recently been approved for Department of Transportation (DOT) drug testing. Learn more.

What is oral fluid drug testing?

Oral fluid drug testing, also known as “saliva drug testing”, is a method of detecting the presence of drugs and its metabolites in saliva. A swab is often used to collect enough saliva sample from the mouth, which is then analyzed in the laboratory—typically taking at least 1-3 days. However, there are commercially available onsite oral fluid drug test kits that can provide results within minutes. 

Detection of drug metabolites via oral fluid testing offers fast and accurate detection, easy and non-invasive collection, and enables the detection of a wide range of drugs and metabolites.

How oral fluid drug testing works

Oral fluid drug testing involves the collection of an individual’s saliva. It is usually done via the use of an oral swab or an absorbent pad, which is then placed inside the mouth. Typically, it will be placed against the inner cheek or underside of the tongue, to ensure adequate sample collection.

Where oral fluid drug testing is used for

There are plenty of applications for oral fluid drug testing, especially in various industries like:

  • Workplace testing. Employers may request oral fluid drug tests, to ensure workplace safety; especially in safety-sensitive job positions like construction, manufacturing, and mining.
  • Law enforcement & roadside drug testing. Police, law enforcement and private security companies require drug testing to screen their personnel to ensure public safety. 
  • Sports & athletics. This is done to maintain the integrity of professional and international sports competitions to prevent the use of performance-enhancing drugs and doping.
  • Drug rehabilitation programs. To provide regular monitoring of individuals undergoing addiction and substance abuse treatment programs. 
  • Forensics. It can provide valuable evidence in legal proceedings like in criminal cases and traffic accidents to confirm substance abuse. 

Drugs detectable through oral fluid testing

Oral fluid drug testing can detect with accuracy the presence of the following illicit compounds (with corresponding initial test cutoff levels):

  • Marijuana (THC) 4 ng/mL
  • Cocaine/Benzoylecgonine 15 ng/mL
  • Codeine/Morphine 30 ng/mL
  • Hydrocodone/Hydromorphone 30 ng/mL
  • Oxycodone/Oxymorphone 30 ng/mL
  • 6-Acetylmorphine 4 ng/mL
  • Phencyclidine 10 ng/mL
  • Amphetamine/ Methamphetamine 50 ng/mL
  • MDMA/MDA 50 ng/mL

If your test result is equal to or greater than these thresholds, it is considered positive, and a confirmatory test is usually done. Note that these values may vary depending on specific test used. Depending on the substance, oral fluid drug tests have a short window of detection, wherein drugs are generally detectable for up to 48 hours after last use. However, some drugs, such as marijuana, can be detected for longer periods of time.

Advantages of oral fluid drug testing

Oral fluid drug testing has several advantages compared to other methods of drug testing. Here are some of the key advantages:

1. Non-invasive 

Collecting an oral fluid sample is a non-invasive process. It involves swabbing the inside of the mouth with a cotton swab, which is less intrusive and more comfortable for the individual being tested compared to other methods such as urine or blood testing.

2. Easy sample collection

Collecting an oral fluid sample is relatively simple and can be done under direct observation, reducing the possibility of sample tampering or adulteration. The process is less time-consuming and requires minimal training, making it convenient for use in various testing settings.

3. Ability to detect recent drug use

Oral fluid drug tests can detect the presence of drugs and their metabolites in a relatively short detection window. While the exact detection times can vary depending on the drug and individual factors, saliva testing generally provides a window of detection spanning a few hours to a few days, depending on the drug used, making it suitable for identifying recent drug use.

4. Overcomes shy bladder wait time

An oral fluid drug test can eliminate up to three-hour shy bladder wait with a urine collection and donor inability to void a urine specimen. It also eliminates the uncomfortable direct observed urine collections.

5. Reduced risk of sample tampering or adulteration

The collection process of oral fluids can be directly supervised and monitored without running the risk of sample tampering or substitution with malicious intent. It is a reliable method if sample integrity and authenticity are concerns.

Comparison with Other Drug Testing Methods

Oral fluid secretions can contain the actual drug compound and its metabolites, within 48 hours after drug use. In comparison with other methods, it is generally a non-invasive, easy method with a short detection window that can detect a wide range of drugs with accuracy. 

Here’s a table showing a quick comparison with other drug testing methods:

Drug TestAdvantageDisadvantage
Urine– Can detect high concentrations of drugs & metabolites- Sample available in sufficient quantities- Established & well-studied method– Short window of detection- Easy to adulterate- Some individuals may have “shy bladder” syndrome, and cannot provide a sample
Sweat– Can detect recent drug use- Non-invasive- Difficult to adulterate– Difficult to collect- Can be contaminated easily- Few facilities for testing- Results can be affected by external factors
Blood– Can detect recent drug use- Established method– Expensive- Invasive—requires venipuncture- Requires training in sample collection- Limited detection window- Has infection risk
Hair follicle– Longest detection window in drug use over time, for about 7 days- Non-invasive- Difficult to adulterate- Readily available sample– Cannot detect recent drug use- Can be costly & time consuming- Few facilities available for testing- Can be contaminated easily
Breathalyzer– Established method for alcohol testing- Readily available sample– Only applicable for alcohol use- Short detection window- Might be difficult for sample collection from intoxicated or uncooperative individuals

Challenges and Limitations of oral fluid drug testing

Since oral fluid drug tests have a short detection window, it is not effective in detecting drug use that has occurred several days or even weeks before the test. As such, urine samples or hair follicle drug tests are more suitable, since they have longer windows of detection. Oral fluid tests can also be susceptible to contamination from external sources, such as food or drinks, which can potentially affect the accuracy of the results. It is essential to follow proper collection procedures and minimize the risk of contamination.

Concluding Remarks

Oral fluid drug testing is an emerging method for detection of drug use, surging in popularity in various industries due to its ease of use, accuracy, and non-invasiveness, which can reliably detect various illicit drugs in an individual’s saliva in up to 48 hours of recent drug use. Various industries are now embracing oral fluid drug testing, underscoring its significance in ensuring public safety, workplace productivity, and maintaining integrity.

More on Oral Fluid Drug Testing

Frequently Asked Questions

Is oral fluid drug testing a reliable for detecting recent drug use?

Yes. Oral fluid drug test is a reliable method in detecting recent drug use. It has a short detection window from a few hours up to 2 days. The test can detect trace amounts of drug and its metabolites in the saliva of an individual.

How long does it take to get oral fluid drug test results?

Rapid on-site test kits that can provide preliminary results in a few minutes are commercially available. However, confirmatory tests may be required, which are processed in a laboratory for analysis that usually take 2-3 days before the results are received.

Can medication or other factors interfere with oral fluid drug test results?

Yes. Some medications like antibiotics, antihistamines and pain medications can interfere with oral drug test results. Oral hygiene products such as mouthwash can also interfere and affect the accuracy of the test. Food and drink consumption, especially if acidic, are also not advised before oral fluid drug testing. Follow the instructions to avoid false positive/negative results.

References

Source: The Clinical Biochemist Reviews

Title: “Drug Testing in Oral Fluid”.

Source: Journal of Analytical Toxicology.

Title: “Drug Testing in Oral Fluid—Evaluation of Sample Collection Devices”.

Source: Child and Adolescent Psychiatric Clinics of North America.

Title: “OBJECTIVE TESTING – URINE AND OTHER DRUG TESTS”.

Source: Annals of the New York Academy of Sciences.

Title: “Interpretation of Oral Fluid Tests for Drugs of Abuse”.

Source: Substance Abuse and Mental Health Services Administration.

Title: “Mandatory Guidelines for Federal Workplace Drug Testing Programs – 2015 Oral Fluid 94 FR 28054”.

Source: Journal of Analytical Toxicology.

Title: “Analytical Evaluation of Four On-Site Oral Fluid Drug Testing Devices”.

Source: Journal of Analytical Toxicology.

Title: “An Evaluation of Rapid Point-of-Collection Oral Fluid Drug-Testing Devices”.

Source: ThermoFisher Scientific.

Title: “Oral Fluid Drug Testing”.

Source: Journal of Analytical Methods in Chemistry.

Title: “A Study on the Reliability of an On-Site Oral Fluid Drug Test in a Recreational Context”.

Source: Clinical Chemistry.

Title: “Oral Fluid Testing: Promises and Pitfalls”.

Oral fluid testing swab and cup
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