What you need to know about oral fluid drug testing

Oral fluid is a clear, tasteless liquid secreted by the salivary glands of the mouth. It moistens the mouth, keeps teeth strong, helps with chewing and swallowing, begins the process of digestion, and is essential to the sense of taste. While many people think of oral fluid and saliva being synonymous, they aren’t. For clarification, saliva is just one component of oral fluid; the drug testing completed by Quest Diagnostics is on “oral fluid.”

The origins of oral fluid testing come from alcohol detection and roadside testing; however, today it is a popular, non-invasive alternative to a urine or hair drug test. Its advantages include excellent detection of recent drug use and the flexibility of performing observed collections on-site. 

Saliva drug testing faq

Is an oral fluid drug test accurate?

Yes, laboratory-based oral fluid drug testing has proven to be both scientifically and legally sound. Sophisticated lab instrumentation makes it possible to accurately detect both the parent drug and/or its metabolite in oral fluid. Additionally, an oral fluid collection device manufacturer must provide independent, empirical data to support its accuracy claims and the information provided in the device’s package insert.

What drugs are tested using Oral-Eze®?

Our laboratory tests a variety of drugs in oral fluid including amphetamine, methamphetamines (including MDMA and its metabolite), cocaine (metabolite), marijuana (THC), opiates (codeine, morphine, hydrocodone, hydromorphone, 6-AM, oxycodones (oxycodone and oxymorphone), and phencyclidine (PCP). 

Is Oral-Eze effective at detecting marijuana?

Yes. The technology in oral fluid testing has proven effective in detecting recent drug use, especially for marijuana. Data from the Quest Diagnostics Drug Testing Index™ revealed that marijuana positivity increased nearly 75% in oral fluid drug tests in the general U.S. workforce from 2013 to 2016. The latest data reported marijuana positivity in oral fluid at 10.2%.

Download our white paper to examine marijuana detection using oral fluid.

What is the detection window for drugs in oral fluid?

While every drug and individual is different, oral fluid is widely regarded as the most reliable specimen type for detecting recent drug use. Oral fluid is able to detect most drugs starting soon after ingestion and extending for 24-48 hours after use.

How does the detection window for Oral-Eze oral fluid testing compare with urine testing?

Just like urine testing, the window of detection in oral fluid is different for each drug. Like urine drug testing, oral fluid testing detects recent drug use and may also identify very recent usage that may be missed by urine testing. For most drugs, the maximum window of detection in oral fluid is about 1 to 2 days. In contrast, urine testing detects drugs or their metabolites for a slightly longer period of time (1 to 3 days). Moreover, oral fluid testing may detect drug use 1 to 2 hours after ingestion/use while urine testing usually requires 2-6 hours to detect use after ingestion/use. Even with slightly different detection windows, the positive prevalence (“positivity”) rates for urine and oral fluid are quite similar. 

What drug testing situations are best suited to an oral fluid drug test?

Oral fluid testing is ideal for a broad range of testing situations ranging from pre-employment, to reasonable suspicion, to post-accident testing where the employer is interested in assessing drugs that are in an individual’s system at the time of collection.

Who collects an oral fluid drug test?

Oral-Eze drug test collections are typically conducted by the employer at the workplace. The “collector” is an observer and has a small role in the “chain of custody,” the process most often challenged by donors.

How is an oral fluid drug test collected?

During an observed collection, the donor guides the collection device into his or her mouth and directs saliva to the cotton pad. The sample adequacy window on the Oral-Eze wand will turn blue when an adequate amount of oral fluid has been collected. The wand is then removed from the donor’s mouth, the pad is ejected into the collection tube, and the cap is sealed tightly. In our time studies, 83% of donors provided an adequate oral fluid specimen in 5 minutes or less. However every donor is different.

The risk of an individual cheating or tampering with an oral fluid drug test is minimized because every collection is directly observed. A donor’s mouth must be empty – meaning no food, gum, liquids, or tobacco – for at least 10 minutes prior to the start of the drug test. Collectors monitor every step in the process to prevent someone from trying to introduce anything onto the cotton pad or into the drug test vial.

Can donors cheat an oral fluid drug test?

We perform specimen validity testing (a test for albumin) on every oral fluid specimen, giving employers the added assurance that the specimen is appropriate for testing. Albumin is an endogenous (naturally occurring) substance that is expected to be in all donors’ oral fluid. The test helps to ensure that the specimen is oral fluid and that there is a enough of the specimen to perform the testing. 

Quest Diagnostics tests oral fluid using Oral-Eze®, an FDA-listed collection and testing system developed by our own scientific experts in 2011. Like other drug test methodologies, oral fluid testing helps to screen job applicants and employees to promote a safe, drug-free workplace.

Read more FAQs about oral fluid testing.

Download the Oral-Eze whitepaper.

To learn more about oral fluid testing, visit our website or contact us online.