Simplifying and advancing workplace drug testing with oral fluid

The landscape of workplace drug testing is evolving, with oral fluid testing at the forefront of this evolution. As the U.S. Department of Transportation (DOT) and other federal agencies approve an oral drug test for regulated programs, employers will soon have a new tool at their disposal for maintaining safe and drug-free workplaces. 

Here’s what you need to know.

The rise of oral fluid testing

Oral fluid drug testing has been in development for over two decades. While its origins began in the insurance industry, it quickly gained traction in workplace drug testing as well.

Lab-based oral fluid drug testing offers you an easy method to collect chain of custody drug screen specimens almost anywhere. Your employees simply open the sealed collection device and place it in their mouth; the designated collector then transfers the specimen into a tube that’s shipped to a laboratory for testing.

In 2023, both the U.S. Department of Health and Human Services (HHS) and DOT finalized regulations allowing oral fluid testing in federally regulated programs, marking a significant milestone in drug testing policy. While oral fluid testing isn’t readily available for DOT-regulated employers to implement at this time, it is currently available for non-federally regulated testing, 

Regardless of your regulatory body, it’s important to learn the pros and cons of this modality as its availability is inevitable.

What you need to know about implementing oral fluid testing

While oral fluid testing offers many advantages, here are some things you should consider before implementing this testing modality:

• Regulatory compliance: For DOT-regulated employers, it's crucial to note that only split specimen collections using approved devices will be permitted. Prior to implementation, ensure your program complies with all applicable regulations
• Collection training: New collection procedures will need to be implemented. Wait for official DOT guidance before training collectors, as procedures may differ slightly from HHS guidelines
• Medical Review Officer (MRO) requirements: MROs will need additional training and certification specific to oral fluid testing. Ensure your MRO is properly qualified to avoid any complications
• Laboratory certification: Currently, no laboratories are certified for federally regulated oral fluid testing, but many are in the process of becoming certified, including Labcorp. Ensure your lab of choice has obtained certification before implementing a program
• Cut-off levels: Familiarize yourself with the new cut-off levels for oral fluid testing, which are significantly lower than urine testing levels
• Detection windows: For most drugs, oral fluid has a shorter detection window than urine. This can be advantageous for detecting recent use, but it may not capture use from several days prior

Labcorp's oral fluid testing capabilities

As one of the largest drug testing laboratories in the country, Labcorp can support all your oral fluid testing needs. Here's what you should know about our capabilities:

• Extensive experience: Working with oral fluid testing since 2000, Labcorp has over two decades of experience in this testing modality
• Comprehensive test panel: Our oral fluid panel includes all drugs mandated by federal regulations, matching the scope of current urine testing programs
• State-of-the-art collection devices: Samples are collected by the Quantisal™ II device, which allows for split specimen collection as required by DOT regulations
• Lower detection limits: Oral fluid testing requires much lower detection limits than urine testing. Our advanced analytical capabilities reliably detect drugs at these lower concentrations
• Potential for additional biomarkers: The federal regulations allow for the possibility of additional biomarker testing in oral fluid. Labcorp is at the forefront of research in this area, with biomarkers expected to further enhance the effectiveness of oral fluid testing in the future and provide more comprehensive drug use information

As we continue to develop our oral fluid testing program, employers can expect several more advancements:

The future of workplace drug testing

While oral fluid testing isn’t yet available for federally regulated programs, employers can take four steps to prepare:

1. Stay informed: Keep up to date with the latest developments in oral fluid testing regulations and lab certification progress.
2. Review current policies: Examine your existing drug testing policies and consider how oral fluid testing might be incorporated.
3. Educate key stakeholders: Inform HR personnel, MROs, safety managers and other relevant staff about the potential transition to oral fluid testing.
4. Consult with experts: Reach out to Labcorp and other drug testing experts to discuss how oral fluid testing might benefit your organization. 

The approval of oral fluid testing for federal programs represents a significant advancement in workplace drug testing technology. Its numerous advantages over traditional urine testing—including simplified collection, direct observation and detection of recent use—make it an attractive option for many employers.

However, it's critical for employers to proceed cautiously and wait for full implementation of federal guidelines, laboratory certifications and official collection protocols before making changes to your federal drug testing program. Stay informed about developments in this rapidly evolving field and consider consulting with drug testing policy experts to ensure your program remains compliant and effective as you navigate this transition. 

By understanding the capabilities and advantages of oral fluid testing and partnering with experienced providers like Labcorp, employers can enhance their drug testing programs and contribute to safer, more productive workplaces.

For more details on this topic, watch Dr. Lance Presley’s latest presentation.