Oral Fluid Drug Testing for DOT Employers

  • The DOT has approved oral fluid drug testing for all DOT employers.
  • It's highly accurate, quick, and non-invasive.
  • US Drug Test Centers will assist new and existing clients with setting up accounts for oral fluid testing.

The United States Department of Transportation (DOT) has approved oral fluid drug testing for DOT-regulated employers. Oral fluid testing will not begin until two laboratories are certified by the United States Department of Health and Human Services (HHS). This is not expected until late 2023 or early 2024.

The new oral fluid testing rules will affect all DOT agency drug and alcohol testing programs, including:

DOT Oral Fluid Drug Testing Updates
DOT Oral Fluid Drug Testing Updates
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DOT Oral Fluid Testing - What Employers Need to Know
DOT Oral Fluid Testing - What Employers Need to Know
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Preparing for DOT Department of Transportation Oral Fluid Testing
Preparing for DOT Department of Transportation Oral Fluid Testing
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DOT Oral Fluid Durg testing - What Employers Need to Know
Important Information Regarding DOT Oral Fluid Testing

The United States Coast Guard (USCG) will also adopt the new DOT rules for oral fluid drug testing.

Why Oral Fluid Drug Testing?

  • Cheating on oral fluid drug testing is difficult.
  • Oral fluid drug testing can eliminate the three-hour wait when there is a shy bladder in a urine collection.
  • All oral fluid drug tests are observed collections and do not have the stigma of a urine collection under direct observation.
  • Oral fluid drug testing has a shorter window of detection than urine drug testing, so it’s beneficial for reasonable suspicion testing and post-accident testing.
  • Oral fluid drug testing eliminates the urine direct observation dilemma when there is not a same-gender person to do the observation.

Oral fluid testing has existed for many years for non-DOT drug testing programs. It is an accurate method of testing for drugs and, in fact, typically picks up more positive results. The main difference between urine and oral testing is the detection time. For urine testing, it’s usually six to eight hours after drug use, and for oral fluid testing, it’s almost immediate, especially for marijuana.

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Urine or Oral Fluid – Who Decides?

Urine drug testing is not going away in the DOT drug testing program. Oral fluid is an alternative specimen that can be used as authorized by the employer. Only the employer can authorize the use of either urine or oral fluid or switch to the other when there might be a problem collection such as:

  • A temperature that’s out of range.
  • A shy bladder with up to a three-hour wait time.
  • A specimen that appears to have been tampered with.
  • Dry mouth.

Applicants and employees cannot choose for themselves between urine and oral fluid testing. Collectors cannot make the decision to perform urine or oral fluid testing. The choice as the regulation stipulates is always an employer decision.

There is one situation where oral fluid will be required. Oral fluid testing must be available for directly observed collections for transgender and nonbinary individuals.

Employers are encouraged to have standing orders so that the collectors know what specimen they need to collect for regular collections and for direct observation, shy bladder, and dry mouth collections. The standing orders should include information on when to switch from urine to oral fluid or oral fluid to urine.

US Drug Test Centers – A Leader in Oral Fluid Testing

US Drug Test Centers is an industry leader in DOT drug testing, and this will now include oral fluid drug testing. Our new and existing clients will have full services available with urine drug testing, oral fluid drug testing, and/or a combination of urine and oral.

US Drug Test Centers will assist new and existing clients with setting up accounts for oral fluid testing. Assistance will be provided for employers to develop standing orders from the employer so that collectors know what specimen they need to collect for regular collections and for dry mouth, direct observation, and shy bladder situations. This will provide maximum efficiency for DOT drug and alcohol testing programs.

Contact Us for more information on oral fluid testing.

More on DOT Testing & Services from US Drug Test Centers:

FAQs for DOT Oral Fluid Drug Testing

Learn more on our US Drug Test Centers web page: DOT Approves Oral Fluid Drug Testing

To whom does the new DOT oral fluid testing rule apply to?
The new rule applies to safety-sensitive employees in the transportation industry. This includes all agencies covered by DOT regulations, including the Federal Aviation Administration (FAA), the Federal Motor Carrier Safety Administration (FMCSA), the Federal Railroad Administration (FRA) and the Federal Transit Administration (FTA). The rule will also affect specimen collectors, laboratories and medical review officer’s. This is a Federal program so no State drug testing laws will affect this program.
When can I start doing DOT oral fluid drug testing?
This final rule is effective on June 1, 2023. However, oral fluid collections will not be available for DOT-regulated employers until such a time as the Department of Health and Human Services (DHHS) approves two laboratories for oral fluid. Also, an oral fluid specimen collection device must become available and be FDA approved. It is estimated that none of this will happen until first quarter or 2024 or later.
Why did DOT implement this new rule for DOT oral fluid testing?
Oral fluid testing was implemented as an alternative to urine drug testing providing options for employers to use oral fluid and/or urine specimens. Additionally, DOT was required to harmonize with pertinent sections of the HHS/SAMHSA oral fluid Mandatory Guidelines. Some specific reasons to add oral fluid are:
  1. a) Easy collection, not gender specific and always direct observed
  2. b) An oral fluid collection can eliminate the uncomfortable urine direct observation procedures
  3. c) No bathroom requirements, Oral fluid collections can occur in a variety of locations and eliminate many collection issues found with urine.
  4. d) Some employers may elect to train employees to perform in house oral fluid collections
  5. e) Oral fluid drug testing provides for a recent window of drug use detection which may be particularly useful for post-accident and reasonable suspicion testing.
Who decides whether to use oral fluid, urine or a combination of both?
Collection sites, applicants and employees cannot choose which specimen to be used. Only the employer can authorize the use of either urine or oral fluid or switch to the other when there might be a problem collection such as:
  1. a) A temperature that’s out of range
  2. b) A shy bladder with up to a three-hour wait time
  3. c) A specimen that appears to have been tampered with
  4. d) Dry mouth
What is the oral fluid testing window for drug detection?
As with urine, detection times vary and is not an exact science. Oral fluid drug testing will for sure have more recent use detection. A drug may be detected in oral fluid in less than one hour and remain detectable for five up to 48 hours after last use.
Can oral fluid testing be used for any reason of testing (i.e., pre-employment, random, post-accident, reasonable suspicion, etc.) or only for certain reasons?
DOT oral fluid drug testing can be used for any of the DOT reasons for testing which include:
  1. a) Pre-employment
  2. b) Post-accident - makes sense because of the recent use detection
  3. c) Random
  4. d) Return-to-duty - makes sense to avoid the required direct observation
  5. e) Follow-up - makes sense to avoid the required direct observation
  6. f) Reasonable Suspicion/Cause - makes sense because of the recent use detection
How will collection sites be able to tell if an employee tries to "cheat" an oral fluid test?
Collectors will need to be trained to perform oral fluid collections and the training will include methods to observe potential cheating. Potential cheating techniques might be drinking excessive amounts of water, using products that claim to clean oral fluid, aggressively brushing their teeth, tongue, and cheeks, excessively rinsing with antiseptic mouthwash, chewing ice and or eating mints. DOT regulation 49 CFR Part 40 states:
  1. (a) The collector must be present and maintain visual contact with the employee during the procedures outlined in this section.
  2. (b) The collector must note any unusual behavior or appearance of the employee on the CCF. If the collector detects any conduct that clearly indicates an attempt to tamper with a specimen (e.g., an attempt to bring into the collection site an adulterant or oral fluid substitute), the collector must terminate the collection and report the information to the DER so that the employer can decide whether to deem the situation a refusal.

Additional steps for the oral fluid collection including a potential 10 minute period are outlined in DOT Rule 49 CFR Part 40 Section 40.72.

How will the FMCSA Clearinghouse be affected by oral fluid drug testing? Will these positive specimens or refusals to provide oral fluid specimens be reported to the Clearinghouse just like a positive or refused urine or BAT test? Will the Clearinghouse be creating a separate section to report these types of violations?
There is really no affect on Clearinghouse. All Clearinghouse requirements will remain to include reporting of violations including positive tests, refusals and actual knowledge. There would not be a Clearinghouse separate section to report violations.
I am a DOT regulated employer, how can I get ready to implement DOT oral fluid drug testing.
There are a few things you can do now to start to prepare for oral fluid drug testing.
  1. a) Get informed and make decision on when and where you will utilize oral fluid specimens and when and where you will continue to use urine specimens.
  2. b) Determine how you will collect oral fluid samples (on-site with trained employees and/or professional technicians or at off-site collection facility).
  3. c) Discuss these decisions with your drug testing third party administrator (TPA) and start the process of updating your policy and procedures to include oral fluid specimen collections and oral fluid drug testing.
  4. d) Stay informed with regular updated from US Drug Test Centers
Let’s say we were to start or own a collection site and wanted to use the oral fluid testing only. Could we do that or does there have to be the option for urine as well?
You would not have to have an option for urine, but you might lose business from employers who prefer to use urine specimens in certain situations. In addition, in a dry mouth situation, upon employer request you would not be able to switch over to a urine collection.
What are “Standing Orders?”
As employers make decisions on whether to use urine, oral fluid or a combination of both; the employer should communicate these decisions to the collection facilities they are utilizing. These decisions formulate what will be called “Standing Orders” to provide to the collection sites and C/TPA’s. If the employer has a standing order to allow oral fluid testing in such situations, the collector will follow that order. If the collection site is not aware of the standing order, they should be contacting the employee's Designated Employer Representative (DER) to determine which specimen to use. An example of a “Standing Order” could be:

Use oral fluid specimen collection:

  1. a) For any drug testing that requires direct observation
  2. b) Anytime a donor goes into a shy bladder process
  3. c) After a urine specimen shows temperature out of range or appears to have been adulterated or substituted
  4. d) Remote areas where finding a collection site is difficult (employer representatives can be trained to collect oral fluid specimens)
  5. e) All post-accident and reasonable suspicion drug testing


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