Which Drug Screen Do I Choose?

We have received the following question from several of our clients: 
"Which drug screen do you recommend— urine, saliva, or hair?"

We asked WorkersFirst Physician, Dr. Hiland, to shed some light on this topic. According to Dr. Hiland, you must consider the circumstance for the test to determine which is best.

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URINE
Let's start with urine drug screening (UDS). There are dozens of published scientific studies that validate this form of screening, and it is uniformly accepted by federal and state laws. Urine drug screens are–the least expensive option, easy to collect, and at federal cutoff values, will not be positive by passive exposure.

HAIR
Hair analysis testing is sensitive for detecting any drug use for up to 90 days. However, there are several disadvantages to this form of testing–it is twice as expensive as urine drug testing, and not as accurate. The test needs to be sent to a lab for results. Hair analysis is not as reliable as it can be positive from passive exposure–drug metabolites bind more easily to some hair types and that can lead to falsely high concentrations. This test is not helpful in detecting recent or single drug use. While hair analysis testing can be used to detect a lifestyle of drug use, a UDS and a random UDS program would still be recommended.

SALIVA
Oral fluid (or saliva testing) is most sensitive in the immediate post-accident testing and DUI. Drugs and breath alcohol can be detected within a very short window with this test.  It is not as accurate for THC as hair analysis or UDS and can also be positive by passive exposure. Saliva testing is more expensive than a urine drug screen. Given the short duration of reliability we recommend employers use it only for onsite post incident testing. Saliva testing is an acceptable alternative for immediate post-accident testing and DUI.

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In summary, Dr. Hiland and WorkersFirst recommend urine drug screening as the gold standard overall. Urine drugs screening is most validated form of drug screening and has the best cost, accuracy, and validity.  

We recommend that employees get UDS, BAT & Saliva testing for onsite accidents. WorkersFirst has partnered with Secure Testing Services (STS, our preferred-on site mobile vendor in the mid-Atlantic region).  STS can deliver onsite post-accident testing and random on-site drug testing surveillance. 

We understand that some entities require hair follicle testing, for example, and employers can incorporate a combination of specimen types into their policies and programs to more effectively detect drug use in a variety of circumstances. WorkersFirst can perform any of the testing necessary to meet our clients' needs and can review employer policies if desired. 

For more information or to speak with us about our services, please call us at 757-608-2760.