Urine and Oral Fluid Comparison - National Drug Screening

General Comparison

Used as workplace standard and for federally regulated testing e.g., Dept. of Transportation (DOT). Also widely used for non-regulated workplace drug testing
Ideal for detecting historical drug use (1-7 days). Estimates depend on the substance, amount, and frequency of use
May require gender-specific staff to observe collection (depends on regulation or employer policy)
Issues with “shy bladder”
Possibility for adulteration if collection not observed
If problems occur during collection, and another specimen is required, donor may not be able to provide urine immediately
Less expensive when comparing actual urine to oral fluid tests. Wider range of urine test panels and drug configurations available

Ideal for detecting recent drug abuse. Popular with programs that require convenient, gender-neutral specimen collection. Authorized for DOT testing but not yet available for regulated workplace testing (DOT) until Labs are certified.
Ideal for detecting recent drug use (4-24 hours). Estimates depend on the substance, amount, and frequency of use
Conveniently collected on-location. Specimen directly and easily observed. No gender-specific staff needed
Minimal chance of specimen adulteration
Additional oral fluid specimens can be provided immediately, or within minutes when mouth is dry
Cost-effective when considering collection overhead factors: reduced collection time, no need for gender specific staff, or separate rest room/collection facility
May be more effective for post-accident and reasonable suspicion testing

Initial screening may feature EIA, GC/MS, or LC/MS/MS1. Presumptive positive specimens may be confirmed by a second, more sensitive test method: GC/MS or LC/MS/MS. (Varies by lab)
Certified laboratory’s test methods are scientifically accepted, provide highly specific drug identification, and are legally defensible
24 hours for negative results, 24-72 hours for positive results
Accurately detects a broad range of drugs, detailed toxicology reports, and technical staff support. Permitted for federally regulated testing e.g., DOT
Adulteration concerns; shipping and handling requirements

Initial screening may feature EIA, GC/MS, or LC/MS/MS1. Presumptive positive specimens may be confirmed by a second, more sensitive test method: GC/MS or LC/MS/MS. (Varies by lab)
Certified laboratory’s test methods are scientifically accepted, provide highly specific drug identification, and are legally defensible
48 hours for negative results, 48-72 hours for positive results
Minimal chance of specimen adulteration
Accurately detects a broad range of drugs, detailed toxicology reports, and technical staff support
Currently, not permitted for federally regulated testing e.g., DOT
Shipping and handling requirements

Note: National Drug Screening does not recommend instant or POCT oral fluid drug testing.

Test method - lateral flow chromatographic immunoassay screen targets multiple drugs and drug metabolites in urine
Qualitative screen provides a preliminary result
Many products available - collection/test cups, dip cards, cassettes
Results typically 5 minutes. (Varies by manufacturer)
Store at room temperature with approximate 24 month shelf life. (Varies by manufacturer)
Simple to follow procedures. Rapid test negative results on-location
Adulteration concerns. “Shy bladder” concerns (difficulty urinating)
May require separate, gender specific collection facility
Cross reaction interferences can arise, thus false-positive results are possible
Laboratory confirmation testing is absolutely necessary for non-negative instant results
NexScreen product is sold with the instant device, lab confirmation and MRO included

Test method - lateral flow chromatographic immunoassay screen targets multiple drugs and drug metabolites in oral fluid
Qualitative screen provides a preliminary result
Collection is by mouth swab plus test device
Results typically 10 minutes. (Varies by manufacturer)
Room temperature with approximate 18 month shelf life. (Varies by manufacturer)
Simple to follow procedures.
Convenient collections and rapid test results on-location
Most U.S. states require use of a FDA cleared device for initial testing in a workplace setting. At present, only one device is cleared: Oratect®
Cross-reaction interferences can arise
Laboratory confirmation testing is absolutely necessary for non-negative instant results
There can be a challenge having enough sample available for the confirmation testing
Many employers report very few positive results