The Department of Transportation (DOT) has issued a final rule, effective from June 1, 2023, approving the use of oral fluid testing in their regulated drug testing program. However, implementation is contingent upon the certification of at least two labs by the Department of Health and Human Services (HHS). One lab will serve as the primary facility, while the other will function as the split specimen laboratory.

Under the new rule, employers will have the option to choose between urine or oral fluid samples for drug testing. In cases where a second sample is necessary due to temperature issues or insufficient quantity, employers can switch to the alternative sample collection method to complete the required testing. The DOT’s approval of oral fluid testing represents a significant shift in drug testing methods for safety-sensitive industries, including transportation. The decision acknowledges the potential advantages of oral fluid testing over traditional urine-based tests, such as convenience, accuracy, and a shorter window of drug detection.

Oral fluid testing offers several benefits that make it an appealing alternative to urine testing. Firstly, the collection process is non-invasive and can be easily administered on-site, eliminating the need for specialized collection facilities. Additionally, oral fluid tests have a shorter detection window, capturing recent drug use more accurately. This feature allows for a more real-time assessment of impairment, ensuring increased workplace safety. Oral fluid testing will be mandated for observed collections involving transgender and non-binary individuals and must be made available for such testing scenarios.

Consortium/Third Party Administrators (C/TPAs) will need to update their guidelines to reflect the employer’s policy on sample type selection for regular collections, direct observations, as well as situations involving shy bladder or dry mouth. Each collection site must have standing orders specific to the employer, indicating the appropriate testing method for each situation. The decision on which type of testing to employ will rest with the employer, although employees should always be informed about the testing procedures for different situations.

Employers will continue to be responsible for determining whether a refusal occurred at the collection site based on the information provided by the collector. While collectors relay the events at the testing site, it remains the employer’s prerogative to classify a situation as a refusal. It is important to note that if an employee fails to show up for a pre-employment test or leaves before receiving their urine cup or unwrapping the oral fluid device, this should not be considered a refusal to test.

DOT collectors will now be required to undergo proficiency training on the specific oral fluid device(s) they will be using and obtain collector certification for DOT oral fluid collections. This certification is crucial to ensure collectors understand the approved methods for obtaining the required split specimen and correctly completing the Custody and Control Form (CCF) with the device’s expiration date. The use of an expired oral fluid device will result in a Fatal Flaw. Collectors should also have the Drug and Alcohol Program Manager’s (DER) information on hand to address situations where the appropriate specimen collection method is unclear.

Employers must familiarize themselves with the new procedures, including sample collection, chain of custody, and proper storage. Adequate training should be provided to testing personnel to ensure accurate and consistent results. Clear communication with employees about the transition and the reasons behind the change will help facilitate a smooth implementation process.