A new rule established by the Department of Health and Human Services (DHHS) is calling for the inclusion of oral fluid testing in the Mandatory Guidelines for Federal Workplace Drug Testing Programs, including the US Department of Transportation (DOT).

The new rule published in the Federal Register on October 25, 2019 states, “Some agencies, such as the Department of Transportation, are required to follow the guidelines in developing drug-testing programs for their regulated industries,” 

This change, going into effect on January 1, 2020, will require the DOT to determine what circumstances to use oral fluid testing methods to test truck drivers and other DOT employees.

Urine testing has been considered the gold standard for workplace testing, criminal justice, and pain management within the USA since 1988, along with blood, hair, and sweat. However, over the years, the benefits of oral fluid testing have become more well-known and accepted.

Some of the benefits of oral fluid testing include the following:

1. Saves time

2. Always observed

3. Simple to administer compared to urine

4. Can demonstrate recent use of a substance

5. No requirement for a washroom

6. Fewer privacy concerns compared with urine collection

7. No need for same gender collectors for observed testing

Under the Substance Abuse and Mental Health Services Administration (SAMHSA) guidelines, two oral fluid samples must be collected to allow for split specimen testing similar to urine collection. No DNA testing will be allowed on any oral fluid specimens.

Effective January 1, 2020, laboratories can begin the application process for oral fluid certification. All interested labs will need to be SAMHSA approved to start testing oral fluid. There is an expected timeline of 18 months for labs to get certified and approved.

This chart references the screening and cut-off levels for oral fluid testing listed in the DHHS’s Mandatory Guidelines for Federal Workplace Drug Testing Programs – Oral/Fluid. The levels differ from those being used by Canadian companies conducting non-DOT oral fluid testing.  

As you can see from this chart above, the confirmation cut-off levels in the Mandatory Guidelines for Federal Workplace Drug Testing Programs – Oral/Fluid are much lower for some of the substances being tested for in comparison to what many Canadian companies are using now. The lower the cut-off level, the longer the timeframe of detection is. In other words, with a lower confirmation cut-off level, a person will test positive for a longer period of time after the use of that substance, in comparison to the higher cut-off levels being used now. The reason for the lower cut-off levels is due to the desire to detect any use of these substances.  With the use of any of these substances, whether prescribed, used illicitly or authorized by a physician, there is a known increase in risk in the workplace. Being able to detect if an individual has used any of these substances allows the employer to determine if that employee is at a higher risk of safety concerns. 

With the lower cut-off levels in the Mandatory Guidelines for Federal Workplace Drug Testing Programs – Oral/Fluid, the timeframe of detection is similar to urine testing with the exception of THC.

For THC, with a cut-off level of 2 ng/mL, the timeframe of detection is approximately 24 hours. This differs greatly from urine, when a positive test may indicate use days to weeks prior.

There are a number of steps that need to be taken before the laboratory is able to test at these new oral fluid cut-off levels. However, once there is inclusion of oral fluid testing in the Mandatory Guidelines for Federal Workplace Drug Testing Programs, the laboratories will have the ability to test at these levels. Non-DOT clients using oral fluid testing will then have more options with respect to cut-off levels being used for testing.

The DOT is expected to have its rulemaking ready for implementation to coincide with lab certification, which is estimated to be 18 months away. In the future, the DOT estimates about 25% of all DOT tests will eventually be done via Oral Fluid.

Related Services:

Oral Fluid Drug Testing

Articles of Interest:

Webinar Recording – Exploring Oral Fluid Testing in Transportation and Other Safety-Sensitive Industries

Oral Fluid Testing: What You Should Know

Oral Fluid Drug Testing FAQs

DOT Authorizes Employers to use Oral Fluid Drug Testing