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Oral Fluid Drug Testing

Oral Fluid Drug Testing

Oral fluid drug testing measures drug levels in a donor’s saliva. It detects drug use in the past 12-24 hours (dependent on the drug ingested) and does not test for historical usage.

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Oral fluid drug testing measures drug levels in a donor’s saliva. This form of testing continues to grow in popularity and acceptance because:

  1. It is easily collected and can be conducted anywhere.
  2. It is nearly impossible to adulterate and minimally invasive.
  3. It provides the closest link to impairment on the job because of the drug detection timelines.

Testing for Current Impairment

An oral fluid drug test detects drug use in the past 12-24 hours (dependent on the drug ingested) and does not test for historical usage.

By implementing oral fluid drug testing, companies eliminate the impairment argument commonly found with urine testing and THC – that the drug could have been ingested on the individual’s own time.

If an oral fluid drug test comes back positive from the lab, employers are armed with a strong indicator that the donor recently ingested the drug and was impaired on the job.

Oral Fluid Limitations

Oral fluid testing continues to evolve and is rapidly finding a place in the occupational testing arena. However, the tests currently have the following limitations:

  • No reliable express method or point of collection testing exists
  • Slower turnaround time on lab results
  • No historical view of the donor’s drug use (because of the limited 12-24 hour detection window)

SureHire has the expertise to recommend how oral fluid testing will best fit with your drug and alcohol testing program.

Express & Lab-Based Testing

  • Express (point of collection) testing
  • Lab-based testing (6 and 10 panel lab options)

Express Oral Fluid Testing

Express/point of collection testing will instantly identify if the following drugs have been ingested by the donor:

  • Amphetamines
  • Methamphetamines
  • THC
  • Cocaine
  • Opiates
  • PCP

The results of express oral fluid drug testing are instant, qualitative, and presented as a pass or fail.

With express testing, the level of the drug in the donor’s system is not determined.

It is important to note that express oral fluid drug testing has limitations. The technology lacks the reliability and validity of testing done in the lab.

Lab-Based Oral Fluid Drug Testing

Lab-based oral fluid testing can be completed solely or in addition to express testing and will identify the presence of the following drugs:

  • THC
  • PCP
  • Cocaine
  • Opiates
  • Amphetamines
  • Methadone
  • Propoxyphene
  • Benzodiazepines
  • Barbiturates
  • Methamphetamines

With lab-based testing, the oral fluid sample is sent to a SAMHSA-certified lab to be tested with standardized equipment that provides a legally defensible quantitative result. This will identify the drug level in the body and the final result can be reviewed by a Medical Review Officer (MRO).

Negative lab results are available in 24 hours, while confirmed positive results take 72-96 hours to process.

You will first be required to present some form of government-issued photo identification when you come in for your appointment.

If you are coming in for a private appointment, payment must be made prior to testing. Forms of payment accepted include debit card or credit card.

Once your ID is verified, you will receive paperwork to fill out. This paperwork includes an authorization allowing SureHire to perform the test and provide the results to your employer/potential employer. If you are coming in for a private test, the form will have a spot where you can indicate where you would like the results to be sent. You will also have a short form to fill out indicating your contact information and any prescription or over-the-counter drugs that you are currently using.

Once your paperwork is submitted, you must not leave the testing facility until testing is complete. If you choose to leave the testing facility, it will be indicated as a refusal to test and considered a fail.

How to Prepare

  • Bring your government-issued photo ID (driver’s license, passport, military ID, etc.)
  • Abstain from using illegal drugs
  • If you are taking a prescription medication, know the name of the medication you are taking. You may also bring a list of medications that you may be taking to note on your paperwork.

Testing Expectations

  1. You must spit out any gum or tobacco that you have in your mouth so that it does not affect the quality of testing.
  2. You will then be required to provide a sample of your saliva into an oral fluid collection device.
  3. Once you have provided a sample, the tester will ensure it meets our collection criteria. If the sample is acceptable, one of two things may happen:
    - If you are booked in for an express oral fluid test, the tester will wait for the given amount of time specific to the collection device and then read the device to determine if drugs are present in your sample.
    - If you are booked in for a lab-based oral fluid test, the tester will fill out a Chain of Custody, and package the sample to go to the laboratory. Lab results typically take 2-5 business days.
  4. If your lab based drug screen is positive, or if your express drug screen is confirmed positive at the lab, you will be contacted by a Medical Review Officer (MRO). The MRO will contact you with the information you put down on your intake form. Ensure that this information is correct. It is the responsibility of the MRO to determine whether the positive drug screen was due to legitimate prescription drug use or if it is due to illegal drug use or prescription drug misuse.

Schedule of Acceptable Identification

OPTION 1 – ACCEPTABLE GOVERNMENT ISSUED PHOTO ID (1 PIECE) (EXPIRED ID IS NOT ACCEPTABLE)

  • Valid permanent driver’s license issued in Canada or the United States of America, as permitted to be used for identification purposes under provincial law.
  • Valid passport issued by the Government of residing country.
  • Certificate of Indian Status issued by the Government of Canada.
  • A document or card, bearing the individual’s photograph and signature, issued by any of the following authorities:
    -Insurance Corporation of British Columbia
    -Alberta Registries
    -Saskatchewan Government Insurance
    -Department of Service Nova Scotia, Department of Transportation, Province of Prince Edward Island
    -Service New Brunswick, Department of Government Service, Province of Newfoundland and Labrador
    -Department of Transportation of the Northwest Territories, Department of Community Government and Transportation of the Territory of Nunavut
  • Firearms License or Military ID
  • Homeless Aid Centre photo identification
  • Correctional Centre photo identification

OPTION 2 – 2 PIECES OF NON-PHOTO ID AND 1 PIECE OF NON-GOVERNMENT PHOTO ID

  • ACCEPTABLE NON-PHOTO ID (2 PIECES)
    -Employee photo identity card, issued by an employer that is well known in the community.
    -Certificate of Canadian Citizenship or a Certification of Naturalization, in the form of a paper document or card, but not a commemorative issue.
    -A provincial health insurance card, as permitted to be used for identification purposes under provincial law1.
    -Social Insurance Number card issued by the Government of Canada.
    -Birth Certificate issued in Canada.
    -Interim Driver’s License.
  • ACCEPTABLE NON-GOVERNEMENT PHOTO ID (1 PIECE) (MUST CONTAIN FIRST & LAST NAME AND PHOTO)
    -Employee ID Card – from a reputable company within the community
    -Student ID Card – from a reputable educational institution within the community
    -Gym Membership
    -Costco ID Card

OPTION 3 – MANAGEMENT ID

  • If no ID is available, the tester will call your employer and speak to their DER. If the manager gives the tester a satisfactory physical description of the donor or confirmation of personal information, the testing can proceed.
  • Management ID: 3 contact attempts within 30 minutes. If the tester cannot obtain management ID, online bookings will be advised that the client does not have sufficient ID to continue with testing. You will need to contact your company to re-book the appointment.

OPTION 4 – OPTION FOR OCCUPATIONAL & NON-OCCUPATIONAL

  • If no ID is available, the client must get a notarized letter with a photo attached to the actual letter. Any lawyer, doctor, pastor or other notary can provide this.

Oral Fluid Cut Off Levels (Lab-Based Testing – Quantisal)

Analyte Cut-off ng/mL Tecan ELISA Cut-off ng/mL LC/MS/MS
Amphetamine 50 50
Methamphetamine 50 50
MDA n/a 50
MDMA n/a 50
MDEA n/a 50
Cocaine metabolite 20 8
Cocaine Parent n/a 8
Opiates 40 see the following opiates
6AM n/a 4
Morphine n/a 40
Codeine n/a 40
Hydrocodone n/a 40
Hydromorphone n/a 40
Oxycodone 10 40
Phencyclidine (PCP) 10 4
Marijuana Metabolite 4 or 10 2 or 10
Marijuana Parent n/a 2 or 10
Barbiturates 50 50
Benzodiazepines 10 10
Methadone 50 20
Methadone Metabolite n/a 20
Propoxyphene 20 10
Ethanol 20 mg/dL 20 mg/dL

Oral Fluid Cut Off Levels (Point of Collection)

Analyte Initial Testing ng/mL
Amphetamine 50
Methamphetamine 50
Cocaine Metabolite 20
Opiates 40
Oxycodone n/a
Marijuana Metabolite 4
Phencyclidine (PCP) 10
Barbiturates 10
Benzodiazepines n/a
Methadone 60
MDMA 50
Propoxyphene n/a

Testimonials & Case Studies

This industrial construction company implemented pre-hire Fitness-to-Work testing with SureHire in April 2012. From April 2012 to December 2015, *4322* candidates were tested.

Read the full case study

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