Oral Swab vs. Urine Drug Testing: Which Should You Choose?

By Accutrace, Inc.

The number of variables in drug test panels can be compared only to the various ways these drug tests can be administered.

With all these options, it can be hard to know exactly the right test for your company and we will explore when each one is the right choice.

Types of Drug Test Specimen Collection

Oral Swab Drug Testing

Easy and Effective.

Oral testing is easy to administer because it is done by the collector who creates a sample by swiping the inside of the donor’s mouth.  This type of testing is not subject to donor tampering because the sample is always in the presence of the collector, sealed in a tamper-proof container, and together with the Chain of Custody (CFF) form, is sent to the lab for analysis.  This method is very accurate and cost-effective. 

Oral testing detects persons who have recently taken drugs, usually within the one to a three-day window of past use.  Oral tests are usually 5-panel tests that test for cocaine, opiates, amphetamines, cannabinoids, and phencyclidine. You should determine if additional panels are necessary to identify other drugs important to your industry and select a background screening firm/link that can provide a variety of panel tests with the flexibility to add any industry-specific tests you desire. 

Urine Testing

The standard for workplace drug testing.

Many companies choose to administer urine tests as it is very accurate and easy for collection points to perform. Urine testing is generally used to test for opioids, steroids and a component of marijuana called THC and illicit drugs as it is ideal for detecting regular drug use within one to seven days.  Urine testing can also detect a drug’s parent drug called a metabolite.  Metabolites stay in the body longer than the parent drug and are an indicator that the individual took its related drug. 

Urine testing is the only testing method approved for federally mandated drug testing because it detects recent drug use.  

Hair Follicle Drug Testing

Produces Results.

Hair testing is very effective in revealing drug use as much as 90 days prior to the test. If the new hire has used drugs recently, it will show up close to the scalp and it it’s been a while, it will show up farther down the hair shaft.

On average, hair grows approximately a half an inch per month and it takes about a week for any current drug use to show up in hair testing.  It’s important to remember that hair testing does not determine what drugs were used at any particular time.  The test will only reveal the presence of drugs in the new hire’s system.  Hair testing is typically used to identify cocaine, marijuana, opiates, methamphetamine and phencyclidine drug use.

When hair testing is done, the collector will take a sample from the back of the head in a place that is inconspicuous and only a small amount is needed for the test.  But what if the new hire shaved their head or doesn’t have hair at all? 

The collector can still obtain a hair sample from another part of the body.  It can even be collected from multiple locations on the body to get the amount needed for the test.  Hair cannot be used from a comb or hairbrush because the collector doesn’t know where it came from and cannot certify that the sample is from the new hire.  Hair must be collected from the individual at the collection point.

How Long Do Drugs Stay In The Body?

How long drugs will stay in a person’s body varies depending on a number of factors. 

Factors include a person’s:

  • Physiology
  • Body mass
  • Body fat
  • Age
  • Exercise regimen
  • and how healthy they are.

Drugs tend to be stored in a person’s body fat, so the more the individual has, the longer it stays in the body.

The type of drug also determines how long it remains in the body and how it is metabolized in one’s system.  Most drug tests can only detect drugs that have been taken one to three days before the test.  If a new hire knows they will be drug tested, they may wait three days before going for the test rendering the test less accurate.  You can consider that when you make your new hire offers.

So how long can drugs be detected in the body? 

Our chart below outlines the basics. 


What Happens When a Drug Test Produces a False Positive?

Hold the phone. What if the result comes back positive? What then?

There are times when your new hire is legitimately taking prescription or over the counter medications that show up in drug testing.  When this happens, it is called a “false positive” result.  Some of the common drug classes that may produce a false positive are:

  • Antihistamines
  • Antidepressants
  • Antibiotics
  • Analgesics
  • Decongestants
  • Some OTC medications

At the lab, when a positive result is returned, the lab will retest the unused portion of the donor’s sample and do a more sensitive test to determine the concentration level of the drug found and at what concentrations. 

Each test has a cutoff level where concentrations that fall below the test concentration are negative and those that are above the cutoff level are positive.  Even ibuprofen (Bufferin) and NSAIDs (Advil) can cause a false positive for barbiturates! Any positive drug test can result in negative consequences for the new hire that is not warranted so accurate, reliable drug testing is extremely important. 

When a false positive is returned, a second confirmatory test is performed.  Company human resource professionals should develop a policy on what actions the company should take when they receive a positive result.  New hires should be able to report the medications they are currently taking so that can be considered before the tests are done.

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