TESTING
approximate annual number of regulated specimens for DOT and the NRC are 6 million and 200,000, respectively, according to the proposed guidelines. “Should DOT and NRC allow oral fluid testing in regulated industries’ workplace programs, the estimated annual numbers of specimens for DOT would be 180,000 oral fluid and 5,820,000 urine, and the numbers of specimens for NRC would be 14,000 oral fluid and 186,000 urine.” Te proposal also states: “Te transition
to the testing of oral fluids will be gradual and steady over the course of four years, when it should plateau. By this time, it is expected that oral fluid tests will account for 25–30 percent of all regulated drug testing.” Tis correlates to 1.7 million to 1.905 million specimens per year. Applying the same 25–30 percent projection to the overall market for drug testing in the United States of approximately 50 million
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annual tests, we could expect to see about 15 million lab-based oral fluid tests a year.
Proposed Guidelines Highlight Benefits of Oral Fluid Testing Various federal agencies and commitees have spent years researching lab-based oral fluid testing, both from a practical as well as a scientific standpoint. Could this testing method measure up to the high standards for accuracy and defensibility established decades ago for lab-based urine testing? What benefits could employers expect to realize by switching from urine to oral fluid testing? Of course, the issuing of the proposed
guidelines indicates that SAMHSA concluded that yes, lab-based oral fluid testing does meet the test. And while proponents of lab-based oral fluid testing have been singing its praises for years, for the first time there now exists a document in which the federal
government explains its benefits. So as not to unintentionally interject private opinion, following are directly and unaltered quotes from the proposed guidelines addressing key benefits of lab-based oral fluid testing from SAMHSA’s perspective:
Science—“… [T]he scientific basis for use of oral fluid as an alternative specimen for drug testing has been broadly established. Corresponding developments have proceeded in analytical technologies that provide the needed sensitivity and accuracy for testing oral fluid specimens.”
Accuracy Compared to Urine— “An earlier study of 77,218 oral fluid specimens reported similar trends in the positive prevalence rates compared to the DTI for urine specimens collected during the same period. In that study, the overall combined positivity rate for oral fluid was 5.06 percent compared to 4.46 percent
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