Oral Fluid Testing FAQs

Frequently Asked Questions: Oral Fluid Testing


1. What is Oral Fluid Drug Testing?
Oral fluid testing analyzes a saliva sample for parent drugs and their metabolites.  An absorbent collection device is placed in the mouth and the saliva collected is screened for drugs of abuse. Samples are checked to verify the saliva is human and undiluted. 
 
It is important to note that Omega’s oral fluid drug testing is a completely laboratory-based process.  While some instant oral fluid collection devices may be available, note that they are often not properly cleared and are not sensitive enough to detect usage of certain drug classes.  It is for these reasons that a laboratory-based process must be used in order to secure valid results.

2. What drugs can Omega test for with oral fluid?
Omega’s 6-Panel oral fluid drug test can detect marijuana, cocaine, opiates, amphetamine, methamphetamine (including Ecstasy), and PCP, which represent the most common drugs requested by employers for workplace drug testing. Additional drugs included in the 10-Panel test are oxycodone, barbiturates, methadone and benzodiazepines.  

3. What time period does oral fluid testing cover?
For most drugs, the window of detection in oral fluid is typically 24-48 hours.

4. How soon after use can a drug be detected in saliva?
Oral fluid testing can detect drugs in the saliva roughly 30-60 minutes after ingestion.  This short timeframe makes it an excellent test for post-accident and reasonable suspicion testing situations.

5. How does the detection time frame for oral fluid testing compare with other methods?

Like traditional urine testing, the window of detection in oral fluid testing is different for each drug. Of most significance is that oral fluid testing identifies recent usage that may be missed by urine testing. By contrast, urine testing relies on drug metabolites retained in the body's waste supply and will detect drugs for 24-72 hours.

6. How effective is oral fluid testing in detecting drug users?
A review of data from over 4.5 million oral fluid tests shows positive rates comparable to laboratory urine testing. 

7. Can oral fluid be affected by cross-reacting substances such as over-the-counter medications?
Enzyme-immunoassay antibodies (EIA), similar to those used to test urine, are used for the initial screening test for drugs of abuse in saliva. Therefore the potential for substances such as over-the-counter medications to cause a false positive screening result does exist. To eliminate this possibility, Omega confirms all positive results by LC/MS/MS.

8. What methodology do you employ?
Oral fluid samples are first screened in our laboratory using fully cleared enzyme immunoassay (EIA) technology, which has been proven reliable for routine drug testing. Any samples that test positive in the screening process are then subjected to liquid chromatography/mass spectrometry/mass spectrometry (LC/MS/MS). This tandem "MS", as it is called, provides the most sensitive fingerprint of the drug target available.

9. How does Omega Laboratories establish its cut-off levels?
Omega’s cutoff levels for our Confirmation methods are based on the Substance Abuse and Mental Health Services Administration’s (SAMHSA) proposed guidelines and on research performed by experts in the field.

10. What is the turnaround time?
Samples received by Omega Laboratories will report out within 1-3 business days. 

11. Is Omega Laboratories' internal chain-of-custody comparable to a urinalysis laboratory test procedure?
Omega's internal chain-of-custody is modeled after Federal guidelines (SAMHSA) as well as other accrediting agencies, such as the College of American Pathologists (CAP).

12. How long are excess oral fluid samples and test reports saved? 
Any oral fluid remaining from initial positive testing is retained for one year.  Test reports are retained for a period of two years or as mandated by law.

13. Can an oral fluid test be beaten?
A wide range of adulterants have been studied and none have been found that can beat our oral fluid drug test system. Of course, donors may attempt to introduce something onto the collection pad or into the collection vial. However, this risk is highly unlikely since every collection is directly and easily observed. Dilution tactics often employed to beat urine tests are not effective in oral fluid testing.

14. How is the data reported?
As with all Omega testing, results are reported to the designated party and Medical Review Officer, if appropriate.  This may be done via the Omega Extranet, fax or electronic data exchange of test results.

15. Who collects the sample?
The donor collects his or her own sample under the direct visual supervision of a trained collector.  The donor places the collection pad between his or her lower cheek and gum, saturates the absorbent collection pad, places it in a vial, then seals and initials the vial in preparation for transport.  The entire process takes approximately five minutes and is very difficult to challenge as the donor has performed the collection while under observation.

16. Is oral fluid a hazardous substance?
The Occupational Safety and Health Administration (OSHA) does not consider oral fluid specimens to be hazardous. In addition, oral fluid specimens are not subject to the same handling and disposal issues that face other bodily fluids.

17. What collection device does Omega Laboratories use? 
Omega Laboratories has partnered with OraSure Technologies, Inc. and uses the Intercept® collection device.   The Intercept device has been used to process over 15 million samples over the last 10+ years on the market.  This includes over 4.5 million workplace samples showing comparable positive rates to urine testing.  Additionally, the Intercept has been upheld in multiple court cases in criminal justice and family courts.

Intercept® is a registered trademark of OraSure Technologies, Inc.

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By using a combination of hair and oral fluid testing through Omega Laboratories, employers can create a safer workplace environment. Both offer several advantages over traditional, urine-based drug testing programs.  

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