DOT Oral Fluid Testing: Final Ruling Issued by The DOT

The Department of Transportation (DOT) has published a final rule in the Federal Register (88 FR 27596) on May 2, 2023, amending the DOT-regulated industry drug testing program to include oral fluid testing. The final rule will be effective on June 1, 2023.

However, DOT oral fluid testing cannot be implemented until the Department of Health and Human Services (HHS) certifies at least two laboratories—one as a primary laboratory and a second as a split specimen laboratory.

Implications for Employers

Employers are responsible for choosing the collection methodology for the test reason and subsequent collections following a shy bladder, dry mouth, or other tests that require a directly observed collection. Employers should have business relationships with oral fluid collectors and labs and maintain a standing order with each collection site.

What is Oral Fluid Drug Testing?

Oral fluid drug testing is a non-invasive method of collecting a biological sample from an individual by swabbing their mouth to test for the presence of drugs or their metabolites. This method uses saliva or other oral fluids to screen for various substances, such as opioids, amphetamines, marijuana, and other drugs. Oral fluid drug testing is becoming increasingly popular due to its convenience, efficiency, and ability to reduce opportunities for tampering.

Easier Than Collecting Urine

Oral fluid drug testing is considered easier and more convenient than collecting urine samples for several reasons:

1. Non-invasive: Oral fluid collection is a less invasive and more comfortable process for the individual being tested, as it does not require them to provide a urine sample in a bathroom setting.

2. Collection process: Collecting oral fluid samples is quick and simple, usually involving using a swab or collection device placed in the individual's mouth for a short time. This eliminates the need for special bathroom facilities or privacy concerns associated with urine collection.

3. Reduced opportunity for tampering: Oral fluid testing reduces the likelihood of sample adulteration or substitution, as the collector can directly observe the collection process without infringing on the individual's privacy.

4. Faster results: Oral fluid tests can provide results faster than urine tests, as the sample does not need to be sent to a lab for analysis in many cases. This allows for faster decision-making and timely interventions when necessary.

Implications for Employees

Employees may be subject to either oral fluid or urine collection for any DOT-regulated test, such as pre-employment, random, reasonable suspicion/cause, post-accident (excluding FRA[1]), return-to-duty, or follow-up. Whether to conduct an oral fluid or a urine test is at the employer's discretion. Substance Abuse Professional (SAP) evaluations may be conducted remotely.

Implications for Collectors

Collectors should know the employer's preferences and standing orders for regular and problem collections. They must ensure that either they or a coworker is qualified to collect either specimen type by enrolling in a collector training program for DOT Oral Fluid drug testing. Sprciemen Colelction must obtain training in operating the particular oral fluid collection device they will be using and complete the correct line on Step 2 of the CCF – ORAL FLUID.

Implications for (C/TPAs)

C/TPAs administering a program for an employer must ensure agreements are in place for both oral fluid and urine collections and laboratory testing. Oral fluid testing must be available for directly observed collections for transgender and nonbinary individuals.

Implications for Medical Review Officers (MRO):

MROs are not required to undergo recertification training for oral fluid testing, but they are strongly suggested to seek supplemental information about it.

Implications for SAPs

SAPs may conduct in-person or remote evaluations, and the technology must meet specific criteria to protect confidentiality and ensure a quality evaluation.

For directly observed collections involving transgender or nonbinary individuals, an oral fluid collection must be conducted. The final rule can be viewed on ODAPC's website.

Why Drug-Free Workplaces Matter

Drug-free workplaces matter for various reasons, as they promote safety, productivity, employee well-being, legal compliance, and a positive work environment. Here's a closer look at why drug-free workplaces are essential:

1. Safety: A drug-free workplace is crucial for ensuring the safety of employees and the public. Employees under the influence of drugs may have impaired judgment, slower reaction times, and diminished coordination, increasing the risk of accidents and injuries. This is especially important in industries that involve safety-sensitive tasks, such as transportation, construction, or healthcare.

2. Productivity: Employees free from drug influence tend to be more focused, alert, and productive. A drug-free workplace helps maintain a workforce that can perform tasks efficiently, meet deadlines, and contribute to the overall success of the organization.

3. Employee health and well-being: A drug-free workplace supports employees' physical and mental well-being. Substance abuse can lead to health issues, lower job satisfaction, increased absenteeism, and higher healthcare costs. Employers can help prevent these problems by promoting a drug-free environment and contributing to a healthier workforce.

4. Legal compliance: Many organizations, particularly those that receive federal funding or contracts, are legally required to maintain a drug-free workplace. Employers must implement drug-testing policies and provide employee education and assistance programs to comply with these regulations. Failure to maintain a drug-free workplace can result in legal consequences, financial penalties, and potential loss of contracts or funding.

5. Positive work environment: A drug-free workplace fosters a positive work environment by promoting trust, professionalism, and a sense of responsibility among employees. This can enhance a company's reputation, attract and retain skilled employees, and contribute to a supportive and collaborative workplace culture.

Drug-free workplaces matter because they contribute to a safer, more productive, healthier work environment while ensuring legal compliance and maintaining a positive company reputation.

Why Collector Training Matters?

Specimen collector training is a critical aspect of the drug testing process, as it ensures the test results' accuracy, reliability, and legal defensibility. Here are several reasons why specimen collector training matters for drug testing:

1. Proper collection procedures: Trained specimen collectors are knowledgeable about the correct collection procedures for various testing methods, such as urine or oral fluid testing. Proper collection is essential to obtain accurate and reliable results, minimizing the risk of false positives or negatives.

2. Minimizing contamination and tampering: Specimen collector training helps ensure that collectors follow the proper protocols to prevent contamination, adulteration, or substitution of samples. By adhering to these protocols, collectors can reduce the possibility of tampering and ensure the integrity of the testing process.

3. Chain of custody: A trained collector understands the importance of maintaining the chain of custody for the samples. This involves accurately documenting each step of the collection, handling, and transportation process to ensure that the samples are not compromised at any point. The chain of custody is crucial for maintaining the legal defensibility of the test results.

4. Compliance with regulations: Specimen collector training ensures collectors know and comply with federal, state, and industry-specific drug testing regulations. Compliance is vital for avoiding legal issues, potential fines, or penalties associated with non-compliant testing procedures.

5. Handling difficult situations: Trained collectors are equipped to handle challenging situations, such as shy bladder or dry mouth, and confrontations with uncooperative individuals. Adequate training prepares collectors to manage these situations professionally and in accordance with established guidelines.

6. Protecting privacy and confidentiality: Specimen collector training emphasizes the importance of protecting the privacy and confidentiality of individuals being tested. Trained collectors are aware of the appropriate measures to take to safeguard personal information and ensure that the testing process is conducted with dignity and respect.

Specimen collector training is crucial for the drug testing process as it promotes accuracy, reliability, legal defensibility, and compliance with regulations. Proper training also ensures the protection of privacy and confidentiality, and equips collectors with the necessary skills to handle challenging situations professionally.

Final Thoughts

It is essential for affected entities, including employers and service agents, to review the final rule issued by the Department of Transportation (DOT) or other relevant regulatory bodies. This review will help ensure legal compliance with drug testing regulations and minimize the risk of penalties, fines, or other legal consequences. By understanding and adhering to the requirements set forth in the final rule, organizations can maintain a drug-free workplace that promotes safety, productivity, and employee well-being while protecting their reputation and financial interests.