Department of Transportation Proposes to Amend Drug Testing Procedures to Include Oral Fluid Testing

On February 28, 2022, the U.S. Department of Transportation (DOT) published a proposed rule to amend the transportation industry drug testing program procedures to allow oral fluid testing as an alternate drug testing method to urine.

The notice stated that adding oral fluid as a drug testing method option for employers would “help combat employee cheating on urine drug tests and provide a more economical, less intrusive means of achieving the safety goals of the program.”

“This will give employers a choice that will help combat employee cheating on urine drug tests and provide a more economical, less intrusive means of achieving the safety goals of the program.”

The deadline for public comment was April 29, 2022. During the 60-day comment period, the DOT received over 450 comments with many trucking associations, employers, owner-operators, MROs, and Third-Party Administrators (TPAs) voicing their opinions. While the DOT has yet to make a final decision, comments indicate that the industry is generally in favor of adding oral fluid testing as an option.

How do Lab-Based Oral Fluid Tests Work?

  1. Under direct observation, the donor places the collection device into their mouth and directs saliva toward the collection pad.
  2. Once an adequate sample is provided, the device is removed from the donor’s mouth, put into a collection tube, sealed, and sent to the lab with a completed chain-of-custody form for analysis.
  3. The lab analyzes the sample, sends the results to the MRO for review, and a final result is released to the employer.

The collection process typically takes less than 5 minutes and result turnaround times average between 24 to 48 hours.

What are the Benefits of Oral Fluid Testing for Employers?

Oral Fluid Tests are “Observed” by Nature

Specimen adulteration and substitution continues to occur during urine drug tests as more products are available in the market to help donors cheat. The risk of a donor introducing a compound into an oral fluid collection tube is highly unlikely as every collection is directly and easily observed, unlike urine drug tests where samples are provided out of the collector’s sight.

No More “Shy Bladder” Procedures and Related Medical Examinations

Currently, when a donor is unable to provide a sufficient quantity of urine, per DOT regulation, they have up to three hours to provide a sufficient specimen. If after three hours they’re unable to provide a sufficient specimen, the donor must be medically evaluated to determine whether there is an adequate medical explanation. This process involves a lot of time—and money—for the collection site, employee, employer, and MRO. Oral fluid testing would eliminate the shy bladder process.

Increased Flexibility and Convenience

Oral fluid collections can be performed anywhere at any time. For example, if an employer determines a DOT post-accident or reasonable suspicion drug test is needed, an oral fluid collection could be conducted at the scene of the accident or incident. The collection procedures are simpler than urine drug tests and there are less collection site requirements (i.e., restrooms, bluing agent in toilets, secured water sources such as faucets). The reduced requirements and complexities of oral fluid testing makes self-collection easier, which allows employers to avoid the costs, time, and administrative burden of sending employees to collection sites for testing.

What is the Detection Window for Oral Fluid Drug Tests?

A graph showing the window of detection of various drug testing methods.
From E.J. Cone, Addiction Research Center, NIDA

Depending on the drug(s) used, dosage, and route of ingestion, substances may be detected in oral fluid less than one hour after usage, and will remain detectable for approximately 3 days. While this detection window is shorter than urine drug tests, oral fluid testing identifies recent drug use that can be missed by urine tests.


What are the Costs of Oral Fluid Testing?

Oral fluid tests performed at a collection site are typically similarly priced to urine drug tests; however, cost savings opportunities are mentioned in the DOT rule surrounding employers being able to perform collections more easily themselves, avoiding collection site fees and lost time on the job.

What’s Next?

The DOT is reviewing the feedback provided by the industry in the comments on the proposed rule and will consider the responses before updating the rule or making a final decision. TEAM will continue to monitor the progress and keep our clients up-to-date on solutions for maintaining a safe, drug-free workplace.