Saliva (Oral Fluid) Drug Test: Definition, Key Points, Usages, Benefits, and Limitations

Saliva drug tests are a non-invasive and effective method for detecting drug use. A saliva test works by collecting oral fluid from the inside of the cheek or under the tongue, and then testing for metabolites of drugs in the saliva. In addiction treatment, saliva drug tests are beneficial for monitoring patients recovering from substance use disorders, as they offer quick results and the ability to detect recent drug use.

These tests also help prevent relapse by regularly screening individuals in recovery. 10% of employers implement saliva drug testing, according to a 2018 HireRight study. Under Executive Order 12564, all federal employees in roles involving law enforcement, national security, the protection of life and property, public health or safety, and other functions requiring a high degree of public trust are subject to mandatory drug testing.

The key points of saliva drug tests include their ability to detect fentanyl, synthetic drugs, and polysubstance abuse, making them fundamental for treatment programs and workplace testing. They are particularly effective in identifying recent drug use within 24 to 48 hours. The saliva drug tests serve as an alternative to urine drug tests, which have a longer detection window but require more privacy for sample collection. 97% accuracy is achievable when a saliva drug test is conducted properly, as examined by Krotulski et al. 2018 in “Field Detection of Drugs of Abuse in Oral Fluid Using the Alere™ DDS®2 Mobile Test System with Confirmation by Liquid Chromatography Tandem Mass Spectrometry (LC–MS/MS).”

The primary usages of saliva drug tests are uncovering drugs such as fentanyl, synthetic drugs, and illicit substances, as well as monitoring individuals for polysubstance abuse. Unlike urine drug tests, which have a longer detection window, saliva tests identify recent drug use within a shorter time frame, typically 24 to 48 hours. This makes them a steady tool for assessing immediate drug use and detecting any relapse episodes early.

The benefits of saliva drug tests are rapid results, allowing for immediate intervention in addiction treatment; non-invasive collection, eliminating the need for specialized facilities; higher compliance, since the test is supervised directly, minimizing tampering risks; effective detection of synthetic drugs, which are not always traceable through urine tests; and suitability for relapse preclusion, as frequent testing provides ongoing monitoring. The Drug & Alcohol Testing Industry Association states that drugs clear from oral fluids faster than urine, making saliva testing more effective for detecting recent drug use.

Saliva drug tests’ limitations comprise a shorter detection window, making them less efficacious for discovering long-term drug use; potential interference from medications or food, which affects accuracy; lower sensitivity for certain drugs, meaning some substances are not detected as reliably as with urine or blood tests; and variability in results, as hydration levels and saliva composition influence detection. Despite these drawbacks, saliva drug tests remain a valuable tool in addiction recovery owing to their convenience and real-time monitoring capabilities.

What Is a Saliva Drug Test?

A saliva drug test, also known as oral fluid testing or a mouth swab drug test, is a method used to detect the presence of substances such as drugs or alcohol in an individual’s system. This type of test analyzes a sample of saliva collected from the mouth, making it a non-invasive and convenient option for substance detection. The process involves swabbing the inside of the cheek or under the tongue to gather oral fluid, which is then tested for traces of specific substances. Saliva drug tests are favored for quick results and ease of administration, providing outcomes within minutes. They are used in workplaces, law enforcement, and other settings where brisk and optimized screening is necessary.

Adults generate over 1,000 milliliters of saliva daily, producing approximately 5 milliliters per minute while spitting and 0.05 milliliters per minute during sleep, as written by the American Correctional Association (2003).

How Does Oral Fluid Drug Test Work?

Saliva drug testing works by collecting oral fluid using a swab and analyzing it for chemical markers of drug use. The non-invasive process makes oral fluid testing a brisk, resourceful, and reliable procedure for detecting recent drug use.

The following is a step-by-step breakdown of the process:

1. Collection: A swab is placed inside the mouth, typically between the cheek and gums or under the tongue, to collect oral fluid. The swab absorbs saliva, which contains traces of substances if they have been recently used.
2. Sample Preparation: The collected sample is transferred to a testing device or container. In some cases, the swab is placed in a solution to extract the oral fluid for further analysis.
3. Initial Screening: The sample is first analyzed using rapid detection technologies like Enzyme-linked immunosorbent assay (ELISA). This mechanism identifies the presence of certain drugs or their metabolites by detecting antibodies that react to the chemical markers in the sample.
4. Confirmation Testing (if needed): If the initial screening indicates a positive result, the sample undergoes further analysis using advanced techniques like Gas chromatography-mass spectrometry (GC-MS). This tack separates and identifies individual compounds in the sample with elevated accuracy, confirming the presence of specific substances.
5. Result Generation: The testing device or laboratory generates results based on the analysis. Rapid tests provide results within minutes, while confirmation testing takes longer. Results are typically reported as positive or negative for specific substances.

What Substances Can Be Detected By a Saliva Drug Test?

A saliva drug test can detect substances like marijuana (THC), opioids such as heroin, morphine, oxycodone, and codeine, cocaine, amphetamines such as methamphetamine and ecstasy, benzodiazepines like Xanax or Valium, methadone, and fentanyl.  These substances are detectable in oral fluid attributable to their swift absorption into the bloodstream and subsequent secretion into saliva. 

Two reports have indicated the detection of methamphetamine in saliva (Kajutani et al., 1989; Suzuki et al., 1989. Suzuki et al. 1989 established methamphetamine in saliva samples from drug users up to two days after their last use. Out of 19 saliva samples collected, 3 showed detectable concentrations of methamphetamine, with the extracted amounts being 0.3 µg, 0.5 µg, and 2.1 µg. Amphetamine was not detected in any of the samples, as referenced in an Office of Justice Programs write-up (2004).

Common substances detectable by a saliva drug test are given below: 

• Marijuana (THC): Detects tetrahydrocannabinol (THC), the psychoactive component in cannabis. Saliva tests are fruitful for exploring recent use, within 24-48 hours after consumption, depending on usage frequency.
• Opioids: Identifies drugs like heroin, morphine, codeine, and synthetic opioids such as fentanyl. These substances are ascertained in the oral fluid within a few hours of use and up to 1-2 days, predicated on the specific opioid and dosage.
• Cocaine: Detects cocaine and its metabolites, such as benzoylecgonine. Saliva tests peg cocaine use within minutes of ingestion and for up to 1-2 days afterward.
• Amphetamines: Includes substances like methamphetamine and MDMA (ecstasy). These stimulants are recognized in saliva within a few hours of use and for up to 1-3 days, based on the drug and individual metabolism.
• Benzodiazepines: Identifies prescription medications such as Xanax (alprazolam) or Valium (diazepam). Saliva tests diagnose these drugs within a few hours of use and for up to 1-2 days on the premise of the specific medication and dosage.
• Alcohol: While less common in standard saliva tests, ethanol is found in oral fluid shortly after consumption. The detection window is short, ranging from a few hours to 12 hours on the basis of the amount consumed.
• Phencyclidine (PCP): Picks out the use of this hallucinogenic drug. PCP is worked out in saliva within a few hours of use and for up to 1-3 days, influenced by the dose and individual factors.

What Shows Up on a Saliva Drug Screen?

A positive or negative result shows up on a saliva drug screen on the grounds of the presence of the targeted substances. When using rapid testing devices, results are displayed through color-coded indicators, such as lines or symbols, on the test strip. For example, a visible line indicates a negative result, while the absence of a line signifies a positive display for a particular drug. Some tests also encompass a control line to ensure the test is functioning correctly. Confirmation tests, like GC-MS, offer more elaborate results, noting the exact substances and their concentrations. The simplicity and clarity of the outcomes make saliva drug screens an efficacious tool for quick substance detection.

What Is Saliva Drug Test Used For?

A saliva drug test is used for workplace testing, where employers screen employees, law enforcement settings, such as roadside checks or arrests, to speedily check impaired driving or recent substance use, and addiction treatment programs, aiding healthcare providers to monitor patients’ sobriety and track their recovery progress. These applications highlight the test’s versatility for promoting safety, accountability, and health across different sectors.

How Is Saliva Drug Test Used in Addiction Treatment?

In addiction treatment, saliva drug tests are utilized to monitor patients’ sobriety and ensure compliance with their treatment plans. These tests furnish a snappy and non-invasive way to detect recent drug use, assisting healthcare providers to note potential relapses early and intervene promptly. By regularly testing patients, treatment programs support relapse prevention, track progress, and adjust therapeutic approaches as needed. The ease of administration and zippy results make saliva drug tests useful for maintaining accountability and fostering long-term recovery. 

How Does Saliva Drug Testing Help Prevent Relapse?

A saliva drug test helps prevent relapse by granting early detection of drug use, allowing for timely intervention. Determining substance use early empowers healthcare providers or support networks to act promptly, tackling latent relapse triggers and reinforcing the recovery process.

Almost 50% of individuals with substance use disorders (SUDs) experience at least one relapse during recovery, spotlighting the major challenge of substance abuse recurrence. Research from the National Institute on Drug Abuse (NIDA) shows that relapse rates range from 40% to 75% within the first few months following treatment.

Are Saliva Drug Tests Effective in Identifying Polysubstance Abuse?

Yes, saliva drug tests are effective in identifying polysubstance abuse as they disclose multiple substances simultaneously. The effectiveness of these tests leans on several aspects, covering the type of test used, the substances being tested for, and the timing of the test relative to when the drugs were used. For instance, saliva tests unmask an amalgamation of substances like marijuana, opioids, and cocaine within a short window after use. 

A study assessed the accuracy of self-reported cannabis, cocaine, and amphetamine use compared to saliva drug tests (DrugWipe 5+) in emergency department patients in British Columbia, Canada. Among 1,190 participants (75.1% response rate), only 21.1% of those admitting cannabis use tested positive, while 2.1% of those denying use had a positive result. For cocaine and amphetamines, 50% and 57.1% tested positive among users, while 2.1% and 1.3% denied use but tested positive. Self-reports of cannabis and amphetamine use were more accurate than those for cocaine, as observed by Macdonald et al. 2015 in “Concordance of Self-Reported Drug Use and Saliva Drug Tests in a Sample of Emergency Department Patients.”

Can Saliva Tests Assess the Severity of Addiction?

No, saliva drug tests cannot assess the severity of addiction. These tests are designed to suss out the presence of specific substances in oral fluid, offering a snapshot of recent drug use. Conversely, the saliva drug tests do not measure the frequency, quantity, or long-term patterns of substance use, which are foundational in determining the severity of addiction.

Additionally, saliva tests have a limited detection window, laying bare drug use only within a few hours to a couple of days. To evaluate addiction severity, comprehensive assessments, consisting of clinical interviews, behavioral evaluations, and sometimes blood or hair testing, are necessary. While saliva drug tests are valuable for monitoring sobriety and compliance, they are not sufficient for diagnosing or gauging the depth of an addiction.

How Reliable Are Saliva Drug Tests for Designer or Synthetic Drug addictions like Fentanyl Addiction?

Saliva drug tests are limited in the reliability of detecting synthetic drugs, such as fentanyl, assignable to the complex nature of these substances. The detection of designer drugs is challenging because they are engineered to bypass conventional drug testing methods. While advancements in testing technology have ameliorated the recognition of synthetic substances, such as fentanyl addiction, saliva tests still struggle with certain variations in chemical composition. The reliability of these tests also is based on elements like the type of drug, its concentration in the body, and the timing of the test. Although newer testing methods have shown promise, the ability to reliably detect these drugs remains inconsistent.

Illicit drug abuse in the U.S. has reached epidemic levels, with opioid overdoses and synthetic designer drugs becoming increasingly prevalent. Detection remains challenging due to limited metabolic data, drug rebranding, and the lack of FDA-approved screening methods. While gas chromatography-mass spectrometry was the gold standard, liquid chromatography-tandem mass spectrometry now offers superior detection. This assay exposes fentanyl and its analogs, including acetyl fentanyl and butyryl fentanyl, with 100% cross-reactivity, bolstering clinical screening as analyzed by Liu et al. 2018 in “Newly Emerging Drugs of Abuse and Their Detection Methods: An ACLPS Critical Review.”

What Are the Key Benefits of Using Saliva Drug Tests in Outpatient Programs?

The key benefits of using saliva drug tests in outpatient programs include convenience, quick results, and their role in supporting outpatient monitoring. Saliva tests are non-invasive, making them easier and more comfortable for patients compared to other testing methods, such as urine tests. They expeditive fast results within minutes, which allows healthcare professionals to assess drug use promptly and intervene when necessary. This quick turnaround is especially beneficial for outpatient programs, where regular monitoring pushes for recovery progress and precludes relapse. Saliva drug tests deliver a flexible testing option that is easily integrated into routine appointments, making them a practical tool for ongoing patient monitoring.

What Are Key Considerations for Saliva Drug Testing?

Key considerations for saliva drug testing are timing, accuracy, and patient preparation. The timing of the test is vital, as drugs remain detectable in oral fluids for a shorter period relative to other biological samples, such as urine. Therefore, to ensure accurate results, testing must occur soon after suspected use. Accuracy is also influenced by the type of drugs being tested, as certain substances are more difficult to detect in saliva than others. Proper patient preparation avoids contamination and guarantees usable results; patients are instructed to refrain from eating, drinking, or smoking prior to testing. These factors collectively impose upon the proficiency and stability of saliva drug testing, especially in settings such as addiction treatment and workplace testing.

How Soon and How Long Can Saliva Drug Tests Detect Substances?

Saliva drug tests can detect substances within a few hours to several days. These detection windows are dependent on the substance, frequency of use, and the timeframe in which the test is conducted after consumption Below is a table outlining the detection windows for various substances:

Substance	Detection Window (Hours)
Marijuana	12-24 hrs
Opioids	24-48 hrs
Cocaine	24-36 hrs
Amphetamines	24-48 hrs
Benzodiazepines	12-24 hrs
Fentanyl	24-36 hrs
Synthetic Drugs	Varies

How Accurate and Reliable Are Saliva Drug Tests?

Saliva drug tests are 90-98% accurate. Factors affecting accuracy are sample handling, test quality, and environmental conditions. A study by Krotulski et al. 2018 found that saliva drug tests using the Alere™ DDS®2 Mobile Test System demonstrated an accuracy rate of over 97%. False positives ensue if the test mistakenly detects a substance that isn’t present due to cross-reactivity with other substances or medications. The timing of the test in relation to drug use is important because substances are not detectable after a certain period.

Can Prescription Medications Affect the Saliva Drug Test Results?

Yes. Prescription medications can affect saliva drug test results, eliciting false positives. Certain medications contain compounds that cross-react with the test’s detection markers, provoking the test to inaccurately express the detection of illicit substances. For example, medications like antihistamines, cold medications, antidepressants, and antipsychotics have been known to induce false positives in drug screenings. Additionally, drug interactions between prescription medications and substances being tested for causing these false readings. 

The presence of compounds like pseudoephedrine in cold medications or benzodiazepines in anti-anxiety prescriptions leads to erroneous results, which complicate interpretation and necessitate confirmation testing.

Biochemical laboratory tests (BLTs) influence 60–70% of medical decisions, thus being critical in diagnosis and treatment evaluation. Drug-laboratory test interactions (DLTIs) affect up to 43% of patients, sparking misinterpreted results, incorrect diagnoses, unnecessary tests, and inappropriate treatments. Recognizing DLTIs is vital to bar false clinical decisions. Healthcare professionals must collect medication histories, particularly for drugs used in the last 10 days before testing, as investigated by Katanić et al. 2023 in “Drug Interference with Biochemical Laboratory Tests.”

What Can Negatively Affect a Saliva Test?

Factors that negatively affect a saliva drug test are improper sample collection, contamination, consumption of certain foods or drinks, mouth hygiene, and medications. These components all interfere with the accuracy of the test, spawning unreliable results. Common factors that negatively affect a saliva drug test result are given below:

• Improper Sample Collection: If the sample is not collected correctly, such as by not swabbing the inside of the cheek or tongue thoroughly, the test does not yield proper results.
• Contamination: Exposure to foreign substances, such as touching the swab with dirty hands or allowing the swab to come into contact with surfaces that carry contaminants, alters test results.
• Certain Foods or Drinks: Consuming food or drinks before the test affects the pH level of the saliva, potentially interfering with the test’s ability to detect substances. For example, acidic foods like citrus fruits (lemons, oranges) or beverages like coffee and alcohol adjust the pH and render inaccurate readings.
• Mouth Hygiene: The presence of excessive saliva from chewing gum, smoking, or brushing teeth right before testing dilutes the sample or impedes the test, producing a false reading.
• Medications: Certain medications, specially those with high sugar content or strong chemical compounds, contribute to the saliva’s composition, whose ramifications are inaccurate test outputs.

How Is Saliva Drug Testing Different from Urine and Hair Testing?

Saliva drug testing is different from urine and hair testing in terms of detection window, invasiveness, and ease of collection. Saliva tests provide a short detection window, making them more suitable for getting a fix on recent drug use, whereas urine tests have a longer detection window, which allows for substantiating use up to a few days prior. Hair tests, on the other hand, have the longest detection window, allowing for the identification of drug use over an extended period, but they exact an invasive sample collection process. 

Urine drug testing is vital for patients in long-term medication-assisted treatment (≥6 months), providing valuable information for practitioners. The study concluded that 10% of specimens illustrated evidence of relapse through non-maintenance opioids, while nicotine, caffeine, marijuana, alcohol, and gabapentin were the most common substances. Oral fluid testing was contrasted with urine testing for 126 subjects, showcasing a 98% agreement rate. These results support the use of oral fluid as a well-founded alternative for compliance testing in medication-assisted treatment, as demonstrated by Miller et al. 2017 in “Urine Drug Testing Results and Paired Oral Fluid Comparison from Patients Enrolled in Long-Term Medication-Assisted Treatment in Tennessee.”

The table below outlines the key differences:

Criteria	Saliva Drug Test	Urine Drug Testing	Hair Drug Testing
Detection Window	Short (up to 24-48 hours)	Longer (up to 1-3 days for recent use)	Long (up to 90 days or more)
Invasiveness	Non-invasive	Non-invasive	Invasive (requires hair sample removal)
Ease of Collection	Easy (mouth swab)	Easy (urine sample)	Difficult (hair sample)
Cost	Relatively low	Moderate	High
Suitability	Ideal for immediate or recent use detection	Suitable for monitoring ongoing use	Best for long-term use history
Tamper Resistance	Easy to manipulate	Difficult to manipulate (e.g., dilution)	Difficult to manipulate
Limitations	Short detection window, limited substance range	Requires privacy, longer detection time	Expensive, cannot detect very recent use

Are Saliva Drug Tests Admissible in New Jersey Courts for Addiction-Related Cases?

Yes, saliva drug tests are admissible evidence in New Jersey courts for addiction cases, provided they meet certain legal standards. New Jersey law is cognizant of the validity of saliva tests when they are carried out using reliable and scientifically accepted methods. For saliva drug test results to be considered admissible, proper procedures must be followed, including chain of custody, calibration of testing equipment, and the use of certified technicians. These requirements ensure that the test results are credible and are used productively in court to address addiction-related matters.

The Statewide Substance Abuse Overview provides data on substance abuse treatment in New Jersey for the 2021 calendar year. In 2021, there were 87,745 treatment admissions and 86,626 discharges reported to the New Jersey Department of Human Services, Division of Mental Health and Addiction Services by treatment providers, as reported by the Department of Human Services Division of Mental Health and Addiction Services in “New Jersey Drug and Alcohol Abuse Treatment.”

What Are the Benefits of Saliva Drug Testing?

The benefits of saliva drug testing are non-invasiveness, easy sample collection, and rapid results with immediate analysis. These features make it a practical choice for workplace screenings, law enforcement, and addiction treatment programs. 

Common benefits of saliva drug testing are explained below:

• Non-Invasive – This method does not require blood draws or restroom facilities, making it a less intrusive option.
• Easy Sample Collection – A simple oral swab is used, eliminating the need for specialized equipment or trained personnel.
• Rapid Results and Immediate Analysis – Saliva drug tests provide quick results, within minutes, allowing for timely decisions. 

How Does Saliva Drug Test Improve Addiction Treatment Outcomes?

A saliva drug test improves addiction treatment outcomes by enabling real-time monitoring, supporting personalized treatment plans, and ensuring patient compliance. Regular testing helps clinicians track substance use patterns, allowing for adjustments to treatment strategies based on individual needs. Immediate results facilitate timely interventions, reducing the risk of relapse. Non-invasive testing breeds patient participation, ameliorating adherence to recovery programs.

What Are the Limitations of Saliva Drug Testing?

The limitations of saliva drug testing are short detection windows, the capacity for contamination, and the possibility of false positives.

Common limitations of saliva drug testing are given below:

• Short detection windows: Saliva tests find recent drug use, within 24–48 hours, making them less effective for validating long-term substance use.
• Potential for contamination or improper collection: External factors such as food, drink, or insufficient saliva samples affect test accuracy.
• Possible false positives: Some prescription medications and certain foods bring forth inaccurate results, precipitating confirmatory testing for reliability.

What Drugs Might Be Missed by Saliva Drug Tests?

Drugs that might be missed by saliva drug tests are substances with long detection windows or those that do not concentrate well in saliva.

Those drugs are detailed below:

• Benzodiazepines: Some long-acting benzodiazepines, such as diazepam, have low saliva concentrations, diminishing detection accuracy.
• Methadone: This opioid is chiefly detected in blood and urine, making saliva testing less reliable for its identification.
• Fentanyl: Due to its rapid metabolism and low presence in saliva, fentanyl detection rates are lower in comparison to urine or blood tests.
• Barbiturates: These sedatives have limited saliva excretion, making them harder to detect in standard tests.
• Long-term cannabis use: While THC is detected in saliva, heavy users have inconsistent results due to differing metabolite concentrations.
• Synthetic cannabinoids: Many designer drugs in this category do not show up on standard saliva tests because of their unique chemical structures.

How Do Environmental Factors Influence Saliva Drug Test Results?

Environmental factors influence saliva drug test results by modifying the composition and pH level of saliva, potentially affecting detection accuracy. Consuming acidic or alkaline foods and drinks, such as citrus juices or dairy products, modifies saliva’s pH level, impacting drug stability and test sensitivity. Smoking, including tobacco and cannabis, introduce contaminants or interfere with oral fluid production, leading to variable results. Additionally, mouthwash or breath fresheners containing alcohol or other chemicals temporarily mask drug residues, raising the risk of false negatives or positives.

What Are the Best Practices for Accurate Saliva Drug Test Results?

The best practices for accurate saliva drug test results focus on proper sample collection, handling, and preparation to ensure reliability. The following are the best practices for accurate saliva drug test results:

• Follow handling protocols: Ensure the collection of an uncontaminated sample by following proper protocols to hinder adulteration or degradation.
• Avoid food, drink, or smoking before testing: These activities change the saliva’s pH level or introduce contaminants, which skew results.
• Use clean collection devices: Always use approved and sterile swabs or devices for sample collection to avoid cross-contamination.
• Proper storage of samples: If samples cannot be tested immediately, store them in a cool, dry place to maintain their integrity until testing.
• Follow manufacturer’s instructions: Each saliva test has specific instructions regarding timing, sample volume, and other points that must be followed for optimal results.

Is Saliva Drug Testing Legal in All States?

Saliva drug testing is legal in most states, but there are exceptions and different regulations that employers and organizations must consider. For example, Hawaii, Maine, and Vermont have stricter laws regarding drug testing, challenging employers to have a strong justification, such as safety concerns, before doing tests. 

In New Jersey, while saliva drug testing is permitted, employers must follow specific guidelines to make sure there is compliance with state privacy and anti-discrimination laws. These regulations are providing advance notice to employees and obtaining written consent. Organizations need to research and adhere to state-specific laws to avoid legal complications when implementing saliva drug testing programs.

DOT Rule 49 CFR Part 40, Section 40.210 allows employers to choose either urine or oral fluid specimens for drug testing, but not both simultaneously. If there’s an issue with the collection (e.g., insufficient sample), the employer switches specimen types with approval. Only specimens tested at HHS-certified laboratories are permitted; point-of-collection (POC), hair, or instant tests are not authorized (U.S. Department of Transportation Office of Drug and Alcohol Policy & Compliance, 2023).

How Sensitive Are Saliva Drug Tests?

Saliva drug tests are highly sensitive and capable of detecting low drug concentrations in oral fluid. Most tests have sensitivity thresholds ranging from 1 to 50 nanograms per milliliter (ng/mL), depending on the substance being tested. For example, THC (marijuana) is detectable at concentrations as low as 4 ng/mL, while opioids like morphine are identified at thresholds of 10 ng/mL or lower. This high sensitivity allows saliva tests to pointedly identify even trace amounts of drugs, making them definitive for detecting recent use. Sensitivity levels are variegated between test brands and methodologies, so it’s vital to choose tests that meet specific detection needs.

A study related the Alere™ DDS®2 Mobile Test System’s on-site drug detection in oral fluid (OF) with laboratory-based confirmation using Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS). Conducted at a music festival in Miami, the study involved 124 participants providing two OF samples: one for field screening and one for laboratory testing. The DDS®2 showed 100% sensitivity, specificity, and accuracy for cocaine, amphetamine, methamphetamine, and benzodiazepines. For THC, the DDS®2 demonstrated 90% sensitivity and 97.5% accuracy, as discussed by Krotulski et al. (2018) in “Field Detection of Drugs of Abuse in Oral Fluid Using the Alere™ DDS®2 Mobile Test System with Confirmation by Liquid Chromatography Tandem Mass Spectrometry (LC–MS/MS).”

Are Saliva Drug Tests More Reliable Than Urine Tests?

Saliva tests are more reliable for inspecting recent drug use, while urine tests are better for a broader timeframe. A study analyzing 1,500 paired urine and oral fluid tests noted that urine drug testing was more streamlined in detecting overall substance use, with substances identified in 3.7% of urine samples but only 0.5% of oral fluid samples, as detailed in “Comparison of Urine and Oral Fluid for Workplace Drug Testing” by Casolin A. 2016.

Is a Saliva Drug Test Easier to Pass Than a Urine Test?

A saliva drug test is easier to pass than a urine test due to its shorter detection window. Saliva tests record neoteric drug use within hours to a couple of days, making it more challenging for individuals to mask or alter results. In contrast, urine tests have a longer detection window, which makes them harder to pass, especially for those with expanded-term substance use.