Oral Fluid Drug Testing and Potential Cost Savings

Oral Fluid Drug Testing and Potential Cost Savings

Last updated on October 2nd, 2020 at 05:04 pm

Are you considering oral fluid drug testing for your company? Be prepared! Know what it takes to have your supervisors, HR staff or medical staff perform the oral fluid specimen collections on-site.


According to a recent survey, in 2017 over 34 percent of drug testing employers use oral fluid, either by itself or in combination with urine or hair testing. The survey goes on to show that nearly three quarters of drug testing providers see greater interest in oral fluid or anticipate increased interest in oral fluid soon. The reasons to switch are compelling. Oral fluid testing is perceived to be less invasive than urine testing.  It offers a detection window that starts within approximately an hour of use and extends 36-48 hours from use. Lab-based oral fluid offers the same level of accuracy as other testing methods. And moreover, it can be more affordable than other specimen types. But where do these cost savings come from?

While lab-based oral fluid testing adds the cost of a collection device, it eliminates the cost of an offsite collection. Lab-based oral fluid can be collected by a trained supervisor or manager on-site after a short training and certification process. The sample is then shipped to a laboratory for analysis and follows the same rigorous processes as other lab based testing methods. For employers who are used to urine drug testing, this may come as a surprise. After all, you pay a third-party administrator to take care of all the leg work, right? Do you really want to get involved with the Do It Yourself (DIY) process of lab-based oral fluid? Consider both sides of the argument.

Obstacles to Self-collection

Imagine that you’re sitting in a conference room brainstorming the pros and cons of switching to lab-based oral fluid and conducting the collection yourself. Your cons list might look something like this.

  • Extra training for supervisors, managers, etc.
  • Logistical hurdles
  • Legal concerns

Let’s start with that first one: training. While oral fluid collection is simple, it still requires training to be done correctly.  Although at program launch, companies often work with the lab or device manufacturer to schedule an in-person training, most employers opt to retrain and add additional supervisors by using the online training and certification programs available with most devices. Either way, training means time out of busy schedules and additional administration on the part of the employer. On the upside, once training is finished, it can be covered as refresher material in regular supervisor training meetings. As well, if using online videos, training can be quickly incorporated into supervisor training that is already required by many state drug testing laws. The proverbial two birds with one stone approach.

Next are logistical hurdles, such as finding a room to do collections. Urine collections are complex, requiring private bathroom facilities with no access to water and other safety precautions to prevent tampering. That is not the case with oral fluid testing. While it may seem logical to do collections in a private setting, it is not actually required. There is nothing compromising or embarrassing about having an employee swab his or her mouth. This can simply be done in the supervisor’s or the HR manager’s office. Oral fluids collections do mean that whoever is overseeing collections has to take time out of their day to pull workers off the line and spend the entire collection process present in his or her office, since he or she is doing the collections. In contrast, oral fluid collection administration eliminates the convenience of simply notifying employees of a drug test and letting them find their own way to the collection facility. However, it has the added bonus of keeping your employees at the jobsite, preventing a supervisor from accompanying the donor to an offsite collection facility (in the event of an accident or reasonable suspicion) and paying for the time it takes the employee to drive to and from the collection facility.

Finally, there are legal concerns. Is it legal to do the collection yourself? DOT does not allow oral fluid testing. The laws for oral fluid drug testing are not more complex by state than those for any other testing type. A leading concern is “do state drug testing laws require medical or lab professionals to do collections?” For example, Alabama’s voluntary drug testing law requires that the following individuals conduct collections: physician or assistant, registered nurse, licensed practical nurse, nurse practitioner, certified paramedic, or employee of a certified lab. Maine’s mandatory drug testing law requires that collections take place at a medical facility. Just as with other testing methods, it is important to check applicable state drug testing laws before switching drug testing methods or types.

Benefits of Self-collection

Imagine again that you’re in that conference room we talked about earlier. What would your list of pros of self-collection look like? Maybe something like this:

  • Complete control of collection process
  • Less time away from work for employees
  • Less opportunity for cheating
  • No more collection cost

Self-collection means the employer knows exactly when, where, and how collection takes place. There’s no need to coordinate testing hours of operation, hiring schedules and random events with a third party collection provider. This makes pre-employment testing easier and faster. It makes random testing truly random and a surprise for employees being tested. And in the event of an accident, it eliminates the need to send potentially injured employees to a collection site. Employees are away from work for an average of 15 minutes instead of two or three hours. All an employee has to do is walk to the manager’s office, swab, and go back to work. This approach also means that there is less opportunity for cheating. There’s no such thing as shy-bladder when collecting oral fluid samples, nor can an employee swap out his oral fluid for his buddy’s. And of course, it costs less to do self-collection than a professional collection.


Oral fluid testing is an excellent way for employers to save money on their drug testing program while taking advantage of a lab-based test.  When self-collection isn’t feasible in all instances, oral fluid testing can be combined with a different testing methodology or professional collectors can be used.  As with any drug testing program, design and implementation are critical and each should be tailored to your organization’s program goals and corporate culture.  And, as with any program, compliance with all federal and state drug testing laws, partnership with reputable TPA’s, manufacturers and laboratories, and an updated policy are critical to a successful program.