Oral Fluid Testing – A Simple Solution for Effective Drug Screening

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nurse performing oral fluid testing

A very practical, cost-effective and reliable means to implement or update a drug testing program may be to offer oral fluid testing.

Why Choose Oral Fluid?

Oral fluid drug testing (sometimes referred to as saliva testing) uses saliva and cellular debris collected from the inside of a donor’s mouth which is then tested for the presence of drugs.


  • Easily collected – non-intrusive
  • Not vulnerable to subversion – collected under observation of tester
  • Very accurate
  • Cost effective

Window of Detection

Oral fluid is great for detecting recent drug use. The window of detection for oral fluid is two to three days for all substances. This timeframe more closely mirrors the impairment window—the duration of time an individual is impaired by drug use. That means if someone gets a positive result on an oral fluid drug screen, he or she may have been impaired at the time the sample was collected.

Oral fluid testing cannot indicate historical usage of drugs, however. So, if marijuana or other illicit drugs are detected, the test will not indicate how often the person uses the drug.

Drugs Screened For

The majority of oral fluid screens are 5-panel tests that look for cocaine, amphetamine, opiates, phencyclidine and cannabinoids (THC).  Broader panel tests are available which include additional analytes such as benzodiazepines, barbiturates, and methadone.

Program Types and Advantages

Companies who truly want a drug-free workplace can make a real impact with oral fluid, which has a higher rate of positive results than most other drug screening methods. For example, it has a 300%+ higher positive rate than urine.

It is very effective for incumbent employee programs that test regular workers at random and for-cause/reasonable suspicion. Since it is easily collected by a company representative, there is essentially no lost time from work when collecting random testing.  For the same reason, oral fluid is a great test for after-hour for-cause testing.  Along with the ease of collection, if the test shows positive due to the narrow detection window (particularly for marijuana), it means the employee is likely impaired.

Random drug testing with oral fluid is good for companies who want an effective deterrent. For example, a business may randomly test 2% of its employee population each month. When employees know this kind of program exists, they are likely to use illicit drugs less often.

In general, oral drug testing also works best for businesses with static facilities—places where employees regularly come in to a facility to work. Examples might include a warehouse or manufacturing plant, or businesses with white collar jobs.

How Much Does it Cost?

Typically, a company can expect to pay around $25-$35 for each test if they have the capability to collect it themselves, or $40-$50 if the sample is collected by a third-party clinic. As with all screening methods, costs will also vary by the number of panels included in the test—the more drugs included, the higher the price.

Timeline to Get Started?

Drug-free workplace policies will need to be updated and specimen collection procedures will need to be created. In addition, appropriate staff will need to be trained on how to perform the collection process.

Building an oral fluid drug screening program can be accomplished in a very short period of time. Once you’ve selected your device, you can conduct training session and be up and running in as little as two weeks.

For additional information download HireRight’s eBook – What You Need to Know about Implementing an Oral Fluid Drug Testing Program.

Dr. Todd Simo

Dr. Simo is the Chief Medical Officer and the Managing Director of Transportation at HireRight. He served as HireRight’s medical director starting in 2009 and was promoted to chief medical officer in 2015. Dr. Simo was also appointed to the role of managing director of transportation and drug & health screening in 2018. Dr. Simo came to HireRight with a decade of experience in the medical consulting arena. Before that he was the medical director for an occupational health clinic in Virginia and owned a consulting firm providing medical director services to employers across the United States

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