With lab based oral fluid drug testing, an oral fluid or saliva specimen is collected and sent to the laboratory for screening and confirmation testing. The procedure at the lab is similar to urine drug testing. Oral fluid drug testing is sometimes referred to as saliva drug testing.
Oral fluid drug testing has gained popularity due in large part to it being perceived as less invasive and a perception that it less expensive. The oral fluid drug test captures oral fluid with a device that appears to be a sponge on a stick. The donor inserts the oral fluid collection device into the mouth to collect the oral fluid. Most devices will take at least two minutes for the collection pad (sponge) to collect a sufficient amount of oral fluid.
As of the spring of 2016, oral fluid drug testing remains prohibited for DOT drug testing but for many years it has been allowed for non-DOT drug testing. The oral fluid drug test is marketed as a product that may be used by the employer to collect the specimen at the employer place of business. Often employers engage mobile collectors to come to the business and collect specimens from multiple employees at one time. While some mobile collectors will do oral fluid collection, neither LabCorp nor Quest Diagnostics offer oral fluid drug test specimen collection at their Patient Service Center (PSC) collection sites. Most third party collection sites are also not offering oral fluid drug test collections at this time. An employer using a specific collection site on a regular basis may request that a collection site stock oral fluid collection devices and perform oral fluid collections.
Unlike urine drug screens, it is very difficult to cheat a saliva based or oral fluid drug test as the collection is witnessed or directly observed. It is important however to carefully monitor the donor to insure they do not introduce something onto the pad or collection vial. Labs are seeing a higher percentage of positive drug tests with oral fluid testing particularly with marijuana. This may be due to the difficulty in cheating on an oral fluid drug test as opposed to urine drug testing and they detection window may also be a factor. Oral fluid drug testing will detect more recent use of the drug particularly for marijuana.
One of the major differences between oral fluid drug testing and urine drug testing is the detection time. The detection time is different for each drug tested. The notable difference is that the detection time is shorter for oral fluid drug testing and recent drug use is more likely to be detected with oral fluid drug testing. The window of detection for oral fluid drug testing is from several hours after use to two days. The narrow but immediate detection window makes oral fluid drug testing a natural choice for reasonable suspicion testing and for post-accident testing.
Different labs are testing for different drug panels utilizing oral fluid testing and we also see the labs using different collection devices. Below is a summary of what we have observed from the various labs in regards to oral fluid drug testing, the drugs being tested and the collection devices being used.
This laboratory has their own collection device called the Oral-Eze collector. This is a patented oral fluid collection system with built-in indicator window that turns indicating that there is an adequate sample collected for drug testing. Quest Diagnostics provides this device with orders for oral fluid drug testing laboratory accounts. The drug panels currently available from Quest Diagnostics are:
This lab uses a collection device called Quantisal which has as a unique “volume adequacy indicator” that ensures enough specimen for screening, confirmation and repeat testing. LabCorp offers some additional panel options for oral fluid drug testing including:
This lab uses the Intercept oral fluid drug testing collection device. The original Intercept does not have a volume indicator. The Intercept 2 oral fluid collection device as of this writing is awaiting FDA clearance for workplace drug testing and does have a volume indicator. The panels available from Alere Toxicology include:
Primarily testing with hair follicle and oral fluid, this lab uses the Intercept oral fluid drug testing collection device. Omega offers panels as follows: