Since the 1980s, urine testing has dominated the drug testing market in the United States. Over the past few years, alternative specimen types and expanded testing panels of drug testing have become more commonplace and many employers in the United are combining the use of urine, hair, and oral fluid drug testing for more effective programs. In 2017, it is estimated that 14 percent of employers were utilizing all three methods and that number has continued to grow. This issue of Inside Drug Screening will provide insights into the 3 main specimen types used for drug testing.
Urine Drug Testing
Urine drug testing has been the “gold standard” for many years. It is legal in all states and results from urine testing are legally defensible if conducted properly. The main concern or challenge with using urine for drug testing is that is it the easiest type of test to cheat when not directly observed. Direct observation is only used in very specific circumstances and it not typically used in employment testing except for Federal DOT testing programs and then only as specified by regulations. There are measures in place to catch cheaters such as properly trained collectors and specimen validity testing conducted by laboratories. This may include Ph, specific gravity, and creatinine.
Some employers utilize instant urine tests, and these would not have the same level of specimen validity testing in the initial screen which may lead to false negatives. For instance, someone could pour coffee into an instant test kit and it would test negative. Some may have specimen validity testing built-in that would indicate an issue, but others may not. It is important that instant tests that screen positive be sent to the laboratory for confirmation testing otherwise, the employer may risk legal issues if taking actions on a result not confirmed by laboratory testing. It is also important to note that some states do not allow instant testing to be used for employment.
Hair Drug Testing
Hair testing generally results in a higher positivity rate than urine specimens which may be attributed to the fact that hair testing is significantly more difficult to cheat than urine testing. Hair has a much longer window of detection of up to 90 days with 1.5” of hair compared to 2-7 days for urine. Like urine testing, there are products available online that claim to beat drug tests, such as “detox” shampoos, but there is no evidence that these products actually work.
Unlike urine testing, hair testing is not legal in all states. In many instances, this is due to the state laws being written prior to hair testing being confirmed as an accurate and effective testing method. Hair testing is not authorized for Federally regulated testing such as for DOT testing programs, but many Trucking companies have added hair testing under company policy to be conducted in conjunction with DOT required testing. This as proven extremely effective in improving safety and reducing the number of employees that test positive for illegal or illicit drug use.
Oral Fluid/Saliva Drug Testing
Oral fluid testing is now gaining in popularity as it offers lab-based drug test results with a minimally-invasive collection process that is directly observed. Oral fluid, unlike hair testing, which may take over 7 days to appear in a hair sample, is a great choice for detecting recent drug use. By using oral fluid instead of urine or hair, employers can easily perform collections onsite at their location and can have donors can collect and cap their own oral fluid samples in the presence of a monitor or collector; this virtually eliminates the likelihood of tampering and may minimize the risk of a donor challenge to the collection or process.
Oral fluid testing does have a short detection window so it is best used for post-accident and reasonable suspicion situations but can also be used for the initial pre-employment drug screen. One challenge with Oral Fluid testing at this time is that many collection sites do not carry oral fluid collection devices or may not carry the on specific to the laboratory you use for testing. Unlike urine specimens, some states do not allow Oral fluid testing for employment and the collection device needed for oral fluid collection is specific to each laboratory that is conducting the testing.
Oral fluid testing was recently approved by SAMHSA for use with Federal testing but at the time of this article, it has not yet been authorized for DOT testing. Once that is authorized, then it is likely that it will become more standardized and more readily available at collection sites around the country.
Final Thoughts
To have the most effective program, employers should choose the right specimen type or combination of types to fit the goals of their organization and should make sure their drug free workplace policy reflects those choices. If changing or adding to your program, it is also important that employees are updated on these changes and how it will affect them. There are two other specimen types and you can read about those by clicking the link to each. Blood Drug Testing and Fingernail Drug Testing.
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About Tom Fulmer
Tom Fulmer, CPCT, is the Vice President of Business Development for National Drug Screening, a nationwide leader in employer drug testing and top provider of drug testing, training, & TPA/Consortium software. Tom writes articles for National publications and presents at conferences. In 2017 and 2018, he won HR.com “Best Customer Service Leadership Training Program” awards and in 2018, he also won a top 10 award for “Best Sales Leadership Training Program”. Tom also conducts training for collectors, employers, and sales and customer service teams.
