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Screening for Drug Abuse and Addiction: The Differences Between Drug Testing in Oral Fluids, Urine and Hair

Drug addiction and abuse is becoming a huge epidemic in America. Studies show that 1 in 7 Americans are likely to develop an addiction. Of these people, only 10% of those who abuse drugs will ever get treatment or any help. Many people are in denial of their addiction. It’s hard to own up to it. The best that you can do is to keep an eye out on the people around you and to reach out if you think they might be addicts. Those who have strong suspicions, but are always met with denials, can confirm their suspicions with drug tests. There are several different types of drug tests that are available on the market today. The most popular options include oral fluid drug tests, urine drug tests and hair drug tests. All have unique properties and features that make them more suitable for certain circumstances.

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Drug Screening via Oral Fluids

A saliva sample is all that’s needed for an oral fluid drug test. This fluid is secreted from the human body by three major salivary glands. They include the parotid, the sublingual and the sub maxillary. There aren’t many proteins in oral fluids. As a result, it’s easy to detect drug particles that are suspended within it to determine whether the test-taker has been abusing and using drugs.

Express vs. Lab-Based Testing

These drug tests come in two different forms: express and lab-based. Each possesses its own benefits and disadvantages in identifying drug use and addictions.


Results from express oral fluid testing are achievable during the point of collection. These tests can identify the following 6 drugs:

  • Amphetamines
  • Cocaine
  • Marijuana
  • Methamphetamines
  • Opiates
  • Phencyclidine

The tests will simply show whether the user is positive or negative for the drugs. It may not show whether a user is truly addicted.


To get more comprehensive results, a lab-based oral fluid drug testing is needed. This type of testing can test for 10 different drugs, including:

  • Amphetamines
  • Barbiturates
  • Benzodiazepines
  • Cocaine
  • Marijuana
  • Methadone
  • Methamphetamines
  • Opiates
  • Phencyclidine
  • Propoxyphene

Send these samples to a SAMHSA-certified lab to get a quantitative analysis. This test can identify and determine the drug levels in the body at the time that the test was taken. Unfortunately, this type of testing is not instant. In fact, it can take anywhere from 2 to 5 days for you to receive the results.

Reasons to Rely on an Oral Fluid Drug Test

Oral fluid testing has become increasingly popular in homes and in work environments. This is because they are quite accurate when detecting recent drug use. It can even detect drug use up to 4 days after last use, depending on the drug abused and the quantity taken. The ability to detect drugs immediately is an advantage. Most other tests are unable to detect usage within the first four hours. This is because the drugs take time to get broken down and metabolized by the body. There are many other reasons why oral fluid drug tests are popular. They include:

  • Affordability, as these tests are quite cheap
  • Fast and reliable results capable of detecting recent drug use
  • In-depth analysis of dosage of drug taken based on concentration levels
  • Reduced ability to tamper with the sample, as it is collected under the supervision
  • Strong correlation and connection to impairment

Since oral fluid drug tests screen for recent drug use, the presence of drugs in this test is a good indicator of impairment at the time that the test was taken. Although it can determine whether any drugs were in the test-taker’s system, it cannot determine whether the user is struggling with an addiction.

Problems with Saliva Drug Testing

While oral fluid drug tests can be quite popular, they also do have some disadvantages, like:

  • Being unable to detect drug use beyond 4 days
  • Being unable to measure the frequency of use
  • Being unable to measure the number of drugs used
  • Running into difficulties when obtaining a sample

It’s also important to point out that oral fluid tests are not yet approved for federal testing. Oral fluid drug tests need a fair amount of saliva in the sample. Some people may have difficulties providing the amount of saliva needed. This is especially true if they have symptoms of dry mouth, which is also a condition commonly found infrequent drug users. To stimulate the production of oral fluids, citric acid candy or chewing gum may be used. It’s important to note that these methods may change the pH and the concentration of the drugs in the sample. These methods can lower codeine and methamphetamine concentrations by two to four folds. It can also lower cocaine concentrations by approximately five folds.

Testing for Drugs with a Urinalysis

Urinalysis, or a urine drug test, is one of the most popular drug screening agents used. It’s inexpensive, efficient, non-invasive, and able to screen for a large array of drugs. There are two different types of urine drug tests: an immunoassay and a gas chromatography/mass spectrometry (GC/MS).

The Mechanisms Involved with an Immunoassay

An immunoassay uses antibodies or antigens to detect small molecules in the urine. This is a biochemical test that measures the concentration of certain drugs. If the levels exceed a certain amount, the test will show a positive detection. The main issue with this type of test is that it doesn’t always screen for all types of opioids. In addition, it could also show a false positive.

The Basics of a GC/MS Drug Test

A GC/MS is a more complex test that is usually only attempted if an immunoassay comes back positive. This test carefully looks at the various particles suspended within the urine. It then looks at the specific density and characteristics of each particle to determine its identity. A GC/MS can provide more detailed information on whether drugs are present in the system. It can provide an estimate of the number of drugs taken prior to the urinalysis.

Types of Drugs that Are Detectable

Urine drug tests are popular because they can detect a fairly wide range of drugs. Detectable drugs include:

  • Amphetamines, which are detectable 2 to 3 days after last use
  • Antidepressants, which are detectable 2 to 7 days after last use
  • Barbiturates, which are detectable 1 to 3 weeks after last use
  • Benzodiazepines, which is detectable 1 to 4 days after last use
  • Cocaine, which is detectable between 2 to 3 days after last use
  • Ecstasy, which is detectable 2 to 4 days after last use
  • Marijuana, which is detectable anywhere from 1 to 7 days after last use
  • Methamphetamines, which are detectable 2 to 3 days after last use
  • Methadone, which is detectable 1 to 3 days after last use
  • Opioids, which are detectable 1 to 3 days after last use
  • PCP, which is detectable 7 to 14 days after last use

Whether the drug will be detectable or not will depend on the frequency of abuse and the dosage taken.

The Advantages of Using a Urine Drug Test

Urine drug tests are some of the most popular ones on the market. All that’s needed from a suspected drug user is some urine. The process is non-invasive. The test usually comes in the form of a stick. Simply stick the drug test into a cup of urine to finally find out the truth. Other advantages of using a urine drug test include:

  • Affordability, especially when purchased in bulk
  • Dependability, as most tests are 99% accurate
  • Quick ability for detecting recent drug use
  • Reliability, as these tests have a long track record

Many work environments rely on urine drug tests. They’re mostly accurate, and easy to use for screening purposes. It’s not rocket science!

The Issues with a Urine Drug Test

While convenient and inexpensive, there are some unresolved issues. Urine drug tests can often be manipulated through:

  • Adulteration, which involves adding a substance into the urine, so drugs become undetectable
  • Dilution, which involves drinking a substantial amount of water within a short period of time to dilute the urine sample
  • Substitution, which involves submitting and using someone else’s urine

Fortunately, there are some ways to work around these issues. The most important solution is to observe the collection process. If an efficient collection system is set up, many issues can be avoided. In comparison to an immunoassay, a GC/MS urinalysis is more expensive. On the upside, it’s also a lot more accurate.

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Using Hair Samples to Determine Drug Use

Although not instant, hair samples are able to provide the most in-depth analysis on drug use. Based on various studies, the hair on your head grows about 0.5 inches every month. Most drug testing labs will only test the newest 1.5 inches in growth to determine whether there has been any drug use within the past 90 days. The hair samples should be cut as close to the scalp as possible for accurate and precise results. It doesn’t matter if the hair has been chemically treated and dyed. In addition, hair from other parts of the body can also be used. Approximately 40 to 50 strands of hair are needed for the tests. Drugs are detectable 4 to 5 days after they were ingested, and will remain in the hair until it is shed off.

Types of Drugs Tested

Hair samples offer in-depth analysis on 5 different drugs. They include:

  • Amphetamines
  • Cocaine
  • Marijuana
  • Opiates
  • Phencyclidine

The analysis will not only determine whether the users did any drugs but can also determine the level of drug use. It can identify whether the drugs were used recreationally, daily or only on weekends, or constantly to the point where it is an addiction. For example, levels of 7,500 pg/mg or more of amphetamines indicate high use or addiction. On the other hand, levels between 2,500 and 7,500 pg/mg usually indicate moderate use. This means that the user abuses amphetamines either on a daily basis or on weekends only. Hair sample tests can determine without a doubt whether the user has an addiction. This is what sets this test apart from others. It can also provide information as to when the drugs were first taken, and past drug use.

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Test for Drug Use, Abuse and Addiction

Drug tests can screen for drug use. They can help you determine whether someone you love is lying or not, and whether they truly need help. While effective, not all of these tests can determine whether drug use has taken a turn for the worst and become an addiction. However, if you pair drug use with these suspicious behaviors and activities, you might be able to get a better idea of their situation. If someone you love is struggling with an addiction, get them to seek help immediately. Speak with one of our counselors today for more information on the programs that we offer. We offer different levels of care, and specific treatments for different drugs. If you’re looking to get sober or help someone you love become sober again, we’re here to help!