A Brief Introduction to Oral Fluid Drug Testing

Introduction The first studies reporting the detection of drugs of abuse in oral fluid (saliva) were published more than 20 years ago. Oral fluid has been widely used as a specimen in pharmacokinetic studies, therapeutic drug monitoring and for the detection of illicit drugs. Laboratories specializing in the risk assessment business have used oral fluid to test for HIV, cotinine and cocaine metabolite for more than five years. LabOne has performed tens of thousands of tests on such specimens. This brief will review methods of collection for oral fluid, the benefits of collection using the Epitope device compared to urine collection, and the detection of a number of drugs of abuse, particularly marijuana (or hashish). This drug presented the biggest challenge and we have developed data showing some of the advantages of oral fluid testing. We also examined other drugs, including heroin and cocaine, and showed that oral fluid was at least comparable to urine for detecting these drugs. In fact it was more efficient at detecting the 6monoacetylmorphine (MAM) metabolite of heroin than urine in a population of known users.