Oral Fluid Drug Testing – Advantages and Limitations

For non-regulated or non-DOT drug testing, the use of oral fluid has been around for well over 10 years. For United States Department of Transportation (DOT) drug testing as of November of 2021 this specimen type is not allowed for DOT required testing. 2023 Update – DOT Oral Fluid Drug Testing, Collections & Mocks

In this article we will cover:

The discussion in the article is limited to lab based oral fluid drug testing. Oral fluid specimens are collected and sent to a laboratory for initial screening and if necessary – conformation testing. This author does not recommend instant, rapid or POCT oral fluid testing in any situation. A medical review officer (MRO) should review all results released by a laboratory.

Although there are some significant advantages to oral fluid drug testing, it is always important for employers to pay attention to the oral fluid drug testing limitations outlined below.

For employers considering switching to oral fluid drug testing, consider the advantages and limitations. Some employers might consider a hybrid program and perhaps do the traditional urine drug test for pre-employment and the in-house oral fluid drug test for random, post-accident or reasonable suspicion drug testing.

Advantages of Oral Fluid Drug Testing

There are some very significant advantages to oral drug testing that include:

Particularly with the current status of marijuana being legal in many states either medical or recreational; the short detection time in oral fluid testing becomes very important. Employers want to know if the employee is under the influence of marijuana at work.

Currently there is no approval for any workplace testing that will show if the employee is under the influence of marijuana at work. However, the oral fluid drug test can detect very recent consumption of marijuana products – smoking marijuana or edibles. It is the very recent use of marijuana that would be concern to employees.

Limitations with Oral Fluid Drug Testing

Companies marketing oral fluid drug testing often promote that oral fluid drug testing is less expensive than traditional urine drug testing. This is true only when the specimen collection is done by the employer at the workplace. While this in house specimen collection may work for some employers, many other employers may have no interest in collection of oral fluid specimens at the place of business.

Another benefit promoted for oral fluid testing is a quicker collection time because of not sending the employee out to a clinic for a urine collections. No waiting time, no travel time, no cheating and no shy bladders. Again, this is only the case when the employer trains someone in house to do the oral fluid specimen collections at the employers’ business.

In both of the above examples if a clinic is used for the oral fluid collection, the cost of oral fluid drug testing becomes more than the cost of traditional urine specimen drug testing. This leads to the biggest limitation for oral fluid drug testing. The limitation is that most collection facilities throughout the United States are not currently equipped for and typically do not offer oral fluid collections.

For urine drug screening, most employers are familiar with collection sites such as Quest Diagnostics, LabCorp, Concentra and other clinics that perform drug testing. For the most part these same facilities do not currently offer oral fluid drug screening collections. It remains to be seen whether this will change when DOT finally approves oral fluid testing for DOT required drug testing.

National employers that hire employees all over the country will have a hard time finding facilities for oral fluid collections. This limitation can be avoided if the employer elects to train someone in house for the oral fluid specimen collections at the workplace.

National Drug Screening highly recommends using oral fluid drug testing for post-accident and reasonable suspicion drug testing.
More information on oral fluid drug testing:

Oral Fluid Drug Testing

Oral Fluid Drug Test Panels

Video Blog: Oral Fluid Drug Testing – What is the Best to Use?

Urine, Hair, and Oral Fluid Drug Testing: A Q&A Approach to Drug Testing Methods

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