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Comparing the Key Qualities of Urine, Oral Fluid and Hair Drug Testing Methods

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This information is provided for educational purposes only. Reader retains full responsibility for the use of the information contained herein.

Employers have a myriad of viable options available when choosing a drug testing method ... In fact, in many instances, the combination of different methods enhances a company’s opportunity to achieve its drug testing objectives.

Drug testing works! It has proven to be a powerful deterrent to illicit drug use and an effective means of identifying people who need help. Today, employers have a myriad of viable options available when choosing a drug testing method to best meet their needs. In fact, in many instances, the combination of different methods enhances a company’s opportunity to achieve its drug testing objectives.

Following is a brief overview of the key qualities of the three major drug testing methods: urine, oral fluid and hair:

Urine Testing—The most common drug testing method; best at detecting lifestyle drug use.

  • Flexibility—Urine testing can be conducted via laboratory analysis or point-of-care (POCT)/ instant-result devices.
  • Legality—Lab-based urine testing is legal in all 50 states and permitted as part of all federally mandated drug testing regulations, including the U.S. Department of Transportation (DOT). The use of POCT devices is permitted in most states, though restrictions may apply.
  • Accuracy—When conducted via a certified lab and utilizing standard testing procedures established by the federal government, urine testing is considered scientifically accurate and results have been proven legally defensible from an accuracy perspective.1
  • Ease of Use—Collections are often conducted by professional technicians who typically follow strict standard procedures established by the federal government, which ensures consistency and integrity in the testing process.2 Instant-result testing can be administered by professional technicians or employees who have been trained to follow the same collection procedures that apply to lab-based testing.
  • Window of Detection—Many factors affect detection times, but most drugs are detectable in urine samples for 2-3 days at the cut-off levels commonly utilized for workplace testing (1-4 days for cannabinoids).3 However, because urine is used to detect drug metabolites rather than the parent drug, it is usually several hours before a drug can be detected in a urine specimen.

Drug

Detection Window

Benzodiazepines

Ultra-short acting

Short acting

Intermediate acting

Long acting

 

Up to 12 hours

Up to 1 day

Up to 2-4 days

Up to 7 days

Barbiturates

Shorter acting

Long acting

 

Up to 1-2 days

Up to 7 days

Methadone

Up to 1-2 days

Amphetamines

Up to 1-3 days

Methamphetamines

Up to 1-3 days

Buprenorphine/Subutex Analgesic

Therapeutic dose

Maintenance dose

 

Up to 1-3 days

Up to 10-12 days

Cannabinoids (THC)

Up to 1-4 days

Cocaine

Up to 2-3 days

Opiates

Up to 2-3 days

Ketamine

Up to 3-5 days

Tramadol

Up to 3-5 days

  • Adulteration—Drug test cheating efforts typically fall into one of three categories: dilution, substitution, and adulteration. Urine samples are susceptible to all three methods. A quick trip to the internet will yield literally hundreds of websites offering free advice or expensive products designed to help drug users beat a urine drug test.

Oral Fluid Testing—Best at detecting recent drug use.

  • Flexibility—Oral fluid testing can be conducted via laboratory analysis or point-of-care (POCT)/ instant-result devices.
  • Legality—Lab-based testing is legal in 47 states (Maine, Vermont and Hawaii being the exceptions) but not currently permitted as part of DOT drug testing regulations. The use of POCT or instant-result devices is permitted in many states, though restrictions typically apply and some states with voluntary drug testing laws (e.g., Tennessee, among others) or industry-specific laws (e.g., Illinois’ public works contractor law, among others) usually require lab-based urine testing.
  • Accuracy—The federal government stated the following regarding lab-based oral fluid testing:

“The scientific basis for the use of oral fluid as an alternative specimen for drug testing has now been broadly established… the OFMG  provide the same scientific and forensic supportability of drug test results as the Urine Mandatory Guidelines for Federal Workplace Drug Testing Programs.”

  • Ease of Use—Oral fluid collections are easy to administer and eliminate many of the steps required as part of a urine collection. Employees can be trained to conduct collections, which reduces costs by eliminating the use of professional technicians and time away from work incurred when donors and managers are sent to off-site collection facilities.2
  • Window of Detection—Most drugs such as marijuana and cocaine are detectable in oral fluid samples for up to 24 hours, though it may take up to 1-2 days for certain drugs.3 The parent drug is detectable in oral fluid samples making it possible to detect drugs almost immediately after usage.

Drug

Detection Window

Cocaine

Up to 24 hours

Benzodiazepines

Up to 24 hours

Cannabinoids (THC)

Up to 24 hours

Methamphetamines

Up to 24 hours

Opiates

Morphine

Codeine

Up to 1-2 days

Up to 24 hours

Up to 1-2 days

Amphetamine

Up to 1-2 days

Buprenorphine

Up to 1-2 days

Ketamine

Up to 1-2 days

Methadone

Up to 1-2 days

  • Adulteration—Typical drug test cheating methods such as adulteration or substitution have not proven to work with oral fluid testing.

Hair Testing—Best at detecting historic drug use.

  • Flexibility—Hair testing is only available as a lab-based test.
  • Legality—Hair testing is permitted in many states though most state drug testing laws do not mention it specifically. It is not permitted under the DOT regulations. Most state voluntary or industry-specific laws only permit lab-based urine testing.
  • Accuracy—The science behind hair testing has proven to be accurate at detecting most drugs at cut-off levels equivalent to urine and oral fluid testing.
  • Ease of Use—Collecting hair samples is a more complex process compared to urine and oral fluid. A specific amount of hair at specified lengths must be collected to provide a viable sample. People without head hair must provide samples from other parts of the body.
  • Window of Detection—By some accounts, most drugs are detectable in hair samples for approximately 90 days depending on several factors. However, there is a lag time of up to 14 days after usage before most drugs can be detected in a hair sample.1
  • Adulteration—It is much more difficult to adulterate a hair sample compared to urine, though there are products available that claim to mask the presence of drugs in a donor’s hair.

Conclusion

At a time when drug abuse, especially marijuana use, is going up and more workplace drug tests are coming back positive, drug testing has never been more important. It helps to deter drug use and identify those who need help. Lab-based urine, oral fluid or hair testing or single-use, instant-result devices with urine or oral fluid represent viable options that can help a company make a good-faith effort ensure their places of business are free of the negative impact of workplace drug abuse.

Editor’s Notes:

Explanation of acronyms used in this document.

POCT—stands for “point-of-collection” or “point-of-care” testing. POCT typically involves the use of a single-use, disposable device that yields a rapid qualitative (yes or no) result at the site of the test or collection. Both urine and oral fluid POCT devices are commonly available.

OFMG—stands for “oral fluid mandatory guidelines.” The OFMG are drug testing guidelines issued by the Substance Abuse and Mental Health Services Administration (SAMHSA) for federal workplace drug testing programs. It is anticipated that the U.S. Department of Transportation will eventually permit lab-based oral fluid drug testing by DOT-covered employers by adopting the OFMG.

DOT—stands for U.S. Department of Transportation.

References

  1. The Department of Health and Human Services (2019, October 25) Mandatory Guidelines for Federal Workplace Drug Testing Programs – Oral/Fluid. Retrieved February 28, 2020 from https://www.federalregister.gov/documents/2019/10/25/2019-22684/mandatory-guidelines-for-federal-workplace-drug-testing-programs-oralfluid. (while this is the announcement for the new guidelines for lab-based oral fluid testing, it refers to the accuracy of lab-based urine testing).
  2. “Urine Collectors.” U.S. Department of Transportation, 29 Jan. 2020, https://www.transportation.gov/odapc/collectors.
  3. “Windows of Detection.” Abbott, https://www.aleretoxicology.co.uk/en/home/support/testing-explained/windows-of-detection.html.
  4. The Department of Health and Human Services (2019, October 25) Mandatory Guidelines for Federal Workplace Drug Testing Programs – Oral/Fluid. Retrieved February 28, 2020 from https://www.federalregister.gov/documents/2019/10/25/2019-22684/mandatory-guidelines-for-federal-workplace-drug-testing-programs-oralfluid.
  5. Ibid.
  6. “Windows of Detection.” Abbott, https://www.aleretoxicology.co.uk/en/home/support/testing-explained/windows-of-detection.html.
  7. “Windows of Detection.” Abbott, https://www.aleretoxicology.co.uk/en/home/support/testing-explained/windows-of-detection.html.

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