Oral Fluid, Urine, and Hair Testing: What's the Difference?

By Kurina Baksh
Published: November 8, 2016 | Last updated: August 23, 2018 04:14:44
Key Takeaways

Oral fluid, urine, and hair drug testing all have different strengths and weaknesses.

The screening of workers for illicit drug use began in the 1980’s and was first done primarily by private American companies that were looking for a way to manage the risks associated with drug abuse in the workplace. At that time, in the United States, it was estimated that the economic burden of drug use was approximately between $46 and $85 billion annually. One of the first groups to start screening their workers for the use of drugs on a regular basis was the American military. The American military, based on the National Institute on Drug Abuse’s testing procedures using urine, developed a drug-free workplace policy. Soon after, the Department of Transportation ruled that drug testing should be applied to all employees in aviation, maritime, mass transit, and railroad and pipeline industries, which kick started the concept of workplace drug testing.


What Types of Samples can be Used in Drug Testing?

Since the inception of workplace drug testing in the 1980’s, the technology has evolved to detect drug metabolites in various sample types such as saliva, blood, hair, nails, tears, feces, semen, and sweat. However, urine remains the most popular medium.

What is the Difference?

Although urine is almost the most universally accepted test medium for drug testing in the workplace, recently, oral fluid and hair analysis have made an entrance into drug testing, each of which has its own advantages and disadvantages, including under what circumstances an invalid drug test might result. (Learn more in "Drug Test Types: 5, 7, and 12 Panel Urine Screening Differences and Reasons to Use".)


Urine Drug Testing

Presently, urine remains the most commonly used drug-testing medium, although there are several types including point of collection (5 panel and 7 panel most commonly) and lab testing. (Learn more in "Three Types of Drug Testing: What Employers Should Know About Lab Testing, POCT, and Express to Lab Testing".)


  • Urine testing is currently the only method approved for federally mandated testing, including DOT. (Learn more in "Introduction to the 5 Panel Drug Test".)
  • Compared to other testing media, it is the most flexible and customizable with hundreds of different test panel options.
  • It is inexpensive.
  • Can be used to detect recent drug use for up to 72 hours.
  • Can be performed for a wide range of illicit and prescription drugs.
  • Suitable for all testing reasons: pre-employment, random, post-accident, and reasonable suspicion, as well as follow-up and return-to-work.
  • It has a proven track record.
Free Download: An In-Depth Look at Drug Hair Testing


  • It is vulnerable to cheating via adulteration, dilution, and substitution, especially since the collection process is not generally observed, although temperature anomalies can be tested for and other methods are available to test for adulteration if a split specimen is taken.
  • It does not measure the frequency of drug use.
  • It does not detect use until approximately 5 hours after use.
  • It does not indicate the severity of impairment.
  • It is perceived as an intrusive method of testing.
  • The sample can deteriorate over time, being affected by heat and humidity.
  • Point of Collection tests require confirmatory testing of positive results.

Oral Fluid Drug Testing

Oral fluid testing is considered less intrusive than urine collection by some. (Learn more in "Everything You Need to Know about Oral Fluid Drug Testing".)


  • No adulteration issues. The test sample is collected under supervised observations making tampering next to impossible.
  • It is inexpensive.
  • Narrow but immediate detection window, usually within 10 minutes.
  • Can be used to detect recent drug use for up to 48 hours.
  • Scientifically accurate lab-based testing.
  • Suitable for all testing reasons: pre-employment, random, post-accident, and reasonable suspicion, as well as follow-up and return-to-work.


  • Unable to detect the presence of illicit drugs if 48 hours has already passed.
  • It does not measure the frequency of drug use.

Hair Drug Testing

When drug testing is scheduled at workplaces, it may be the intention of some employees to cheat the drug test by abstaining from drug use for a few days prior to the scheduled oral or urine drug test. However, when testing for drug abuse using hair, cheating can be far more difficult since drugs can be detected in hair sample for up to three months. Furthermore, habitual drug users may find it extremely difficult to refrain from drug use for such a long period of time. (Learn more in "Hair Follicle Drug Testing".)


  • Long window of detection, usually up to 90 days.
  • It is difficult to cheat.
  • It is difficult to tamper with the hair sample.
  • It can reveal the individual’s history of drug use.
  • It is perceived as less invasive by most cultures, therefore decreasing privacy issues associated with workplace drug testing.
  • Suitable for pre-employment and return-to-work testing.


  • It is expensive.
  • Longer turnaround times.
  • Currently it is not approved for DOT mandated testing. (Learn more in "DOT vs. Non DOT Testing: What's the Difference?")
  • Because of the long window of detection, it is not suitable for post-accident or reasonable suspicion testing as it can not isolate recent use.

Selecting the Right Test for the Right Need

With many testing methods to choose from, it is important for employers to choose the most effective option for their needs. Therefore, employers should evaluate the various types of testing specimens, oral fluid, urine, and hair, to determine which one best suits the needs of their organization. Some factors that employers should consider when selecting a testing methods include:

  • The cost.
  • Whether the test can be done on-site.
  • The detection time window.

Essentially, these factors are the differences in the three types of drug testing methods discussed above. It should be noted, however, that drug testing is just one component in managing the risks associated with drug abuse in the workplace. An efficient and effective drug-free workplace program should also seek to ensure that the workplace is free of health and safety hazards, which may be caused by the abuse of drugs and alcohol by employees. (Learn more in "The Importance of a Good Drug and Alcohol Policy in the Workplace".)


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