Drug Test Specimen Types: The Pros and Cons

Posted: March 20, 2018

drug test lab

Spoiler alert: there’s no clear-cut answer for the best drug test specimen type when performing employee drug tests. There are a wide range of common specimen types, including urine, hair, saliva and more. And, the one your organization should choose depends on a variety of factors, including your level of risk tolerance, the type of testing required, desired detection length, costs, compliance with federal regulations, and more. Each specimen offers strengths and weaknesses – so, you may want to choose to use multiple test specimen types to best fit your organization’s needs.

Urine Drug Testing

In the late 1980s and 1990s, private organizations began implementing drug-free workplace programs. At this time, urine was considered the best substance for drug testing because it was easy to move and collect, inexpensive to test, provided a fair detection window, was accurate and was difficult to subvert (at that time). However, over time, the drug testing industry began to notice that the number of positive drug tests were significantly increasing. Despite any issues that may occur, urine testing remains the most commonly used drug test specimen type today. Here are some quick facts about urine as a drug testing specimen: Pros:
  • Low-cost
  • Drugs can be detected anywhere from 24 hours up to several weeks.
  • Results are fairly quick, taking around 1-5 days with MRO review.
  • Works well for a variety of testing reasons, including: random, pre-employment, reasonable suspicion, post-accident, return-to duty and follow-up
  • Hundreds of different complex drug panel configurations
  • Most common drug test method and permitted for DOT testing
  • More easily manipulated than other specimens, through substitution, dilution and adulteration
  • Collection process is private and, therefore, not observed (unless requested)
  • Cannot measure the frequency of illicit drug use or severity of impairment
  • Biological hazard for specimen handling and shipping to lab

Saliva (Oral Fluid) Drug Testing

Oral fluid drug tests are collected by the donor, and are supervised, so tampering with this type of specimen is virtually impossible. This type of test is valuable for organizations with remote work locations, and with collection sites that are in rural areas. Also, the narrow, immediate detection window makes saliva (oral) a good test specimen for post-accident and reasonable suspicion testing. Pros:
  • Scientifically accurate
  • Difficult to cheat/tamper with
  • Detects recent drug use (up to 48 hours)
  • Oral QED devices can detect alcohol use
  • Samples can be self-collected easily in virtually any environment
  • Cannot measure frequency of use
  • Some illicit drugs can’t be detected beyond three days
  • Not currently approved for federal testing (in process)
  • Drugs and drug metabolites do not remain in oral fluids as long as they do in urine
  • Not as effective in detecting marijuana use

Hair Drug Testing

Because of its long detection window, hair testing is useful in settings in which drug testing is scheduled, such as return-to-duty or pre-employment screenings. Sometimes individuals with substance abuse issues try to avoid positive drug test results when they know one is coming by abstaining from drugs for a few days. This often works in oral fluid or urine drug tests, but it doesn’t have an impact on hair tests because users must refrain from drug use for 90 days in order to pass. Note, however, that the time tested depends on the length of hair in the sample. Hair grows about a half-inch each month, so a 1½-inch specimen would show a 3-month history. Pros:
  • Detection window up to 90 days
  • Able to detect long-term patterns of repetitive drug use
  • Higher rate of positive results than other specimens
  • Hard to cheat
  • Can measure chronic drug use
  • Greater stability (does not deteriorate)
  • Can take up to 5-10 days for results
  • Often doesn’t accurately detect sporadic drug use, including marijuana
  • Relatively high cost
  • Not approved for DOT federal testing
  • Challenging if the donor is missing head/body hair
  • Not appropriate for reasonable suspicion or post-accident testing
  • Panel customization limitations
  • Unable to detect recent drug use

Drug Screening Considerations

In conclusion, work with a certified drug testing company to evaluate the various testing specimens to determine which one(s) best meet your needs. Consider cost, whether testing takes place, and the length of the detection window. When evaluating a drug screening provider, look for one that has a deep expertise and experience in drug testing for your industry and unique needs. Look for a provider that is able to offer customized solutions, not a one-size-fits-all program. Also, ensure the provider offers a wide variety of drug screening specimen types and testing panels for different drugs. You can also learn about the various drug testing laws and specimen recommendations in each state with our drug testing compliance by state guidelines.