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DOT proposes adding oral fluid testing for drugs, alcohol

On Feb. 28, the U.S. Department of Transportation (DOT) issued proposed rulemaking to add oral fluid testing as an alternative to urine testing for the federal DOT-regulated drug and alcohol testing program. If finalized, the greater flexibility will better position the trucking industry to curb cheating and improve safety among its drivers.

According to the U.S. Department of Health and Human Services (HHS), oral fluid testing provides the same scientific and forensic supportability as urine testing. In fact, federal employees have relied on oral fluid testing as an alternative since 2020.

To protect an individual’s right to bodily privacy, most urine test collections are not directly observed – making it easier to cheat by adulteration or substitution. In contrast, the collection of oral fluids can be openly observed without infringing on privacy, thereby reducing the likelihood of cheating. Cheating on drug and alcohol testing in the trucking industry is especially dangerous; an impaired driver operating a heavy-duty vehicle threatens the safety of everyone on our roads.

If the proposal goes into effect, and there was an accident where there was concern that the driver was impaired, the driver could undergo oral fluid testing at the scene of the accident – better ensuring accuracy and identifying liability. Oral fluid tests can identify marijuana, the drug most commonly detected in truck drivers, immediately and up to 24 hours after use, making it an effective tool for post-accident and traffic stop tests.

Oral fluid testing is not only a win for the safety-conscious, but the cost-conscious too. According to the DOT, oral fluid tests typically cost $10 to $20 less than urine tests. Savings would be significant – motor carriers are required to drug test every incoming driver during the onboarding process and 50% of their drivers each year.

While adding oral fluid testing is sure to be welcomed by industry, it begs the question – why not hair testing? The most accurate and noninvasive of the three, hair testing offers the best chance at keeping drug users out of the driver’s seat. In 2015, Congress mandated HHS to release hair testing guidelines. However, when the guidelines were published in 2020, they were widely criticized by hair testing advocates for being redundant because they required another sample to verify results, like oral fluid or urine.

To improve safety without needlessly sacrificing efficiency, the trucking industry should continue to press DOT to incorporate hair testing, without requiring a second sample-type. It appears though that industry and DOT already agree about the advantages of oral fluid testing. As an alternative to urine testing, oral fluid testing will reduce cheating, lessen costs, and improve flexibility. As an industry always striving for greater safety, trucking should embrace this step toward more robust and accurate options for drug and alcohol testing.