Oral fluid drug testing has proven to be scientifically reliable, is endorsed by federal guidelines, and is supported by the Substance Abuse and Mental Health Services Administration (SAMHSA).

One significant advantage of oral fluid testing is its ability to detect recent drug use, making it especially valuable for post-accident testing or in states that require proof of impairment for employment actions. Oral fluid testing offers employers a clear and immediate understanding of substance use and supports timely decision-making.

The legalization of marijuana has further driven the need for methods that detect recent use. Oral fluid testing excels at identifying parent Tetrahydrocannabinol (THC) — the psychoactive component of marijuana. This capacity is crucial in states that require evidence of impairment alongside a positive result for employment decisions. The shorter detection window of oral fluid testing allows employers to maintain safe, drug-free workplaces with greater confidence.

Although lab-based oral fluid testing is generally allowed across the U.S., it’s essential for employers to consult their legal teams for state-specific regulations and compliance guidance. While lab-based urine testing remains universally accepted, oral fluid testing may require additional steps or licensing in certain states, such as New York.

A notable development is the U.S. Department of Transportation's (DOT) approval for the use of lab-based oral fluid testing for DOT-regulated employees. However, this cannot be implemented until at least two HHS-certified laboratories are available to process these tests, a requirement that, as of early November 2024, has not yet been met.

Overall, oral fluid testing is a scientifically sound, permissible option in most states. It effectively supports current detection needs, particularly as laws around drug use continue to evolve. Employers should partner with their legal advisors to ensure compliance and make well-informed choices that enhance workplace safety and productivity.

Sources:

Bolaños, P. (2024, April 11). Employers are asking about oral fluid drug testing options, but why now? | Quest Diagnostics. Quest Diagnostics Workforce Health Solutions Blog. https://blog.employersolutions.com/oral-fluid-testing/

DeFrancesco, M. (2023, November 9). Debunking common oral fluid testing misconceptions - EHS Daily Advisor. EHS Daily Advisor. https://ehsdailyadvisor.blr.com/2023/11/debunking-common-oral-fluid-testing-misconceptions/