Exploring the Advantages of Oral Fluid Testing
Drug testing as a part of employment background screening in the U.S. has been a hot topic for years, balancing workplace safety with concerns about efficiency and privacy. Traditional methods of drug testing such as urine testing, while established, have their flaws. However, a new era is dawning with the rise of oral fluid testing
Drug testing as a part of employment background screening in the U.S. has been a hot topic for years, balancing workplace safety with concerns about efficiency and privacy. Traditional methods of drug testing such as urine testing, while established, have their flaws. However, a new era is dawning with the rise of oral fluid testing.
This innovative approach is gaining traction thanks in part to the Department of Transportation (DOT)’s 2023 approval of oral fluid as a testing specimen and evolving state laws around cannabis use helping to drive growing interest in detecting recent drug impairment over historical drug use.
Here, we will demystify oral fluid testing, exploring the various types and processes, and highlighting its key benefits. By the end, you'll be better equipped to determine if oral fluid testing is the right test for you and your drug testing program.
Oral Fluid Testing: A Timely Solution
While iterations of oral fluid testing have existed for years, its adoption as an alternative to urine has recently accelerated. Several key factors are driving this surge in popularity, positioning oral fluid testing as a timely solution for employers.
DOT Approval
In 2023, the U.S. Department of Transportation (DOT) announced a new final rule that amends the regulated transportation industry drug testing program to include lab-based oral fluid testing. The new rule is expected to significantly impact regulated transportation industries' drug testing programs, including those in aviation, trucking, railroads, and transit agencies once the U.S. Department of Health and Human Services (HHS) certifies sufficient laboratories for testing to begin. Currently, the DOT does not have certified labs for oral fluid testing.
Shifting Cannabis Legislation
Emerging legislation around cannabis use is further propelling the adoption of oral fluid testing. As of January 2024, employers in California and Washington need to adjust their marijuana testing procedures, as both states passed legislative measures that, effective January 1, 2024, restrict employers from taking adverse actions against candidates based on their off-duty use of cannabis or on the result of pre-employment drug tests that find non-psychoactive cannabis metabolites. Employers in these jurisdictions may consider oral fluid testing as an alternative to urine testing, as it can identify the presence of psychoactive cannabis metabolites.
Quicker Detection
Employers often need to assess recent drug use, particularly in post-accident scenarios. Salivary glands are highly perfused, and drugs are transferred rapidly from blood to oral fluids. Therefore, drugs become detectable in oral fluid sooner than in urine. Oral fluid testing can identify the presence of psychoactive cannabis metabolites shortly after cannabis consumption, usually within a few hours up to a few days. It therefore provides a window of detection that aligns with identifying impairment rather than historical use.
Types of Oral Fluid Testing
Lab-Based Oral Fluid Testing
Compared with traditional urine testing methods, lab-based oral fluid testing offers distinct advantages for employers. One key benefit lies in the direct observation during sample collection, which significantly reduces the risk of tampering or manipulation, helping ensure the integrity of the test results. These types of samples can be collected by the donor in either an employer setting or at a clinic with administrative oversight. All samples are packaged up and shipped to a lab for testing, so no need for employers or administrators to interpret results.
HireRight now offers the option of using a clinic environment to help support the collection of oral fluid samples. This method is very similar to how urine drug testing works today, where candidates can select a site that offers this solution and go to a clinic to have a sample taken. There are quite a few benefits to this for companies and clinics alike. Companies may like this option if they hire candidates throughout the U.S., as this offers the candidate the flexibility to find a site near them to have the test performed. Clinics may like the offering as it allows them to support drug testing without the “shy bladder” issues that they sometimes face with urine samples. It allows them to also accept drug test collections much later in the day. This is relatively new, as many clinics do not typically house oral fluid devices onsite to support this testing. We expect to see many more clinics ramp up to support this in the very near future!
Instant Oral Fluid Testing
Instant oral fluid tests offer a unique advantage: self-administration and direct observation by the employer or designated representative, right within the workplace, completely eliminating the need for specialized facilities for sample collection. It provides a significant convenience and cost benefit to the employer.
The biggest advantage of instant oral fluid testing, however, is timeliness. Negative results are available within minutes which can prove invaluable when swift action is crucial, such as in post-accident or reasonable suspicion testing scenarios. Moreover, some instant oral fluid tests (such as HireRight’s offering) work in conjunction with third-party mobile applications, eliminating the need for administrators to complete the interpretation. This supports accuracy and reduces administrative burdens.
Advantages of Integrating Oral Fluid Testing into Your Drug Screening Program
Having explored the different types of oral fluid testing, let's delve into the key benefits they offer. Analyzing some of the key benefits may prove useful in discussions with your legal counsel to determine if incorporating them into your drug screening program is the right move for your organization.
Direct Observation
For nearly as long as drug tests have existed, there have been individuals looking for ways to beat the tests. Unlike traditional urine testing, both lab-based and instant oral fluid tests are conducted under direct observation, minimizing the risk of tampering, and enhancing sample integrity.
Detection of Recent Use
A critical advantage of oral fluid testing is its ability to detect recent drug use by employees or candidates. This proves particularly valuable for reasonable suspicion testing or post-accident scenarios, and in locations where off-job use is permitted. Employers can promptly address potential concerns by sending individuals for lab-based testing or by using instant oral fluid tests directly at the workplace, where permitted.
Simplified Collection Process
Traditional urine testing often carries challenges with specimen collection. Individuals may need to visit specific facilities, perform the test on-site, and sometimes have trouble providing a sample due to hydration levels or a “shy bladder”. This can delay the testing process and raise privacy concerns.
Oral fluid testing can help to overcome these hurdles. Specimens can be collected anytime without relying on hydration levels. The non-invasive process helps eliminate privacy concerns with sample collection, and employers can conduct the collection themselves at the workplace.
No Interpretation Required
Up until recently, instant oral fluid tests required employers to interpret the results themselves. A huge benefit now is that there are mobile applications that scan the testing device to provide clear and accurate interpretations, eliminating guesswork and reducing potential human error.
Both lab-based and instant oral fluid testing offer a compelling alternative to traditional methods. They provide benefits in terms of direct observation, detection of recent use, ease of collection, and objective results interpretation. Additionally, oral fluid testing is gaining traction across industries and the nation due to DOT approval and emerging legislation around cannabis. By carefully considering these advantages, you can determine whether oral fluid testing aligns with your specific drug screening needs. As legislation around drug testing and the use of oral fluid as a specimen varies depending from state to state and oral fluid may not be allowed for every employer in every location, it is recommended employers speak with legal counsel to determine if this will work for your organization.
Learn more about Oral Fluid Testing on our website, check our Oral Fluid Testing FAQ’s (need link), or watch our webinar What you need to know about Oral Fluid Testing
Release Date: March 13, 2024
Katy Britto, with over 15 years of tenure at HireRight, serves as the Senior Director overseeing the Transportation and Drug and Health product lines. Throughout her career, Katy has demonstrated a commitment to enhancing drug and health screening services. Her expertise lies in consulting with clients and internal teams to design optimal experiences for customers and candidates alike. With a focus on cost control, regulatory compliance, and efficiency, Katy has played a pivotal role in developing solutions that streamline the hiring process while ensuring adherence to evolving regulations.