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OralScreen4 Article:

Oral Fluid Testing Update

Among the newest widely accepted testing technologies, oral fluid testing is gaining ground while enhancing workplace safety. 
by Matt Andrie

Drug testing was implemented to protect workplace safety--but it can work better. Interest in fast and economical ways to conduct drug testing, such as oral fluid, has captured national attention. Today, oral fluid testing is proving to be reliable, cost effective, and an important component in workplace safety.

Nearly 73 percent of all illegal drug users in the United States are employed. Drug use causes lost productivity, accidents, and increased worker's compensation insurance and health insurance premiums.1 Oral fluid drug testing gives employers a significant option in maintaining a drug-free environment.

Oral fluid testing is designed to provide businesses with the technology they need to implement a quick and effective drug testing program without the unpleasant nature and high costs associated with urine testing. Onsite oral fluid testing can be administered by anyone and has immediate results, which protects workplace safety. For the first time, small as well as large businesses now can truly afford to provide a safe and healthy work environment.

Substances such as blood, hair, sweat, and oral fluid are alternatives to urine for drug and alcohol testing.2 Blood analysis is problematic because it requires sophisticated techniques of analysis. Also, collecting blood is invasive and requires trained personnel.3 Sweat testing does not provide information as to recent use, which is a crucial issue for employers.

Urine drug testing is accurate and accepted, but it has its drawbacks. Companies that handle their own specimen collections typically find their staff members do not want to handle urine. There are significant issues with specimen adulteration and the cost of organizing specimen collection. Urine testing has been criticized by employees and the courts as being demeaning or invasive.

In contrast, point of contact oral fluid testing requires only that an employee place a collection swab in his or her mouth to collect a sample. It provides results in 15 minutes or less. Oral fluid testing reduces overall costs, virtually eliminates sample tampering, and preserves employees' dignity.

Advantages of Oral Fluid Testing
Oral fluid testing is the method of choice for many companies because it solves a number of burdensome issues that plague drug testing. Oral fluid testing has the following advantages:

• On-site oral fluid testing is very valuable where safety demands immediate results because of the potential for injury or loss of human life. On-site oral fluid testing can test job applicants or employees before they operate dangerous machinery.
• Oral fluid is the most easily obtained specimen for all drugs. Many drugs and alcohol can be detected in oral fluid. Oral fluid testing can accurately and reliably detect the major classes of illicit drugs: marijuana, cocaine, opiates; phencyclidine (PCP), methamphetamines and amphetanimes.4
• Oral fluid testing can be conducted virtually anywhere, making it the most convenient form of testing available. It can be performed right at the work site or in an office--no special collection facilities are required, unlike with urine-based testing.
• On-site oral fluid testing allows new employees to go to work immediately. This is particularly good for small businesses that need to put people to work as quickly as possible in order to remain competitive in the marketplace.
• Oral fluid greatly reduces the chance of sample adulteration. The sale of urine adulteration products has become a major industry on the Internet. The sophisticated regular drug users know how to "fool" the urine test. As a result, the very people who need an intervention into their drug use are falling through the cracks. This undermines the effectiveness of a company's drug-free workplace program and hurts employee morale. They see the dangerous, drug-using employee as "getting away with it." Oral fluid technology allows easy collection in practically any setting and minimizes the risk of tampering.
• A key advantage of oral fluid testing is that it reflects recent drug use. To establish probable cause in a workplace accident investigation, an oral fluid test is useful because it can detect drugs of abuse within minutes of being used. Drugs typically take hours to be detectable in urine tests, however. This makes oral fluid testing the best choice for post-accident, random, and probable cause testing where influence is the primary concern. It is equally valuable for pre-employment and return-to-duty testing.
• Cost is also a major benefit for oral fluid testing. Oral fluid testing permits an employer to collect a specimen anywhere and at any time, without a special specimen collection facility. To properly collect urine, the employer must contract with a collection site or have a secure restroom with protections to avoid specimen adulteration. Because the company can collect the oral fluid easily in house, this reduces the costs associated with outsourcing this process, saving up to $100 per test when collection site fees and lost employee time are factored in.
• Specimen collection can be directly observed each time without embarrassment, and gender no longer is an issue in the collection process. The collection process is completely non-invasive and typically takes less than two minutes.

Recent and Pending Federal Actions
After a rigorous evaluation by the federal Department of Transportation's National Highway Traffic Safety Administration, onsite oral fluid testing for alcohol was approved for testing of millions of transportation workers.5 Oral fluid testing is scientifically correlated to blood testing for alcohol, and several studies show a significant correlation between oral fluid and blood ethanol concentrations.6

As a testament to the reliability of oral fluid testing, many states now use it for driving while intoxicated prosecutions.7 It is likely that oral fluid-based drug testing will be approved by DOT within one to two years.

The Substance Abuse and Mental Health Services Administration has incorporated oral fluid testing into the most recent draft of Mandatory Guidelines for Workplace Drug Testing Programs.8 These guidelines cover the millions of employees who are subject to federal regulation and are in safety-sensitive positions.

In addition, almost all states permit use of oral fluid for workplace testing.9

Oral Fluid Testing Products
Two oral fluid tests are currently on the market. One is the first point of contact oral fluid test for drugs of abuse, an on-site screening test capable of detecting the presence of marijuana, cocaine, opiates, and methamphetamine (including Ecstasy) in 15 minutes or less. The other is a laboratory-based oral fluid test. Several companies are in the process of developing additional oral fluid tests, which should begin emerging on the market within the next year.

Oral fluid testing has many safety advantages for employers. It is an advancing technology that has proven to be effective and reliable. Its ease of use and low cost make it a good choice to protect workplace safety. 

Matt Andrie is the Marketing Manager for Avitar lnc. (www.avitarinc.com) of Canton, Mass. Avitar specializes in the development and marketing of innovative drug testing technologies, including oral fluid and hair testing products.

References

1. National Household Survey on Drug Abuse published by SAMIHSA; Evans, David G., Drug Testing Law Technology and Practice (West Group, Deerfield, Ill), Chapter 1.
2. Hawks, Analytical Methodology, NIDA Research Monograph 73, 39-40 (1986).
3. Nichols Drinking/Driving Lit (Tr Notebook) ch 32. (West Group, St. Paul, Minn.).
4. Evans, David G., Drug Testing Law Technology and Practice (West Group, Deerfield, Ill), Chapter 5.
5. 60 Federal Register 42214.
6. Jones, A.: Distribution of Ethanol Between Saliva and Blood in Man. Clin. and Exper Pharmacol. & Physiol. 6, 53-59, 1979; Bergmeyer, H.: Methods of Enzymatic Analysis, Academic Press: New York, p. 285, 1965; Review of Medical Pharmacology, 4th ed.; Meyers, R, Jawetz, E., and Goldfien, A., Eds.; Lange Medical: Los Altos, Calif., pp. 236-238, 1974; McColl, K, Whiting, B., Moore, M., and Goldberg, A,: Correlation of Ethanol Concentration in Blood and Saliva. Clinical Science, 56, 283-286, 1979.
7. As an example, see Colorado C.R.S.A 42-2-126.
8. Third draft, proposed Mandatory Guidelines for Federal Workplace Drug Testing Programs (12/5/00).
9. As an example, see Arizona Rev. Stat. 23-493(7).

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