Oral Saliva Drug Testing: Pros and Cons

Oral Saliva Drug Testing: Pros and Cons


The choice of a drug test depends upon several factors, which include federal regulations, workplace policy, cost, the type of testing: random selection, reasonable suspicion, pre-appointment, follow up or post-incident. Oral, urine, blood, hair, sweat, and breathalyzers are some of the standard drug tests. Each has its own advantages and disadvantages.

Urine remains the most widely employed specimen today. Urine is familiar and has been around for a reliably long time. It’s inexpensive and used in the detection of a wide range of drugs. Drugs and their metabolites also last in the urine for a more extended time, significantly increasing the drug detection window. However, urine testing is prone to manipulation as it cannot be monitored. Urine adulteration, dilution, and substitution are common in the collection of specimens and thus distort the interpretation of results. Oral drug tests are an alternative to urine tests. They are incredibly easy to carry out and difficult to tamper with as the oral fluid specimen is collected under supervised observation.

Table Of Contents:

Oral drug testing advantages

Oral drug testing is a non-invasive method of drug testing that works by testing an individual's saliva. The oral fluid specimen can be provided separately in a paper cup that may come with an oral drug testing kit or collected using a sterile swab placed inside the mouth for 1-3 minutes to absorb saliva. Testing has included alcohol and a host of other drugs of abuse and steroids such as amphetamines, methamphetamine, methadone, 6-MAM, morphine, MMJ, cocaine, phencyclidine, etc.

Oral drug test deliver instant result

Oral tests provide instant results. It can take place on-site, which reduces the cost involved in laboratory testing a given sample. Results of on-site testing are often ready within minutes and proven to be scientifically accurate. Oral drug tests have found application in testing employees at workplaces and, more recently, in roadside drug testing.

Oral drug test offer benefits over alternative drug screen tests

An oral drug test kit is easier to administer. Alternative drug screening tests such as urine and blood are often hazardous fluids and lead to the transmission of diseases. Collecting a blood sample is an invasive and painful process, and urine cannot be produced on demand. Oral fluids have a short detection window. Drugs are detectable for up to 48 hrs and thus effective in detecting recent drug use. The short detection window of a drug in oral fluid samples makes it suitable for reasonable suspicion testing and post-incident testing.

Oral drug disadvantages

While oral drug tests offer many benefits compared to other drug screening methods, it has a few drawbacks. Its short drug detection window means it cannot detect illicit drug use beyond 48 hours. For an oral drug test to be effective, test subjects must be tested not long after drug ingestion. It is also difficult to measure the frequency of drug use because of this limited detection window. A recent study on workplace drug testing revealed some of these limitations.

Oral drug tests are prone to contamination and often erratic

People administering an on-site oral drug test are not always trained in the specific handling of specimens. They may lack sufficient know-how regarding medical procedures and administering drug screens that can compromise a test. Apparently, some drugs can cause dry mouth, which makes collecting an oral fluid sample challenging. A range of physiological factors may also thwart collection. Food and techniques designed to stimulate specimen production can affect the concentration of drugs which oral drug testing tricky.

Oral drug test can be subverted by illicit drug users

An oral drug test can give reliable and accurate results when carried out correctly. There are no known contaminants that can compromise the result of an oral drug test. The presence of albumin in most oral drug tests ensures that the fluid collected is saliva. However, ingestion of certain over-the-counter (OTC) medication and other liquids and food can taint the result of an oral drug test. The use of legal medications like codeine, for instance, may indicate a positive in a drug test panel for opiates and can be misinterpreted as a case of illicit drug use. Similarly, using legal products unwittingly, such as a mouthwash with ethyl alcohol, can indicate a false-positive. Best practice for administering an oral drug test includes observing the test subjects closely and ensuring that they do not ingest anything at least 10 minutes before taking the test.

The bottom line

There have been considerable developments in the area of drug testing. Oral drug test offers an easy and cost-effective method of screening for drugs of abuse. Unlike other drug testing methods, it does not require a trained professional to administer the tests. However, improper handling of the specimen can lead to contamination. Hence, one should consider looking for a provider with in-house medical review officers to validate and verify drug test results.

An oral drug test is difficult to tamper with and particularly effective in detecting recent drug use. Because of a narrow detection window, one must perform an oral drug test quickly and immediately. Oral drug testing provides a quick and non-invasive alternative to blood and urine tests, especially when adulteration is suspected. However, oral drug testing cannot be seen as a substitute for blood or urine drug testing.

Today, many drug-free workplace programs contain a combination of different specimen or multiple specimen drug testing to streamline the process of drug screening.

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